CBD Oil For Narcissism

Cluster B personality disorders often come with a slew of negative behaviors that can impact every day life and relationships. Cannabis may offer some help! Do you know the difference between being confident and being narcissistic? Do you know the signs and symptoms of Narcissistic Personality Disorder? Find out the what NPD looks like and if CBD oil will be able to help treat NPD in this article. In this report, we present a case of a 16,9-year-old patient with multiple substance use disorder (cannabis, MDMA, cocaine, ecstacy), severe depression, so

Those With Cluster B Personality Traits May Find Relief With Cannabis

Personality disorders are divided into three clusters called A, B, and C. The clusters account for ten different types of personality disorders, each with different symptoms. Cluster A disorders are categorized as odd and eccentric with disorders such as paranoid personality disorder, while cluster C disorders are categorized by fearful and anxious conditions such as obsessive-compulsive personality disorder. Cluster B, the focus of this piece, is characterized by dramatic, overly emotional, and/or unpredictable thinking or behavior. Can cannabis help individuals suffering from cluster B personality disorders? Let’s find out.

Personality Disorders Explained

Personality disorders are long-term patterns of behavior and internal experiences that can influence the individuals’ quality of life and functioning. Personality disorders affect the individuals’ manner of thinking about themselves and others, responding using their emotions, relating to others as well as the control over their behavior.

What are Cluster B Personality Disorders and What Can Cannabis Do for Them?

The personality disorders in this cluster B include (1) antisocial personality disorder, (2) borderline personality disorder, (3) histrionic personality disorder, and (4) narcissistic personality disorder.

Antisocial Personality Disorder

Individuals who struggle with Antisocial Personality Disorder do not follow societal norms and they tend to be more deceitful and inconsiderate towards others. These individuals also show tendencies such as impulsive and reckless, which may even lead to violence. Some of these individuals even turn to the exploitation of others. They exhibit behaviors that include a disregard for others’ needs and feelings which includes persistently lying, using aliases, and even conning others. They have a total disregard for their own safety, as well as for the safety of others. What’s more, is that they seem to present no remorse for their behavior. Individuals suffering from this disorder are also at high risk of attempting suicide and following through with it.

Symptoms include causing distress to others, as well as being deceitful, dishonest, impulsive, aggressive, irritable, reckless, irresponsible, remorseless, and having suicidal tendencies.

Borderline Personality Disorder

Individuals who struggle with Borderline Personality Disorder often engage in impulsive and risky behavior with unstable and/or fragile self-injury. These individuals also have unstable and intense relationships due to up and down mood swings. Despite the nature of their relationships, they have an intense fear of being alone or abandoned. Furthermore, these individuals suffer from feelings of emptiness, frequent displays of anger as well as stress-related paranoia.

Symptoms include mood swings, inappropriate anger, suicidal tendencies, paranoid, rapid changes in self-image, patterns of unstable relationships, impulsive behavior, taking extreme measures to avoid rejection and abandonment.

Histrionic Personality Disorder

Histrionic Personality Disorder sufferers exhibit constant attention-seeking behaviors and are excessively emotional and dramatic. Some of these behaviors include being overtly sexually provocative and loudly expressing strong opinions even with little to no facts to back up these opinions. Contradictory to that, sufferers are easily influenced by others. These individuals also tend to have shallow but rapidly changing emotions. They are particularly concerned with their physical appearance and they tend to think that their relationships are more closely knit than they actually are.

Symptoms include attention-seeking behavior, unsupported strong opinions, shallow tendencies, and excessive concern for physical appearance.

Narcissistic Personality Disorder

Individuals suffering from Narcissistic Personality Disorder typically hold a strong belief that they are more special and important than others. They often suffer from delusions of grandeur and exhibit tendencies toward fantasizing about having power over others, success and being the subject of envy. These individuals lack empathy, often exaggerate their achievements or/and talents, and expect to be consistently praised and admired for the smallest efforts. They may often take advantage of others to get what they want, refuse to be held accountable for their actions at all costs, and expect unreasonable favors in return.

