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Bipolar disorder is a mental health condition that causes shifts in energy levels, mood, and focus. People with bipolar disorder may experience periods of high energy, also known as manic episodes, often followed by depressive episodes.

It can be difficult to diagnose bipolar disorder because not everyone with a mental health condition will experience the same pattern of behaviors or mood shifts.

While most pop culture portrayals of bipolar disorder involve extreme mood swings, not everyone with bipolar disorder experiences dramatic shifts in mood.

While standard treatment of bipolar disorder often involves prescription medication, some people are curious whether cannabidiol (CBD) may be another option.

Even though evidence suggests CBD may have some health benefits for conditions like anxiety and depression, it may not be as effective for bipolar disorder. Here’s what the research says.

There’s limited information on the effects of CBD in people with bipolar disorder. But available evidence doesn’t really support the idea that CBD can help with bipolar disorder.

A 2020 review, for example, suggests that CBD may help reduce symptoms of mental health conditions like social anxiety and schizophrenia. However, the review concludes that the evidence on the use of CBD for bipolar disorder is weak and requires additional studies.

Similarly, other research reviews from 2020 and 2021 note that there’s insufficient evidence to support cannabinoids (including both CBD and THC) for affective disorders, like bipolar disorder. Another review points out that there aren’t many ongoing clinical trials in this area, and that more research is needed.

One study from 2015 even suggests that cannabis use may negatively impact people with bipolar disorder by lowering their chances of long-term remission.

However, it’s important to note that cannabis — sometimes referred to as marijuana — contains higher levels of THC than CBD products do. And people with bipolar disorder may be more likely to use cannabis in the first place.

Still, there’s evidence that CBD may help with stress, anxiety, and depression. CBD’s potential ability to help with depression may benefit people with bipolar who are experiencing a depressive episode. However, this area of research is also ongoing.

CBD is a substance called a cannabinoid. Cannabinoids are found in cannabis plants. Other cannabinoids include cannabinol (CBN), cannabigerol (CBG), and tetrahydrocannabinol (THC). Unlike THC, CBD produces mild effects and no obvious “high.”

There are three types of CBD:

  • Isolate: This pure form of CBD contains no additional compounds from the cannabis plant.
  • Broad-spectrum: This form of CBD contains some cannabis plant compounds other than CBD, including terpenes and other cannabinoids, but no THC.
  • Full-spectrum: This form of CBD contains the full spectrum of substances from the cannabis plant. It also has a small amount of THC.

CBD comes in different forms, including:

A note on THC content

Even CBD isolate products have the capacity to contain trace amounts of THC. If you want to avoid THC altogether or are drug tested, you may want to avoid CBD products.

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The human body is equipped with an endocannabinoid system (ECS), which helps to keep systems running smoothly. The ECS is made up of endocannabinoids, enzymes, and receptors.

Your body naturally produces endocannabinoids. The two that experts know of are anandamide (AEA) and 2-arachidonoylglyerol (2-AG). These bind to CB1 and CB2 receptors in your body and trigger specific effects like pain relief. Once endocannabinoids have completed their job, enzymes break them down.

Experts still aren’t clear on how the ECS works, but research suggests it may be involved in:

  • metabolism
  • chronic pain
  • mood
  • sleep
  • inflammation
  • immune system responses
  • stress
  • appetite and digestion
  • learning and memory

Since CBD is a cannabinoid, it can bind to your body’s endocannabinoid receptors. But experts don’t know how the ECS and CBD interact. Some believe that CBD stops enzymes from breaking down endocannabinoids, but that’s just one theory.

What researchers are pretty sure of is that CBD and THC work better together than alone. This happens due to the entourage effect. That’s why full-spectrum CBD may have more pronounced effects than other forms of CBD.

If you want the full benefits of CBD, opt for full-spectrum products — unless you’re trying to avoid THC. In that case, you’re better off with a broad-spectrum or isolate product.

CBD is considered safe to use, according to the World Health Organization.

However, over-the-counter CBD products aren’t approved by the Food and Drug Administration (FDA). And while the FDA does send warning letters to companies making false health claims about CBD, they don’t regulate what actually goes into each CBD product. That means that quality can vary widely.

Side effects

CBD is less likely to cause side effects than THC. Still, it’s possible to experience mild side effects like:

  • diarrhea
  • weight changes
  • appetite changes

Important note on medication interactions

If you decide to take CBD for any reason, it’s essential to talk with your doctor. CBD may interact with certain medications like those sometimes prescribed for bipolar disorder. Lithium, for example, may interact with CBD and cause lithium toxicity.

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If you do decide to try CBD, research the brand that you’re interested in. Not all brands are high quality, and some may not actually contain what they say they do.

The best way to be sure of what you’re ingesting is to review the certificate of analysis (COA) for a product before you buy it. The COA should come from a reputable third-party lab, and it should tell you exactly what testing your product has undergone. This includes testing for levels of:

  • CBD, THC, and other cannabinoids
  • terpenes
  • contaminants like heavy metals, pesticides, and molds
  • residual solvents

You might also want to check the brand’s reputation, searching for any FDA warning letters or lawsuits, as well as what past customers have to say about the brand.

Finally, peruse the brand’s website to see how transparent they are about their manufacturing process and ingredient sourcing.

Typically, doctors treat bipolar disorder using a combination of the following:

These treatments are backed by more research than CBD is.

Finding the right treatment for any mental health condition can be challenging because symptoms often differ significantly from person to person.

Anecdotally, some people say that taking CBD helps with their anxiety and depression. But it’s important to remember that CBD is not a replacement for traditional mental health therapies.

If you have a mental health condition like bipolar disorder, talk with a mental health professional about available treatment options. And, if you’re already taking medication for bipolar disorder, continue taking it and talk with your doctor before taking CBD. Some medications, including lithium, may interact with CBD.

Is CBD legal? The 2018 Farm Bill removed hemp from the legal definition of marijuana in the Controlled Substances Act. This made some hemp-derived CBD products with less than 0.3% THC legal at the federal level. However, CBD products containing more than 0.3% THC still fall under the legal definition of marijuana, making them illegal at the federal level. Some states have legalized CBD, so be sure to check state laws, especially when traveling. Also, keep in mind that the FDA has not approved nonprescription CBD products, and some products may be inaccurately labeled.

Steph Coelho is a freelance writer with chronic migraine who has a particular interest in health and wellness. When she’s not click-clacking away on her keyboard, she’s probably nose-deep in a good book.