You’ve probably heard it before or have even said it: “Cannabis helps my anxiety – I can’t function without it.” And at first, it really did help. A few puffs can bring a temporary sense of calm, detachment from stress, or even better sleep. But mental health professionals across the country—including myself—are seeing a concerning pattern: over time, the very symptoms people hoped cannabis would relieve often get worse. In some cases, especially in younger users or those with vulnerability to psychosis, cannabis use may even trigger intense paranoia, panic, or full-blown psychotic episodes. I have seen the brain maps of people using cannabis regularly and can tell yo – it isn’t pretty.
So what’s really going on?
The Double-Edged Sword of Cannabis and Anxiety
Cannabis interacts with the brain’s endocannabinoid system, which plays a role in regulating mood, stress, and sleep. In the short term, this can create feelings of euphoria, relaxation, or even numbness. But here’s the catch: the effects are not stable over time. Many users report tolerance—needing more for the same effect—or rebound anxiety, where anxiety is actually worse after the drug wears off.
In my own practice, I’ve seen clients experience a marked decrease in anxiety and paranoia once they stop using cannabis—even when they initially insisted that it was helping them manage those very symptoms. Over time, undesirable things happen with use.
The Link to Psychosis: Not Just a Scare Tactic
Reports from therapists, psychiatrists, and emergency departments are increasing: young people showing up in full-blown psychosis with a history of regular cannabis use—often high-potency concentrates (like dabs, vapes, or edibles). This is very, very serious.
A 2021 study in Lancet Psychiatry found that daily cannabis use, especially high-potency strains, was associated with a fivefold increase in the risk of developing psychosis in some individuals. Other research has shown that people with a genetic vulnerability—such as a family history of schizophrenia or bipolar disorder—may be especially at risk.
Translation: For some, cannabis doesn’t just increase anxiety. It can lead to hallucinations, delusions, or a break from reality that doesn’t always resolve with abstinence.
Why It’s So Convincing at First
Part of what makes cannabis so tricky is that it really can help people feel better—at first. It’s not unusual to hear things like:
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“It’s the only thing that helps me sleep.”
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“It keeps me from having panic attacks.”
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“I don’t feel like myself without it.”
But over time, cannabis can become a kind of emotional crutch—masking symptoms without addressing their root causes. It may dull emotion temporarily, but it often blunts growth, too. And when the calming effect wears off, anxiety can return stronger than before, along with irritability, low motivation, or memory issues.
What Therapists and Families Should Watch For
Signs that cannabis is doing more harm than good:
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Increased social withdrawal or lack of motivation
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Mood swings or unexplained irritability
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Paranoia, suspiciousness, or panic
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Sleep disruption after initial drowsiness
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Declining grades or job performance
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Denial of any issues despite mounting evidence
These patterns are showing up across diagnoses: ADHD, depression, trauma, anxiety, and more. The common thread is that people are using cannabis not recreationally—but as a coping strategy. And when that strategy backfires, it can be hard to recognize because it feels like it’s still helping.
What You Can Do Instead
If you’re using cannabis for emotional regulation, you’re not alone. But here are a few alternatives worth exploring:
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Therapy with someone who understands the whole picture. You don’t need judgment—you need a plan that works.
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Body-based anxiety tools (deep breathing, vagal nerve techniques, somatic work)
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Medication review (if appropriate) with a provider trained in psychiatric care
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Support groups or peer coaching—not to shame use, but to offer other ways forward
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Journaling or tracking moods in connection to substance use for greater insight
Closing Thoughts
Cannabis can seem like a friend at first—but over time, it may become a quiet antagonist to your emotional health. If you’ve noticed your anxiety or panic getting worse or paranoia developing despite continued use, you’re not imagining it. You’re also not broken or weak.
We all want relief. The goal is to find the kind that lasts—and that restores your mind, rather than dulling it.
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About the Author
Janet Schryer Donahue, LPC, NCC, CCTP, ADHD-CCSP
Janet is a licensed professional counselor in Michigan specializing in healing the effects of Trauma, Anxiety, and ADHD. She offers Christian counseling when clients request it. She is founder of TADAS Counseling where the focus is on finding core issues for true life long change. Janet’s bio is on www.JanetSchryerDonahueTherapist.com. You can request a free phone consultation from one of the therapists at TADAS by scheduling here.
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References & Resources
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Di Forti, M., et al. (2019). “The contribution of cannabis use to variation in the incidence of psychotic disorder across Europe (EU-GEI study): a multicentre case-control study.” The Lancet Psychiatry, 6(5), 427–436.
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Volkow, N. D., et al. (2014). “Adverse health effects of marijuana use.” The New England Journal of Medicine, 370(23), 2219–2227.
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National Institute on Drug Abuse (2020). Cannabis (Marijuana) Research Report.
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Personal clinical observation and synthesis from TADAS Counseling clinicians, Michigan.
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