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What about medical marijuana as a treatment for bipolar disorder? Now that cannabis is legal in many states, many people want to try smoking as a primary treatment method. Realistically, even before cannabis was legalized and regulated, people touted its benefits as a treatment of all kinds of mental health issues from depression to psychosis. But is it true? Join us as Gabe shares his own experience with marijuana use and Dr. Nicole shares the latest research surrounding living well with bipolar disorder and cannabis. Gabe Howard is an award-winning writer and speaker who lives with bipolar disorder. To learn more about Gabe, or book him for your next event, please visit his website, gabehoward. She completed a residency in psychiatry at the University of Oklahoma in Tulsa. Since completing her residency training, Washington has spent most of her career caring for and being an advocate for those who are not typically consumers of mental health services, namely underserved communities, those with severe mental health conditions, and high performing professionals. Through her private practice, podcast, speaking, and writing, she seeks to provide education to decrease the stigma associated with psychiatric conditions. Find out more at DrNicolePsych. Thank you. Gabe: Welcome, everyone. My name is Gabe Howard and I live with bipolar disorder. My favorite one is wacky tobacky. I want to be honest. Nicole, wacky tobacky. And they ask me what I think about this. My bet is you get asked about this a lot. Nicole: I do get asked this question a lot. Can I quit my meds? Can I just use weed? Can I just use cannabis? Whatever word you want to use. So, this is actual THC marijuana. Many different strains, many different potencies, many different types. But moving away from that, we also have something in our society called cannabis oil, which you can buy at the gas station. And then even in those things we have non-THC cannabis and there just seems to be a lot of products, right? That are sold with cannabis in the title or marijuana in the title. Nicole: That is very, very true. You know, that marijuana plant has hundreds and hundreds of chemicals in it. The main ones that we worry about are the cannabidiol. CBD has like 0. Say that with a mouthful of stuff, right? Delta nine tetrahydrocannabinol. But one of the things that I want to be clear is when people talk about this, I appreciate the discussion. Gabe: Right? I want there to be robust discussions about ways to treat bipolar disorder. So, I am not anti the discussion. What I am anti is the, oh, yes. Yes, it does. What is your proof of that? Well, I just hate Big Pharma so much because all they want is your money. Poison ivy is natural. So, I think we know for sure. But for some reason when it comes to cannabis, people just are so adamant that, no, this is good for me. This is from the earth. I think it may have its place. Which surprises a lot of people. That is what being a good doctor, a good scientist, a good researcher, and frankly, an intelligent person means. As data becomes available, we shift our thinking. And that information is naturally going to change as we do the research. Now, unfortunately, the flip side to that is you can cherry pick any data you want. You know it so well, people will believe you. And that can be very dangerous. But the other thing with like studies that you brought up and I think this is important, there are good studies, there are strong studies, there are poorly constructed studies. But there were only 24 people in the study and they were all stable. These are people who were largely stable, so they felt more positive emotions. I do not want researchers rounding up a whole bunch of suicidal people and doing stuff to them. That sounds dangerous to me. But we do have to acknowledge that the purpose of psychiatric medications in many cases is to prevent suicide, to not allow people to get to that suicidal level. The next thing that we have to look at is where do we get the participants for the study? Did they respond to an ad? Did they drive themselves there every day? They may not even have a strong support system. They may not have health insurance and they may not have access to a standard pharmaceuticals. They got the check-in appointment, the therapy appointment. They got the phone calls to do the questionnaire. And people suddenly care about them. We know with bipolar disorder that support is a protective factor. And again, I want to state plainly this is a problem in all studies. Nicole: Yeah. But you can. Nicole: I believe that you could argue anything, Gabe. Those brains are different. The chemicals are different. So, heck, sometimes the structures are different. Arsenic is natural, poison ivy is natural. A nonprofit, as a as a public service? And that really scares me because the same reasons that you should not trust the pharmaceutical companies are the same reasons that you should not trust the marijuana