Sports Performance Anxiety (SPA) is well known to have a detrimental effect on athletic performance (Craft et al. 2003). Reasons for this impairment from SPA relate to the significant effect on the overall physiological, psychological and behavioural performance of an athlete (Khan et al. 2017). For example, effects of SPA include increased muscular tension, frequency of urination and sweating, loss of appetite, decreased concentration, elevated worrying, social isolation, anger and aggression (Khan et al. 2017). Typically, behaviour therapies (e.g. cognitive behavioural therapy) are the preferred treatment for SPA, although a combination of pharmaceutical and psychological interventions may be utilised in some cases (Patel et al. 2010). 

In a recent review, CBD appears to have a promising role as an alternative therapy in the management of anxiety disorders owing to its actions on the endocannabinoid system (Skelley et al. 2020). Results from clinical trials on subjective anxiety suggest that CBD has anti-anxiety effects (300-600 mg) under “stress-inducing” conditions in both healthy participants and those with social anxiety disorder (McCartney et al. 2020). Further support for CBD reducing anxiety-related disorders has been demonstrated in a cohort of 72 adults with anxiety and sleep complaints. Anxiety scores decreased within the first month in 79% of patients and remained decreased during the study duration (Shannon et al. 2019).

Clinical evidence is now linking the actions of CBD with receptors for the neurotransmitters gamma-aminobutyric acid (GABA) and serotonin (5-HT) in the CNS (Blessing et al. 2015). In fact, CBD (300 mg) had comparable effects to the anti-anxiety serotonin analogue drug ipsapirone during a simulated public speaking test (Zuardi et al. 1993). Activation of GABA and 5-HT receptors promotes better sleep quality and a sense of calm which positively affects sports performance and the ability to cope with challenges in our daily lives. 

Overall, CBD appears to be a viable therapeutic approach for the management of anxiety disorders in a range of individuals including professional and amateur athletes. More studies are needed, however, to determine the appropriate dosing strategy for CBD in conjunction with behaviour therapies for those who are negatively impacted by SPA.

WRITTEN BY Dr. Nick Kimber

References

Blessing, E. M., Steenkamp, M. M., Manzanares, J., & Marmar, C. R. Cannabidiol as a Potential Treatment for Anxiety Disorders. Neurotherapeutics 12(4): 825–836 (2015).

Craft, L., Magyar, M., Becker, B. & Feltz, D. The relationship between the Competitive State Anxiety Inventory-2 and sport performance: A metaanalysis. Cr J Sport Exerc Psychol. 25(1): 44–65 (2003).

McCartney, D., Benson, M. J., Desbrow, B., Irwin, C., Suraev, A., & McGregor, I. S. Cannabidiol and Sports Performance: a Narrative Review of Relevant Evidence and Recommendations for Future Research. Sports medicine – open 6(1): 27 (2020).

Muhammad, K. K., Alamgir, K., Sami, U. K. & Salahuddin, K. Effects of Anxiety on Athletic Performance. Res Inves Sports Med. 1(1): (2017)

Patel, D. R., Omar, H. & Terry, M. Sport-related performance anxiety in young female athletes. J Pediatr Adolesc Gynecol. 23(6): 325-35 (2010).

Shannon, S., Lewis, N., Lee H. & Hughes, S. Cannabidiol in Anxiety and Sleep: A Large Case Series. Perm J 23: 18-041 (2019). 

Skelley, J. W., Deas, C. M., Curren, Z. & Ennis J. Use of cannabidiol in anxiety and anxiety-related disorders. J Am Pharm Assoc 60(1): 253-261 (2020).

Zuardi, A., Cosme, R., Graeff, F. & Guimaraes, F. Effects of ipsapirone and cannabidiol on human experimental anxiety. J Psychopharmacol. 7(1S): 82–8 (1993).