How to Overcome Anxiety, Solved

Here's the uncomfortable truth about anxiety: most of what people reach for to fix it was chosen because it feels easy, not because it works. The supplement that went viral on TikTok, the CBD gummy, the glass of wine after a hard week... they range from doing nothing to actively making things worse. We ranked 17 of the most popular anti-anxiety interventions from the absolute worst to the number one most effective, according to the research. Along the way, we get into why alcohol is the anxiety cure that 2 billion people use that actually creates more anxiety in the long run. We talk about the UGC marketing conspiracy behind the magnesium craze. We break down the difference between harmonious and obsessive anxiety, why your brain is literally doing therapy on itself every night while you sleep (and what happens when you don't let it), and why exercise is essentially practice for being afraid. The pattern that emerges is painfully clear: everything that actually works is a lifestyle change, and everything that doesn't is a quick fix. The real question isn't which intervention is best. It's whether you're willing to be uncomfortable long enough for the right ones to work. Get your free episode guide: https://solvedpodcast.com/anxiety/ CHAPTERS Chapters 00:00:00 Welcome to Solved: Ranking 17 Anti-Anxiety Interventions 00:04:07 What Is Anxiety and Why Does It Exist? 00:07:26 The Causes of Anxiety: Genetics, Age, Trauma, and Existential Dread 00:17:34 The Bullshit Category: Why Alcohol Makes Anxiety Worse 00:26:37 Not Helping, Not Hurting: Magnesium, Journaling, and CBD 00:45:34 Digital Detoxes and Breathwork: Short-Term Relief, Not Long-Term Solutions 00:55:55 The Complicated Truth About Benzodiazepines 00:59:39 Probiotics, Yoga, and Adaptogens: The Maybe Depends Category 01:14:43 SSRIs: Effective But Probably Overprescribed 01:26:00 Psychedelics: Massive Effect Sizes But Still Early Days 01:40:01 The Top Five: Social Connection as Nervous System Regulation 01:41:58 Sleep Optimization: Your Brain Doing Therapy on Itself 01:48:20 Exercise: Training Your Body to Be Afraid and Act Anyway 01:54:09 Meditation: Changing Your Relationship to Anxious Thoughts 02:01:05 Therapy Wins: CBT's Durable Advantage and When to Stop 02:10:55 The Pattern That Emerges: Quick Fixes vs. Lifestyle Changes ⇨ Sign up for my newsletter, Your Next Breakthrough. It will help make you a less awful person: https://go.markmanson.net/cdi1xzha ⇨ Get clarity on what actually matters. Try Purpose, Mark's AI mentor app that learns your patterns, challenges your blind spots, and helps you take action. Get started at https://go.markmanson.net/217i5ys5 FOLLOW MARK Mark's IG: https://www.instagram.com/markmanson Solved IG: https://www.instagram.com/solvedpodcast/ Twitter: https://x.com/markmanson LinkedIn: https://www.linkedin.com/in/markmanson/ YouTube: https://www.youtube.com/@IAmMarkManson WEALTHFRONT DISCLOSURE: This experience may not be representative of other Wealthfront clients, and there is no guarantee of future performance or success. Experiences will vary. Mark Manson receives cash compensation from Wealthfront Brokerage for paid endorsement in his podcast, creating a conflict of interest. The Cash Account, which is not a deposit account, is offered by Wealthfront Brokerage LLC, member FINRA/SIPC. Wealthfront Brokerage is not a bank. The base APY is 3.30% on cash deposits as of January 30, 2026, is representative, subject to change, and requires no minimum. If eligible for the overall boosted rate of 4.05% offered in connection with this promo, your boosted rate is also subject to change if the base rate decreases during the 3 month promo period. Additional terms and conditions apply, which can be found on wealthfront.com/solved. Funds in the Cash Account are swept to program banks, where it earns the variable APY. Same-day withdrawal or instant payment transfers may be limited by destination institutions, daily transaction caps, and by participating entities such as Wells Fargo, the RTP® Network, and FedNow® Service. New Cash Account deposits are subject to a 2-4 day holding period before becoming available for transfer. Investment advisory services are provided by Wealthfront Advisers LLC, an SEC registered investment adviser. Securities investments: not bank deposits, bank-guaranteed or FDIC-insured, and may lose value.

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Mark Manson?

  Welcome to Solved, everybody. I'm your host, Mark Manson, and today we are ranking anti-anxiety interventions from the worst to the best, according to the current science. Have you ever tried to put out a kitchen fire with a glass of water and then stood there wondering why the kitchen is somehow more on fire than before? No, this has never happened, but apparently this has happened to Drew Bernie, so we're running with it, because that's kind of what most people are doing with their anxiety. Reaching for something that feels like relief, watching it work just well enough to keep reaching for it, and then ending up worse than where they started. Now, most of the interventions that people swear by, the supplements, the apps, the techniques, all of the stuff that we're going to get into in this episode, they are not chosen because they're the most effective, they're chosen because they feel easy and they feel quick.

• 0:45Mark Manson?

  And we're going to talk quite a bit about that, about the relationship between the quick fix and the actual long-term solution. We've picked 17 of the most common practices, supplements, and interventions that people use to combat their anxiety. Here they are in alphabetical order: adaptogens, alcohol, benzodiazepines, breath work, CBD, digital detoxes, journaling, physical exercise, magnesium, meditation, probiotics, psychedelics, therapy, sleep, socializing, SSRIs, and your favorite, yoga.

• 1:20Mark Manson?

  We're going to break down each of these 17 interventions into how well they work, how efficient they work, how long-lasting the benefits are, whether there are any benefits or not, and how strong the actual research behind them is. As always with these ranking episodes, there are surprises and there are interesting patterns that emerge. And as always here at Solved, we categorize everything into four categories: things that legitimately work, actually good things to do, the sort of depends category, the stuff that maybe works for some people, not for others, maybe works in some situations, but not in every situation. There's the not helping but not hurting category either, this is where you get a lot of your placebo effects, or just things that are, the effect is so miniscule that

• 2:05Mark Manson?

  like, you're not really doing anything, but you're not hurting anything either. And then finally, there's the bullshit category, which is the pseudoscience, the stuff that is potentially harming you, and the stuff that is counterproductive. We will start with the bullshit category, work our way up to the legitimate fixes, and end at the number one intervention for anxiety in the world, based on the current science. You might be surprised, you might not. There's definitely some interesting caveats either way. Anxiety seems ever-present these days, Drew. It seems like everyone and their dog has anxiety. I use that saying a lot, everyone and their dog, but like, in the case of anxiety.

• 2:42Speaker 01

  Literally.

• 2:43Mark Manson?

  I can't tell you how many friends I have, they're like, oh, my dog has anxiety, I have to go home. I'm like, when did this become a thing?

• 2:48Speaker 01

  And they're maybe even on meds too, their dogs. Yep.

• 2:52Mark Manson?

  Is this, is this how far we've come?

• 2:54Speaker 01

  This is, this is where we're at.

• 2:55Mark Manson?

  This is where we're at, alright. Everyone and their dog has anxiety, so we will inevitably get into many of the mechanisms and processes behind anxiety. We'll get into a lot of the cultural stigma and labeling around anxiety. We will get into how anxiety is perceived and treated today versus, say, generations past. And basically, by the end of the episode, listeners, you should have a deeper, more comprehensive, and more nuanced understanding of anxiety, how it works, and how to actually resolve it than you ever had before. For those of you who are new here, I am the three-time number one New York Times bestselling author, Mark Manson, and this is my co-host, lead researcher, producer, and all-around sick man, Drew Partey.

• 3:37Speaker 01

  In more ways than one.

• 3:38Mark Manson?

  Yes, yes. And this is the Solve Podcast, where we are the most over-researched and comprehensive personal growth and life advice podcast in the world. If you love the show, please like and subscribe, leave a comment, share with some friends, follow us at solve podcast.com.

• 3:55Speaker 01

  You ready?

• 3:56Mark Manson?

  I'm ready.

• 3:58Speaker 01

  Let's do it.

• 4:07Mark Manson?

