Weed panic attacks: What to do if anxiety kills your high

While many find weed a relaxing drug, cannabis also has a direct connection to panic attacks. Even a habitual smoker who seems to be 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 and panic attacks.

How weed can cause panic attacks

Weed can push you toward a panic attack, Ryan Vandrey, who studies the behavioral pharmacology of cannabis use at Johns Hopkins University School of Medicine, tells Mic. "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 explains.

How to recognize a panic attack

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 says. "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. 

How to come down from a weed panic attack

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 practically 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 says, 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 adds. "None of it is applicable to everybody."  

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 says. "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.

Try deep breathing and grounding techniques

Deep-breathing and grounding exercises are both known to have calming effects for people in the midst of an anxiety or panic attack. Of course, taking slow, deep breaths is easier said than done — especially when you’re feeling very on edge — so it may be helpful to use an app that can guide you through the process. If you’re a visual person, try watching this simple GIF and breathing along with it, as the lines expand and contract.

Or, you can give the 4-7-8 breathing technique (which is also good for falling asleep) a shot. Susan George, an Ohio-based psychotherapist, previously explained the technique to Mic. “Slowly take a deep breath in for three seconds through your nose as if you are filling up a balloon inside your belly,” she said. ““Hold your breath for 4 seconds. Then, slowly release your breath through your mouth for 5 seconds. For those who are more experienced, breath in for 4 seconds, hold for 7 seconds, and release for 8 seconds.” Repeat 10-12 times.

It may also be helpful to try literally sitting on the ground, trying the 5-4-3-2-1 sense technique (“Name 5 things you see, name 4 things you hear, name 3 things you can touch, name 2 things you can smell, name 1 thing you can taste,” Annie Hsueh, a psychotherapist in California, previously explained to Mic), or even cuddling with a pet to feel grounded.

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 non life-threatening, which is a huge advantage when your mind is playing tricks on you.

It’s also handy to have a companion who can address any simple and immediate needs when it comes to limiting environmental stressors.

"There’s no one way to treat this," Vandrey says. "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 says they're "not common at all." They're especially unusual for "frequent, experienced" users: "It rarely happens, and usually only after very high doses,” he says. 

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 says, 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 caused your weed panic attack

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 compound 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 points 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 says — 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.