The Highs and Lows of Cannabis

Cannabis is part of many people’s lives. Some use it to unwind at the end of a long day, others for medical reasons, and for many it’s simply recreational. Like a glass of wine, a good meal, or sex, it can be enjoyable. But like anything we rely on to cope, there’s another side we need to talk about. Cannabis can also become something we lean on too heavily, especially when we’re stressed, overwhelmed, or struggling with mood and focus.

I want to be clear: there is no judgment here. Many of my clients use cannabis, and some of the people closest to me do too. My role isn’t to shame or take it away, but to help you explore how it’s working for you. Sometimes it supports wellness. Sometimes it complicates it. Often, it’s both.

THC, CBD, and How Cannabis Has Changed

Two main compounds drive the effects of cannabis: THC (tetrahydrocannabinol) and CBD (cannabidiol). THC produces the classic “high” but also contributes to side effects like anxiety, paranoia, or panic. CBD, in contrast, doesn’t cause intoxication and may have calming or anti-anxiety properties.

Here’s what’s important: modern cannabis isn’t the same as the cannabis of the 1970s. Today’s strains often contain 10–15 times more THC than they did decades ago, with much less CBD to balance it out. That means the effects, both positive and negative, can be much stronger. For people who already struggle with stress, mood swings, or mental health vulnerabilities, that intensity matters.

What Research Shows About Cannabis and Mood

• Psychosis and Schizophrenia. Research is clear: early and heavy cannabis use, especially in genetically vulnerable people, raises the risk of psychosis and worsens outcomes for those already living with schizophrenia.

• Depression. For years, the connection between cannabis and depression was unclear. Newer studies suggest regular use increases the risk of major depression, and that symptoms may appear earlier in those who use heavily.

• Bipolar Disorder. Among people with bipolar disorder, cannabis use is linked to longer and more intense mood episodes, faster cycling between depression and mania, lower chances of stable remission, and higher suicide risk.

• Anxiety. While some people feel calmer after smoking or vaping, others experience the opposite: racing thoughts, panic, or restlessness. THC is unpredictable, and what soothes one person can agitate another.

This doesn’t mean everyone who uses cannabis will develop depression or bipolar disorder. But it does mean the risks are higher for those already prone to mood challenges, and that even people with “just stress” or “trouble sleeping” might notice over time that cannabis leaves them more flat, unmotivated, or foggy.

Self-Medication or Self-Care?

Why do people keep turning to cannabis, especially if it sometimes makes things worse? One explanation is self-medication: using weed, alcohol, or other substances to soften emotional pain. For someone who feels keyed up or low, cannabis can bring quick relief. But long term, it can also deepen the cycle - stress fuels use, cannabis changes mood regulation, and the underlying issues remain untreated.

This is especially true for people with ADHD. Poor impulse control can make it harder to set limits around use, and while cannabis may feel calming in the moment, research shows it often worsens attention, memory, and motivation. In other words, the very symptoms people with ADHD are trying to manage can quietly grow stronger over time.

There’s another layer too. In bipolar disorder, for instance, impulsive or manic phases can push people toward more frequent cannabis use. It’s not just the depression, sometimes the elevated mood itself feeds the pattern.

Cannabis vs. Medications Like Lexapro

A question I often hear: “Isn’t cannabis just like an antidepressant? Both are drugs, but one is natural.”

Here’s the distinction:

• Medications like Lexapro are carefully studied in large trials, standardized in dose, and monitored for safety.

• Cannabis is natural, yes, but its potency varies widely by strain, product, and even individual use. What calms one person might trigger panic in another.

• “Natural” doesn’t always mean safe.” THC acts on the same brain reward and mood circuits that regulate emotion. Repeated high-dose exposure can destabilize mood, especially in people with genetic vulnerability.

This isn’t about “good vs. bad.” It’s about predictability and safety. Medications let us adjust the dose and track outcomes. Cannabis can be more of a wild card.

When Use Becomes a Problem

Cannabis use isn’t automatically a problem. Many people use it recreationally without consequences. But here are signs it may be crossing into harmful territory:

• Needing more to get the same effect.

• Craving or daily reliance.

• Using it to numb emotions rather than cope with them.

• Struggling with work, school, or relationships because of use.

• Feeling flat, unmotivated, or disconnected when not using.

Clinically, addiction is defined as continued use despite harm. In real life, it often looks like, “I thought this was helping, but now I’m not sure it is.”

For those with ADHD, cannabis can add an extra layer of difficulty, clouding focus, disrupting routines, and making it even harder to follow through on daily responsibilities. What starts as a way to take the edge off can end up amplifying the very challenges that were there to begin with.

The Double Diagnosis Challenge

Research shows about half of people with mood disorders also meet criteria for a substance use disorder, and vice versa. Psychiatrists call this dual diagnosis. It’s not a coincidence. Cannabis can worsen mood instability, and low mood can drive heavier use. Treating just one side rarely works; both need attention.

That doesn’t mean everyone must stop cannabis forever. It means if someone is dealing with stress or mood struggles and using cannabis regularly, we have to talk about both. Ignoring one makes recovery harder.

The Takeaway

This blog isn’t about demonizing cannabis. For some, it’s enjoyable, even beneficial. For others, especially those leaning on it daily to get through stress, worry, or mood swings, the risks are real.

The most important thing is openness. You should never feel like you can’t tell your provider if you’re smoking or using cannabis. My role isn’t to lecture but to listen and help you find balance.

Cannabis can be like wine, carbs, or sex: something that brings pleasure in moderation but creates problems if it becomes the only tool you use to cope. The key question isn’t whether cannabis is good or bad - it’s whether it’s helping you build the life you want.