PTSD and Cannabis, A Primer

The first iteration of this article first appeared a year ago on www.monroeblvd.com; This is updated for Pennsylvania patients considering we have unique products and needs within our incredibly closed market. Further, since having access to Pennsylvania dispensary products my personal methodology regarding products and dosages is entirely revised as well. Thank you to Ayad Mahar for allowing me to graciously retain the intellectual rights to my initial draft of this article.

PTSD- no matter how many times I revise this article for both other publications as well as myself I find myself stuck in an aversion cycle. The difficulty in me writing about this issue is that even describing it brings on symptoms- and although through therapy and self education, as well as cannabis medication, I am light years ahead of my past self in navigating this condition- however, that is at best a truce with the condition rather than a cure.

This image is modified from a vague shutterstock image by an anonymous artist. It also somewhat resembles the author,

PTSD: THE EXPERIENCE

The difficulty of writing or reading an article on PTSD is the significant chance of triggering an episode or making an already present episode more challenging for those of us who live with this condition daily.

Fortunately, spending the past several years crawling my way out of the maelstrom of difficulty created by intrusive memories and disassociation known as Post Traumatic Stress Disorder (PTSD), I will explain to you how I used hemp and cannabis derivatives in combination with other healthy coping mechanisms;  we can all pull through this condition together, the best we are able, one step at a time with a combination of self care and pharmacology.

My hope is this article helps you feel less alone in your experiences with this condition.

PTSD: THE DEFINITION OF THE CONDITION

First, let’s look at the short definition of the clinical diagnosis according to the Mayo clinic:

Post Traumatic Stress Disorder (PTSD) is a mental health condition that’s triggered by a terrifying event — either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.

So, traumatic experiences create a surge of adrenaline to the human brain that activate our startle response to react quickly to dangerous and painful situations and stimuli. When this reaction occurs without advantage to our surroundings, it creates a disassociation between past traumas and a (hopefully safer) present.

However, we are far from alone. 

According to Sidran.org

An estimated 70 percent of adults in the United States have experienced a traumatic event at least once in their lives and up to 20 percent of these people go on to develop posttraumatic stress disorder, or PTSD.

Fortunately, most people will never experience PTSD symptoms after a traumatic event, however, for those of us that do, there is hope for significant improvements in managing your symptoms and improving your quality of life.

  • Remember PTSD is not a personal failing, it is an injury of the psyche.  With time and self care you will see improvement. 
  • PTSD can start from a variety of sources: military service, abusive childhood, illness, breakups, deaths of loved ones, psychological stress, just about any instance where you felt powerless, harmed, or without control in unfortunate circumstances. It is a sign of survival through trauma.

How to Recognize the Symptoms of Flashback Episodes 

  • First you need to develop awareness that often when an episode is immanent, like migraine headaches and seizure disorders, a PTSD event may begin with a sensation of aura, a sense of uneasiness, unsteadiness, and agitation. If you see these symptoms begin in yourself, slow down.  
  • In recognizing your triggers, you can better care for yourself; learn to recognize both physical pain and psychological stress can be the primary psychological triggers that can set off a domino effect of feeling like an incapacitated time traveler doomed to relive emotionally and through visual memory, every traumatic experience of your past. It’s going to be okay, I feel like that during my episodes as well.
  • In recognizing the symptoms you experience with the disorder;  you should extraordinarily carefully minimize all unnecessary stressors in your life. If that means limiting your contact with certain people or limiting your time in crowded places, that is perfectly natural and healthy.
  • Remember, there are good days as well. You had good days in your past, your future holds unlimited and beautiful possibilities. 
  • You are an amazing human being who has survived trauma.  Simply making the effort to find resources is the drive that will improve your life.

Immediate Coping Strategies

This is a description of how you can use coping skills with cannabis to refocus and ground yourself from mentally paralyzed to productive again.

