Bipolar disorder is a mental health condition that can cause extreme changes in mood. This includes low, depressive episodes and high, manic episodes. These mood swings can be both extreme and unpredictable.

Someone living with bipolar disorder can also have symptoms of psychosis including:

Going through the emotional highs and lows of bipolar disorder can greatly affect a person’s ability to function in day-to-day life. There’s no cure for bipolar disorder, but treatments can help.

Standard treatments, such as prescription medications and therapy, can help a person manage their mood changes and other symptoms. Researchers continue to look into other treatment options as well, including medical marijuana. But is it safe? Here’s what we currently know about the pros and cons of marijuana use in people with bipolar disorder.

Marijuana is from the cannabis plant whose dried leaves, stems, and seeds are smoked, eaten, or “vaped.” Marijuana contains compounds called cannabinoids. These compounds include a chemical called delta-9-tetrahydrocannabinol, or THC. This is the ingredient in marijuana that can make a person feel “high.”

While marijuana and medical marijuana aren’t currently legal in all states, doctors are discovering how the compounds could help relieve certain symptoms in people with chronic conditions. According to the National Institute on Drug Abuse (NIDA), compounds in marijuana can help treat symptoms such as:

  • appetite loss
  • inflammation
  • muscle control issues
  • nausea
  • pain

Today, there are medications available that contain compounds similar to cannabinoids, but don’t make a person feel high. An example is dronabinol (Marinol), which doctors prescribe for people with cancer to stimulate their appetite.

Smoking or consuming marijuana on its own can be helpful in reducing the side effects of some conditions, such as certain types of cancer. However, the research isn’t as conclusive when it comes to bipolar disorder.

Because marijuana can have anxiety-relieving effects, some people think it can help people with bipolar disorder to improve their moods. Some research has found no harmful effects from marijuana use, while other research has found actual benefits. Examples include the following:

Low mental impairment and better moods

A study published in 2016 found that people with bipolar disorder didn’t experience significant mental impairment when using marijuana compared to people with bipolar disorder who didn’t use marijuana. Critics of marijuana use for bipolar disorder say that it affects a person’s thinking and memory. This study didn’t find that to be true. The study also found that after using marijuana, the patients with bipolar disorder reported better moods.

Mood enhancing and a positive outlook

A study published in 2015 found that marijuana use in some people with bipolar disorder enhanced their mood and promoted a more positive outlook. However, the researchers found that people were more likely to use marijuana when they were already having a good day mood-wise and not when their symptoms were more severe.

It’s important to keep in mind that the research surrounding the beneficial effects of marijuana use in bipolar disorder is very preliminary. Also, marijuana can affect each person differently, so these results don’t suggest that marijuana can benefit everyone with bipolar disorder.

Some researchers have actually found that marijuana use can make bipolar symptoms worse in some people. Examples of their studies include the following:

Triggering manic episodes and worsening symptoms

A review published in early 2015 found that using marijuana could make manic symptoms worse in a person with bipolar disorder. They also found that marijuana use could trigger a manic episode. In addition, the 2015 study above touting benefits to marijuana use, also found that it worsened manic or depressive symptoms in some people.

Higher rates of attempted suicide and early onset

According to another study from 2015, suicide attempt rates in people with bipolar disorder were higher in those who used marijuana than in those who didn’t use marijuana. The study also found that people who used marijuana were younger at bipolar disorder onset (when their symptoms first started) than those who didn’t use it. This is a concern, as doctors think that a younger age at onset of bipolar disorder causes worse symptoms throughout a person’s life. The effect of marijuana on early onset and suicide rates wasn’t clear however, researchers said.

While marijuana may help some people with bipolar disorder, these studies show that it could also cause problems for others with the condition.

Research has also shown that the use of marijuana can affect people differently based on their genetics.

According to the NIDA, people who carry certain gene types are more likely to experience psychosis. For instance, people who have an unusual variation of the AKT1 gene are more likely to have psychosis, and the risk is higher if they use marijuana. Also, psychosis risks from adolescent use of marijuana have been linked with a genetic variation in the gene that controls an enzyme called catechol-O-methyltransferase (COMT).

If you have bipolar disorder and are considering using marijuana as a treatment, talk to your doctor about possibly testing for these or other genetic variations.

Right now, there isn’t enough research to say whether marijuana use for treating bipolar disorder is a good thing or a bad thing. Some people have reported positive effects, such as improved mood. But others have reported negative effects, such as worsened mania or suicidal thoughts. Further research is needed on marijuana’s effects on bipolar disorder, as well as the long-term effects of prolonged use.

What doctors do know is that marijuana isn’t as effective as prescription medication and therapy can be in managing the symptoms of bipolar disorder. So if you have this condition, be sure to stick to the treatment plan prescribed by your doctor. And if you’re considering using medical marijuana, talk to your doctor about the pros and cons first. Then, if you decide to try it, keep your doctor posted about how it affects you.

Together, you and your doctor can determine if it’s a good addition to your treatment plan.