VTNCA Health Tips: Creatively Maladjusted

Martin Luther King Jr. was a legendary leader in the civil rights movement, admired for his nonviolent approach, enthusiastic civil disobedience, and tireless fight for racial equality.

This same racial inequality MLK fought against so many years ago is, of course, still present today – as evidenced by the disproportionate rates at which minorities face the consequences of cannabis prohibition.

Just as MLK set out to change a segregated culture, I’m grateful to be setting out in an extraordinary time of cultural transition and transformation as this global healing shift with cannabis takes hold.

Dr. King had a dream, as we all do. He also had his own personal struggles, as we all do. The World Economic Forum names Martin Luther King as one of 4 great leaders with mental health disorders. While Dr. King was never formally diagnosed, he was described as depressed and creatively maladjusted – and both conditions made him much more empathetic and driven to be the passionate changemaker we honor today.  

On this MLK Day, in honor of Dr. King and his struggles with depression, let’s talk about how cannabis can be utilized as a support for increasing mental health.

16.2 million adults had at least one major depressive episode in the last year, equating to 6.7% of all adults.

According to Psychology Today “King realized that to solve problems of human life…we have to become, in a sense abnormal…stop accepting…become maladjusted to become creative.”

Dr. King said “Everybody passionately seeks to be well-adjusted. But there are some things in our world to which men of goodwill must be maladjusted.”

After pondering for a bit, I can relate to that. Cannabis relates to that.

I bet you know someone, if not yourself, that can relate somehow – maladjusted, creative, or even depressed.

According to NIH in 2016, 16.2 million adults had at least one major depressive episode in the last year, equating to 6.7% of all adults. This is higher amongst females at 8.5% in comparison with males at 4.8%. The age group with the highest rates, at 10.9%, was 18-25 year olds.

The American Academy of Family Physicians reports that nearly 1 out of 12 people have depression, and women are twice as likely to be diagnosed. AAFP and US Preventive Services Task Force recommend screening for depression in the general adult population, including pregnant and postpartum women.

The American Psychological Association informs us that mental health disorders are associated with increased risks such as cardiovascular disease, diabetes, obesity, asthma, epilepsy and cancer, and that individuals dealing with mental health issues are less likely to receive medical care. Major depressive disorder is the leading cause of disability in United States.

Journal of American Medical Association calculates that one out of six americans take psychiatric medications (ie. antidepressants, anxiolytics, mood stabilizers, hypnotics, stimulants, antipsychotics). That equals 17% of the population, or 40 million Americans. Antidepressants are the most commonly prescribed psychiatric medication.

Your most typically prescribed antidepressant would be a selective serotonin reuptake inhibitor (SSRI) such as Prozac, Paxil, Zoloft, Celexa, or Lexapro. These medications show low to moderate risk of interaction with cannabis. Serotonin–norepinephrine reuptake inhibitors (SNRI) like Cymbalta and Effexor, and norepinephrine–dopamine reuptake inhibitors (NDRI) like Wellbutrin are also considered low to moderate risk of interaction. Monoamine oxidase inhibitors (MAOI) and tricyclic antidepressants (TCA) are high risk for interaction and not recommended with cannabis. Sedatives like benzodiazepines and hypnotics like Klonopin, Ativan and Phenobarbital are not in the antidepressant category, but are often used for psychiatric medications, and are also considered to have a higher risk for interactions.

Countless anecdotal patient reports plaster the internet sharing success stories of how they were able to decrease the number of medications, and/or the medication dosage, or even switch from their prescribed medication to cannabis alone.

It is no small secret that psychiatric medications, come with a flurry of unwanted – and possibly unsafe – side effects. Most common side effects listed by the FDA are nausea and vomiting, weight gain, diarrhea, and sexual problems. Less common, but more severe side effects, include muscle spasms, seizures, psychosis, heart attack and possible death. The Citizens Commission On Human Rights was created specifically to protect human rights in mental health, and states that psychiatric medication has been proven to create a lifetime of physical and mental damage.  

If you ask most medical cannabis patients about the common side effects of cannabis, you would probably get things like dry mouth, red eyes, drowsiness and hunger (aka The Munchies). Cannabis labels and commercials will not be listing death as a possible side effect anytime soon as far as I can tell. Cannabis can not only help with many of the aforementioned side effects of medications, but it can be a nice accompaniment, working well in combination with those more mainstream pharmaceuticals.

When used in combination, psychiatric medications should be monitored for necessary dose adjustments. Countless anecdotal patient reports plaster the internet sharing success stories of how they were able to decrease the number of medications, and/or the medication dosage, or even switch from their prescribed medication to cannabis alone.

Leafly has some great information regarding the question of cannabis and medication interactions. Most identified potential interactions are relatively mild. One should consider abstaining from cannabis if starting a new medication, and or abstaining from cannabis for a short period of time while on medication, to see the individualized effects. It may be harder to gauge effectiveness of medication, and difficult to isolate and understand effects of cannabis or medications, with multiple substances in your system.

Mayo Clinic addresses another common question and misperception by stating that there is no clear evidence that cannabis causes depression. WebMD tells us that low doses of cannabis can help depression and higher doses can increase depression. Most cannabis users will tell you that too much THC could increase anxiety.

