Anxiety and Sports Performance

AN INTRODUCTION TO ANXIETY AND

SPORTS PERFORMANCE

Anxiety is a feeling of uneasiness and worry, which is often a reaction

to stress.1 This will likely occur when an individual is anticipating a
new or stressful situation, for example, starting a new job, giving a
public speech, or when starting a competitive sport. Oftentimes, this
will lead to physiologic symptoms such as a fast heartbeat, sweating,
and shakiness.2 All of these symptoms can make it very difficult to
focus. Experiencing anxiety can leave many individuals feeling fearful
and nervous when encountering new situations. Although it is normal
to feel anxious when anticipating an event or facing a challenging
circumstance, there are times when stress can negatively impact an
individual’s performance – especially in sports. Fortunately, there are
many ways to manage anxiety and sports performance.
Aside from lifestyle changes at home, one of the more recent and
innovative methods to potentially reduce anxiety includes the use of
cannabidiol (CBD). Although there is not a conclusive study that has
determined that CBD can improve sports performance, there are
various studies that show that CBD can improve symptoms of anxiety.
Therefore, by reducing the symptoms of anxiety with CBD use,
individuals can indirectly improve their sports performance.

What is CBD?
CBD is one of the two major chemical components found within the
cannabis plant species.3 The other major chemical component is
called delta-9-tetrahydrocannabinol (THC), which is the chemical that
will produce euphoric effects.3 CBD is the component that has been
used for possible therapeutic benefits, and it has come a long way in
terms of popularity amongst users because it does not produce the
same euphoric effects of THC.3 There have been many studies
conducted to determine the range for therapeutic potential of CBD.
One of the many benefits includes improvement in symptoms of
anxiety. CBD use can be beneficial for many additional reasons
including the management of symptoms causing chronic pain.
Additionally, this is a product that can be found in various formulations
including creams, oils, and ointments, which makes the product easy
to use.

Anxiety and Sports Performance

Anxiety, in relation to sports performance, can be classified into three
categories: cognitive anxiety, somatic anxiety, and behavioral
anxiety.4,5 Cognitive anxiety pertains to negative expectations about
success, worries about performance, negative self-talk, images of
failure, and inability to concentrate.4,5 Somatic anxiety results in
nervousness, elevated blood pressure, increased heart rate, and
many more physiologic symptoms.4,5 Lastly, behavioral anxiety relates
to avoiding eye contact, covering face with hands, fidgeting and
defensive mannerisms.4,5
Anxiety is an issue that can negatively affect sports performance.
Many athletes may consider anxiety to be debilitating towards their
performance.4 As mentioned, any sports game or competition can
induce anxiety when an individual’s perceived ability does not stack up
against the expectation or demand. Sports psychologists suggest that
high levels of anxiety during competitions are detrimental. 4 They can
decrease performance levels and even lead to athletes dropping out
of competitions or their sport altogether.4 It is often natural to
experience stress and anxiety prior to intense training or prior to the
start of a sport.4 Nonetheless, when one experiences any of these
symptoms of anxiety, athletic performance can be negatively
impacted.
A study done in 2017 highlighted this cause and effect by
demonstrating how anxiety can lead to physical impairment. 4 For
example, sometimes anxiety can cause individuals to have
gastrointestinal symptoms such as an upset stomach.4 Anxiety can
also cause tremors which can be detrimental to performing many
sports, such as tennis and basketball, both of which require moving or
holding items.4 Additionally, these symptoms can cause rapid
breathing which can result in hyperventilation and increased
production of sweat.4 This can lead to experiencing shortness of
breath which can be debilitating in any high intensity sport which
requires running.4
Another study completed in 2016 assessed the relationship between
competitive trait anxiety and collegiate powerlifting performance. 6 The
study involved 36 collegiate powerlifters (26 males, 10 females). Prior
to competitions, the athletes were given a survey containing questions
about powerlifting performance history along with a 15-item Sport
Competition Anxiety Test (SCAT). The SCAT total score was
negatively correlated to the athletes’ percentage of best total achieved
in the competition.6 And with the individual lifts, the SCAT total score
was also negatively correlated to the percentage of personal best for
the bench press and the deadlift.6 These results show that increased
SCAT scores were associated with decreased powerlifting
performance. The study concluded that competitive trait anxiety
negatively impacted performance.6

