Panic Attacks and Marijuana

Panic Attacks and Marijuana

Teen: Dear Dr. Expert,

Last year I was diagnosed with panic disorder. I have been going to a therapist for the past year and doing cognitive-behavioural therapy (CBT). I'm doing a lot better. A bunch of my friends are having a party next week and I know there is going to be pot there. I'm really anxious about smoking pot - I'm so worried that something bad is going to happen, like I will feel out of control and get dizzy, or totally freak out. What if I get panicky? (Yeah, I know this isn't dangerous but I don't exactly want to have a panic attack at a party!) I know that you aren't going to tell me that it is okay to smoke pot, but is there another reason I shouldn't?

Contemplating in Cornwall
Dr. Expert: Dear Contemplating in Cornwall,

Your gut feeling about not smoking pot is actually right. Marijuana has been found to make panic attacks worse. As you know, panic disorder is an intense fear or discomfort that comes out of nowhere and includes symptoms like racing or pounding heart, difficulty breathing, feelings of choking, etc. People with panic disorder become very focused on these bodily sensations and begin to think all sorts of terrible thoughts about what those sensations might mean (such as going crazy or dying).

It's great that you have been doing CBT. We know that interoceptive exposure (purposely bringing on certain physical sensations in order to get used to them) and cognitive challenging (examining catastrophic thoughts, such as you're going crazy) works wonders. However, when highly anxious people (who are already sensitive to their bodily sensations) smoke pot it amplifies everything. Pot can bring on intense bodily sensations, which will likely trigger panic in teens prone to anxiety problems. In addition, when people smoke pot their thinking can get a bit paranoid and they are more likely to catastrophically misinterpret their body sensations. All of this is to say - you might want to skip the pot.

For more help and ideas, check out the MindShift app.