industry. Because according to popular culture, anything that exists for profit is inherently evil. Marijuana exists for profit, so all of your concerns about the pharmaceutical companies should equally apply over to the medical marijuana industry. Nicole: Absolutely. I mean, you have to question everything. You should question the things that people tell you, especially if they sound too good to be true. I think that all industries have the potential to be good and bad. The medical marijuana industry. But the medical marijuana industry exists for profit as well. They have the same motive to feed you misinformation as the pharmaceutical companies. Gabe: I want to do a slight, slight twist and talk about the marijuana industry that well, all of us in our mid 40s remember. It was a hard no. Any marijuana that I use to manage the symptoms of bipolar disorder was done illegally. I cannot be more clear on that. Any young people listening? So, when I was when I was diagnosed at 26, any marijuana that I found, I found illegally. Gabe: I want to discuss regulation. I want to be as straight as I can. I used to smoke marijuana. I did not know that I had bipolar disorder and it did provide me the relief. The relief that it provided me was escapism. It was not making me better. It was not treating bipolar disorder. But when I was high, I forgot. I forgot about the pain. And I was buying from largely the same people time and time again. Well, this is all stems and seeds. This is all stems and seeds. No, this is the good stuff. This is the good stuff. Feel it. And but the thing is, is it was the same price every time. It was just different every time. I mean, could you imagine if every day you just picked a pharmaceutical pill and took it and it was different every day? No, no, no. Just pick any one. People are like, yes, yes, marijuana is a miracle and it works. Or guess now that 46, maybe 26 years ago. Gabe: What are you doing to me? Gabe: 20 years was right the first time. Twenty-six when I was diagnosed. Forty-six now. Nicole: Maybe, you know, 20, anywhere from 20 to 26 years ago. I mean, our parents, you know, and so we look back and we think like, wow, look at those people. They look so cool. Look at Snoop Dogg. He looks so cool. The potency of what is out today is exponentially higher than what was out 20 something years ago. Things evolve. Things change. I am so glad that you brought up Snoop Dogg. Snoop, Snoop Dogg is my jam. I remember when Snoop Dogg came out with Dr. Dre, and he was he was a badass and he was high. And he did that. He did that rock back and forth thing. And nothing scared him. And he was cool. And he had he had the guns and he was from the streets and just I remember his songs and his music like I was the generation that he was marketing to. Um, it turns out that Snoop Dogg is a liar. Have you seen Snoop Dogg lately? He goes to hockey games, he fusses over his kids. He hangs out with Martha Stewart on cooking shows. I kind of get the feeling that he does. If that man stopped smoking marijuana right now, it would be in his best interest for his career to just pretend that he did. But what I do fault is people who get their medical information from celebrities based on their persona. Nicole: So, I may have a little bit different take on that. And then you achieve a certain level of fame and when you know better, you do better. However, I think the important thing to not compare yourself to is a person who does not have bipolar disorder. I think that is where the comparison comes in. They look relaxed and chill. Has nothing to do with you. Gabe: Dr. But what I do know is that people are using how he behaved 20 years ago as justification for their behavior today. And marijuana has this whole romanticized mythos about it. It made her a better singer, it made for better plays, it made for better books. And anything bad that happens is just shoved down and forgotten about. We all think about Woodstock and all of the illegal drugs that were used at Woodstock, and for some reason we still remember Woodstock is this this this magical event. I have fond memories of it. Why do I have fond memories of a drug-fueled music festival that happened before I was born? And many of us have this this just really positive feeling about something that literally happened before we were born, I think that marijuana and other illegal drugs. Gabe: Marijuana just has all of this romance around it. But it really smacks of a conspiracy theory to me. Now, see, I think people with bipolar disorder, myself included, we want the quick fix. But it turns out that the solution has been there the whole time. I think that marijuana is the conspiracy theory for people with bipolar disorder. Bipolar disorder is really difficult to manage. It takes a long time. But you know what? Gabe: Marijuana will take all of this away from you if you just walk towards that direction. Does that make it harder for you to treat people with bipolar disorder when they believe that