Do frequent cannabis users have more symptoms of anxiety and depression than infrequent users, and are those with more symptoms less likely to use medication approved by the Food and Drug Administration (FDA)? A recently published study demonstrated a higher occurrence of anxiety among frequent cannabis users, but a lack of medication use for the symptoms (1).

Cannabis and Mental Health Symptoms

The study notes that the psychoactive cannabinoid tetrahydrocannabinol (THC) has been recognized as possibly managing anxiety symptoms, while some studies cannabis use is associated with higher frequencies of mental health conditions, especially among frequent users, though the evidence is mixed. Additionally, sleep disturbances are a common side effect of anxiety and depression, the study noted.

Individuals using cannabis for medical conditions are more likely to choose homeopathic treatments over FDA-approved medications, the study added. These medications might include benzodiazepines, selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine inhibitors (SNRIs), tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs).

Study Overview: Cannabis, Anxiety, and Depression

This research was a secondary analysis of a previously published cross-sectional study on cannabis and sleep. The 195 adult participants were confirmed cannabis users or non-users and completed Hospital Anxiety and Depression Scale (HADS), Beck Anxiety Inventory (BAI), Beck Depression Inventory-II (BDI-II). Cannabis exposure in the participants was confirmed through urinary THC metabolites.

Frequent cannabis use was defined as at least 15 uses in the past 30 days, with infrequent use was defined as less than 14 uses in the past 30 days.

The study, “Frequency of cannabis use and symptoms of anxiety and depression: a cross-sectional analysis of the Colorado cannabis users health cohort,” was published in the Journal of Cannabis Research in October 2025. It was described as one of the largest studies to examine anxiety and depression, prescription medication information, and biologic measurements of cannabis.

Results: Higher Anxiety Among Frequent Cannabis Users

The results indicated:

• Frequent use of cannabis was associated with a higher occurrence of anxiety (using both the HADS and BAI measurements) but not of depression
• Use of FDA-approved medications did not differ between frequent users, infrequent users, or non-users
• Levels of cannabinoids were not associated with symptom severity for anxiety or depression

The most common reasons for using cannabis, according to the participants, was sleep, anxiety, stress, and pain reduction.

Limitations and Future Research Needs

Limitations of the study include a lack of studying the symptoms over time, the dosages and methods of consumption or products of cannabis were not analyzed, and THC potency was also not tracked. Additionally, possible selection bias was considered, as the participants were recruited from dispensaries, and a prevalence of participants with sleep disorders – the main focus of the primary study – could have resulted in a lack of generalizability.

Overall, the researchers concluded that anxiety among frequent cannabis users did not coincide with medication use for symptoms. “These findings support the concept that cannabis users may be self-treating their anxiety with cannabis,” they stated. “Our findings suggest that anxiety symptom screening among adults who use cannabis may present opportunities to connect individuals with FDA-approved anxiolytic/hypnotic treatment.” They also suggested prospective studies and randomized trials to establish a causal relationship between cannabis use and anxiety or depression, and interactions between mental health symptoms, medications, and cannabis use. Examining tobacco smoking as a confounding factor for associations among nicotine use, anxiety, and sleep disturbances was also suggested.

Reference

1. Steeger, CM.; Tandukar, P.; Hoth, KF. et al. Frequency of cannabis use and symptoms of anxiety and depression: a cross-sectional analysis of the Colorado cannabis users health cohort. J Cannabis Res. 2025. 7, 78. DOI: 10.1186/s42238-025-00327-2.