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I am marijuana user. Suffering from anxiety and panic attack. What should I do?

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Practicing since : 2003
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I had a bit of a frightening experience about 2 days ago- I hadn't eaten in two days, and I had just woken up and smoked about two or three bongs of marijuana- I am a fairly heavy user, and had about an 1- 1 1/2 hours of a good high. Then I smoked another single bong. This is basically just background information, as shortly after that I had a major hypoglycemic attack with an accompanying panic attack that lasted about 40 minutes. The problem I am having is that I am suffering from a prolonged anxiety that has persisted since then. I don't have any history of anxiety or panic attacks. My main concern is that I have heard about people who had been regular users of pot, used marijuana once and had a panic attack which caused them to suffer permanent pronged anxiety afterwards. But I know that panic attacks can also take several days to recover from, and I can't tell whether I am anxious now because of some horrible neurological effect of the marijuana or just the mere fear that I have been messed up by the drug in some way. I have smoked a bit since without suffering further panic attacks, but with a slight increase in anxiety. I was hoping you could possibly confirm or debunk this notion of pot suddenly causing a persisting anxiety problem in people. I feel a little better today than I did yesterday, so I am hoping this is just a temporary thing. I also suffered from depersonalization/derealization problems, but these have also improved since yesterday.
Thanks for your help!
Posted Sun, 7 Oct 2012 in Anxiety and Stress
Answered by Dr. Jonas Sundarakumar 3 hours later
Hi and welcome to Healthcare Magic. Thanks for your question...

Cannabis (Marijuana) is indeed associated with a variety of psychiatric problems, including anxiety symptoms / panic attacks. This association could be due to one of the following three factors:
1) Effects of acute intoxication
2) Effects of withdrawal (after regular and heavy use for a prolonged period)
3) "Unmasking" of a dormant underlying anxiety disorder

Many users experience a variety of anxiety symptoms (panic attacks being one of them) due to the acute intoxicating effect. This is more likely if the quantity of use is high and during the first few times of use. These symptoms usually tend to subside as the drug gets eliminated from the body, however, some persons may experience prolonged symptoms lasting for a few days.

Now, to answer your specific question, cannabis / marijuana / pot is unlikely to suddenly cause a permanent or life-long anxiety due to it's direct effects. However, there may be a reason why some users may be suffering from prolonged anxiety symptoms after cannabis abuse. Like I had mentioned earlier, one reason could be an "unmasking" of an underlying, dormant anxiety / panic disorder, since frequent use of the drug can cause an instability in the brain's psychological functioning. The second reason may be that once someone experiences a frightening and traumatizing panic attack, generally they tend to develop a fear or become anxious of getting another attack. This is called "anticipatory anxiety".

So, my advise to you would be to reduce the usage of the drug (stop, if possible) and refrain from taking large quantity 'binges'. Your anxiety symptoms should most likely subside gradually, though you may have some anticipatory anxiety for a few days. In case you continue to have significant and prolonged anxiety symptoms, then please don't hesitate to get professional help.

Wish you all the best.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist
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