People commonly associate cannabis with relaxation, but it’s also known for causing feelings of paranoia or anxiety in some folks. What gives?

First, it’s important to understand what paranoia involves. It’s similar to anxiety, but a bit more specific.

Paranoia describes an irrational suspicion of other people. You might believe people are watching you, following you, or trying to rob or harm you in some way.

Experts believe your endocannabinoid system (ECS) plays a part in cannabis-related paranoia.

When you use cannabis, certain compounds in it, including THC, the psychoactive compound in cannabis, bind to endocannabinoid receptors in various parts of your brain, including the amygdala.

Your amygdala helps regulate your response to fear and related emotions, like anxiety, stress, and — wait for it — paranoia. When you use cannabis that’s rich in THC, your brain suddenly receives more cannabinoids than usual. Research suggests this excess of cannabinoids may overstimulate the amygdala, making you feel fear and anxiety.

This would also explain why products rich in cannabidiol (CBD), a cannabinoid that doesn’t directly bind to endocannabinoid receptors, don’t seem to cause paranoia.

Not everyone experiences paranoia after using cannabis. Plus, most people who do experience it don’t notice it every single time they use cannabis.

So, what makes someone more likely to experience it? There’s no single answer, but there are a few major factors to consider.

Genetics

According to an animal study from 2019, cannabis tends to produce positive effects, such as relaxation and decreased anxiety, when it provides more stimulation to the front region of the brain.

Study authors suggest this has to do with the large number of reward-producing opioid receptors in the front of the brain.

If the back portion of your brain has more THC sensitivity than the anterior, however, you could experience an adverse reaction, which often includes paranoia and anxiety.

THC content

Using marijuana with higher THC content may also contribute to paranoia and other negative symptoms.

A 2017 study looking at 42 healthy adults found evidence to suggest that consuming 7.5 milligrams (mg) of THC reduced negative feelings associated with a stressful task. A higher dose of 12.5 mg, on the other hand, had the opposite effect and increased those same negative feelings.

While other factors like tolerance, genetics, and brain chemistry can come into play here, you’re generally more likely to experience paranoia or anxiety when you consume a lot of cannabis at once or use high-THC strains.

Sex

A 2014 animal study exploring THC tolerance found evidence suggesting higher estrogen levels can increase cannabis sensitivity by as much as 30 percent and lower tolerance for marijuana.

What does this mean for you? Well, if you’re female, you may be more sensitive to cannabis and its effects. This goes for positive effects, like pain relief, as well as negative effects, like paranoia.

If you’re experiencing cannabis-related paranoia, there are a few things you can try for relief.

Relax

Do things that relax you, like coloring, putting on restful music, or taking a warm bath.

Some people report that yoga and deep breathing exercises, particularly alternate nostril breathing, can also help.

Try this

To do alternate nostril breathing:

  • Hold one side of your nose closed.
  • Slowly breathe in and out several times.
  • Switch sides and repeat.
Healthline

Take a whiff of pepper

Cannabinoids and terpenoids, such as the terpenes in pepper, share some chemical similarities, which may be one reason why they seem to have some benefit for countering the effects of too much THC.

If you have fresh peppercorns, grind them up and take a deep breath. Just don’t get too close — stinging eyes and sneezing might distract you from paranoia temporarily, but not in a fun way.

Make lemonade

Got a lemon? Limonene, another terpene, may also help with the effects of too much THC.

Squeeze and zest a lemon or two and add some sugar or honey and water if desired.

Create a relaxing environment

If your environment makes you feel anxious or stressed, that won’t help your paranoia much.

If possible, try to go somewhere you feel more relaxed, like your bedroom or a quiet space outdoors.

If you’re at someone else’s house or unable to easily change your surroundings, try:

  • switching on chill or soothing music
  • wrapping up in a blanket
  • cuddling or stroking a pet
  • calling a friend you trust

So, you made it through an episode of paranoia and you never, ever want to experience that again.

One option is to just skip the cannabis, but this might not be ideal if you find some of its other effects beneficial. Fortunately, there are a several things you can do to reduce your chance of having another bout of cannabis-related paranoia.

Try using less at a time

Decreasing the amount of cannabis you consume at a time may lower your chances of experiencing paranoia again.

Start with less than you’d typically use in one sitting, and give it at least 30 minutes to an hour to kick in. If you don’t experience paranoia, you can experiment with different dosages, slowly increasing until you find the sweet spot — a dose that produces the effects you do want without paranoia and other negative symptoms.

Look for marijuana with a higher CBD content

Unlike THC, CBD doesn’t produce any psychoactive effects. Plus, research suggests that CBD-rich cannabis may have antipsychotic effects. Paranoia is considered a psychotic symptom.

Products with higher ratios of CBD to THC are becoming increasingly common. You can find edibles, tinctures, and even flower that contains anywhere from a 1:1 to a 25:1 ratio of CBD to THC.

Some people also report that strains with a pine, citrus, or peppery scent (remember those terpenes?) can help boost relaxing effects and make paranoia less likely, but this isn’t backed by any scientific evidence.

Get professional support for anxiety and paranoid thoughts

Some evidence suggests people with an existing sensitivity to paranoia and anxious thoughts have a higher chance of experiencing both when using cannabis.

Paranoia can overwhelm you to the point where it becomes difficult to interact with others. You might avoid talking to friends, going to work, or even leaving your house. A therapist can help you explore these feelings and other potential contributing factors.

Since paranoia can happen as a symptom of serious mental health conditions like schizophrenia, anything beyond a few passing, mild paranoid thoughts may be worth bringing up with your healthcare provider.

It’s also wise to consider working with a therapist for anxiety symptoms.

Cannabis can temporarily help relieve anxiety for some people, but it doesn’t address the underlying causes. A therapist can offer more support by helping you identify contributing factors and teaching coping methods to help you manage anxiety symptoms in the moment.

If you recently stopped using cannabis, you may still experience some feelings of paranoia, anxiety, and other mood symptoms.

This isn’t uncommon, especially if you:

  • used a lot of cannabis before you stopped
  • experienced paranoia while using cannabis

Research from 2017 suggests lasting paranoia can happen as a symptom of cannabis withdrawal syndrome (CWS). According to this review, which looked at 101 studies exploring CWS, mood and behavioral symptoms tend to be the primary effects of cannabis withdrawal.

For most people, withdrawal symptoms seem to improve within about 4 weeks.

Again, other factors can also play a role in paranoia, so it’s important to talk to your healthcare provider if your paranoid thoughts:

  • become severe
  • don’t go away within a few weeks
  • affect day-to-day function or quality of life
  • lead to violent or aggressive thoughts, like wanting to hurt yourself or someone else

Paranoia can feel a little unsettling at best and downright terrifying at worst. Try to keep calm and remember it will likely disappear once your cannabis high starts to wear off.

If you notice particularly intense thoughts, or paranoia that persists even when you stop using cannabis, talk to a healthcare provider or mental health professional as soon as possible.


Crystal Raypole has previously worked as a writer and editor for GoodTherapy. Her fields of interest include Asian languages and literature, Japanese translation, cooking, natural sciences, sex positivity, and mental health. In particular, she’s committed to helping decrease stigma around mental health issues.