Symptoms include a distorted sense of self-importance, lack of empathy, a sense of entitlement, exaggeration, preoccupied with fantasies, superior and arrogant behavior, monopolizing conversations, and belittling people.

How Can Cannabis Help Cluster B Personality Disorders?

The endocannabinoid system in our bodies assists with the maintenance of homeostasis and balance, which includes playing a role in regulating metabolism, memory, pain, and more. As you consume cannabis, the cannabinoids from the plant bind to the endocannabinoid receptors located throughout our bodies. Cannabis may be able to help personality disorders by treating aggressive behaviors by elevating mood which combats anxiety and depression. It’s able to do this because of the CB1 receptors which are located in the central nervous system and in the brain. Cannabis also has more than 85 identified and distinctive cannabinoids, each of which brings along different effects and benefits.

A 2018 study by Nathan Kolla and Achal Mishra looked at the endocannabinoid system, aggression, and personality disorders. Their results reported that tetrahydrocannabinol (THC) was effective in reducing aggression but that there is still too much discrepancy in the results of cannabis specifically for personality disorders. In the same light, cannabis has been reported to alleviate some of the symptoms related to cluster B personality disorders directly from patients or/and from family members and friends of the patients.

The Mayo Clinic explained that personality is a combination of thoughts, emotions, and behaviors which is what makes each of us unique. Causes of personality disorders include (a) your genes that contain inherited traits such as your temperament as well as (b) the environment in which you grew up, trauma from physical, sexual, and emotional abuse, and relationships with family members. It is believed that the combination of genes and environmental influences leads to the development of personality disorders. According to the Mayo Clinic “Your genes may make you vulnerable to developing a personality disorder, and a life situation may trigger the actual development”.

To avoid any negative interactions, always check with a physician before attempting cannabis therapy. If you’re interested in legal access to medical cannabis or would just like to see if it’s right for you, contact Veriheal and we will guide you through every step of the way.

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Confidence or Narcissism?

Do you know someone who exudes confidence in a gregarious way? Are you one of these people? While confidence is something we should all strive toward, some people have an illness that causes them to overcompensate making them seem selfish, unreasonable, and unable to express empathy. So how do you know if it is being confident or having Narcissist Personality Disorder?

What Is Narcissist Personality Disorder?

Narcissist Personality Disorder (NPD) is a personality disorder that causes people to believe they are superior or special. Someone with NPD may focus on fantasies like how intelligent, beautiful, or successful they are. They are often known for their grandiosity, lack of empathy, and desire for affirmation and admiration. Friends and family might describe them as arrogant, self-centered, manipulative, and demanding. They may often try to only associate with other people that they think are special in some way. They do this because it helps to enhance their self-esteem which believe it or not, is quite fragile beneath the surface.

NPD can start in early adulthood, and for it to be classified as NPD, they have to exhibit symptoms in multiple situations such as at work or in relationships. They will likely seek attention and admiration excessively craving the knowledge of whether or not someone thinks highly of them. They have a very hard time with criticism because of their fragility. Criticism and defeat cal leave them feeling empty or humiliated.

Symptoms Of Narcissism

  • Exaggerating own importance
  • Preoccupied with fantasies of power, success, intelligence, or beauty
  • Believing they are special and can only be understood by special people
  • Requiring constant admiration and attention
  • Taking advantage of others to reach their own goals
  • Lacing empathy, disregarding feelings
  • Envious of others or believing that others are envious of them
  • Arrogant behavior and attitude

Causes of NPD

The majority of the patients who are diagnosed with NPD are male; the percentage is between 50 and 70%. It’s not uncommon for adolescents to show this kind of behavior, but that doesn’t mean that they will develop NPD later on in life. Scientists aren’t entirely sure how this disorder is developed, but they believe it could be genetic and environmental factors. Treatment of this disorder can be difficult, but luckily, scientists have discovered differences in their brain that could point to where this disorder comes from.