There is substantial statistical evidence of a drop in suicide rates amongst men ages 20-39 in states where medical marijuana is available.

Project CBD reiterates the Mayo Clinic saying that Cannabis use does not increase the risk of depression, but does go on to note other contradicting studies. Healthline notes that “while acute cannabis intoxication temporarily alleviates perceived states of depression, anxiety, and stress, the repeated use of cannabis does not appear to lead to any longer-term reductions in these symptoms.”

There is substantial statistical evidence of a drop in suicide rates amongst men ages 20-39 in states where medical marijuana is available. And cannabis, or exogenous phytocannabinoids, can be a big part of the recovery for many patients with depression, and begin to heal and stabilize the endocannabinoid system (ECS). The human ECS regulates mood, appetite and pain. Even so, no medical cannabis programs allow for depression as a qualifying condition.

Altered mood and pain can both be reflections of inflammation and a dysregulated ECS. To best heal and support ones ECS, depression and anxiety, use cannabis regularly rather than sporadically. So, to view it simply and for best results, consistent, longer lasting methods of cannabis dosing is more appropriate and desirable. Edibles, patches, and oils would be some suggested ways of dosing for mood stabilization. Inhaled routes of administration are best for acute or PRN dosing.

Most states with medical marijuana programs do have post traumatic stress disorder (PTSD) as a qualifying condition, and allow for provider discretion in determining eligibility for the program. In Vermont, for example, for a patient to have PTSD as their qualifying diagnosis, they also must be engaged in therapy with a psychotherapist or mental health counselor. New Jersey allows medical cannabis for anxiety.

Whether edibles or smoke, if you are going to use cannabis for mental health, what are the best cannabis chemovars or strains available?

Unanimously…Jack Herer for the win.

I have several patients successfully using a 1:1 coconut infusion I have crafted from one of my indoor harvests. One patient recently was able to completely stop taking her anti anxiety medication Xanax with the help of this 1:1.

This strain is known to be uplifting and spark creativity. The limonene and pinene terpenes in Jack Herer enhance the therapeutic properties, increasing mood and focus. There is more information pouring out every day about the importance and synergistic effect of terpenes and cannabinoids, and I am excited to see where this field takes us.

I had the pleasure of growing Jack Herer this past outdoor season. I wasn’t overly intrigued or impressed at first, but come harvest time, was astounded with the gigantic, sleek, sexy, eye candy of a tree that she became. She was easy to grow, sturdy as can be, proved to be mold resistant and ended up with a great yield. The flower proved to be a true hit with several local patients for PTSD and depression, with a great and clear daytime high. After making and enjoying several batches of Jack Hyrer dabs, today I am crafting a fresh batch of Jack Herer infused olive oil!

Pineapple Express is the next suggestion for depression, as it’s fruity and refreshing. Harlequin 1:1 chemovars are said to counteract anxiety along with other high CBD chemovars, like Pennywise. I have several patients successfully using a 1:1 coconut infusion I have crafted from one of my indoor harvests. One patient recently was able to completely stop taking her anti anxiety medication Xanax with the help of this 1:1.

Psychotherapy and mind-body therapies, healthy dietary choices and adequate hydration, fresh air and sunshine, omega 3s and vitamin supplements (just to name a few), go hand and hand in successfully learning to manage and treat mental health issues.

Catatonic, Amnesia Haze, and the Vermont classic AK47 also come recommended to lift one’s mood while reducing anxiety. The now popular Blue Dream and Girl Scout Cookies can’t go without mention, and I have to finish by giving a shout-out to Jilly Bean, by a female breeder.

Regardless of what I throw at you, you read or hear, we ultimately know we need more research. We know individuals respond to cannabis differently, and that we have much to learn from this incredible, healing plant that has been ostracized for decades. Cannabis, by itself, isn’t a cure all, and just like the cannabis community, just like MLK’s dream, cannabis needs to work in synergy, in combination with other supports.

Psychotherapy and mind-body therapies, healthy dietary choices and adequate hydration, fresh air and sunshine, omega 3s and vitamin supplements (just to name a few), go hand and hand in successfully learning to manage and treat mental health issues.

Please be sure to reach out to a medical professional for support with any and all needs regarding mental health, medication and cannabis interaction, recommendations, additions and adjustments.

If you or anyone you know is in a mental health crisis please get help immediately by contacting:

• First Call Vermont: 1-800-488-7777
• National Hopeline Network 1-800-442-HOPE
• Vermont Suicide Prevention Center: Text 741741
• National Suicide Prevention Lifeline: 1-800-273-TALK

Whether you have today off or not, celebrate and honor Dr. King, and the cannabis plant, and remember to stay creatively maladjusted and civilly disobedient!

Jessilyn Dolan, RN, CMT, CLD, ADS is a nurse researcher and educator and founder of The Vermont Cannabis Nurses Association.

She’s a Cannabis Nurse Educator and co-owns HomeGrown Consulting for cannabis cultivation and medication consultations. Jessilyn is a proud Clean Green Certified organic H.E.M.P.  (Horticultural Excellence Medicinal Perfection) farmer.

She will be bringing a weekly dose of Whole Plant to Whole Person medicine and healing tips your way.