Bonus: Pot For Panic In A Pandemic April 20, 2020 Illustration by Iris Gottlieb Ann’s got anxiety. So On Something has come out of hibernation on 4/20, the most auspicious of drug-related holidays, to talk about self-medicating. During this pandemic, it’s okay to feel like your mental state is a bit more fragile than normal. Join Ann as she delves into the complicated feelings and the science of using weed to cope. And then, it’s your turn to tell us your story. Is there a substance — legal or not — that’s helping you manage your mental health right now? Maybe it’s marijuana, or maybe it’s micro-dosing something else. Leave us a voicemail at 720-420-6587 and tell us: What are you using? Why? How does it help you? You may hear your voice in a future episode of On Something. Transcript: Ann Marie Awad: From Colorado public radio and PRX. This is On Something. Heath: Swallow it. Swallow it. Swallow it. Ann Marie Awad: This is Heath. He’s 32 years old. He lives in Denver and he’s trying right now to negotiate with his dog, Rudy to get him to take his daily medication. Heath Irwin: My name is Heath Erwin. I am Ann’s partner and I, yeah, I am an Aquarius. I um, Ann Marie Awad: We live together here in Denver and he’s pretty much the only person that I’m going to see in the flesh up close for the unforeseeable near future of this pandemic. Ann Marie Awad: He’s my main man, my guy, my person. A few weeks ago Heath had just a regular old cold, but he also has severe asthma. So for weeks after he recovered, he just had this cough hanging around and in the past he’s used an inhaler for this. Sometimes if the cough gets really bad, he needs a second emergency medication. On the second date that we were stuck at home together, we started talking about refilling all of our prescriptions and I said he should refill both of those medications. He didn’t think they were both necessary. Heath Irwin: You were basically thinking of every little thing that could possibly go wrong if I didn’t fill the second medication. Ann Marie Awad: We started to have an argument over this, but it was less and less like one of our normal arguments. I started to get frantic and frustrated that he wasn’t concerned about all the worst case scenarios like I was. Heath Irwin: You were kind of panicked, um, over this. You didn’t want us to get into a situation where I would have to go to the ER because the hospitals were, were already starting to get overwhelmed. Ann Marie Awad: My mindset at the time was, Oh my God, we have to prepare for the absolute worst. Ann Marie Awad: Heath would start coughing all night. That was a sign that it was really bad and then we’d have to go to the ER for emergency asthma care. Something we’ve had to do before I might add, or even worse, he would get the virus or maybe he already had it and maybe now we both had it. I even started saying stuff to him like if you get sick, I can’t come with you and I might never see you again. All of this over an inhaler. Ann Marie Awad: At some point I started crying, but nonetheless, we continued to have this argument even while I was trying to get dressed and get ready to work from home that day and who was escalating it every step of the way? Me baby, I was full spiral. I was throwing factoids from the news at him while he was standing there just confused about how things had escalated so quickly. I was being really aggressively concerned at him. Heath Irwin: You were basically crying in a bathrobe and it was just a cascade of catastrophic events that might occur if I don’t get this medicine. Ann Marie Awad: It’s been a few weeks since that argument and it’s important to say that absolutely none of the things that I was worried about happened. Heath is over his cough. We never had to go to the ER. He never got his medication anyways, but that doesn’t matter. We’re fine. But that day, the day of the argument, I felt completely out of control. I had a panic attack. I hadn’t had one in years actually for a long time. I could count the whole two I had had in my lifetime. I have struggled with anxiety my whole adult life, but rarely did I ever get to that point. I was so shaken up. I ended up calling into work sick that day. Since the beginning of this pandemic, I have started to have more frequent panic attacks. My anxiety feels harder to manage than ever. My mind starts to enter that feedback loop. Bad things could happen and I need to do everything I can to counter those bad things, which as it turns out is impossible and so on and so on until eventually I’m just scrolling Twitter, dead-eye on the couch, I have to admit that lately weed has helped snap me out of it. Heath Irwin: I think cannabis tends to get you out of that brain short circuit, that loop of everything’s terrible. I can’t control anything. Cannabis kind of slingshots you out of that loop. Ann Marie Awad: Weed relaxes me. It reminds me to eat and rest. It helps me sleep. Anyone else out there having a hell of a time sleeping lately? Anyway, now seems like as good a time as any to talk about weed and anxiety. Ann Marie Awad: This is On Something. Stories about life after legalization. I’m Ann Marie Awad. We had not planned on making an episode right now. In fact, this whole COVID crisis throws a lot of things into question for us as I’m sure it does for pretty much everyone right now. But we’re here and we’re here to get personal. I hate talking about my mental health for the record and I most certainly never in my wildest dreams planned on making an episode of this show all about it. But then this pandemic happened and then the panic attacks started happening and I thought maybe I really need to talk about how I’m feeling and maybe a bunch of other people feel this way and need to talk about it too. Now while all of this is happening, the fact that pot is relaxing to many people is generally just part of its reputation, right? Maybe you have a friend who uses it to wind down at the end of the day. Maybe you heard it from a