Does CBD Oil Help With Anxiety?

Q and A with Janice Newell Bissex, MS, RDN and Holistic Cannabis Practitioner
By: Dena Gershkovich

Janice Newell Bissex is a registered dietitian nutritionist, a holistic cannabis practitioner and the owner of Jannabis Wellness. I interviewed Janice to find out more about her practice and the role cannabis and cannabidiol, or CBD, can play in the wellness space, particularly in treating anxiety. 

Please note that this Q and A has been lightly edited for clarity. 

DG: Can you please summarize what you do in a few sentences? 

JNB: I’m a registered dietitian nutritionist and a holistic cannabis practitioner, so I help people who suffer from anxiety, depression, pain, insomnia, irritable bowel syndrome, inflammatory bowel disease, and other debilitating conditions find relief using CBD or cannabis. 

DG: Do you ever combine your dietetics background with your current holistic cannabis practice?

JNB: Yes. With everything I do, I’m a dietitian first. So for everyone that I counsel, I look at their lifestyle and I look at their diet because that’s part of the holistic aspect of things. I try and find out what sort of changes they can make in their lifestyle, whether it be exercise, stress management, and the like, combined with diet. Then, if we decide it’s appropriate to add some CBD to the mix, we do that.

DG: Lauren told me that you weren’t always in the CBD space. What was the focus of your career before? What inspired you to learn more about CBD? Was there a specific moment, event or situation that piqued your interest in CBD?

JNB: Before this I was a cookbook author, recipe developer, food blogger, radio podcaster, speaker, spokesperson… I was involved in the media space for much of my career. I also worked in cardiac rehab, sold nutrition software, was a dietitian for the U.S. Senate, and spent a decade working at a luxury hotel. 

Almost four years ago, my dad had some medical issues that caused severe pain, and they gave him all of the traditional pain medications. These meds made him groggy and very constipated. After a hospitalization for constipation, I said to his doctor, “Is there anything else that we can do to help manage the pain?” I knew that in Massachusetts medical marijuana had just been made legal, so I said, “What about medical marijuana?” And I thought, “Oh, please say no because I don’t know anything about this” (laughs). But he said, “I think that’s  a great idea.” So I had to learn about it. The more I read and learned, the more I thought, “Why the heck is this not suggested, A, and B, available nationwide to help people manage their pain?” So we tried it; it worked. He had pain relief. The day that he tried it for the first time and he said, “Wow, I’m not in pain,” is the day that I decided to leave my business of 15 years and start a new business. I went back to school, to the Holistic Cannabis Academy, became certified as a Holistic Cannabis Practitioner, and now that’s all I do. If you would have told me five years ago that I’d be doing this, I would have said, “Really? What are you smoking?” because it wasn’t on my radar even a little bit. 

The Science of CBD, THC and Hemp

DG: What is CBD (cannabidiol), and how is it different from THC and hemp?

JNB: CBD is one of the compounds called cannabinoids in the cannabis and hemp plants. The difference between a cannabis and a hemp plant – they are very similar – is that hemp has almost no THC (less than 0.3%), while cannabis does contain THC. THC is a cannabinoid that, if consumed in excess, makes you high or stoned. CBD will not impair you. But, it’s incorrect to say that CBD is not psychoactive because CBD is neuro-calming – it calms your brain, and that is a type of psychoactivity. It tampers down anxiety, but it’s not intoxicating.

Hemp and cannabis contain dozens of other cannabinoids, as well as compounds called terpenes, that are responsible for the aroma. The terpenes also contribute health benefits, and each terpene has its own effect on people. So, if you’re looking to get a good night’s sleep, you might want to have some of the terpene myrcene, which is a little bit sedating. And linalool is a terpene that’s also found in lavender, and a lot of times people use the essential oil lavender for calming. Cannabis and hemp also have linalool in it. 

DG: From a chemical/scientific perspective, what are the “active components” of cannabis, and what effect does each component have on the body? Which component(s) are involved when it comes to helping someone feel better from a medical perspective? Is it just the CBD component that’s helpful, or are there other “active components” of cannabis that can be medically helpful?

