Is it High Time for a New Way to Treat Mental Health in Ohio?

Uncovering the Uncommon Commonalities between Cannabis, PTSD, Autism, and Anxiety

Could it be high time for a new treatment approach to mental health in Ohio? The Ohio State Medical Board says no, as earlier this month they disregarded previous recommendations to add autism and anxiety to Ohio’s Medical Marijuana Control Program (OMMCP). Paling in comparison to physical ailments, PTSD is the only neurological disorder, out of 21 conditions that is permitted for MMJ in Ohio. Cachexia, (a physical wasting condition often related to cancer and AIDS), was the only condition to be recommended for further research.

This begs the question, should mental health be treated with the same sense of urgency as physical health? When considering mental health and physical health, the two should not be thought of as separate—as poor mental health can lead to an increased risk of developing physical health problems and vice versa. 

Mental Health Taking a Physical Toll

Mental health plays a major role in one’s ability to obtain and maintain good physical health. Mental illnesses, such as depression and anxiety, can often hinder someone’s ability to engage in daily social activities, affecting one’s quality of life.  

According to the NAMI, National Alliance on Mental Illness, “1 in 5 U.S. adults experience mental illness each year, 1 in 25 U.S. adults experience serious mental illness each year, 1 in 6 U.S. youth aged 6-17 experience a mental health disorder each year, 50% of all lifetime mental illness begins by age 14, and 75% by age 24.”

Additionally, a tracking poll conducted by the Kaiser Family Foundation from March 25 to 30, found that seven in ten Americans (72%) say that their lives have been disrupted “a lot” or “some” by COVID-19. Stating that 45% of adults said that the pandemic has affected their mental health, and 19% say it has had a “major impact.” Results found that these statistics were slightly higher among females, Hispanic, and African American adults. 

Suicide, now a major contributor to premature mortality, is the tenth leading cause of death for all ages in the United States. In fact, suicide ranks as the second leading cause of death for ages 10-34 and the fourth leading cause for ages 35-54. Despite national goals to lower the suicide-related mortality rates, several reports noted a steep uptick in suicide rates over recent years. 

So, what is important—mental health or physical health? The answer is both. 

Understanding Neurodiversity

Neurological ailments are often conditions that affect your mental and physical health, impacting your mood, and behavior. Symptoms may be mild or long-lasting (chronic), affecting one’s ability to function each day.

There are various types of neurological conditions, common ones include:

• Anxiety disorders, including panic disorder, obsessive-compulsive disorder, and phobias
• Developmental disorders, such as Autism 
• Mood disorders, including depression, and bipolar disorder
• Eating disorders 
• Personality disorders
• Post-traumatic stress disorder
• Psychotic disorders, including schizophrenia

There is no direct causation for mental illness, as a wide array of factors may contribute to one’s risk, such as:

• Genetics/family history
• Stress, trauma or a history of abuse, especially in childhood
• Biological chemical imbalances in the brain
• Traumatic brain injury
• Use of alcohol or recreational drugs
• Underlying health conditions

So, who is at risk for mental disorders? Mental disorders are very common. More than half of all Americans will be diagnosed with a mental disorder at some point in time in their life.

How are mental disorders diagnosed? The steps to getting a diagnosis include:

• Prior medical history
• Examination to rule out other medical conditions may be causing symptoms
• A psychological evaluation, answering questions about one’s thought process, emotions, and behaviors.

PTSD 

PTSD, or post-traumatic stress disorder, is a commonly known condition that is characterized by an overactive neurological response, primarily triggered by past trauma. PTSD, the only neurological condition to qualify for MMJ in Ohio, actually shares a wide array of comorbidities with both anxiety and autism. 

Symptoms of PTSD can often be coupled with other common conditions such as insomnia, anxiety, paranoia, impaired social functioning, physical pain, along with various other physical and neurological comorbidities. 

Comorbid conditions or comorbidities, are ailments that entail more than one disease or condition. Such conditions are often chronic, or long-term.

Because of the many comorbidities, PTSD is considered to be debilitating for many diagnosed and is unique to each person.

People with PTSD may experience:

• Behavioral: agitation, irritability, hostility, hypervigilance, self-destructive behavior, or social isolation
• Psychological: flashback, fear, severe anxiety, or mistrust
• Mood: loss of interest or pleasure in activities, guilt, or loneliness
• Sleep: insomnia or nightmares
• Also common: emotional detachment or unwanted thoughts

Autism

Having autism can sometimes mean enduring a litany of traumatic events, starting from a young age, (especially for the nonverbal community). And for many, these events may add up to severe and persistent post-traumatic stress disorder (PTSD).

Clinicians suspect that an autism diagnosis increases the risk for certain kinds of trauma, such as bullying, environmental circumstances, and other forms of stress. Even still, few studies have investigated the correlation or the psychological aftermath of such trauma, including PTSD in those diagnosed with autism.

Manifestation of comorbid PTSD in autistic people can be unexpected, and is liable to exacerbate a regression of skills, as well as stereotyped behaviors and communication. 

Even when trauma is known and documented, treating someone on the spectrum is far easier said than done. When children are nonverbal or simply view the world differently, specialists can struggle to find the most effective way to help them work through their experiences.