Scientists have discovered that the areas in the brain that control emotional empathy are smaller in the brains of people who have NPD. It’s not that these individuals don’t care to feel emotions for others, it is that they are unable. They also have found that the brain doesn’t react the way it is supposed to when someone with NPD thinks of themselves. Normally, your reward system will be stimulated when you have thoughts about yourself, making you feel good. People who have NPD lack this sensation which researchers believe is what drives them to seek out affirmation.

Treatment For NPD

Treatment for NPD isn’t easy by any means. Most of the people who have this personality disorder are very defensive and have such a thick veil of grandiosity they can’t see past it. This makes it difficult for them to acknowledge their problems so they can fix them. Therapy is often advised, both individual and group, because it can help them healthily relate to others.

Suggested Therapies For NPD

  • Mentalization-based therapy
  • Transference-focused psychotherapy
  • Schema-focused psychotherapy

Can CBD Oil Help With NPD?

There has yet to be a study that gives definitive evidence that CBD oil can help with NPD specifically. But CBD oil has shown to help with certain symptoms in other illnesses that can transfer over to this personality disorder.

While studying addiction and CBD oil, they found that CBD helps to regulate the reward system. They found that CBD oil helps to reduce cravings by preventing the reward system from being overactive while using a substance. Because CBD oil is a regulator, it is possible that it may work oppositely. By regulating the reward system, CBD oil may be able to help people with NPD get the sensation they have been looking for when thinking about themselves. However, there has yet to be a study to test this theory.

CBD oil has also shown in many studies to promote neurogenesis. This means that it helps your cells stay healthy and repair themselves. CBD even elevates a chemical called BDNF which acts as a brain fertilizer helping brain cells grow. If there is a lack in brain mass that leads to NPD, CBD oil may be able to help by repairing the damage that caused this. However, once again, there has yet to be a definitive study to confirm this theory.

Cannabidiol treatment in an adolescent with multiple substance abuse, social anxiety and depression

In this report, we present a case of a 16,9-year-old patient with multiple substance use disorder (cannabis, MDMA, cocaine, ecstacy), severe depression, social phobia and narcissistic personality disorder.

We administered Cannabidiol (CBD) capsules in different dosages (starting dosage 100 mg up to 600 mg over 8 weeks) after unsuccessful treatment with antidepressants.

CBD was a safe and well tolerated medication for this patient. Upon treatment with CBD and cessation of the antidepressant medication, the patient improved regarding depressive as well as anxiety symptoms including simple phobias and symptoms of paranoia and dissociation. Furthermore, the patient quit abusing illegal drugs including THC without showing withdrawal symptoms. This is the first report of CBD medication in a patient with multiple substance use disorder with a positive outcome.

Until today it is not clear if CBD holds promise as a therapeutic option in substance use disorder as RCTs are lacking, but in this single case the substance seems to work in various domains.


Wir präsentieren den Fall eines 16,9 Jahre alten Patienten, der aufgrund eines multiplen Substanzmissbrauches (Cannabis, MDMA, Kokain, Ecstacy), schwerer depressiver Symptomatik, einer Sozialphobie und einer narzisstischen Persönlichkeitsstörung behandelt wurde.

Wir verschrieben Cannabidiol (CBD) in Kapselform in unterschiedlichen Dosierungen (100 mg bis 600 mg pro Tag über 8 Wochen), nachdem die antidepressive Medikation keine Symptomreduktion brachte.

CBD wurde zu allen Zeiten gut vertragen. Auch nach Beendigung der antidepressiven Medikation profitierte der Patient bezüglich der depressiven Symptomatik, der Angstsymptomatik sowie paranoider und dissoziativer Symptomatik. Außerdem konsumierte der Patient während der Behandlung keine weiteren Substanzen wie THC oder andere illegalen Drogen, ohne dass es zum Auftreten von Entzugserscheinungen kam.