  Before we dive into the rankings, Drew, I think we should lay a little bit of groundwork and talk about what is anxiety, what makes it unique? I do think it is a unique emotion in some ways. It is a little bit different than most other emotions that we experience. The American Psychological Association defines anxiety as, quote, "an emotion characterized by apprehension and somatic symptoms of tension in which an individual anticipates impending danger, catastrophe, or misfortune." What's interesting about anxiety, I think, is that it's, A, it's future-based, and because it's future-based, there's a certain amount of cognitive load. It's almost like an outshoot of our, our natural tendency to like, just want to predict what's gonna happen.

• 4:50Mark Manson?

  And so I think what makes it a little bit different than most other emotions is that it is... Very much influenced by our thoughts. A lot of emotions are almost more primary. You know, it's like we have the emotion and then our thoughts kind of justify that emotion after the fact. I think in a lot, to a certain extent, anxiety, because it is an outcrop of us trying to predict the future, it is somewhat cognitively induced.

• 5:17Speaker 01

  Okay.

• 5:17Mark Manson?

  And I think we'll see this kind of show up in the rankings when we go through them. That a lot of the stuff that doesn't really work is just trying to apply to the emotion. Whereas the things that tend to work a little bit better are a little bit more cognitively.

• 5:34Speaker 01

  Address those underlying thoughts.

• 5:35Mark Manson?

  Yeah.

• 5:36Speaker 01

  It's kind of like it's our ability to predict or our penchant for prediction.

• 5:40Mark Manson?

  Yes.

• 5:40Speaker 01

  What you're saying. Marrying that with our negativity bias almost too, right?

• 5:44Mark Manson?

  Yes.

• 5:45Speaker 01

  You could define anxiety almost like that. It's our, we have this like strong, just like desire to predict the future and try to figure out what's going to happen. But we're also very negatively biased towards bad things happening as well.

• 5:57Mark Manson?

  Yes.

• 5:57Speaker 01

  And that's anxiety.

• 5:58Mark Manson?

  Which is, if you think about it, evolutionarily adaptive, right? So it's like, let's say you and I are hunter gatherers and we're out on a hunt.

• 6:04Speaker 01

  Right.

• 6:05Mark Manson?

  This is how anxiety differs from fear. Fear is present based and it's very specific. Let's say we're on the savanna and all of a sudden a lion jumps out and is ready to attack us. You and I would both experience fear because it is, there is a present danger. It's immediately in front of us and is very specific. It's like, there's a lion and he's about to attack me. I'm afraid. Anxiety would be if you and I are on the savanna and we are thinking about what if there's a lion around here? Where should I look to try to spot the lion? That's anxiety. It's kind of this low level discomfort at potential futures that might happen. And obviously it's important to think about those potential futures because in many ways, like the more you worry about something,

• 6:50Mark Manson?

  the less likely it is to happen because the more you're going to prepare for it and prevent it from happening. It is adaptive to a certain extent. It's unrewarding in that like when anxiety is actually useful, you don't get to experience that usefulness. Right? Right. Because, because all you know is that like the bad thing didn't happen. So let's talk about causes. Like, why, why do people struggle so much with anxiety? And I think this is also going to be very useful for, once we get into the rankings. Researchers estimate that roughly 30 to 40% of anxiety is, is largely genetic. Some people just have far more sensitive sympathetic nervous systems than other people. They're more easily triggered, they're more sensitive to their surroundings, they're more predisposed to experiencing fear, anxious thoughts.

• 7:33Mark Manson?

  I think in personality research that you would just call this a highly neurotic person. Women are consistently more anxious than men across the board, all ages, all cultures, regardless of how much equality, gender equality, socioeconomic equality there is. Women are just always more anxious. Second thing that's really interesting is that young people are more anxious than old people. And that I find really interesting, especially given the future-based foundation of what anxiety is. In many ways, young people have a lot more to be anxious about than old people. And also, old people have lived through so many more failures, setbacks, challenges,

• 8:14Mark Manson?

  struggles, et cetera, et cetera, that they've probably developed scar tissue where they're like, "I'm gonna be fine. I don't need to worry about this." So when it comes to environmental factors, obviously, trauma gets talked about a lot. Trauma or other early childhood adverse experiences. They sensitize the amygdala and they often disrupt our prefrontal cortex from helping us emotionally regulate. I think this is maybe an important distinction. It's not that trauma causes anxiety, it makes us less equipped to inhibit anxiety. Right, yeah. Attunes you to it, yeah. People who experience a lot of trauma, they, they, they struggle to regulate their emotions in general, they struggle to think clearly, they get triggered more easily.

• 8:58Mark Manson?

  And so, again, kind of that cognitive intervention of actually thinking to yourself, "Is this threat reasonable? Is there really a lion that's gonna come eat me?" It prevents you from being able to do that in the moment. The other cause that I've added here, that I have not really seen talked about much in the psychological literature, is... What I would call more of an existential anxiety. And I've written at this point, pretty extensively about how I personally believe that much of the mental health crisis is kind of an offshoot of this existential crisis that people are having. This dates back to Kierkegaard in the 19th century. So Kierkegaard noticed that there was something about modern life that seemed to like amplify people's anxieties, that they seemed to consistently be anxious about nothing.

• 9:43Mark Manson?

  And that that seemed to be kind of a new thing. And throughout his life, it appeared to be getting worse. Kierkegaard attributed this to the, quote, dizziness of freedom. What he argued is that as modern life gives people more freedom, more optionality, more opportunities in their lives, they become paralyzed and afraid to make decisions. Each individual decision suddenly becomes much more difficult because it has far more long-term implications on their lives. And so paradoxically, that increase in freedom and optionality makes them feel more anxious for the future, even though objectively their lives are better than, say, previous generations. In my opinion, today, we're just living through that on steroids.

• 10:28Mark Manson?

  In many ways, I think what people experience as anxiety is kind of just this crippling fear of commitment, of making a decision, of owning a decision, of being accountable to their own decisions.

• 10:38Speaker 01

  Because you might make the wrong one.

• 10:39Mark Manson?

  Because you might make the wrong one and it'll fuck up your future forever. And so it's better to just like be really scared and stay at home and doom scroll for another six hours. Anything you want to add, Drew, before we get into it?

• 10:51Speaker 01

  Um, I have anxiety.

• 10:58Speaker 01

  Drew, what's been your history, I guess? I had panic attacks when I was younger.

• 11:02Mark Manson?

  Oh, wow.

• 11:03Speaker 01

  I'm in my mid twenties, I would say.

• 11:05Mark Manson?

  Okay.

• 11:06Speaker 01

  So it's definitely, this hits close to home. It runs my family, too.

• 11:09Mark Manson?

  Okay.

• 11:10Speaker 01

  Yeah.

• 11:11Mark Manson?

  Well, I know you have a lot of sleep problems, too.

• 11:12Speaker 01

  Sleep problems, well, that doesn't help, yeah.

• 11:14Mark Manson?

  That's attached to it.

• 11:15Speaker 01

  Yes.

• 11:16Mark Manson?

  Yeah. A lot of rumination at night.

• 11:18Speaker 01

  There's definitely a lot of that, yeah.

• 11:20Mark Manson?

  My anxiety is pretty limited to social anxiety. I had a lot of social anxiety when I was young, but interestingly, like outside of social anxiety, I experienced very little. And I think the social anxiety was just fucking trauma.

• 11:34Speaker 01

  Yeah, I think a lot of people can relate to that, though, too. It's probably the most common source of anxiety, social anxiety, for sure.

• 11:41Mark Manson?

  Absolutely. I guess that's the other interesting thing about a lot of this, too, is that like some of these interventions, I think are a little bit more targeted for certain types of anxiety than others. Like, there is, it might be worth defining that there's kind of a, there's a thing called GAD, which is generalized anxiety disorder. So like, if you go to a psychiatrist and you're just kind of anxious all the time, in every context, every situation, like you can be diagnosed with GAD. That's a relatively small percentage of the population. Most people just suffer with either an acute anxiety in one area of their life, whether it's social anxiety, or performance anxiety, or perfectionism, or insomnia, or whatever. Some people are just very anxious, neurotic people in general, but it's not like a debilitating disorder or whatnot.

• 12:26Speaker 01

  For sure.

• 12:27Mark Manson?

  I don't know, sometimes I think anxiety helps me. That's something that never gets talked about.