  • There is nothing in your life that cannot wait for you to take attention to your breath and center yourself. 
  • Stretch.
  • Focus on five benign objects in your environment, describe them to yourself internally. Describing to yourself the. current light source, material the ground is composed of, locate a place to sit, take notice of any pleasant scents, and choose a single sound to identify helps focus and orientate your awareness to the present moment. 
  • If you have an as-needed pharmaceutical prescribed to you for flashbacks or panic attacks, now is the time to take your medication. 
  • At this point, locate where  you keep your cannabis oil, flower, waxes, creams or other effective solutions. For some episodes, a combination of flower and CBD may be effective, or you might find the slow build of edibles to be a more calming experience. It may take time to find the right combination for you. 
  • A good THC cream rubbed into your neck and shoulders can help relax your physical body enough to release tension in both mind and body. (I prefer Ilera Soothe. It lasts the longest for me)
  • Ingested Cannabis may be helpful solution to nausea associated with prescription rescue medications. When side effects are minimized, it is easier for you to feel better, faster. I have found the Terrapin ICan capsules to be very effective to this purpose.
  • Take it slow. Resist the urge to over-medicate.  Drink a large mug of water, tea, or coffee. Focus on your breathing.  Concentrate on the sensation of how the cannabis positively affects your mind and body.  
  • The correct feeling of a beneficial cannabis treatment should be more relaxed, more calm, more patient, and your focus should become increasingly comfortable instead of more panicked.  
  • If you feel more anxious after medicating, remember to slow down and keep refocusing on the present.
  • Do not be afraid to experiment with many different methods and types of therapy and cannabis treatments! There are always new strains developed specifically for your condition as well as countless methods of delivery to the system. 
  • Further, good advice for good self care, PTSD or not, is you should not hesitant to seek treatment with a skilled therapist quickly after any major potential trauma such a car accident, death of a loved one, or other traumatic experience.
  • Being aware that certain times of year my symptoms are more omnipresent than others based on anniversaries of particularly memorable past traumas can also help you better prepare in advance for rough periods of time.
  • Also remember, life is change, no situation is forever, and practice gratefulness and make a list of the current positives in your life. Focusing on the good and beautiful in your life can help tremendously!  
  • Find an exercise you enjoy.  Swimming, lifting weights, hiking, jogging, dancing or any other physical activity can greatly improve your physical and psychological health
  • Stay organized. Have a list prepared in advance of strategies that have worked.

After taking a vested interest in improving your cannabis medications, and really paying attention in talk therapy you can recover considerably. 

PTSD As Compared to CPTSD

My particular variety of the condition is known as C-PTSD:

Complex post-traumatic stress disorder (C–PTSD; also known as complex trauma disorder) is a psychological disorder that can develop in response to prolonged, repeated experience of interpersonal trauma in a context in which the individual has little or no chance of escape.

In short, without discovering the effectiveness of cannabinoids I would remain locked in my own mind in an endless loop of intrusive memories of the worst, most terrifying periods of my life on endless repeat like “50 first dates” but with Jigsaw the puppet instead of Adam Sandler. Prior to cannabis, I had tried every available treatment from medical studies to EMDR.

In 2012, I was given the opportunity to share my medical records, along with thousands of otherwise intractable cases with similar diagnosis’, to test the potential of medical cannabis legalization and safe regulation in our state.

HOW I USE PERSONALLY USE CANNABIS PRODUCTS TO MANAGE MY CONDITION

This how I get through a flashback using a combination of self care and cannabis, keep in mind that everyone has a unique physiology and psychological composition, so it may take some experimentation with different methods with temperance and a mindset of gentleness towards nursing the (slowly) healing the internal wounds that are flashbacks.

  • Practice self awareness: recognizing I have been operating in a dissociated state, inaccurately superimposing past stress reactions onto my present reality, I medicate.
  • I have several prescribed avenues of effective coping mechanisms, stress reduction techniques, and medication I must choose in combination to allow my startle reflex to calm and to regain productivity.
  •  Knowing pain is a trigger, assessing if I am in pain. If so, what cause? Utilizing medical cannabis reduces the severe side effects of migraine medication and leads to a lower rate of use of prescription painkillers- for this purpose I prefer strong Sativa- based Hybrids.
  • If my issue is a panic attack brought on by an unexpected reminder of a traumatic event, I am prescribed sedatives, however, ideally when paired with a sturdy hybrid or sativa strain for function and indica for sleep greatly reduces the duration of my episodes.
  • At the start of my PTSD symptoms, I did not have any flower on hand so I utilized Charlotte’s web oil under the tongue until dissolved at the recommended dosage which immediately reduced, but did not eliminate my symptoms alone this time.
  • Otherwise, I utilized my other coping strategies of talk therapy, swimming at my local gym, practicing the viola, and taking many careful breaks as necessary that I did not exacerbate my anxiety to the point of prolonging the psychological storm.
  • I drink a ton of water.  Cool water is a huge calming agent for me.  I have known other people feel the same comfort from a healthy herbal tea or even coffee. (Careful, though…stimulants like caffeine can exacerbate your anxiety!)

WOULD CBD HELPS PTSD PATIENTS?

