"The meds for sleep make me feel very unmotivated and then I get anxious because I can't seem to get out of bed and get things done. My meds for depression/motivation worsen insomnia - it's a vicious cycle. "
Cannabis is a very diverse plant that grows all over the world. The genetics of the plant as well as growing conditions and methods of utilizing it will cause different effects to be felt. Trust your nose, see what smells good. Try a number of different strains and see what works best for you. Hybrids are a good place to start.
There is no right strain or dosage unless we have more information. Have you been treated for depression/ anxiety before? If so, what medications have you tried or what therapies? (i.e. have you done talk/behavioral therapy?) Have you been hospitalized before?
Having worked with mental health patients through the pain field as well as knowing many loved ones suffering from mental illness, I think you are doing yourself a grave disservice if you don't at least get formally evaluated first and at least make a first try effort if prescription medication is strongly recommended; you can have a discussion w/ your psychiatrist about med can as a possibility but you have to be willing to listen to other ideas.
As for the side effects of psych meds and worries about them, I see plenty of patients through [HelloMD]](https://hellomd.com/ who are doing successfully integrating both psych meds &/or psych therapy with disciplined cannabis use. However, please please do NOT try to fix this on your own. I have seen disastrous results both as a professional treating patients and personally when people I knew and cared about attempted to use only cannabis to solve mental health issues.
I've had a good deal of this and I find heavy Indica strains are the most beneficial for inducing sleep. I'll often mix these with a CBD strain if I am feeling particularly stressed out, though CBDs can make falling asleep more difficult in some circumstances. In my experiences, when I have taken high CBD strains at bedtime it has kept me awake, while if I have used them earlier in the day, I find at bedtime I am more relaxed and fall asleep easier when I do use an appropriate Indica strain.
Personally, I would stay away from Harlequin for sleep. I would use it for anxiety relief, but for bedtime I would gravitate to an Indica strain, adding maybe a small amount of a CBD strong edible or vaporized cannabis if I am feeling particularly anxious.
Cannabis is a very safe plant and is useful for many conditions. It grows all over the world and many different varieties are available. I would start with a hybrid strain in small doses. You may also try a sublingual tincture with CBD and THC. Experiment with different strains and modes of ingestion and decide what works best for you.
Charlotte's Web is a hemp-based CBD oil
CBD oil does very well for all of these things and has helped me personally. A good Indica strain to smoke or even an edible at night should help with sleeping.
Insomnia can sometimes be a hard nut to crack and not all products react the same with everyone's system. For some, cannabis works beautifully and for others, it does not and yet others it takes a lot of trial and error.
It also depends on what you are able to tolerate. I can not tolerate high amounts of THC as it will put me to sleep but then wake me up. For some, CBD can actually make you relaxed yet stimulate the system. It really is an effort in trial and error for the right product and dosage.
I really like Kiva Terra Bites before bedtime. If I am sleeping they put me to sleep but if I am up then I feel happy and relaxed. I have also tried Absolute Extracts Sleepytime which works well for me although sometimes I may feel groggy the next day. I am a THC lightweight though!
I am not a doctor, but I do run into insomnia and cannabis helps me to fall asleep. When I wake up in the middle of the night, I sometimes vaporize a small amount of cannabis oil in pen cartridge form and that helps me fall back asleep without feeling too groggy. Eating an edible late at night could make you feel drowsy and that's why I vaporize the cannabis since an edible will last much longer in your body.
I agree with the previous doctor who advised keeping in touch with a psychiatrist/mental health professional. Cannabis can help with the issues you describe but it's best when used as one tool, as opposed to the whole toolbox. In the same way there are different strains of cannabis for different issues, there are different medication classes and types of therapy. Sometimes people will have a lackluster initial experience with a mental health provider and then think none can help them, where it may be more of an issue of finding someone with a better personality mesh with you.
That being said, here are some things you can consider:
- Since insomnia seems to be your primary issue, it's possible that treating your insomnia adequately, even without using other treatments for anxiety/depression, will be enough to improve your mood.
- Indica strains tend to be more sedating, and therefore better for sleep. A sativa or hybrid may be too stimulating and may worsen anxiety. Strains with "purple" in the name tend to be good for sleep.