Data on Anxiety and CBD Use

A recent retrospective case series published in 2019 looked at CBD
use in treating patients suffering from anxiety and sleep
deprivation.7 This study was conducted with a total sample of 72 adult
patients that suffered from anxiety and an inability to sleep. 7 Nearly all
individuals were given a CBD dose of 25 mg per day
in capsule form.7 However, depending on the severity of their
symptoms, some individuals had dose increases of up to 50 mg per
day or 75 mg per day.7 All individuals participating evaluated
themselves using a scale called the Hamilton Anxiety Rating
Scale.7 Follow up was done every month and participants were
required to complete assessments to determine if there were any
changes in their anxiety symptoms.7 This study determined that over a
3 month period, anxiety symptoms decreased fairly rapidly with the
use of CBD capsules.7 The overall average anxiety scores decreased
from 24 to 18 after one month of CBD use.7 By the third month, the
overall average anxiety scores reached 17.7 This demonstrated that
the individuals who used CBD displayed improvements in their anxiety
symptoms by the third month of CBD use. As such, organizers of the
study concluded that CBD may hold a benefit for anxiety-related
disorders.7
Another study completed in 2019 assessed the efficacy of CBD
treatment on patients with social anxiety disorder (SAD).8 The study,
which was done with 37 participants suffering from SAD, called for the
participants to receive either 300 mg of CBD daily for four weeks or a
placebo in place of the CBD for that same period of time. SAD
symptoms were, in turn, measured at the beginning and at the end of
the 4-week treatment period using the Fear of Negative Evaluation
(FNE) Questionnaire and the Liebowitz Social Anxiety Scale
(LSAS).8 The end results showed that CBD significantly decreased
anxiety measured by FNE and LSAS scores. The average FNE score
decreased from 24.4 to 19.1, and the LSAS score decreased from
74.2 to 62.1 after four weeks of CBD treatment.8 As with the case
above, this study concluded that CBD was effective in reducing
anxiety.8
Also worth noting here is a 2015 review of evidence from several
preclinical, human experimental, clinical and epidemiological
studies conducted to assess the potential for CBD as a treatment for
anxiety-related disorders.3 One of the studies in this review
determined that CBD use prevented increased anxiety amongst
participants exposed to chronic but unpredictable stress.3 This was an
important finding because the individuals in the study suffered from
anxiety produced as a result of undefined and irregular stressful
situations thereby demonstrating that CBD use could alleviate
symptoms causing short term anxiety.3 Additionally, there were two
studies that examined chronic anxiety symptoms as a result of
PTSD.3 These studies both concluded that use of CBD significantly
reduced the symptoms of PTSD.3 Overall, this review found that there
was strong evidence suggesting that the use of CBD can improve
symptoms of generalized anxiety disorders, social anxiety disorder
and posttraumatic stress disorder.

Can Improvement of the Symptoms

that cause Anxiety Lead to an
Improvement in Sports Performance?
There is evidence that symptoms causing anxiety can negatively
impact the way an individual performs in a sport. Therefore, finding
methods to manage these symptoms is essential in order to optimize
the way one performs as an athlete. Although there is limited data that
directly correlates CBD use with improvements in sports
performance, there is sufficient evidence regarding CBD and its
positive impact on symptoms causing anxiety. And because it has
been demonstrated that anxiety can hurt sporting performance, one
can surmise that CBD can have an indirect positive impact on the
performance of athletes who choose to consume CBD as part of their
program for managing anxiety and stress.
 References:
1. What Are Stress and Anxiety? Healthline.
https://www.healthline.com/health/stress-and-anxiety. Updated on
March 29, 2020. Accessed on October 22, 2020.
2. Everything You Need to Know About Anxiety. Healthline.
https://www.healthline.com/health/anxiety#:~:text=Anxiety%20is%20y
our%20body’s%20natural,to%20feel%20fearful%20and%20nervous.
Updated on September 3, 2020. Accessed on October 22, 2020.
3. Blessing EM, Steenkamp MM, Manzanares J, Marmar CR.
Cannabidiol as a Potential Treatment for Anxiety Disorders.
Neurotherapeutics. 2015;12(4):825-836. doi:10.1007/s13311-015-
0387-1
4. Muhammad K K, Alamgir K, Sami U K, Salahuddin K. Effects of
Anxiety on Athletic Performance. Res Inves Sports Med. 1(1).
RISM.000508: 2017. DOI: 10.31031/RISM.2017.01.000508
5. Patel, Dilip R et al. “Sport-related performance anxiety in young
female athletes.” Journal of pediatric and adolescent gynecology vol.
23,6 (2010): 325-35. doi:10.1016/j.jpag.2010.04.004
6. Judge, Lawrence W et al. “The Impact of Competitive Trait Anxiety on
Collegiate Powerlifting Performance.” Journal of strength and
conditioning research vol. 30,9 (2016): 2399-405.
doi:10.1519/JSC.0000000000001363
7. Shannon S, Lewis N, Lee H, Hughes S. Cannabidiol in Anxiety and
Sleep: A Large Case Series. Perm J. 2019;23:18-041.
doi:10.7812/TPP/18-041
8. Masataka, Nobuo. “Anxiolytic Effects of Repeated Cannabidiol
Treatment in Teenagers With Social Anxiety Disorders.” Frontiers in
psychology vol. 10 2466. 8 Nov. 2019, doi:10.3389/fpsyg.2019.02466

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