Marijuana anxiety? Here's what to do if you have a panic attack while high

Marijuana anxiety? Here's what to do if you have a panic attack while high
Marijuana anxiety
Source: Borysevych.com/Shutterstock
Marijuana anxiety
Source: Borysevych.com/Shutterstock

If you're having a marijuana panic attack, don't worry.

While many find weed a relaxing drug, marijuana also has a direct connection to panic attacks. Even a habitual smoker who seems the very definition of "chill" has likely had the experience of being way too high, man.  

In the moment, that can be overwhelming. But it's not the end of the world. Here's what you need to know about the scary, stressful and sometimes overwhelming problem of weed-induced panic.

Can weed cause panic attacks?

"It can," said Ryan Vandrey, who studies the behavioral pharmacology of cannabis use at Johns Hopkins University School of Medicine, in a phone interview. "It happens from direct effects of the drug in the brain and/or direct effects of the drug on body." 

"Cannabis can modulate neurotransmitters in parts of the brain that control anxiety and elevate your heart rate," which can in turn create a sense of escalating panic, he explained.

A marijuana joint is rolled Wednesday, Nov. 9, 2016, in San Francisco.
Source: Marcio Jose Sanchez/AP

Recognizing the panic attack for what it is

A wide variety of physiological effects fall under the umbrella term "panic attack," though Vandrey cautioned that they're specific to each person, and none can be considered "typical."

There "hasn’t been a lot of research focused exclusively" on the signs of weed-related panic, Vandrey said. "The important thing to note is that it’s dose-related. You see greater exacerbation of heart rate at higher doses. And it's more likely to occur in individuals who already deal with anxiety issues or have a predisposition to or family history of them."

That said, people who experience panic attacks have reported symptoms including, but by no means restricted to:

• Racing heartbeat

• Tunnel vision

• Sweat or chills

• Chest pains

• Tingling or numbness in the extremities 

• Weakness and dizziness

• Trouble breathing

These are some potential results of a "flight-or-fight" response, which is triggered by the brain's hypothalamus when you instinctually detect a threat — either real or imagined. Your whole body is placed on high alert, and fear of impending death or doom is palpable. 

What to do when you know you're panicking

The key thing to remember is that a panic attack can't hurt you. Contrary to what some of the above symptoms may suggest, you're likely not suffering a heart attack or obstructed airway.

There's also zero chance you've "overdosed" on weed. Remind yourself that this condition is not lasting but temporary. In due course, it will all be over. 

The experience "usually doesn't last that long," Vandrey said, perhaps "half hour or an hour, depending on how the cannabis was ingested — shorter if inhaled, longer if eaten."  

"It all depends on the individual," he said. "None of it is applicable to everybody."  

A woman smokes marijuana during a demonstration in front of the Mexican Senate building in Mexico City on Sept. 28, 2016.
Source: Pedro Pardo/Getty Images

Take stock of your situation and surroundings

For many, weed-based anxiety involves a hefty dose of paranoia about other people. Because marijuana is a drug enjoyed in social settings, getting too stoned can lead to suspicions that your own friends resent you, or that you're somehow "ruining" their good time.

"Research has shown that individual responses to a given drug can absolutely be influenced by the situation in which it occurs," Vandrey said. "If somebody takes a drug that produces anxiety in uncomfortable surroundings, they may heighten their anxiety. Cannabis is a perfect example."

If environmental factors are contributing to your fear or stress, removing yourself from that context can help.

Ask for help

Resist the idea that anyone hates you for obscure reasons of your own invention. The truth is that anyone not in the throes of panic can assure you that your symptoms are exaggerated, impermanent and not life-threatening, which is a huge advantage when your mind is playing tricks on you.

A companion is also handy to have when it comes to limiting environmental stressors, and can address any simple and immediate needs.

"There’s no one way to treat this," Vandrey said. "When it does happen in our lab we respond to the needs of the individual. We encourage people to get comfortable and provide them with whatever they need — whether that's food, or water, or sometimes just to close their eyes, lie down and relax."

Give yourself a break

As a panic attack releases its grip, you may feel a little sheepish or outright embarrassed about what you did or said when it took hold. "Why did I freak out like that?" you'll ask yourself. 

Despite popular conceptions of such episodes, Vandrey said they're "not common at all." They're especially unusual for "frequent, experienced" users: "It rarely happens, and usually only after very high doses." 

And while limiting your intake or indulging in a more comfortable environment may prevent a repeat occurrence in the future, the best way to avoid a weed-related panic attack "is is to not use cannabis at all." 

In other words, this is a risk everyone runs with weed — but, Vandrey said, a "subset of people" are particularly vulnerable to it. So while some stoners can laugh about the times they tipped over the edge into full-blown paranoia and horror, treating it like a rite of passage, others will find that they're better off not gambling with their neurochemistry this way.  

In any case, rest assured that a weed-induced panic attack is not going on your permanent record, and will soon be forgotten by whoever happened to witness it. The only judgment you face is your own.

Figure out what went wrong

As we've discussed, "situational" factors are important determinants in matters of substance abuse and addiction, and anyone fond of weed will tell you that the effects are similarly contingent on your surroundings: Where were you? Who were you with? 

And, maybe above all: What was your frame of mind?

Any such detail could have contributed to your panic attack, and after it's over, it's worth considering whether they did — particularly if this was an isolated incident. You might choose to swear off potent marijuana strains with high levels of THC, the cannabinoid responsible for weed's psychoactive "high," or pick the time and place of your weed use more carefully. Strictly limiting the size of your doses is an even better idea.

But, as Vandrey pointed out, none of this is a guarantee against another panic attack. And if the one you had fits into a larger pattern of recurrent behavior, then seeking a doctor's opinion on the nature of your anxiety is the smart move. Even if you think you're self-medicating your anxiety with marijuana, you could be doing more harm than good.     

"Cannabis I don’t think is any different than any other drug that can produce anxiety," Vandrey said — and there are many drugs that can. So don't let weed's chill reputation fool you: As with any prescription you pick up at the pharmacy, it's essential to be informed of possible adverse effects.