• 12:31Speaker 01

  Sure, yeah.

• 12:31Mark Manson?

  There's a certain level of like high functioning anxiety. Like, if you think of some of the most successful and productive people in the world, they're extremely anxious. You know, there's like, the anxiety is kind of a fuel that runs inside of them. So on the one hand, yes, like, it's not great mental health. You're not feeling good when you're super anxious and that drives you to perform really well, or work really hard, or... But on the other hand, it does potentially produce better outcomes. I don't know where I completely land on this. I think as somebody who personally feels, often feels anxious if I'm not doing something productive or useful, I kind of like having that anxiety there.

• 13:13Speaker 01

  I think this is a common fear a lot of people have. If I don't have my anxiety, then how, how am I gonna get anything done?

• 13:18Mark Manson?

  Right.

• 13:18Speaker 01

  How am I gonna pressure myself into doing the things that need to be done? And hanging on to that anxiety, I think, is a very common thing that people do. I definitely do it. I think it honestly got me through. A lot of university.

• 13:30Mark Manson?

  Yeah.

• 13:31Speaker 01

  For one, you know, I was just anxious about it. You know, you talk about, yes, social anxiety is a problem for you, but you don't have a lot of anxiety in a lot of areas, but you tend to hire people who like have that anxiety for you, kind of outsource some anxiety to people. So, I mean, I get it. It's a tricky one, and I think people are like, no, my anxiety actually helps me in some ways. And there's some truth to that, too.

• 13:50Mark Manson?

  This is a common fallacy, I think, in, in mental health and personal growth, which is that like, the optimal amount of a negative emotion is never zero.

• 13:59Speaker 01

  Okay.

• 13:59Mark Manson?

  You should always have some anxiety. Like anxiety exists for a reason. It's adaptive. Like we evolved it because it actually helps us. It helps us do things that are important for our survival and for, for our community and our, our relationships. The problem is when it's chronic and it's occurring in places that it's not helping.

• 14:17Speaker 01

  Misapplied, yeah.

• 14:18Mark Manson?

  Right. Is the fact that I'm constantly anxious at work, is that misapplied? Or is it actually like helping me like crush all my goals and be super successful? You know, it's.

• 14:27Speaker 01

  I, I, the thing I always come up against though, too, is there's people who are like, oh, man, just don't worry about that, you know, like things take care of themselves. No, it's us anxious people who takes care of things sometimes. You know what I mean? It's like, so, so like I get it when people are kind of like, no, actually you do need to worry about it, not, but a hundred percent on, on board with you there where when it's misapplied or just generalized to everything. Yeah.

• 14:48Mark Manson?

  Yeah.

• 14:48Speaker 01

  The optimal amount, you're right, is not zero, but it's also not, you know, a hundred percent.

• 14:54Mark Manson?

  The goal is not to get rid of all anxiety. It's to, I guess, manage or have anxiety in the areas of your life that it's advantageous. I think the other factor here is something I've written about in my books. I have a bit of a spicy take about this, which is that people are not more anxious because the world is scarier today. They're actually more anxious because it's much safer. And it's when your life doesn't actually have real problems to worry about, you start inventing problems to worry about. And the fact that we have access on our phones and the internet and everything to like everything going on in the world, people are convincing themselves that there are very real threats and real problems all the time, where it's like, if you actually objectively look at the average person's life in the developed world, like you are sitting in an air conditioned

• 15:38Mark Manson?

  room on a comfortable couch, watching screens that are broadcasting information that was created thousands of miles away, and you're doing all of this for like. Insanely low cost, like your, all of your food is provided for, your warmth is provided for, like, all of your basic needs are provided for, you're safe, you're secure, you live in a functional society, like, there's actually not a whole lot to be anxious about, from like, on an evolutionary historic scale, but because there's nothing to be anxious about, we invent things to be anxious about, because it feels meaningful, like, we need something to worry about, otherwise, we wouldn't know what to do with ourselves.

• 16:19Speaker 01

  Okay, so like, an anxious system is so fundamental to, like, the human species, you're saying that, it just goes, it's online at all times.

• 16:28Mark Manson?

  So there's a great quote in Subtle Art that I love, which is, it comes from Jose Marti, where he said, "If the mind does not have a problem to work on, it will quickly invent some." And I think, by and large, that's like, the issue of our age, right? You have a lot of people that life is comfortable but meaningless, and so, instead of, like, admitting how meaningless things are, we invent meaning by imagining threats and problems where there aren't any. It comes back to that misapplied anxiety, right? Like, it's like, anxiety is useful when it's applied on, in a realistic way, that's actually helping you, or it's producing some better outcome. If you don't have a place to apply

• 17:09Mark Manson?

  it, if you don't have a direction to point your anxiety, then your mind will just start inventing places to point it, and it will start finding reasons to worry, and because those reasons are not real, and they don't exist, or you have absolutely no control over them, you can't do anything about them, so they persist.

• 17:29Speaker 01

  Okay.

• 17:30Mark Manson?

  Anyway, let's get into the ranking.

• 17:33Speaker 01

  Okay.

• 17:39Mark Manson?

  All right, so, number 17 on our list, there's only one item in our bullshit category for this episode. There's only one thing that if you actively do it, it will make your anxiety worse, at least that we looked into.

• 17:51Speaker 01

  Right.

• 17:52Mark Manson?

  And this one will probably not surprise many people, which is alcohol. It's the anxiety cure that 2 billion people actively use around the world that is making their anxiety worse. The data on the amount of people that self-medicate with alcohol is like absolutely staggering. It is funny that it is conventional wisdom that alcohol helps take the edge off. I used to be one of these people that after a really hard week, I couldn't wait to go out and get a drink because it was just gonna help me relax and chill and forget about my problems and whatnot. And what's interesting is that, yes, alcohol solves anxiety in the short term, but it actually creates more in the long run.

• 18:30Speaker 01

  Yeah, I mean, about 1 in 4 people who have some sort of anxiety disorder, they confess at least to self-medicating with alcohol, right? And it's honestly probably much higher than that, just because it's so accessible. And you're right, they're such a quick fix.

• 18:45Mark Manson?

  Yeah.

• 18:45Speaker 01

  It is a quick fix. It works in the short run. The problem is, is the bounce back. There's an overcorrection towards the other way. If you're paying attention and you've done this before, you know this is what happens, right? I was talking about, you know, I've had panic attacks before. I had some anxiety around things. I noticed too, that after like a heavy night of drinking, the next 2 or 3 days, my anxiety was just off the wall.

• 19:06Mark Manson?

  Wow.

• 19:07Speaker 01

  Right? Just, it was terrible.

• 19:08Mark Manson?

  Yeah.

• 19:08Speaker 01

  It gets a little bit more complicated than that though as well because your motivation for drinking actually does matter here to some extent. If you're, if you are drinking because of your anxiety, that's usually, there's usually a hard bounce back from that. If it's social drinking, light drinking here and there, they, those effects, that bounce back seems to be attenuated, at least to some degree. Can't completely eliminate it, I don't think. But alcohol does, again, it does work in the short run.

• 19:36Mark Manson?

  Yeah.

• 19:36Speaker 01

  Okay? And it has like, it's probably the same mechanism as a lot of drugs that we'll eventually get to here. This, this bounce back effect is actually strongest in the people who are most likely to engage in alcohol for anxiety, right? Or use alcohol for their anxiety. So shy, anxious people who are like socially anxious, who use it, tend to have the biggest bounce back here.

• 20:00Mark Manson?

  Yeah.

• 20:01Speaker 01

  Okay? There's some evidence that has for a long time pointed out, you know, you've probably heard this for a long time. You know, having a glass of wine with dinner is good for you, or you know, one drink a day is good for you, whatever. Honestly, probably not the case. We're finding out more and more. What happens is a lot of times what they'll do in these studies is they'll compare those people who just have one drink here or there, or only drink socially compared to people who don't drink. Usually what happens is these people who don't drink have already quit drinking because of their

• 20:27Mark Manson?

  Health issues?

• 20:28Speaker 01

  Their health issues.

• 20:28Mark Manson?

  Yeah.

• 20:29Speaker 01

  And so they're, they're just naturally less healthy.

• 20:32Mark Manson?