Es ist noch nicht erwiesen, ob CBD eine alternative Therapieoption bei Patienten mit multiplem Substanzabusus darstellt, da keine randomisiert-kontrollierten Studien publiziert sind. Bei unserer Fallstudie konnten wir eine Wirksamkeit in verschiedenen Bereichen der Psychopathologie beobachten.

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Cannabis sativa contains more than 100 phytocannabinoids; one of them, ∆9-tetrahydrocannabinol (THC), is considered responsible for the psychotropic effects, known as a “high” as well as for diverse side effects, for example anxiety and/or panic attacks, altered body image, auditory and/or visual illusions and pseudohallucinations.

One other major component, cannabidiol (CBD), attenuates the psychotomimetic and anxiogenic side effects of THC [1] and is, thus, thought to contain anxiolytic and antipsychotic properties.

First randomised controlled trials (RCTs) among psychiatric populations predominantly focused on patients with psychotic disorders [2,3,4], who mostly showed significant improvement, as well as on patients with ultra-high risk for schizophrenia [5], with less anxiety and paranoia in the CBD group.

In contrast, only little is known about the effect in patients with anxiety disorder [6,7,8,9,10]. Similarly, regarding substance use disorders, there are only few studies on patients with cannabis dependence indicating a larger reduction of withdrawal symptom severity when compared to placebo [11,12,13]. Data pertaining to multiple substance use disorder and psychiatric comorbidities are still lacking. The reader is referred to the literature for a recent review on CBD and psychiatric and mental disorders [14, 15].

In the hitherto published data, CBD was mostly well tolerated with side effects similar to placebo except for mild sedation [14].

In this report, we present a case of a patient with multiple substance use disorder, severe depression, social phobia and narcissistic personality disorder according to ICD-10 criteria. The diagnosis of personality disorder was based on clinical observation as well as the STIPO Interview [16] for diagnosing the structural level of personality organization, which indicated a borderline structure with predominantly narcissistic personality traits.

We administered CBD capsules in different dosages (starting dosage 100 mg and increasing up to 600 mg) after ineffective treatment with antidepressants (sertraline) for over 6 months.

The 16.9-year-old male patient sought help at a large, urban and public clinic in December 2018. He presented with the symptoms of paranoia, derealization, attention deficit, severe depression, social anxiety and social withdrawal as well as multiple substance abuse. At his first appointment, he was using THC on a daily basis and indicated to consume MDMA, cocaine and ecstasy once a week. He had a history of psychiatric treatment over the last 2 years and had been treated with sertraline 100 mg administered orally once daily for 6 months. No other medication was given to the patient.

After written informed consent was provided by the patient and his legal guardians, we started the administration of CBD with an initial dosage of 50 mg twice daily, in the morning and evening. Within 3 weeks, we increased the dosage gradually to 300 mg twice daily (TD 600 mg/day), evaluating adverse effects and clinical improvement. The patient was treated in a day clinic setting, where he received group therapies and individual psychotherapy as well as social cognition training, occupational therapy and physiotherapy. The patient’s parents had support via weekly meetings with the treating psychiatrist.

Cannabidiol was well tolerated at all times and the patient showed good adherence. By his request, he discontinued sertraline after 3 weeks of CBD treatment from one day to the other. Prior intake of sertraline was documented by drug monitoring. Plasma levels were 84.9 ng/mL (therapeutic range 10–150 ng/mL). Sertraline was initially chosen because of the predominant symptoms of social anxiety und depressive mood. Clinically, he showed no difference in mood and anxiety symptoms after abrupt cessation of the antidepressant medication.

There were no side effects regarding heart rate, blood pressure, and weight. Urine drug screenings performed once a week revealed no further usage of chemical drugs. Screenings were positive for THC as known for chronic THC abuse and turned mostly negative after 6 weeks of treatment. Routine blood analysis showed normal values for blood count, liver enzymes, electrolytes, kidney function and inflammatory enzymes. The patient reported no side effects.

