Cannabis has changed dramatically over the past several decades. Many people still think of marijuana the way it existed years ago, but today’s cannabis products often contain much higher concentrations of tetrahydrocannabinol (THC), the primary psychoactive component responsible for the “high.”
In my clinical practice, I have seen an increasing number of adolescents and adults whose anxiety, mood symptoms, or psychotic symptoms appear to worsen in the setting of frequent high-potency cannabis use. While cannabis does not affect everyone the same way, growing research suggests that high-THC products may carry greater mental health risks for some individuals, particularly adolescents and young adults.
At InnerMind Psychiatry & Wellness, discussions about cannabis use are a routine part of comprehensive psychiatric evaluations for adolescents and adults on Long Island and throughout New York.
Cannabis Today Is Not the Same as It Was Decades Ago
One of the biggest misconceptions about cannabis is that it hasn’t changed.
Decades ago, the average THC concentration in cannabis was much lower than what is commonly available today. Many modern cannabis products contain substantially higher THC concentrations, and concentrated products such as oils, waxes, shatter, and vape cartridges may contain THC levels that are considerably higher than traditional cannabis flower.
This increase in potency means that today’s cannabis products can have stronger psychoactive effects than products used in previous generations.
How THC Affects the Brain
THC interacts with the brain’s endocannabinoid system, which plays a role in regulating mood, memory, learning, appetite, sleep, reward, and emotional processing.
For some individuals, cannabis may produce temporary relaxation or euphoria. For others, particularly at higher doses or with high-potency products, THC may contribute to anxiety, panic, paranoia, impaired concentration, or perceptual changes.
The effects vary widely from person to person and depend on factors such as age, genetics, frequency of use, potency, method of use, and underlying mental health conditions.
Mental Health Conditions Associated With High-Potency Cannabis
Research suggests that frequent use of high-potency cannabis is associated with an increased risk of several psychiatric concerns in some individuals.
Anxiety
Although some people use cannabis to relieve anxiety, higher doses of THC may increase anxiety, panic attacks, racing thoughts, or feelings of paranoia in susceptible individuals.
Psychosis
Multiple studies have found an association between frequent use of high-potency cannabis and an increased risk of psychotic disorders, particularly among individuals with a personal or family history of psychosis or other vulnerabilities. Cannabis does not cause psychosis in everyone, but it may contribute to symptom onset or worsening in susceptible individuals.
Bipolar Disorder
Cannabis use has also been associated with worse outcomes in some people living with bipolar disorder, including an increased likelihood of manic symptoms, mood instability, and hospitalization.
Depression
The relationship between cannabis and depression is complex. Some individuals report temporary improvement in mood, while others experience worsening motivation, emotional regulation, or depressive symptoms over time.
Cognitive Function
Frequent cannabis use, particularly when initiated during adolescence, has been associated with difficulties involving attention, learning, memory, processing speed, and executive functioning. Some of these effects may improve after stopping cannabis, while others may persist, depending on the individual and pattern of use.
Why Adolescents and Young Adults May Be More Vulnerable
The brain continues developing well into the mid-twenties, particularly the prefrontal cortex, which is involved in planning, judgment, impulse control, and emotional regulation.
Because these brain regions are still developing, adolescents and young adults may be more vulnerable to the effects of frequent high-potency THC exposure. Research continues to explore how cannabis affects brain development, but current evidence suggests that earlier and heavier use is associated with greater risk.
Does Everyone Who Uses Cannabis Develop Mental Health Problems?
No.
Many people use cannabis without developing psychosis or another psychiatric disorder. However, risk is not the same for everyone.
Factors that may increase vulnerability include:
- A personal or family history of psychosis
- Bipolar disorder
- Frequent or daily cannabis use
- Use of high-potency THC products
- Younger age at first use
- Higher doses
- Other substance use
- Certain genetic and environmental factors
Understanding these risk factors can help patients make more informed decisions about cannabis use.
What Patients Should Know
If you use cannabis and notice worsening anxiety, panic attacks, paranoia, mood instability, hallucinations, or significant changes in thinking, it is important to discuss these symptoms with a healthcare provider.
Many people are surprised to learn that cannabis may contribute to symptoms they initially believed it was helping.
An open, nonjudgmental conversation about cannabis use allows your provider to better understand your symptoms and develop an appropriate treatment plan.
Frequently Asked Questions
Is today’s marijuana stronger than it used to be?
Yes. Modern cannabis products often contain much higher THC concentrations than products commonly available several decades ago, and concentrated products may contain substantially higher levels.
Can cannabis cause anxiety?
In some individuals, particularly with high doses or high-potency THC products, cannabis may increase anxiety, panic, or paranoia.
Can cannabis cause psychosis?
Cannabis does not cause psychosis in everyone. However, research suggests that frequent use of high-potency cannabis is associated with an increased risk of psychosis in susceptible individuals, especially those with certain risk factors.
Is cannabis safe for teenagers?
Because the brain continues developing into early adulthood, adolescents may be more vulnerable to the effects of frequent cannabis use than mature adults.
Should I stop using cannabis if I have bipolar disorder or psychosis?
Many psychiatric providers recommend discussing cannabis use carefully if you have bipolar disorder, psychosis, or a strong family history of these conditions, as cannabis may worsen symptoms or interfere with treatment for some individuals.
The Bottom Line
Cannabis is not the same product it was decades ago. Modern high-potency THC products may have stronger effects on the brain and have been associated with increased risks for anxiety, psychosis, mood instability, and cognitive difficulties in some individuals, particularly adolescents and young adults.
At InnerMind Psychiatry & Wellness, cannabis use is discussed in a supportive, nonjudgmental way as part of comprehensive psychiatric care. The goal is not to shame or criticize patients, but to provide accurate information so they can make informed decisions about their mental health and treatment.