JNB: To summarize, there are cannabinoids, which include THC, CBD, CBC, CBN, CBG… there are lots of them. And then there are terpenes, antioxidants and flavonoids. These are the main components of cannabis and hemp. They’re all helpful, and they all work together. So if you’re wanting to get a good night’s sleep, for example, the cannabinoid CBN, is helpful. CBG may be therapeutic for GI issues. And THC also has medical value. People say, “Oh, THC, that’s the bad one, that makes you high.” Well, yeah, but that’s like saying, “Wine is bad because if you drink a bottle you’ll get drunk.” Having a glass of wine is not a bad thing, and having a little bit of THC is not a bad thing.  

All of the compounds in the plant work together synergistically. You don’t want to just pluck the CBD molecule out of the plant and just put that in a pill and take it – that’s not how it works the best. Some companies offer a CBD isolate, but I advise people to avoid those. It’s as if as a dietitian I said to you, “Alright, broccoli is really good for you, but instead of eating the broccoli, why don’t you just take a Vitamin A supplement?” You can just take CBD, just like you might get some benefit by just taking vitamin A, but to really get the full therapeutic value of CBD, you want it to be along with the other components of the plant to get that synergy. It’s called the entourage effect, so all of these things work well together.

DG: What are some of the different ways to take CBD?

JNB: There are many options for taking CBD. Most of my clients either use a tincture under the tongue, a water-soluble tincture dissolved in water, a daily soft gel, or a topical salve applied directly to the skin, which offers anti-inflammatory and analgesic properties right where you put it. There are also suppositories (which can help alleviate menstrual cramps and colon issues) and transdermal patches, which can be placed on the wrist or ankle and provide a steady release of medicine into the bloodstream over the course of 12 hours. This might be a good option for someone with chronic pain… 

Does CBD Oil Help with Anxiety?

DG: Can CBD be helpful with treating anxiety at all? If yes, I would love to hear in simple terms how exactly CBD works to help alleviate anxiety in the body.

JNB: We all have an endocannabinoid system, which is a system of neurotransmitters in our bodies. The system is made up of receptors, enzymes and endocannabinoids. We make at least two endocannabinoids in our bodies, and one of them is called “anandamide,” and that’s been called the “bliss molecule.” If you have higher levels of anandamide in your blood, your incidence of anxiety may be lower. One of the goals of taking CBD is to allow our bodies to retain more anandamide, which is a feel-good molecule – it acts similarly to serotonin. And CBD can increase your serotonin levels, too. CBD allows your own body to keep more of these feel-good compounds in your body, which can help with anxiety and depression. It can decrease pain signaling, too, which is why many people use CBD to help manage pain. 

CBD Client Success Stories

DG: Do you have any stories of clients who have had success with CBD that you can share?

JNB: Oh gosh, yes. I have a folder of notes from people saying how life-changing the CBD has been for them. I tell people that it does not work for 100 percent of people for 100 percent of conditions. That’s really important. It works for a lot of people for a lot of conditions, and sometimes provides moderate relief, sometimes mild relief, and sometimes significant relief. When I work with someone, I don’t know what kind of relief they are going to get. 

I have one woman who is 50 years old, who had lifelong anxiety and depression, lifelong constipation. She started taking CBD and no longer needs her constipation medication. She is regular, much happier and has much more energy at work. Her coworkers asked her what she was doing differently because she seemed to just have so much more energy. Maybe that’s because she was sleeping better or because she wasn’t in chronic pain, which she suffered from as well. 

I have an older woman who moved into a senior living facility because of severe pain. She’s moving out of senior living because she is no longer in debilitating pain. I mean, that’s crazy!

I have another guy who’s 90 who was anxious and depressed after the death of his wife. His daughters got him some CBD, and they said that after a month there was a huge change in him. 

These are just some of the people who have found relief. I always tell people that CBD is not going to take a pain of 10 and bring it to a zero. It’s not. It will reduce your pain; it’s not going to eliminate your pain. It can decrease that pain signaling and it really makes pain more manageable. Some people have pain that is just so overwhelming, and what CBD can do is bring it to a level that’s tolerable.

Want to learn more about the role that cannabis and CBD can play in anxiety and wellness? Read this Q and A with Janice Newell Bissex, a holistic cannabis practitioner and registered dietitian! #CBDABCs Share on X

DG: Why do you think that there is a stigma against CBD? In your opinion, is there a way to mitigate this stigma? Are there any specific actions that individuals can take?