  Right.

• 20:32Speaker 01

  In the United States, anyway, Arizona has like the highest respiratory illness rate.

• 20:37Mark Manson?

  Okay.

• 20:37Speaker 01

  Which is weird because everybody moves to Arizona because they have

• 20:41Mark Manson?

  The clear air and yeah, the desert air.

• 20:43Speaker 01

  All that, right? But it's because a lot of people with those diseases will move to Arizona, right?

• 20:46Mark Manson?

  Yeah.

• 20:46Speaker 01

  Same thing with like alcohol. People who quit alcohol usually it's because of health issues or problems around their alcohol use.

• 20:51Mark Manson?

  Yeah.

• 20:52Speaker 01

  But the thing is, is that bounce back. I know I would just have terrible hang anxiety. You know what I call it? The next day, just feel awful.

• 20:59Mark Manson?

  I started noticing this probably in my early 30s, that I would often feel like a, like an intense sense of like embarrassment or shame the next day. Which was like completely irrational. Like it's like, I didn't do anything

• 21:12Speaker 01

  Right.

• 21:12Mark Manson?

  embarrassing or shameful. I just feel like I had an awkward conversation. Like I just, I would start ruminating about all these like things that had happened the night before. And eventually I just realized, I'm like, oh, that's part of the alcohol. It's like fucking with my emotions. The interesting thing for me around this, I noticed this back when I was a dating coach. And it was interesting, one of the, one of the fascinating things was to see this confirmed in the research when prepping for this episode. Back early in my career, one of the first businesses I ever started was as, as a, as a local men's dating coach. And so what I would do is I would actually go with guys to parties and bars or whatever, and I would help them talk to girls. Probably the most common issue that guys had was anxiety.

• 21:55Mark Manson?

  And it was interesting because obviously most men, when they're anxious or nervous and they want to talk to a, an attractive woman and they don't have the nerve to do it, what do they do? They have a drink. And that drink like loosens them up, relaxes them, gives them a little bit of courage. I mean, we even call it liquid courage, right? In the business, we used to call this approach anxiety. And it was super common among men. And but what I noticed after I had been coaching for like a year or two, what I, what I started to notice was that the men who drank To get over their approach anxiety, never actually got over it. Like, they would, they would have a bunch of drinks and then they'd go meet a bunch of women at the bar. And then, three weeks later, they would hire me again and they'd have the exact same problem.

• 22:39Mark Manson?

  They had, they hadn't progressed at all, they hadn't learned how to talk to anybody, they hadn't overcome any of their insecurities or fears. Whereas the men who didn't drink and just pushed through it, those guys would get over it. And a month or two later, they're like, they're able to go chat with anybody they wanted. There's an idea of fear extinction, which is like this, it's kind of the, the active component of exposure therapy. Of like, actually confronting a fear, realizing that it's not going to kill you. And then like, teaching your brain, like, hey, don't be afraid of this next time. We're okay, we've got this. Interestingly, some substances interfere with that feedback loop. And they like, prevent the ability for the exposure effect to actually take place. I a hundred percent believe that alcohol is one of these.

• 23:22Mark Manson?

  Because I just, I noticed it myself, like, I didn't get over a lot of my social anxiety until I stopped drinking around other people. And similarly, a lot of my old clients, they wouldn't get over their social anxiety. And so, eventually, I would start, when I worked with guys, I would, if they had a lot of anxiety, I would make them not drink that night. And that in and of itself would freak them out, but.

• 23:44Speaker 01

  It's easy to see how this just becomes a crutch, right?

• 23:47Mark Manson?

  Yes.

• 23:47Speaker 01

  You, you're socially anxious, you have this negative stimulus going on, you reach for a drink, you drink, you're not as socially anxious. So you're good to go. That cycle just repeats itself. But then you're leaning on that all the time, rather than, like you're saying, developing these coping skills, like, actual mature coping skills for this, so yeah. Yeah, this is definitely the only one, though, that gets negative, negative ranking in our, our book here.

• 24:09Mark Manson?

  Yeah. So I was actually curious, and I ran the numbers on what would stopping drinking, where would that land on this list?

• 24:17Speaker 01

  Oh, like as an intervention, you're saying?

• 24:18Mark Manson?

  Right, yeah, exactly. So if you took like, heavy drinkers with anxiety and you got them to stop drinking, what's, what would the effect size be for those people on their anxiety? And then where would that land on our list? Do you want to guess where that would land?

• 24:30Speaker 01

  I don't know, middle of the pack, somewhere probably.

• 24:33Mark Manson?

  Number four.

• 24:33Speaker 01

  Really?

• 24:34Mark Manson?

  Number four. Which, again, as like,

• 24:38Mark Manson?

  Somebody who stopped drinking three years ago, one of the biggest and first benefits I noticed is just like a steady emotional state.

• 24:46Speaker 01

  That's true.

• 24:47Mark Manson?

  Super steady, nothing, like very few things faze me.

• 24:51Speaker 01

  And your ability to regulate emotions too, just in general.

• 24:54Mark Manson?

  Yeah, just like not getting upset over stupid stuff, not worrying about dumb stuff, like I definitely feel that.

• 25:00Speaker 01

  Yeah.

• 25:06Mark Manson?

  All right, number 16, magnesium. I'm a boomer. I don't, I don't really get, I don't really get on TikTok, but apparently this is a huge thing on TikTok.

• 25:16Speaker 01

  All the rage, yeah.

• 25:17Mark Manson?

  There's all of these videos promoting magnesium for anxiety and magnesium supplements and the different types of magnesium and all the different like biochemical mechanisms and all this shit. It's not a thing. Apparently it's just not a thing. It's like very, very, very modest effect.

• 25:34Speaker 01

  For most people, yeah. Now, here's the thing though, if you're deficient in magnesium, that might actually be an issue, but I mean, it's kind of hard to tell whether you're deficient in it or not. I mean, there are a lot of people who are deficient in magnesium.

• 25:47Mark Manson?

  Yeah.

• 25:48Speaker 01

  And so if that's why you're, you're anxious and taking some magnesium will get you back to the baseline. I don't think it's going to fix your anxiety.

• 25:54Mark Manson?

  Yeah.

• 25:54Speaker 01

  But there's a lot of other reasons you might be anxious as well. The problem with the magnesium story really though, it's a plausible mechanism. Don't get me wrong. Like if, again, if you're deficient in it or there's also two just neural mechanisms that use magnesium that where if, if there's not enough magnesium there, it could in theory produce more anxious states.

• 26:14Mark Manson?

  Sure.

• 26:15Speaker 01

  But the problem is, is that the evidence that we have for it is just all over the map in terms of like study quality. They're using different forms of magnesium. It really depends on the type of magnesium you're taking, whether it can actually cross the blood brain barrier or not. The evidence out there is very scant for this because of these methodological issues.

• 26:32Mark Manson?

  Okay.

• 26:32Speaker 01

  And so supplement companies have come out and they've said, oh yeah, that magnesium works because they point to one small poorly done study. We're going to see this, this happen quite a bit, but that's definitely happened with magnesium here.

• 26:42Mark Manson?

  You want to hear my conspiracy theory about magnesium?

• 26:44Speaker 01

  Yes, let's do it.

• 26:47Mark Manson?

  So the Israeli government.

• 26:50Mark Manson?

  I'm just joking. There's this new thing that's happening in social media marketing.

• 26:55Speaker 01

  Yeah.

• 26:55Mark Manson?

  Most people are probably not aware of this, but if anybody works in online marketing, you probably are. So there's this new thing called UGC marketing, which is, stands for user-generated content. And basically, the idea is there are now platforms and mechanisms where you can go, let's say, like, let's say I'm a magnesium supplement brand.

• 27:14Speaker 01

  Yeah.

• 27:15Mark Manson?

  I can go to one of these platforms and I can, what you do is you pay social media creators on a per-view basis. So basically, what you do is you go and you like, set a bounty. You're like, I'm willing to spend a hundred thousand dollars to get 10 million views on social media promoting my magnesium brand. But to qualify for the money, you have to post a video that gets at least, I don't know, 50,000 views or something. You post it on the platform and then there's like thousands of like TikTokers and people who post on Instagram and stuff like that. And then they just make content about it. And then if they get one that blows up and goes viral, they get paid.

