Cannabis use linked to stronger emotional responses but also better recovery in people with anxiety

A large-scale study published in the Journal of Psychopathology and Clinical Science has found that cannabis users with anxiety show more pronounced emotional responses to negative experiences but also bounce back more effectively. These dual effects raise questions about the therapeutic role of cannabis in emotional regulation.

Anxiety disorders affect a significant portion of the population and are linked to a variety of physical health problems, including cardiovascular disease and increased mortality. Emotional reactivity—how intensely and for how long someone responds to a negative experience—tends to be elevated in people with anxiety, and this heightened reactivity may contribute to the persistence and impact of anxious symptoms.

As cannabis becomes more widely legalized and accessible, many people are turning to it to manage anxiety and negative mood. However, scientific understanding of how cannabis use affects emotional reactivity remains limited, particularly outside of controlled laboratory settings. Most existing studies have focused on single doses of synthetic compounds administered in labs rather than the kinds of products people actually use in their daily lives. In addition, few studies have examined the effects of cannabis on recovery—the process of returning to emotional baseline after a stressor.

With their new study, the researchers aimed to fill these gaps by assessing how both acute and extended use of cannabis products with different cannabinoid profiles—primarily THC, primarily CBD, or a 1:1 ratio—affect reactivity and recovery in a naturalistic context among people with mild anxiety symptoms.

“My colleagues and I are generally interested in cannabis use in relation to anxiety given this a prominent reason for use,” said study author Carillon J. Skrzynski, a research assistant professor at the University of Colorado Boulder. “Because reactions to and recovery from negative stimuli can play a role in the development and maintenance of anxiety, and they may be easier to target in the context of treatment, we wanted to know if cannabis use, and specifically different types of legal market products with varying cannabinoid ratios, might affect reactivity and recovery processes after immediate use and/or after several weeks of use.”

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The research team recruited 499 adults from the Denver-Boulder area, all of whom reported at least mild anxiety and had no recent history of psychosis or substance use disorder treatment. About two-thirds were female and most were white and well-educated. Participants were divided into four groups: THC-dominant users, CBD-dominant users, 1:1 THC:CBD users, and a non-use control group.

Those in the use groups were instructed to purchase their assigned cannabis product—either flower or edible—from a local dispensary and use it as desired over four weeks. Products were selected to ensure consistency in cannabinoid ratios, and all products were tested and labeled according to state regulations. Participants in the non-use group continued their normal behavior and did not consume cannabis.

All participants took part in three sessions: an initial baseline assessment, a mobile lab session after four weeks, and a second mobile lab session immediately after cannabis use (or a break for the non-use group). At each session, they completed a standardized procedure called the Negative Affect Induction Task, which included rating their mood, recalling a stressful memory to induce negative affect, and completing a breathing exercise to facilitate emotional recovery. Heart rate was recorded throughout, and negative affect was measured using a visual analog scale.

The study used mixed-effects models to analyze changes in emotional reactivity (from before to after the rumination task) and recovery (from after rumination to after the breathing exercise), focusing on both long-term (extended) and short-term (acute) effects of cannabis use.

The researchers found that, across the full sample, participants responded to the rumination task with more negative mood and increased heart rate, confirming the task effectively induced emotional stress. After the breathing exercise, mood improved, but heart rate remained elevated—suggesting that emotional recovery occurs faster than physiological recovery.

When it came to the impact of cannabis use, some patterns emerged. Participants who used any form of cannabis—regardless of cannabinoid ratio—tended to show greater reactivity to the stressor than those who did not use cannabis. At the same time, they also showed greater emotional recovery during the breathing task.

These effects were observed both across the entire four-week period and after acute use. However, the study did not find evidence that reactivity or recovery changed significantly over time in relation to cannabis use. That is, cannabis users did not become more or less reactive or resilient after four weeks of regular use, nor did the act of using cannabis acutely lead to immediate shifts in emotional processing relative to earlier sessions.

Heart rate data told a slightly different story. THC-dominant and THC+CBD users showed elevated heart rates after acute use compared to CBD users and non-users. CBD-only users did not differ from the control group in terms of heart rate, suggesting that THC may have more pronounced physiological effects than CBD. However, heart rate reactivity and recovery during the task did not appear to change significantly as a result of cannabis use.

“The main takeaway is that on average over time negative reactivity to and recovery from negative stimuli was greater for those who used cannabis (and specifically products with THC in the case of several weeks of use) versus those who did not based on self-reported mood,” Skrzynski told PsyPost. “In contrast, these processes did not change over time differently across groups. This may mean there are pre-existing differences in negative reactivity and recovery processes among individuals who chose to use cannabis versus those who do not.

“Additionally, compared to non-use, average heart rate increased after immediate use of THC products but not CBD product use, suggesting that regardless of negative stimuli, legal market CBD products may not produce immediate physiological effects while THC containing products may.”

The study’s results somewhat align with earlier research suggesting that THC can heighten negative emotional reactions, particularly at higher doses. Prior experimental studies have found that THC increases activity in emotion-related brain areas and can worsen anxiety in some individuals.

“Prior, related research would suggest that use of products high in THC would increase negative reactivity to negative stimuli as experimental studies have demonstrated that use of THC-dominant products can be anxiogenic (i.e., induce or increase anxiety) and can increase brain activation in emotion processing areas after exposure to negative cues like fearful faces,” Skrzynski explained.

“In line with this, reactivity was higher in the group of individuals who used THC-dominant products compared to non-use and THC+CBD use, but this was only on average across the baseline and a mobile van session four weeks later; our study did not find it to be the case that THC changed negative reactivity after either 4 weeks or immediate use. So to some extent, the findings both align and differ from what previous studies indicate.”

Because participants were not blinded to their cannabis product, expectations may have influenced their emotional responses. Cannabis use was also self-directed, with no control over dosage or frequency, introducing variability despite the benefit of studying use in real-world settings.

“One main limitation is that we were not able to control the frequency or quantity of cannabis that people used which limits our ability to make causal conclusions,” Skrzynski noted. “It’s also the case that people were not blinded to their product (i.e., they knew what kind of product they were using). With this in mind, it’s still an open question whether cannabis use does or does not impact negative reactivity and recovery processes as there may be other factors at play (e.g., expectancy or dosing effects).”

Despite these limitations, the study represents a meaningful step forward in understanding how cannabis affects emotional reactivity and recovery outside of laboratory conditions. It is the first to experimentally manipulate affect in conjunction with naturalistic cannabis use using legal market products, and it highlights the complex and potentially bidirectional effects cannabis may have on emotion regulation in people with anxiety.

“Long term, I aim to continue exploring cannabis and its relation to affect and related constructs,” Skrzynski said. “Indeed, I’m currently running a different project that further investigates how cannabis may affect reactions to negative stimuli. Specifically, participants are either assigned to put their hand in freezing cold water or room temperature water and reactions before and after this including heart rate, mood, pain, and perceptions of temperature are measured and assessed in relation to cannabis use. We are currently recruiting in the Boulder/Denver area (title: Perceptual Influences from Smoking Cannabis: an Experimental Study aka PISCES) if anyone is interested!”

The study, “Experimental study on cannabis use and affect: Effects on reactivity to and recovery from negative stimuli,” was authored by Carillon J. Skrzynski, Luiza Rosa, Austin Drake, Angela D Bryan, and L. Cinnamon Bidwell.