friend of a friend or now me. Sarah Peace: How do you describe your, your show again? Your podcast? What’s the language you use for the … Ann Marie Awad: Life after whatever the hell this is? No. Sarah Peace: Yeah, Ann Marie Awad: This is Sarah Peace. Yes. That’s her real name. She’s a therapist with a private practice in Seattle. A big part of Sarah’s approach is harm reduction. It’s a method of working with people to reduce harmful drug use rather than abstaining from all drug use altogether. If my actual therapist is out there listening, I swear it’s not what it sounds like. I’ll admit Sarah’s the first therapist I’ve ever interviewed and while it did bring me some peace, I figured her clients probably have some of the same concerns that I do and that’s why I called her. She’s in Seattle, a place that was an early coronavirus hotspot, which also happens to be a legal state. How was she counseling her patients on their weed use during this time? I offered up some of the questions that I have about my own use for starters. Ann Marie Awad: Like I wonder, Oh, am I self-medicating? And then I sit and I think about like what does self-medicating mean? Like is that a bad thing? I mean, I take like an anxiety medication every day. Am I not doing what I’m supposed to? Sarah Peace: If you take away the judgment of self-medication, it’s like this amazing thing. It’s like, Oh, you’re taking care of yourself the best way you know how. Awesome. Also, what harm is that causing you? Is that OK with you? Um, how are the folks around you doing? Are they doing well? How’s your relationships? Like kind of looking that way. It just, every choice has a gain and a loss. Ann Marie Awad: There are legitimate reasons to feel worried about becoming dependent on weed. But Sarah says it’s also important to consider that some of the feelings that we have around regular marijuana use are feelings that are worth unpacking. Sarah Peace: I don’t know about you, but I grew up with all of the stigma around cannabis, right? And now that it’s kind of more in the, in the daylight and it’s like, Oh, it’s medicine. Oh, it’s recreational. Great. Okay. But I think that like, that fear of is this okay? Like I think some of that comes from sort of the legal and, um, societal framework. Um, from before. Ann Marie Awad: Remember Washington is a legal state. Sarah’s got more than a few clients that discuss marijuana as a tool to manage anxiety. Sarah Peace: Anxiety is like, by the way, you have no control over everything, like feel free to be paralyzed and then sometimes what is helpful in healing is like, okay, I’m not paralyzed. I am here and I have choice right now over this thing. I am going to smoke a bowl right now and change my state of mind. Ann Marie Awad: To be crystal, crystal clear. Neither I nor On Something nor Colorado Public Radio are trying to advocate for weed use in any way here, but these fears, these questions, they come up anytime we discuss marijuana in relation to any medical condition on this show. I’ll get to more about the actual scientific answers a little later on, but I just want to reiterate that my own personal experience is not the same thing as a clinical trial or a conversation with your therapist or doctor. Sarah says it’s most certainly not for everyone. Sarah Peace: There are some folks who navigate addiction, which is I think just leaning too heavily on it, but mostly people get a lot of benefit from it, um, and want to use it sort of mindfully or respectfully. And so I encourage sort of that tracking and that, yeah, that mindfulness of like when are you taking it? How much are you taking? How does it impact you? How does it alleviate your symptoms of anxiety? You know, is there any sort of cost to it later. Ann Marie Awad: Costs like … Sarah Peace: When was the last time I went to sleep without cannabis? Okay. It’s been three years? Maybe I need to see if there’s something else I can be doing because my intake keeps going up. Ann Marie Awad: Basically you have to keep asking yourself, is this putting a bandaid on something I should be managing differently? Is this keeping me from doing things and showing up for things that are important in my life? Is this actually having negative effects on my mental health? It’s a lot of checking in with yourself and how you feel as opposed to using weed to escape how you feel. Sarah Peace: If you were my client, if we were working together, I would explore with you about that. You know, what makes you question yourself? What are the benefits? And also, are there things that you aren’t okay with, right? Is it okay with you that you’re, you’re, um, smoking weed and that it helps you? Um, do you have any sort of old ideas about that? Or are, is it that you actually are worried about yourself? And if so, like, you know, can you kind of move forward with using it in a way that doesn’t feel like, Oh my God, I hope I’m not doing wrong to myself. Ann Marie Awad: When I talked to Sarah recently, she had just transitioned her whole practice online. Remember she’s in Seattle where the virus hit early and hard. She was under a stay at home order before I was. Sarah Peace: I’m now seeing my first full week of online or video sessions or phone sessions and it’s, it’s been way better than I could have imagined. Ann Marie Awad: Do you feel like people are relieved to have that option? Sarah Peace: Yeah. It feels really good to be able to support others during this time of uncertainty. That’s the other thing. It’s like I don’t know much about anything, but I do know that this feels good. Ann Marie Awad: I don’t know much about anything, but I do know that this feels good. That has really stuck with me. It’s okay to not know everything, but it’s good to know what helps. After a quick break, we will delve into the science of weed’s complex relationship with anxiety. Ann Marie Awad: If you’ve reached this point in the episode and all this talk about coping mechanisms has you feeling like maybe we’re talking