People with autism may experience:

• Behavioral: inappropriate social interaction, poor eye contact, compulsive behavior, impulsivity, repetitive movements, self-harm, or persistent repetition of words or actions
• Developmental: learning disability or speech delay in a child
• Cognitive: intense interest in a limited number of things or problem paying attention
• Psychological: unaware of others’ emotions or depression
• Also common: anxiety, hyperactivity, panic, stimming or tics, insomnia, sensitivity to light/sound

Anxiety

Anxiety and PTSD have a long standing relationship, as PTSD actually used to be categorized as an anxiety disorder. Although anxiety is one of the most prevalent symptoms for conditions such as PTSD and autism, they are all categorized differently within the various subcategories of mental health illnesses.

Anxiety is a crippling neurological condition that affects one’s ability to maintain and control one’s mental and physical response to stress. While being so widely prevalent as both a singular and comorbid condition, anxiety is still highly stigmatized and often overlooked.

Often, anxiety disorders involve repeated episodes of sudden feelings of intense fear or terror that come on suddenly, (panic attacks). 

One may avoid people, places, or situations as a deterrent for anxiety attacks. As unwanted feelings of panic are sudden, a disruption to daily activities, difficult to manage, disproportionate, and can be long lasting or chronic. 

Symptoms of anxiety may start during early childhood or the teen years and continue into adulthood. Deeply manifested disorders like chronic and even generalized anxiety if overlooked, can easily develop into PTSD. 

People with anxiety may experience:

• Behavioral: hypervigilance, irritability, or restlessness
• Cognitive: lack of concentration, racing thoughts, or unwanted thoughts
• Whole body: fatigue or sweating
• Also common: anxiety, excessive worry, fear, feeling of impending doom, insomnia, nausea, panic, palpitations, or trembling

Traditional Medicine 

Due to a severe overlap in symptoms and conditions, individuals with mental health conditions are often prescribed a variety of prescriptions. These include antidepressants, anxiolytics, mood stabilizers, antipsychotics, benzodiazepines, as well as stimulants in off-label, untested combinations in an effort to treat symptoms. 

Often to no avail, patients report that many manufactured medications worsen symptoms, leaving them stagnant. A wide variety of these prescriptions have dangerous, even fatal side effects, and when given in combination the risk for long-term harm increases significantly.

Moreover, recent studies suggest that antidepressants can actually worsen the mood in patients with undiagnosed bipolar disorder.

Additionally, substance use disorder is now also considered a mental health disorder by the American Psychiatric Association. It is classified as a “chronic and relapsing brain disease”. Ironically, according to the Washington Post’s DEA database, from 2006 to 2014 there were 4,414,339,501 prescription pills supplied to Ohio. 

By 2013, roughly 22.7 million people in the United States over the age of 12 required specialized treatment for substance abuse, according to the NSDUH.

“Data show high rates of comorbid substance use disorders and anxiety disorders—which include generalized anxiety disorder, panic disorder, and post-traumatic stress disorder”, 

The brain is a fickle creature — complex and long misunderstood. A basic understanding of the human mind is a code that medical science has been trying to crack for decades. This has resulted in a wide array of pharmaceutical medications for a vast amount of different neurological disorders. Individuals diagnosed are very unique in their symptoms and conditions. In turn, medications are allotted in combinations in an effort to alleviate symptoms associated with these conditions — despite the harmful, long-term, and even fatal side effects. So we must ask, are we doing more harm than good? 

Can Medical Marijuana Help?

How can cannabis treat such complex neurological conditions?

The key lies in the endocannabinoid system, which represents a network of lipid signaling pathways. Every human being possesses this network of receptors and molecules called the endocannabinoid system, or ECS. This network helps carry out the chemical and physical processes that maintain health–functions that range from regulating sleep, cognitive function, managing stress, pain management and digestion. In fact, cannabinoid receptors are found everywhere throughout the body, including immune cells and neurons!

Furthermore, if the body is unable to naturally produce enough endocannabinoids or regulate them properly, the endocannabinoid system may be suffering from a deficiency. This can severely alter how our memory, pain management, immune system, and other physiological processes function, in turn causing a flare up of various symptoms and comorbid conditions. 

Moreover, research from Stanford University shows that children with autism have lower plasma levels of anandamide. Anandamide is the specific endocannabinoid that mimics THC in the body, playing a crucial role in learning, memory, social functioning, easing anxiety, etc. Thankfully, the cannabis plant consists of numerous naturally occurring cannabinoids, which can revive the ECS.

The more commonly known cannabinoids are tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is psychoactive (affecting the mind), strains containing THC have been used for pain, nausea, sleep, and stress disorders. Strains that are CBD dominant may help alleviate pain, inflammation, and seizures associated with epilepsy.

Chemical compounds found within the plant are used to treat various conditions in the body. Improvements are a result of the medicinal effects of cannabis on the underlying symptoms and medical conditions. Regulating many, or all, that are dysregulated in various mental health disorders, positive for helping core symptoms. 

A New Perspective 

Due to known the role of the ECS system, also the documented deficit of endocannabinoids found in those with certain mental health conditions, it seems entirely possible that organic cannabinoid-rich extracts from cannabis could be used as agents to target the pathology of these neurological conditions — as well as many debilitating symptoms associated with. 

In turn, influencing an overall improvement of one’s quality of life — therefore, enhancing the impact of positivity for those diagnosed. 

Could the key to better mental health and wellness be embedded within our endocannabinoid system? Many Ohio families and physicians feel that they should have the authorized right to explore these options without fear of legal repercussions. 

####

For more stories like this one, please consider donating to MedicateOH to help support journalism that bridges the gap in education for Ohioans who seek legally and medically guided answers about their holistic health.