- Apart from the particular strain you use, you need to consider ONSET OF ACTION and DURATION OF ACTION. Ie, how long does it take the product to start working, and how long does it last? Smoking and vaping will start working the fastest (a few minutes) and will wear off the fastest (within a few hours). This is best if you have trouble falling asleep only, and are sensitive to morning sedation. Edibles will take the longest period of time to start working (an hour or more), and will last the longest (8+ hours), so you have to take these at least an hour before bed, if not more, and they will be in your system longer to help you stay asleep if you have frequent nighttime awakenings, but could still be in your system in the morning and cause morning sedation. If you smoke or vape and wake up in the middle of the night, you could smoke again and use this to get back to sleep, as long as you have at least 3 hours until you need to get up in the morning, and it should be out of your system.
- Is your sleep hygiene good? Do you keep your room cool and dark, avoid doing work in bed, turn off screens at least an hour before bed? Google "sleep hygiene" and make sure you are following these guidelines too.
- Are there other causes of your insomnia that you need to address? Stress, medical issues, other medications you use that could be contributing to the problem?
- Could you try Cognitive Behavioral Therapy for insomnia? This is a particular type of therapy that helps with insomnia, that is time-limited (you do a dozen sessions, and then you're done). If you're motivated, you can do it on your own. Google "CBT for insomnia."
- If you improve your sleep and you still have depression and anxiety, THEN you need to look into additional treatments besides marijuana, because marijuana does not address the underlying cause of these issues and is more of a short-term solution.
I actually find in the interviews that a lot of patients are using Sativa during the day and then in the evening they change to Indica but I always caution patients to never follow Sativa with Indica because it will just bounce up the THC level and they won't be able to sleep because of the party going on in their head. It is wise after having Sativa to use CBD because CBD will combine with the high THC from Sativa and it will form Indica in your body and you will sleep well.
An exception to this might be when your mind is afraid that you will forget to do something the next day so I also encourage you to have a tablet and pencil next to the bed so you can scribble the thoughts in your head and your mine can relax because you put the thoughts on paper.
You can always keep a high CBD sublingual, nonalcoholic tincture in your refrigerator and if you find there is a party going on in your head, typically you can shut down the party with a couple sprays of CBD. In addition please read Dr. Miller's suggestions.
Finding a cannabis preparation to help them sleep is at the top of the medical cannabis list for many patients. It is useful to remember that cannabis is rich in what are called “essential oils,” terpenoid compounds like orange oil and rose oil. These are what give the plants their characteristic fragrance. Essential oils have been known in folk medicine to have calming and sedative properties, and they are commonly found in teas and herbal remedies.
Some cannabis strains are rich in terpenes that particularly promote these sedative effects, and this may have much to do with how relaxing and sleep-promoting people find them. As other answers have noted, Indica varieties have traditionally been thought of as particularly helpful for sleep. Apart from the issue of terpenes, the CBD:THC balance is very important in avoiding the excitation associated with larger doses of THC taken without enough CBD.
Finding a cannabis variety with a rich terpene profile and relatively rich CBD content might be a useful way to look for a preparation to help sleep. But because so many hybrid varieties have been developed to accent various cannabis properties, and because people can be so different in the way they respond to particular cannabis strains, patience and a bit of cautious experimentation is often required to find what is reliably helpful.
I have many members that have insomnia due to anxiety. Most have results from taking a combination of CBD and THC. Both CBD and THC are helpful with anxiety. An Indica strain of THC is very helpful with insomnia. As long as you take a higher dose of CBD than THC, most people do not feel the "high" of the THC, but do get the medicinal effects. You do have to have patience to experiment to find what is right for you.
You may still need to do a bit of personal experimenting, to identify the dosage and ratio that works best for you. CBD for many people may not alleviate insomnia but instead, increase alertness.
The tincture/juice sounds like a good next step, because there may have been other ingredients in the candy and chocolate that interfered with the delivery of the CBD/THC.
For example, sugar reduces the effectiveness of THC. And, for some people, eating sugar -- or other stimulating foods/drink -- late in the day/night, can significantly interfere with the quality of their sleep. Similar to drinking alcohol before bedtime -- consuming sugar can also be quite disruptive to a good night's sleep.
When researching which juice/tincture or edible may be best for you, look for ones that are made with 'whole plant compounds', and of a cannabis variety that is indicated for relief from insomnia. As a general rule of thumb, Indica strains are known for their 'power down', calming, and sedative effects.
(On a related note: In our TGCC Indica edible we use whole plant compounds, and no cane sugar or other sweeteners that can spike blood sugar levels. We also add a small amount of kava kava, known for its relaxing properties. Many patients who have suffered from severe insomnia have reported that the TGCC Indica solved the problem for them.)