Marijuana for Bipolar: Treatment or Self-Medication?

Patient Expert

My fellow HealthCentral blogger MerelyMe has just posted a very timely article on marijuana for treating anxiety, which I strongly urge you to read. So - why don't we take a brief time-out from our series on sex and bipolar and have a quick look at marijuana use in bipolar?

First, let me say upfront: I'm all for legalizing the drug, but this is an entirely different issue than endorsing its use for treating mania or easing stress. Indeed, three years ago, in response to a reader question, I noted that "not even a drug company could come up with a med as stupid as pot."

This was a reference to the drug's "side effects" profile, namely: loss of rational control of the brain, paranoia, appetite stimulation (with obvious weight gain and metabolic risk), sleep inducement, and loss of reflexes. I didn't even mention risk of psychosis.

Then there is the issue of self-medication, which may turn a manageable bipolar condition into an unmanageable dual diagnosis condition. With characteristic diplomacy, I stated:

In my experience, people I have encountered saying they use pot to control their bipolar are lying, mainly to themselves. In fact, they are potheads in denial and I would have a lot more respect for them if they admitted it.

Why don't I tell them what I really think? Okay:

All that pot offers is what any street drug or alcohol offers. It very quickly lifts you out of your current state of mind into one that you perceive is better. If your life is that pathetic to start with, the answer is to work on improving your life, not escaping into drugs.

A number of readers took unambiguous exception to my comments. David, who credits marijuana for being able to function and hold a job, informed me that if he didn't use the drug to treat his bipolar he "would be sitting on the couch as a zombie."

BJ, who credits marijuana with helping him feel calm, reminded me that while people die every day on prescribed drugs, "there is not one recorded event of someone dying of smoking cannabis."

Says met1973:

Do you have any idea what its like living with bipolar and trying to have a normal life? It's hard as hell and the drugs didn't help but pot does.It is an instant fix, it doesn't take weeks. It doesn't make me suicidal or paranoid. Point in fact it helps, I can be as normal as is possible. When I smoke I don't have the anxiety or the extreme mood swings, the highs the lows ...

On the other hand, 1whocares noted:

In my experience it " felt " like it was calming the mania , but I think it was fuel for the fire. I could not get enough during a hypomania. I can from experience say that it is NOT helpful for this illness.

In California where I live, "medical marijuana" is legal, and there are legalization campaigns underway in other states. Clearly, there is merit to the proposition that marijuana can slow down the brain and "take off the edge," but are most of us wise enough to stop there?

That is the question ...

As always, you - patients and loved ones - are the real experts. Let's open this up to discussion. Comments below ...