• 27:55Speaker 01

  I see. So they're incentivizing trends, basically.

• 27:57Mark Manson?

  Exactly. And so, and the reason it works really well for brands and products is that you can kind of get this like fake feeling of grassroots.

• 28:06Speaker 01

  Yeah.

• 28:07Mark Manson?

  Right? So it's like people are, people are suddenly seeing magnesium pop up in like 20 different spots and like 20 different people. There's like that stay-at-home mom that they follow on TikTok is talking about it.

• 28:17Speaker 01

  There must have been some big study that just came out.

• 28:19Mark Manson?

  And then the fitness influencer they follow on Instagram is talking about it. And it's like, and so you synthetically generate a social trend, just by paying dozens and dozens and dozens of small creators. And I say this as someone who fucking has like three giant bottles of magnesium in his cupboard and takes them every night.

• 28:39Speaker 01

  Yeah.

• 28:39Mark Manson?

  Yes. Was told years ago that I should be taking magnesium. I'm probably deficient. It's going to help me sleep. It's going to calm me down.

• 28:47Speaker 01

  Well, again, if you are deficient, obviously magnesium is very, very important. It's a, it's very essential. Okay. I get it. For example, there's one study that a lot of people point to, this is back in 2021, where they found like a magnesium plus B6 or a magnesium intervention. They had these two groups, like one had magnesium plus B6, one had magnesium. Found that it calmed anxiety. The problem with that, though, was it was this post hoc study. Or this post, it was a different data set that they weren't even using for, to test whether magnesium helped with anxiety or not. They just looked at it after the fact. They didn't have a control group. So we don't know if it's just a placebo effect or not, but a lot of people point to it.

• 29:21Mark Manson?

  Yeah.

• 29:21Speaker 01

  And so if coupled that with your conspiracy theory, you know, where it's like this, kind of like, oh, this one study, which even the, the authors were like, be cautious about this because we don't have a control group. This was just a post hoc analysis. But this happens all the time. Media finds that, they run with it. Couple that with the UGC campaigns you're talking about. What looks like a science backed finding, which is actually just a marketing thing.

• 29:42Mark Manson?

  Yes.

• 29:42Speaker 01

  All behind it.

• 29:43Mark Manson?

  I would say this is actually the, the rule, not the exception in the supplement industry. Shout out to Saul Orwell. So the, I'm old friends with the founder of examine.com. And they analyze all the research on supplements and, and basically like really break down, like, does this actually work or does it not? And surprise, surprise, most of it does not. But I remember I was hanging out with Saul, like maybe five years ago. And he had literally spent his entire career investigating supplements, looking at the research, studying all the research. And I remember asking him, I was like, so in 10 seconds, tell me what is actually worth taking every day? And he was like, dude, it's super simple. Just take fish oil.

• 30:23Speaker 01

  Oh, really?

• 30:24Mark Manson?

  That was it. This was pre like creatine boom.

• 30:28Speaker 01

  Okay.

• 30:29Mark Manson?

  But yeah, I think he was just like, yeah, just take fish oil. Don't worry about anything else. And he was like, oh, and protein, if you like, you know, if you want to get stronger.

• 30:37Speaker 01

  Yeah.

• 30:37Mark Manson?

  That was it.

• 30:38Speaker 01

  Okay.

• 30:39Mark Manson?

  Number 15, I think this is the first surprise for people. This is the first one that people are going to be like, huh? Really? Journaling. Why is journaling this low?

• 30:52Speaker 01

  Well, okay, it's a little bit of a nuanced story here, right?

• 30:55Mark Manson?

  Yes.

• 30:56Speaker 01

  What do you mean by journaling, I guess, first? That's the first question you have to ask yourself.

• 31:00Mark Manson?

  Pulling out a piece of paper, writing out your thoughts.

• 31:02Speaker 01

  Okay.

• 31:02Mark Manson?

  You know, I mean, there's a lot, there's a number of different methods of journaling, right? So there's like gratitude journaling, and there's like goal setting, and there's a, you know, kind of more of a therapeutic journaling, like there's just brain dumping. And I think it's worth remembering that this is not an indictment on journaling's usefulness in general. In fact, on our episode last month, on the most effective self-improvement techniques, journaling scored pretty high.

• 31:27Speaker 01

  Yeah.

• 31:27Mark Manson?

  This is specifically for anxiety.

• 31:29Speaker 01

  Right.

• 31:30Mark Manson?

  As an intervention for anxiety, journaling is not super effective. And I guess to me, it intuitively makes sense, right? Because like, what do people with anxiety do? They think way too much.

• 31:42Speaker 01

  Yeah.

• 31:42Mark Manson?

  And what is journaling? It's thinking about your problem, a lot. So I could see how it could like, not necessarily make things better. But I'm curious what you found, like digging deep into the research.

• 31:54Speaker 01

  I think you're absolutely right. It's the thinking about it too much, the way you're thinking about it too much, actually too, I think matters quite a bit. So like, for instance, gratitude journaling, which we covered in the self-help techniques thing too, it can make you more grateful, sure, especially if you're not a grateful person, probably not going to do a whole lot for your anxiety, though.

• 32:11Mark Manson?

  Yeah.

• 32:12Speaker 01

  Free-form expression journaling, where it's just, just write about whatever. Again, not very directed, probably you just get to ruminating more, is what happens if you're with anxiety. Venting like more catharsis, we talked about that too, that doesn't really work either. Again, just kind of highlights whatever you're anxious about. That said, okay, there is a type of journaling that actually can work. The problem with it is usually that it's the least likely for anxious people to use.

• 32:39Mark Manson?

  Okay.

• 32:40Speaker 01

  And/or stick with.

• 32:41Mark Manson?

  Yep.

• 32:41Speaker 01

  Okay? Which is a form of kind of of exposure therapy, basically. So if you're writing about your anxious thoughts, you're writing about what you're worried about, you're writing about...

• 32:51Mark Manson?

  It's the negative visualization exercise that's, we talked about it on the Stoicism episode, because it's, I believe Seneca actually used to recommend this, is that imagine the worst-case scenario, map it all out in your head, and then imagine how you would handle it and deal with it.

• 33:07Speaker 01

  Right.

• 33:08Mark Manson?

  Like basically mentally rehearse all the things that could go wrong that you're worried about, because... The process of mentally rehearsing it will like give you the confidence to actually confront it. There's truth to that.

• 33:20Speaker 01

  There's, there's some evidence to suggest that this will work. If you do this for 30 minutes a day for three days in a row, there's some evidence that like, hey, this actually helps with your anxiety. You have to be consistent with it. Beyond that, though, probably, most people with anxiety give up after the first one.

• 33:34Mark Manson?

  Yeah.

• 33:34Speaker 01

  That's another problem that they have with it. Like even in a very simple online study that they did where it was internet based, over half the people just gave up on it. They just didn't even want to do it for more than a day, which 30 minutes a day for three days shouldn't be that bad.

• 33:48Mark Manson?

  It's not that much.

• 33:48Speaker 01

  It's bad enough where people with anxiety don't like to do it.

• 33:51Mark Manson?

  I don't have this study in front of me. I do remember early on in the research process coming across the study that one of the things they said is that like there is an effect size here, like journaling does, this method of journaling does help, but it's, you have to do it so consistently for such an extended period of time, for so many hours over so many weeks.

• 34:11Speaker 01

  Yes.

• 34:12Mark Manson?

  That it's just not super practical.

• 34:14Speaker 01

  Right. Yeah. And for most people with, with anxiety, again, they're just, they're, they're reticent to even go around that.

• 34:19Mark Manson?

  Yeah.

• 34:19Speaker 01

  Or to do that. So in the emotions episode, we talked about affective labeling. That can help with emotional regulation for sure. It's usually a short-term fix, though. It's usually, it has a short-term effect. And so any anxious feelings that you have around it where you label them, yes, that can help you in the moment, but like long-term, again, you have to have that structured kind of exposure to it. It's all the things you said. It's like that combination of everything where it's not just the exposure to it, not just thinking about it, but also like, how am I going to deal with it? So what that does is it kind of creates this narrative for you that can help you address the anxiety. That's more of a long-term thing and it's not, it's not gonna, it's not a quick fix, which is what most people are looking for when they go to sit down to journal as a quick fix.