directly to you? Well, we are. On Something is a show for personal stories about life after legalization, which means if you are using a quasi legal or illegal substance of any kind to address your mental health needs right now, I want to hear from you. Call (720) 420-6587 and leave us a voicemail. We have that number for you in the show notes as well. Tell me what are you using, why and how does it help you? You may hear your voice in a future episode of On Something and don’t worry, we’re not going to use your name. Ann Marie Awad: Understandably some of you out there are eagerly awaiting the science and the science as usual does not have a straightforward answer for you. Before we get to the weed, we have to talk about the anxiety. Ann Marie Awad: I have what’s called generalized anxiety disorder. I like to tell people I’m anxious about everything generally, but that’s pretty much what it is. Persistent, unrealistic stress and worry about everyday problems. Although I would say a pandemic is not every day, but anyways. There’s many kinds of anxiety disorders, but this is what I am working with. Anxiety disorders are also super common. About one in five adults has one. It means that the fear center of the brain, the amygdala is hyperactive. Researchers believe that people with anxiety disorders might be low on a neurotransmitter called GABA. Without enough of it people like me have a hard time processing stress and panic. What does that look like on the outside? Well, I become productivity obsessed. I skip meals. I forget to drink enough water. The way I characterize it is that my brain just outpaces my body by about a million work life balance, school life balance — these have all been really difficult things for me to manage. Apparently it’s because I’m short on GABA. When GABA attaches to the right kind of receptor in your brain, it decreases activity in the nervous system. It produces a calming effect which leads me to the weed. The two ingredients in marijuana that we talk about the most, THC and CBD can both affect the level of GABA in the brain. A 2017 University of Washington study found that THC in some people relieves anxiety at low doses but at high doses it can cause anxiety in some people. CBD however was found to relieve anxiety no matter the dose. And as we’ve mentioned on the show before, CBD is shown to moderate the effects of THC. You can learn more about this by listening to our CBD episode. The research on this that is available is also really limited because once again, cannabis is still federally illegal, which you know tends to limit research. Ann Marie Awad: It feels like a boom time for anxiety. Misfortune and mental health struggles often go hand in hand, which is probably why it’s also a boom time for legal weed. Many states are seeing record sales despite the economic downturn of the last month. Maybe you’re like me and you are no stranger to this whole anxiety thing. Maybe every day still feels a little bit like, Oh man, can’t wait to see how the world’s going to hell today. And something like weed offers this small escape. Maybe the world’s not going to hell. Maybe things will be okay. I was more or less a daily user before all of this began and that hasn’t really changed. In fact, Heath and I are preparing to try to make our own edibles, you know, to cut out the smoking. What has changed is that I am not as hard on myself about it. I was never too keen on admitting to, or even talking about my marijuana use on this podcast. Not at first. What’s the point, right? Who listens to this thing to hear about me smoking weed? What is my family gonna think? What are my bosses going to think? Right? I’m just going to be this big Stony stoner and everyone’s eyes and no one’s going to take me seriously anymore and I realized that I’m doing the thing. I’m spiraling out of control over things that I don’t have control over in the first place. Ann Marie Awad: I feel very fortunate to be cooped up with you do. I’m not just saying that because we’re on tape. Heath Irwin: Thank you. Ann Marie Awad: I think you’ve, I think like your perverse ability to remain calm during all this has been kind of a blessing. Heath Irwin: Yeah. Ann Marie Awad: By now, Heath is very familiar with this cycle and he can back me up on this. Smoking weed is also not the only way that I am trying to cope with my anxiety right now. Ann Marie Awad: Why aren’t you starting a sourdough starter? Why aren’t you taking up a crisis craft? Ann Marie Awad: Maybe you are new to this whole anxiety experience. Welcome, welcome. Maybe weed’s not the thing for you. Maybe it’s meditation, maybe it’s running or maybe it’s something else. Now would be a great time to figure out what it is that calms you because we are all going to need it. Ann Marie Awad: Every day is feeling harder. Everybody’s making sourdough starter. Heath Irwin: That was actually a pretty good one. Ann Marie Awad: I had a better rhyme earlier, and I forgot it. Heath Irwin: That was one of your better ones. Ann Marie Awad: I thought of one earlier and I was, I wanted to tell you about it but I was on a call. Ann Marie Awad: On Something is as always, but especially now, a labor of love reported and written by me Ann Marie Awad. This episode was produced by Mark Pagan. Our editor is Curtis Fox music by Brad Turner and Daniel Mescher. Additional music by Blue Dot Sessions. Our executive producers are Rachel Estabrook and Kevin Dale. On Something is made possible by lots of talented people like Francie Swidler, Kim Nguyen, Dave Burdick, Alison Borden, Matt Herz, Iris Gottlieb, Kendall Smith, and Jodi Girsch. This program is made possible in part by the Corporation for Public Broadcasting, a private corporation funded by the American people. This podcast is also made possible by Colorado Public Radio members. Learn about supporting Colorado Public Radio at cpr.org O, by the way, On Something will be back soon, I promise. Maybe not next week or the week after, but soon I swear.