Psychological assessments

We evaluated symptoms of depression, anxiety and early psychosis using a pre–post design. Consequently, the patient was assessed prior to CBD administration and after 8 weeks. Moreover, depressive symptoms were measured twice after 4 weeks and 8 weeks respectively. We used the Beck Depression Inventory II [17] and the German version of the Fear Survey Schedule for Children—Revised [18] to assess depression and anxiety symptoms. The short screening Checklist of the Early Recognition Inventory [19] was used as screening instrument for risk of psychosis. Additionally, the German version of the Wechsler Intelligence Scale for adults [20] was used for the measurement of cognitive functions at baseline level. Results are presented in Table 1.

Summary and conclusion

In this case, CBD was a safe and well-tolerated medication for a patient with multiple substance abuse, social phobia, depression and a comorbid personality disorder. Upon treatment with CBD and cessation of the antidepressant medication, the patient improved regarding depressive as well as anxiety symptoms including simple phobias and symptoms of paranoia and dissociation. Furthermore, the patient stopped abusing illegal drugs including THC without showing withdrawal symptoms. The absence of illegal drug intake was assessed via daily clinical evaluation and confirmed using urine tests showing continuously negative results for a broad range of substances.

To date, two RCT studies have been published regarding cannabis dependency and withdrawal using a combination of CBD and THC [11, 12]. Allsop et al. [11] used a dosage of max 86.4 mg of THC and 80 mg of CBD/day. They reported a reduction of the withdrawal symptoms in the treatment group including irritability, depression and craving. Similarly, Trigo et al. [12] used a combination of THC and CBD (up to a dosage of 108 mg THC/100 mg CBD) and their findings replicated the efficacy with regards to withdrawal symptoms, but not regarding craving [12]. In a follow-up study, the authors found no significant differences between the treatment vs. placebo group on withdrawal scores [13]. In comparison, one case of a young adult with cannabis addiction was treated with CBD oil only with good results in abstinence, anxiety and sleep [21].

In sum, however, empirical evidence regarding multiple substance abuse and psychiatric comorbidities is still lacking. Bhattacharayya et al. [5] showed that after administration of 600 mg/day of CBD in patients with ultra-high risk presented with significantly less paranoia and anxiety compared to the placebo-treated patients. Hence, we decided to use greater dosages of CBD only, reflecting on the data for individuals with ultra-high risk for psychosis, since our patient presented with these symptoms additionally to substance use disorder. The rapid improvement of paranoid symptoms and dissociative symptoms may also be due to cessation of cannabis usage while in treatment in the day clinic setting. Improvements in depressive and anxiety symptoms, especially social anxiety and withdrawal, were seen gradually while increasing the CBD dosage. Since the patient reported good tolerability and no adverse effects, we increased the dosage to 600 mg/day. Concerning antipsychotic properties of CBD, Leweke et al. [2] reported clinical improvement at similar CBD dosages (600–800 mg/day). This improvement was significantly associated with elevated anandamide serum levels, reflecting a possible mode of action [22]. Cannabidiol does not activate cannabinoid receptors, but moderately inhibits the degradation of the endocannabinoid anandamide. Further research should consider examining serum anandamide levels.

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To date, it is not clear whether CBD holds promise as pharmacotherapy for substance use disorder as RCTs are lacking and further investigation into CBD’s mechanism of action and its efficacy are warranted.


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Department of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18–20, 1090, Vienna, Austria

Clarissa Laczkovics MD & Oswald D. Kothgassner

Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Währinger Gürtel 18–20, 1090, Vienna, Austria

Anna Felnhofer & Claudia M. Klier

  1. Clarissa Laczkovics MD

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C. Laczkovics, O.D. Kothgassner, A. Felnhofer, and C.M. Klier declare that they have no competing interests.

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Laczkovics, C., Kothgassner, O.D., Felnhofer, A. et al. Cannabidiol treatment in an adolescent with multiple substance abuse, social anxiety and depression. Neuropsychiatr 35, 31–34 (2021). https://doi.org/10.1007/s40211-020-00334-0

Received : 05 November 2019

Accepted : 23 January 2020

Published : 12 February 2020

Issue Date : March 2021

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