• 35:01Mark Manson?

  Right. They want to feel better.

• 35:02Speaker 01

  Right then.

• 35:03Mark Manson?

  Within five minutes.

• 35:03Speaker 01

  And it's not, that's not gonna happen.

• 35:05Mark Manson?

  Yeah.

• 35:05Speaker 01

  Yeah.

• 35:05Mark Manson?

  Yeah. You have to like really put a lot of time and thought.

• 35:08Speaker 01

  For sure.

• 35:08Mark Manson?

  Into it. Yeah.

• 35:09Speaker 01

  Yeah.

• 35:09Mark Manson?

  I also could see a way that journaling could potentially backfire a little bit. And this is, this is not coming from the research. This is just coming, this, this is a Mark Manson harebrained theory. I do think there's something about. Labeling yourself as a certain way. If I'm always telling myself I have anxiety, at a certain point, that is going to get embedded as an identity, as something, as a way that I see myself. And the way human psychology works is that as soon as you see yourself a certain way, you will start looking for things that confirm it. And so I could see how like if you're constantly writing down or journaling or talking to friends and telling like just telling everybody how anxious you are all the time, you are subtly reinforcing that anxiety. You are, you are, will kind of prime your brain

• 35:54Mark Manson?

  to secretly look for reasons to confirm that anxiety. The act of being vulnerable, of like sharing your truth, could be undermining the actual process of getting rid of the anxiety. I think at a certain point, you have to like, this is gonna sound really obvious when you say it out loud, but it's quite profound that like part of the way of getting over anxiety is deciding you're not anxious anymore.

• 36:18Speaker 01

  Oh, that's it?

• 36:19Mark Manson?

  Yeah, no. All right, episode over.

• 36:22Speaker 01

  Yeah.

• 36:24Mark Manson?

  It's incredibly difficult and complicated to do it, but like that is part of the end state. Like, I do think there is a certain threshold where the impulse to heal yourself is creating the damage. And again, coming back to the point that the optimal amount of anxiety is not zero. If you don't have anything legitimate to be anxious about, your mind will start creating things to be anxious about. You know, there's that saying like, don't believe everything you think. Like, this is, this is a classic. I think anxiety is a great situation to be aware of that.

• 36:58Speaker 01

  Yeah, I think you're right. You can write about it, you can write around it without confronting it. And that's where the, you can stay in that

• 37:04Mark Manson?

  Yep.

• 37:04Speaker 01

  kind of hell for a long time.

• 37:07Mark Manson?

  Yeah, right.

• 37:07Speaker 01

  If you're not careful and you're not aware of it.

• 37:08Mark Manson?

  And what's worse is that you get the sense that you're doing something.

• 37:11Speaker 01

  Right, yeah.

• 37:12Mark Manson?

  And like this is, and we talked about this in the self-help techniques. Like, in many ways, the worst self-help techniques are the things that like, give you the sense that you're doing something without actually doing anything. And I think in this context, the context of anxiety, journaling can do the same thing. If you're constantly writing out all the things you're worried about, all you're really doing is just reaffirming that worry without necessarily solving it. Whereas I do think there are other things in life that are, journaling can be very beneficial for. All right, moving on. Number 14.

• 37:45Mark Manson?

  CBD. Sorry, California bros. Let me go outside and apologize to all the California dispensaries for this one. CBD oils, CBD products, CBD edibles. Not a whole lot there. Tell us about this one, Drew.

• 38:01Speaker 01

  CBD, so cannabidiol, okay. It's a product of the marijuana plant, right? But THC is what gets you high, CBD apparently is what just makes you calm and doesn't get you high. That's kind of the story we've been told, right?

• 38:14Mark Manson?

  Yeah.

• 38:14Speaker 01

  It's a $5 billion market, the CBD supplements market is. $5 billion. Okay, there was a meta-analysis in 2024, so a very recent meta-analysis. They looked at 1,550 studies of CBD, okay?

• 38:27Mark Manson?

  Okay.

• 38:28Speaker 01

  And so they're like, okay, we're gonna, the meta-analysis, again, you find all the studies about the studies, right?

• 38:33Mark Manson?

  Yeah.

• 38:33Speaker 01

  It's a study about the studies. Of those 1,550 research papers that they found, they could only include eight of them in their analysis because they said all the other ones just are so poor quality.

• 38:44Mark Manson?

  They just suck.

• 38:44Speaker 01

  They suck. We can't, like, improper controls, too small, bad methodologies. There was eight studies that were like, these fit the bill for our criteria, stringent criteria.

• 38:56Mark Manson?

  Which, by the way, listeners, eight studies is nothing.

• 38:58Speaker 01

  Is nothing.

• 38:59Mark Manson?

  That's nothing.

• 39:00Speaker 01

  It told 316 participants out of those eight studies, too.

• 39:03Mark Manson?

  Nothing.

• 39:03Speaker 01

  Very, very small sample size where we're going on here.

• 39:06Mark Manson?

  Okay.

• 39:06Speaker 01

  Again, all the others were so poorly done, they were just like, we're not even gonna include them in this, okay? They did find, now, in this study, they found a big positive effect size, okay? But the thing was, is that they're, like, what they call the confidence interval, right? Was so wide that they're like, it's either amazing or it barely does anything. We're confident of that. Like, that's the best we can do. That's what we can tell you. It's either awesome or nothing. Like, that's the best they can do.

• 39:33Mark Manson?

  It's kind of useless.

• 39:33Speaker 01

  Right, and so...

• 39:35Mark Manson?

  Useless information, yeah.

• 39:36Speaker 01

  With magnesium, too. It makes sense, like, the CB1 receptor, which is what the receptor in your neurons that CBD would attach to, it probably is a good target for anxiety. It just looks like the supplements, like, taking oral supplements for it doesn't really work. At least the evidence we have for it is just really not there, okay? And there's just kind of some weird findings they found, too, like, a couple of studies found that exactly 300 milligrams is what you need. Anything more, anything less? Doesn't do anything or makes you more anxious.

• 40:07Mark Manson?

  That doesn't make sense.

• 40:07Speaker 01

  Doesn't make a whole lot of sense to me either. And not only that, but like most of the commercially available CBD supplements out there are between like 10 and 50 milligrams anyway. So even if it was 300 milligrams, you'd have to take a whole bunch of them.

• 40:20Mark Manson?

  So you'd have to take six doses.

• 40:22Speaker 01

  Well, yeah, maybe, maybe, maybe, because, because then the other problem is quality of these supplements. They've, a 2022 study took 80 different CBD products that were commonly found on the market today and tested them. And only just over half of them have what they actually, the amount of CBD that said they had. So you don't even know how much you're getting, even if it does work as an oral supplement.

• 40:46Mark Manson?

  I'm surprised this is higher than magnesium.

• 40:48Speaker 01

  Yeah, honestly, this one, we probably could have switched with magnesium.

• 40:50Mark Manson?

  I mean, I think it got skewed by that one study that found strong results.

• 40:55Speaker 01

  Huge effect size, yeah, but again, that the certainty on it wasn't super high. So in some form, it could work if they come out with some method of delivery that actually, like, we can, we can point to it and say, yeah, that's what's going on.

• 41:07Mark Manson?

  Yeah.

• 41:08Speaker 01

  It might work, but what we have so far is it's kind of garbage. Just not a whole lot going on. I don't know how common this is anymore. I remember this being way more common, say, six to eight years ago, maybe a little more.

• 41:19Mark Manson?

  Yeah.

• 41:19Speaker 01

  I mean, I know there's still some people.

• 41:20Mark Manson?

  Yeah.

• 41:21Speaker 01

  You know, it's like CBD in your coffee or CBD in butter.

• 41:24Mark Manson?

  I feel like it blew up kind of late 2010s.

• 41:26Speaker 01

  Yeah.

• 41:26Mark Manson?

  I remember taking it. I remember I went to some event and one of the sponsors, it was a CBD product and they gave me a bunch of, a bunch of supplements. And I remember taking it, it was supposed to help with like injuries and pain management. Like it's one of those supplements supposedly does everything.

• 41:42Speaker 01

  When it came out, yeah.

