Anxiety disorders are among the most common mental illnesses in childhood and adolescence. Many young people suffer from excessive worry, social insecurity or sleep problems that can severely impair their everyday life and development.
Alongside growing awareness of mental health, interest in alternative therapeutic approaches is also increasing, including cannabidiol (CBD). But can CBD oil actually help children and adolescents with anxiety disorders? And is it safe?
This article summarises the current state of scientific research. It is for information only and does not replace medical advice or diagnosis.
What are anxiety disorders in children and adolescents?
Anxiety is a normal part of life, but when it becomes excessively strong or persistent, it is referred to as an anxiety disorder. The most common forms in young people include:
- Generalised anxiety disorder: constant worries about school, family or health
- Social anxiety disorder (social phobia): intense fear of judgement or rejection
- Post-traumatic stress disorder (PTSD): anxiety following traumatic experiences
Typical symptoms include social withdrawal, sleep problems, decline in performance or difficulty concentrating. If left untreated, such anxiety can impair emotional and social development in the long term.
What is CBD and how does it work in the body?
CBD (cannabidiol) is a plant-based active ingredient from the hemp plant. Unlike THC, it is not psychoactive, meaning it does not produce a “high”.
CBD acts via the endocannabinoid system (ECS), which regulates many processes in the body, including mood, stress, sleep and pain perception. It influences several receptors and signalling molecules:
- CB1 and CB2 receptors: regulate mood and neuronal activity
- Anandamide: CBD can increase its levels; anandamide is often called the “bliss molecule”
- 5-HT1A receptors: part of the serotonin system, important for mood regulation
- GABA and other receptors: involved in calming, inhibition of stimuli and anxiety control
These diverse mechanisms help explain why CBD often shows an anxiolytic (anxiety-reducing) effect in studies, without causing intoxication or dependency.
Scientific evidence: CBD for anxiety disorders in young people
Case report: PTSD in a 10-year-old girl
A widely cited case from the USA describes a 10-year-old girl with post-traumatic stress disorder (PTSD) who suffered from severe anxiety and sleep disturbances. After conventional medications were insufficiently effective, she received CBD oil (25 mg daily, sublingually).
Result: Sleep quality improved significantly, anxiety symptoms decreased and no significant side effects were reported. After five months, the improvement remained stable.
Open-label study: CBD for treatment-resistant anxiety
In an Australian study, 31 adolescents and young adults (12–25 years) with severe anxiety disorders were treated who had not responded adequately to behavioural therapy or antidepressants. They received CBD (up to 800 mg daily) in addition to their standard therapy.
After 12 weeks, the researchers observed:
- around 40–45% reduction in anxiety symptoms,
- improved mood and social functioning,
- mostly mild side effects such as fatigue or hot flushes.
No serious adverse events occurred and overall tolerability was rated as good.
Randomised trial: Social anxiety in teenagers
A controlled study from Japan investigated adolescents with social anxiety disorder. Over four weeks, they received either 300 mg CBD or a placebo.
Result: Anxiety scores decreased significantly more in the CBD group than in the placebo group. No serious side effects were observed.
This provides initial evidence that CBD can reduce anxiety symptoms even in adolescence.
What do experts say about the use of CBD in adolescents?
Professional societies emphasise that the findings so far are promising but not sufficient to make a general recommendation.
Because the adolescent brain is still developing, caution is warranted. Specialists advise using CBD only in medically supervised individual cases, for example when other therapies have not been successful and the burden of symptoms is high.
In addition, only medically tested CBD oil should be used for children to avoid contamination or incorrect dosing.
Safety and possible side effects
To date, studies show that CBD is generally well tolerated in children and adolescents. The most frequent, usually mild side effects include:
- Fatigue or drowsiness
- Loss of appetite
- Diarrhoea
- Rarely: elevated liver enzymes at high doses
Because children can be more sensitive, the dose should be adjusted individually and increased slowly, always under medical supervision.
Regulatory notes
In Germany, CBD is legal as long as it is derived from certified industrial hemp and contains less than 0.2% THC.
The only approved CBD medicine for children is Epidiolex, which is used for certain forms of epilepsy (Dravet and Lennox–Gastaut syndromes).
There is currently no official approval for anxiety disorders.
Parents should therefore always consult a physician before using CBD products for children or adolescents.
Conclusion: Use potential with caution
Initial scientific data suggest that CBD in children and adolescents with anxiety disorders could be helpful, particularly when conventional therapies fail.
The studies conducted so far show good tolerability and positive effects on anxiety and sleep. However, long-term data and clear dosing recommendations are lacking.
Therefore, CBD can be considered as an adjunctive approach, but only under medical supervision and never as a substitute for established therapies such as psychotherapy or evidence-based medication.
Those interested in CBD oil for children should choose only laboratory-tested, low-THC products and ensure that use is always supervised by a physician.
References
- Federal Ministry of Health (2024). Results of the CaPRis study: Increased risk of anxiety disorders due to cannabis use in adolescents. https://www.bundesgesundheitsministerium.de/fileadmin/Dateien/5_Publikationen/Drogen_und_Sucht/Berichte/Broschuere/BMG_CaPris_A5_Info_web.pdf
- Devinsky O, Cross JH, Laux L, et al. Trial of cannabidiol for drug-resistant seizures in the Dravet syndrome. N Engl J Med. 2017;376(21):2011–2020. https://doi.org/10.1056/NEJMoa1611618
- Shannon S, Opila-Lehman J. Effectiveness of cannabidiol oil for pediatric anxiety and insomnia as part of posttraumatic stress disorder: A case report. The Permanente Journal. 2016 Fall;20(4):16-005. https://doi.org/10.7812/TPP/16-005
- Berger M, et al. Cannabidiol for treatment-resistant anxiety disorders in young people: an open-label trial. Journal of Clinical Psychiatry. 2022 Aug 2;83(5):21m14254. https://doi.org/10.4088/JCP.21m14254
- Masataka N. Anxiolytic effects of repeated cannabidiol treatment in teenagers with social anxiety disorders. Frontiers in Psychology. 2019 Nov 7;10:2466. https://doi.org/10.3389/fpsyg.2019.02466
- Efron D, Taylor K. Medicinal Cannabis for Paediatric Developmental, Behavioural and Mental Health Disorders. Int J Environ Res Public Health. 2023 Apr 7;20(8):5430. https://doi.org/10.3390/ijerph20085430
- Iffland K, Grotenhermen F. (2017). An update on safety and side effects of cannabidiol: A review of clinical data and relevant animal studies. Cannabis and Cannabinoid Research, 2(1), 139–154. https://doi.org/10.1089/can.2016.0034
- World Health Organization (WHO). (2018). Cannabidiol (CBD) Pre-Review Report. https://cdn.who.int/media/docs/default-source/controlled-substances/cannabidiol-pre-review.pdf