JNB: I think this stigma exists because CBD is related to cannabis, and there is still a huge stigma around THC and cannabis. There’s not as much of a stigma around CBD as there is around cannabis. I think that CBD is a lot more accepted now than it was two or three years ago. 

There are a lot of people who use cannabis medically – a lot more than I thought. They can manage their chronic conditions using cannabis, and it is medicine. It was used as medicine for 5,000 years. It’s only been illegal for 80 years. History is on our side. Doctors have used it – it was in many medications in the late 1800s and the early 1900s. It was in the pharmacopoeia, which is where doctors look for dosing information for medicine, from 1850 to 1942. Cannabis was included there because it was a medicine. And it was made illegal not because of any potential issues of risks or side effects; it was strictly due to political and racial reasons. We really have to legalize cannabis. It’s just not right. 

To mitigate the stigma against cannabis, we should talk about it. Dietitians should talk to their clients about it because people want information, but they are afraid of being judged. The more we talk about medical cannabis and CBD, the more it’s going to normalize it. 

What to look for in a CBD product…

DG: How can someone tell if a CBD product is good quality? What are some things to look out for?

JNB: I look for either a full spectrum or broad-spectrum product, which means that it has all of those synergistic compounds and is not an isolate. I look for “organically grown” because hemp and cannabis are bioaccumulator plants, which means they draw toxins out of the soil. Also, you want to buy a product from a company that has independent lab testing of their products to prove that what they’re saying is in their product is really there. I would also say that you should buy from a company that will answer your questions. You really need to be careful with who you work with.

DG: How much CBD does one typically have to take/use to see an effect, and how often should they take/use it?

JNB: That is very very individual. One person might find relief with 4 mg of CBD, and another person might need 50 mg. In general, 10 mg to 30 mg of CBD is a common daily dose…  but that’s really, really general because it depends on so many factors.

DG: Are there any situations where taking CBD is contradicted?

JNB: If someone is taking Coumadin (warfarin) then I might say maybe we shouldn’t use a softgel or an edible because when you ingest CBD, it goes through your GI system and is processed by the liver. The enzyme that processes the CBD also metabolizes Coumadin, so if you take them at the same time, there is a potential for the level of Coumadin in the blood to be altered a little bit. So in that case, I would have people take their CBD at least eight hours apart from their Coumadin, or have them use a tincture instead because tinctures avoid that first-pass metabolism in the liver.

It’s important to be aware of potential, though uncommon, side effects of CBD. More vivid dreams are the most common side effect, followed by slight fatigue when first using CBD, and dizziness. Honestly, at the doses most of my clients take, side effects are uncommon. A potential issue could arise if someone with very low blood pressure or taking Coumadin took a big dose of CBD. This could potentially affect their Coumadin level and also cause lightheadedness. CBD is a vasodilator, so it opens up your blood vessels – which is a good thing – you get more blood to your brain and your heart. But if someone has very low blood pressure to begin with, it could cause lightheadedness. 

DG: CBD-containing products, such as waters, teas and even CBD leggings, have been trending lately. How do you feel about these products? Do you think they are worth purchasing?

JNB: It all goes back to the quality of the product. See if the product has independent lab testing and see if you can find out how the product is made. There is nothing wrong with CBD being infused into products like tea, but leggings? I don’t know about that! Also, the FDA has made it clear that CBD cannot be added to foods that cross state lines.

DG: Janice, thank you so much for speaking with me. Is there anything else that you think people should know about CBD? Do you have anything to add to make this interview more complete?

JNB: Do your homework. Do your research, especially on any potential product that you’re planning on using. “Start low and go slow” is really the dosing mantra. You don’t want to just grab a 50 mg CBD softgel and say, “Okay, I’m going to take this.” I always start low and see how people respond to CBD and then increase slowly until they find relief.

Janice Newell Bissex is a registered dietitian nutritionist, a holistic cannabis practitioner and the owner of Jannabis Wellness phytocannabinoid-rich hemp CBD products. To learn more about Janice’s practice and her products, check out her website, jannabiswellness.com, and follow her Instagram account (@janicebissex).

Dena Gershkovich is a Nutrition Starring YOU intern. To see more of Dena’s work, check out her blog, The Artsy Palate, and follow her on Instagram (@theartsypalate).

This post is informational only. As always, consult with your physician or another qualified health professional before adding supplements to your health regimen.