• 41:43Mark Manson?

  Uh, but I remember taking it for like a week or two and I'm like, I don't think this does a fucking thing.

• 41:47Speaker 01

  Yeah.

• 41:48Mark Manson?

  I think I'm just pissing this out every day. Not, not surprised by this one. I gotta say, like, given everything I know and understand about the supplement industry and I, I took, I took one look at the, the research summary for this and I just kind of chuckle. I'm like, eight good studies out of 1,600? Okay. So yeah, I guess I don't think we need to dwell on this too much.

• 42:10Speaker 01

  Yeah.

• 42:10Mark Manson?

  Um, this, this is probably nothing. It's probably a placebo. But number 13, I think is going to shock a lot of people. The digital detox. The getting out in nature, getting rid of your phone, getting out in nature, going for a walk, going outside.

• 42:30Speaker 01

  I want this one to work.

• 42:33Mark Manson?

  Yeah, I'm not gonna

• 42:33Speaker 01

  And it kinda does. Well, we'll get to that.

• 42:35Mark Manson?

  Yeah, I'm not gonna lie. I was a little disappointed too. This is definitely one of those things where it's, we're probably getting out of probably nothing and we're getting into sort of maybe depends?

• 42:45Speaker 01

  Yeah.

• 42:45Mark Manson?

  Category. I think that the surprising thing here is that if you spend time on YouTube or listening to other podcasts, like this is the biggest and most important and life-changing thing. I mean, just among my friends and family members, the amount of people I know who are like going on retreats and going to the forest and like getting rid of their phones and turning their phones off for multiple days and like all this stuff and then swearing that it's like such a detox and a relief and it cleared their mind and everything. It's a very common meme at the moment.

• 43:17Speaker 01

  I think one of the issues might be those that replacing like your digital habits with going outside, it does actually make you less anxious in the moment. It's just not a long-term fix.

• 43:29Mark Manson?

  Yeah.

• 43:29Speaker 01

  What they found like you can decrease anxiety like in the short term.

• 43:33Mark Manson?

  Right.

• 43:33Speaker 01

  By just going outside and not looking at your phone or not looking at screens or, you know, not looking at the news, I think is a big one too. The thing is, is that the bounce back is usually really, really hard.

• 43:43Mark Manson?

  Hmm.

• 43:44Speaker 01

  Is that people go back like as soon as you're out, then you just go right back into it.

• 43:47Mark Manson?

  Right.

• 43:47Speaker 01

  You go right back into this like digital morass or like you're, especially if you're into, you know, news media and stuff like that. That's, I think, more of what's going on here than necessarily. I would be very surprised if you had two people, one who just didn't use their phone at all and was always in nature versus, I would be a little bit surprised if those people weren't, didn't have different anxiety profiles for sure. The problem is, is that bouncing back and forth between the two, that's gonna be an issue at some point.

• 44:17Mark Manson?

  Don't necessarily switch your lifestyle around this, but like, hey, if you're having a really rough Monday morning, like go for a walk in a park, that'll probably help a little bit.

• 44:24Speaker 01

  I mean, I think that's great. Yeah, sure.

• 44:26Mark Manson?

  Yeah.

• 44:27Speaker 01

  Do that. I mean, it will, it will help your anxiety in the, in the very short term. It's not gonna like cure, if you're having a panic attack, I'm not saying, oh, we just go for a walk. That's not gonna happen, right? It's not like a long-term fix. It's probably like added in as part of your routine, sure. I'd go outside, touch grass, absolutely, but it's like, it's not a fix for anxiety.

• 44:46Mark Manson?

  Yeah.

• 44:47Speaker 01

  Yeah.

• 44:47Mark Manson?

  Maybe this is kind of what This is actually doing what people think alcohol is doing, right? Take the edge off a little.

• 44:54Speaker 01

  Right.

• 44:54Mark Manson?

  Help you unwind after a busy day. Help you decompress after like maybe a stressful week.

• 44:59Speaker 01

  I could get on board with that, yeah.

• 45:00Mark Manson?

  Yeah, but it's not really, like you said, as soon as you go back to your life and the screens and everything, it like, everything comes back pretty much immediately. So it's not, there's no sustainability here.

• 45:19Mark Manson?

  I just finished apologizing to all the weed dispensaries here in West LA.

• 45:24Speaker 01

  Yes.

• 45:25Mark Manson?

  Telling them that the CBD, there's no evidence showing that it works. I'm gonna have to go back out and apologize to a lot of people because number 12 on our list is breathwork.

• 45:34Speaker 01

  Okay.

• 45:36Mark Manson?

  This one has a lot of caveats.

• 45:37Speaker 01

  Yeah, yeah, yeah.

• 45:37Mark Manson?

  The important caveat here is that breathwork is definitely one of those things that it works for some people in some contexts and also works depending on the particular technique you're doing. It does not work for everyone in all contexts and not all breathwork techniques work equally. That's the headline that people should take away from this section. There's a lot of nuance going on here. And as somebody who, by the way, has had friends and loved ones go to breathwork classes where the administer clearly had no fucking clue what they were doing, you can have very adverse effects. Like breathwork when done incorrectly or when done with the wrong person with the wrong technique, it can induce panic attacks.

• 46:21Mark Manson?

  So it is like actually counterproductive when done poorly. So that's all just like a PSA for people listening to this that, yes, breathwork can be super helpful and there are people, I know people who swear by it, it's been life-changing for them. I also know people that like fucking hate it, it was one of the worst experiences they ever had, so. Be aware.

• 46:42Speaker 01

  Yes, it can induce some panic attack. It's also, it can help a panic attack.

• 46:46Mark Manson?

  Yes.

• 46:47Speaker 01

  Done correctly.

• 46:47Mark Manson?

  Depending on how it's done.

• 46:49Speaker 01

  Yeah, very much depends. This was definitely like when I would have panic attacks. For whatever reason, I would get panic attacks when I was driving a lot, which was just.

• 46:56Mark Manson?

  That's not good.

• 46:57Speaker 01

  Awful.

• 46:57Mark Manson?

  Yeah.

• 46:58Speaker 01

  So I just had to, I pull over and I would do some cyclic breathing, which is actually what it kind of does help. Usually about a like a, a one to two ratio of in to out breath.

• 47:07Mark Manson?

  Right.

• 47:07Speaker 01

  So you, you inhale for a one count, exhale for a two count or, you know, a three count, a six count, whatever it is. A one to two ratio though.

• 47:14Mark Manson?

  Yeah.

• 47:15Speaker 01

  Uh, and that seems to help just as like a kind of general maintenance thing for anxiety doesn't really, like, small.

• 47:21Mark Manson?

  Yes.

• 47:21Speaker 01

  Small effect. It's not necessarily to that, that longer exhale is like the, the, the key ingredient here. You're bringing attention to your, uh, internal states a little bit more. Uh, and again, you're confronting them, uh, and not trying to, to, to avoid them or, or paper over them. And I think some types of breath work can help with that.

• 47:42Mark Manson?

  From what I've seen, the most effective technique is what you just described. Sometimes it's called box breathing.

• 47:47Speaker 01

  Box breathing, yeah.

• 47:48Mark Manson?

  There's different second configurations, right? So the, the one that I learned was four, seven, eight, right? So you breathe in for four seconds, you hold for seven, you breathe out for eight.

• 47:56Speaker 01

  Right. It's a one to two ratio again, four to eight.

• 47:58Mark Manson?

  Yep. And then you just repeat that. I've seen four, eight, eight. I've seen four, four, eight. The exact numbers don't really matter, but it's mostly the ratio and, and what it is, so I learned this. Uh, my wife, Fernanda, she has a lot of, she has panic attacks. And so what I learned actually, like one of them was so bad that we had to call the paramedics. And the EMT actually explained this to me. He said, it's actually very counterintuitive, but like, when, when you have a panic attack, you're, you're breathing so heavily and so quickly that you're actually, you're not allowing your body to like oxygenate sufficiently, which then creates a negative feedback loop because then you feel even more out of breath and that you need to breathe even quicker and sooner. And so you get into this like bad cycle and that you, you keep breathing harder and harder, but you feel like you're more and more out of breath.

• 48:43Mark Manson?