there is a magic cure that the government is preventing them from having? It adds to the conspiracy. And you say no with no explanation. Nicole: Trying to control me. If you go the step further and just say, hey, these are my concerns. This is why I think marijuana could be very bad for you. It might give you some benefit. Gabe: I cannot agree with you more, Dr. First off, I think that many people are just afraid to bring it up to their doctor at all. Because if you think about if you think about cannabis, you know, there are the different strains. People are all into their sativas or indicas or whatever they use or hybrids or whatever, whatever they choose. And the thing that people say about Indicas is that Indicas will have you in the couch. So, you know, those are the much more relaxing strains. I need to know that. So yeah, it does make it difficult. You can only speak for yourself. But what is your opinion? Your professional opinion? Do most doctors share your point of view? I could see that we have a wide range of opinion in the medical world, in the psychiatrist world, when it comes to substances. Some people have a very deep harm reduction model approach to treatment, which is kind of where I live. I did training in a program where harm reduction was a big part of the training. Harm reduction is a big part of my practice model, which just means that, you know, I work on the harm reduction. Some people do random drug screens. Everybody is different. Is that, am I understanding correctly? Nicole: The only way I would see the police being called is if you were actually intoxicated during a visit and you were going to drive yourself home. And that would happen with alcohol. But so, yes, the biggest thing you have to worry about is will this person continue to see me and continue to treat me if they know that I use A, B or C? This is what you have to juxtapose it against. Do you want a doctor that only has an incomplete medical history and is making decisions without all of the knowledge? Because as Dr. To wrap that all up in a nice little bow? I do agree that disclosing that and losing your doctor is a distraction. Nicole: That is accurate. You owe it to yourself to have a conversation a little bit further with that doctor, take it further. Ask them specifically what is their problem with you doing A, B or C? There are some drugs, marijuana aside, there are some drugs that people use that they tell us about that we know can have very, very serious mental health effects. Like we know for sure. There is no question. You got to listen to their opinion. So, ask them, what is the problem? I live in a medical marijuana state. I pretty much assume that everybody I see has a medical marijuana card and so many of them do. If the card is available, get the stinkin card if you qualify for it. Gabe: As we near the end of the episode, I would be remiss. I really wanted to answer the question of, hey, does marijuana treat bipolar disorder? But the core question of if you live with bipolar disorder and you treat that illness with marijuana, will you do better or worse? Nicole: There is not enough information to support marijuana as a primary treatment of bipolar disorder. Ten years from now. So, a lot of us still fall in the no camp. Because we know about the psychoactive properties and we probably will. Most doctors you talk to will probably fall in the no camp. That is bipolar thinking. If there really was a magic bullet, we would use it. Doctors would use it, companies would use it. That said, I do like the idea of keeping an open mind. It really influences our thinking. And I really think honestly that the marijuana industry has really focused on that. Is something wrong in your life? The real answer surrounding marijuana are much more nuanced. Nicole: Uh-huh. Nicole, thank you so much for being here. I love hanging out with you. Nicole Washington. You can find me on all social media platforms DrNicolePsych to see whatever it is I have my hand in at the moment. Gabe: And listen, we need a favor from you. Tell your friends about this podcast. Post us on social media. Shoot an email, mention us in a support group. Hell, send a text message. Sharing the show is absolutely how we grow. We will see everybody next time on Inside Bipolar. Have feedback for the show? E-mail us at show psychcentral. Previous episodes can be found at psychcentral. Thank you for listening. Listen to the Inside Mental Health podcast to learn coping skills…. Can you live with bipolar disorder and be happy at the same time? This podcast episode asks a serious question. Listen Now. Always thinking the worst and generally being pessimistic may be a common by-product of bipolar disorder. Listen to this episode of Inside Mental…. Psych Central. Gabe Howard. Episode Transcript:. Nicole Washington, a board-certified psychiatrist. Read this next.

Inside Bipolar Podcast: Can Cannabis / Marijuana be a Treatment?

Buying ganja Gabes

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