Yesterday, I realized the CBD oil was not quite reducing my all psychological symptoms, most specifically, my nightmares that occur during flashbacks episodes.  In this case, using hybrid flower with a good medicinal content in conjunction with CBD may help you significantly as this helped me. 

Further, the United States has several national and local 24 hour helplines open for trauma survivors, some even maintain a detailed history on repeat callers and can communicate with your permission with your therapist, doctors, and serve as a liaison to your loved ones if you are in crisis or even find you social worker as needed in many situations.

Even if you are not quite comfortable with using a call as your personal resource, forums on reddit and discord servers abound for peer support.

Since many symptoms are psychological, a combination of a prescribed rescue low dose sedative is increased in effectiveness when combined with a indica or hybrid strain of cannabis. 

It may be wise for you to intentionally keep emergency supplies of your rescue prescriptions squirreled away in the places of your home where you keep other grounding mechanisms- such as books, a musical instrument, your journal, or other hobby just in case you accidentally run short of your medication during PTSD episode at a particularly inopportune moment such as overnight or holidays.

(For example, today I found a stored partially full prescription bottle of an indica heavy hybrid, the strain ‘Blue Dream‘ stored on my bookshelf in front of my favorite book.)

PTSD PATENTS; TIPS FOR SURVIVING THE STORMS

  • A preferred method of cannabis utilization is either injested or through vaporization to create a stronger, less abusive pull of the vapor into the lungs. Edibles are also effective for many patients, but may take longer to act, and may be stronger than anticipated.
  • The strain that has provided the greatest benefits of functionality and sense of well being for me is Incredible Hulk, a strain I have not actually encountered in at least four years (the closest is I can locate in Pennsylvania is Bruce Banner). Here are other strains that are very helpful for my PTSD symptoms that may help you:
    • Dark Blue Dream (Hybrid)- This is one of the easiest strains to find- it’s calming, focused effects are great for calming anxiety.
    • Kosher Tangie (Hybrid-Also known as 24k Gold outside of PA)- This energetic, citrus flavored strain smells like fresh oranges and a taste to match. This is another strain to help focus past flashbacks and continue the rest of your day
    • Honey Boo (Indica)- This calming, sweet strain is most commonly found in disposables. It seems to be fairly consistent in effectiveness. This is a nice, calm, middle of the road strain.
    • Golden Goat (Hybrid)- This rarer strain is found more in carts, concentrates, and pens- one of the strongest strains on this list- I would not drive on it, however, it does seem to help arrest flashback symptoms quickly.
    • Grapefruit Durban (Sativa)- This is another delicious citrus strain- with even more of an ergentic lean than Kosher Tangie- this consistent Sativa is a reliable choice in any format. I find this to be an improvement over its parent strain, Jack Herer.
    • Bio Jesus (Indica)- Although this strain is at least one quarter Diesel in genetics- it is the only Diesel I can tolerate well. When used sparingly, it decreases Depression and Anxiety immensely. However, I also found there is a limit: too much and it may increase anxiety. There have been times where this has been one of the only choices on the local menu at the height of the shortage. It’s fine. However, it is far better for pain relief.
    • GG4 (Indica)- This is Pennsylvania’s own version of Original Glue. Known for it’s profound ability to couchlock even the most experienced cannabis patient, it is now considered a standard strain- easily available in multiple forms at most dispensaries. This strain also has some heavy Diesel genetics (Chocolate Diesel as a parent)- so if you are sensitive to this sort of thing, use caution.
    • The Wife- (CBD) This is by far my favorite CBD strain. I mix this with any of the stronger strains above to cut down on any anxiety-inducing reactions. Sadly, I have not seen this strain in months and have not found another CBD strain I like so well.
  • Listening to random playlists of music artists you  have never explored prior also helped a great deal since there is no preexisting negative associations with music you hear for the very first time.  As you pull yourself through your flashback episodes, the memory of both the trauma as well as your experiences while in a state of hyper negative psychological arousal may be mostly forgotten after the episode has passed.
  • Self care is paramount, spending time exercising to divert your focus away from memories of the trauma, eating your favorite, healthy foods, and distracting yourself with good music and/or taking time to talk with your favorite people also may help considerably.
  • The dosages of each medication were purposely omitted since each person has different physiology, tolerances, and medical history. If you suspect you may have PTSD, please see a healthcare professional for treatment.

The good news is PTSD is a qualifying condition protected by medical cannabis legislation in the great Commonwealth of Pennsylvania at this time.If you are currently in psychological crisis, please reach out to your healthcare team, caring friends and family, 1-800-SUICIDE or any of the links on this page.

One comment

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s