  In that moment, the last thing you want to do is breathe slower. Cause it's, you've, you literally feel like you're going to die if you breathe slower. By breathing slower, you allow your, your body to actually properly oxygenate, which then like calms your nervous system, which then like kind of reverses that, that feedback loop. The thing that I want to call out here is that there's a lot of different breath work classes, breath work techniques. Um, there's a very prominent person in our industry that. Does breathwork interventions at seminars. I've started seeing all sorts of like very big promises attached that simply by doing breathwork for 20 minutes, you can unearth childhood wounds and heal trauma and like, you know,

• 49:26Mark Manson?

  like let go of all of your bottled up emotions and all this stuff. What is interesting about these techniques is that by breathing intensely, you can activate yourself into a high arousal state. And when you are in that high arousal state, like it can be a conduit for a lot of emotions to come up. And so you do, if you go to these breathwork classes, you will see people who start crying. You will see people who, you know, are screaming or like having very intense emotional experiences. And I think if you are the type of person who tends to repress emotion and has trouble experiencing it, I'm sure this can be useful. The problem is, is that if you are somebody like, like my wife or like you, who is already

• 50:10Mark Manson?

  prone to panic attacks, already has a nervous system that is like constantly in a high arousal state, putting yourself in an environment where you are for a very prolonged period of time, pushing yourself into a higher arousal state can have very bad consequences and can actually trigger and induce panic attacks. So I think the clarification that I'd like to make here is that, so the box breathing for somebody who is in a highly anxious state, whether you're having a panic attack or you're just in a very, very high pressure situation, slowing the breath, counting the breath, four seconds, eight seconds, in, out. This, pretty much 10 times out of 10, this will calm you down. It is super effective, but it is, like you said, it's a short-term solution.

• 50:55Mark Manson?

  These longer session, 45 minute, 50 minute, 60 minute breathwork sessions where you're like.

• 51:04Mark Manson?

  Hyperventilating yourself on the floor for like minutes and minutes and minutes at a time, I'm not convinced it does anything really at any sort of deep level. To me, this feels kind of like it's like a new version of catharsis. Just because you're indulging an emotion like doesn't mean you're relieving it. Like this hydraulic theory of emotion of like, oh, I have all this anger bottled up. So I need to be really angry to get it out of my system. That's not how emotions work. Emotions are feedback loops. And so if you are indulging anger, you are actually training your body to become more angry. If you are indulging sadness, you are just training your body to feel more sad. I personally think these, these sorts of techniques are probably nothing at best, placebo at best, counterproductive

• 51:47Mark Manson?

  at worst. And then if you do happen to be somebody predisposed to panic, panic attacks,

• 51:54Mark Manson?

  it's a fucking terrible idea.

• 51:55Speaker 01

  Right. Yeah. Yeah. If you are experiencing a panic attack and you're doing the breathing, like you said, though, and it is calming, it does calm you down. I think what's going on actually is it's not so much the breath itself. It's more you're, you're becoming more aware of your internal bodily states. I think it's just a, it's a redirection from external, oh my God, everything's on fire to, hey, what's actually going on in here? Oh, I can handle this. Then move on.

• 52:23Mark Manson?

  Right.

• 52:23Speaker 01

  Because if, if you sit and you dwell too long on it, that, that is an anxious

• 52:28Mark Manson?

  Yes.

• 52:29Speaker 01

  frame of mind that you're just putting yourself into. It's a tool for the moment. Check in, you're good. Put it down and, and walk away. Cause as soon as you start ruminating, that becomes the counterproductive part.

• 52:40Mark Manson?

  All right. Moving on down the list, we get to number 11. This might actually be the first kind of sensitive one that we talk about. You know, as we said, we're in the maybe depends sometimes category at the moment.

• 52:51Speaker 01

  Sure.

• 52:51Mark Manson?

  And this one, it's when it goes well, goes really well. When it goes poorly, it goes very, very poorly. And that is benzodiazepines. And I should say for the record that you and I are not psychiatrists. We're not doctors. We're just reporting what the research says. We're reporting, you know, at this point, benzos, Xanax, Ativan, Valium, Klonopins, they've been around for Decades, many, many decades, they've been studied back and forth. We have tons and tons of research and data on them. It's a complicated picture. It's a very complicated picture. On the one hand, they can be extremely effective. And what's better is that they're extremely effective very, very quickly.

• 53:32Mark Manson?

  On the other hand, there are very intense drawbacks. People can become dependent on them. Withdrawals from benzodiazepines can actually kill people.

• 53:44Speaker 01

  Right, yeah. You can't just stop taking that.

• 53:46Mark Manson?

  Yeah, it's a very tricky place to be in terms of like a long-term solution. There's a lot of potential for abuse. And interestingly, the combination of benzodiazepines with other interventions. We talked earlier about how alcohol interferes with the fear extinction required for exposure therapy to work. Benzos have the same sort of thing going on. And so what therapists have known for a long time is that when somebody goes on a benzodiazepine, it can actually reduce the effectiveness of therapy. That feedback loop inside your brain is not forming the same way it would if you were sober.

• 54:27Speaker 01

  Yeah, it makes sense. I mean, benzodiazepines operate on the same system that alcohol does too. The GABA system, which is an inhibitory system for the most part. So it makes sense that that, yeah, it extinguishes that fear response when you're doing therapy and you're addressing uncertainties and fears and all of that. Extinguishing that probably has something to do with the way you learn about those things. So, yeah.

• 54:49Mark Manson?

  It's interesting because this fell down to number 11 almost purely due to the complications and the downsides, the potential for harm, which is part of our measurement and our ranking on this. If you remove the potential for harm, this would actually be top three.

• 55:04Speaker 01

  Oh, yeah. Big effect size, pretty big effect.

• 55:06Mark Manson?

  Huge effect sizes, very well replicated, data going back for, like I said, 20, 30, 40 years. It is very complicated. There is a lot of potential for abuse. It's almost like they work too fast. So like, I wasn't aware of this, but there's another drug on the market called buspirone. It's, and it is equally as effective, does not have the downsides, but the catch is it takes two to four weeks to start working. And so patients, over and over again. Tend to go for the benzos because they kick in basically immediately. And I understand, like, if you are an extreme case, like, if you have severe panic disorder or severe generalized anxiety disorder,

• 55:50Mark Manson?

  and you are literally just crippled by anxiety every day, you probably want something that's gonna hit and remedy the situation immediately.

• 55:58Speaker 01

  Even then, though, the recommendation is not to use them for more than two to four weeks.

• 56:03Mark Manson?

  Yeah.

• 56:04Speaker 01

  So, yeah. But that said, I know, I personally know people who've been on, like, a low dose of benzos for a long time.

• 56:10Mark Manson?

  Years.

• 56:11Speaker 01

  Yeah, and so.

• 56:12Mark Manson?

  Years.

• 56:12Speaker 01

  Yeah, doctors don't pay attention to that, apparently.

• 56:15Mark Manson?

  Yeah.

• 56:15Speaker 01

  I don't know.

• 56:16Mark Manson?

  I've known multiple people who have abused them over long periods.

• 56:19Speaker 01

  High, high chance of abuse, yeah, strokes, yeah, for sure.

• 56:22Mark Manson?

  The next one, number 10, probiotics. This gets into the gut health fad phenomenon. I'm curious what the research turned up on this, Drew.

• 56:32Speaker 01

  Again, this is one of those where, like, the mechanism, proposed mechanism, it makes sense.

• 56:37Mark Manson?

  Yeah.

• 56:37Speaker 01

  The vagus nerve, it connects your stomach to your brain. There's a literal connection between your gut and your brain, right? And that's the vagus nerve, that's one of the connections, anyway. They've done several experiments where they give a probiotic, different strains of probiotics, and they've measured brain activity. It alters GABA function in your brain, which is, again, typically inhibitory. So theoretically, it should work, or it could work. This could be a possible pathway by which, you know, your gut and your brain talk to each other, can calm down or get more excited, you know, based on whatever's going on in your gut, sure. The interesting thing, though, that I found is just kind of a split in this one. So people who have been diagnosed with an anxiety disorder, like GAD, or even OCD or anything like that,

• 57:21Speaker 01

  they find that probiotics actually help them more than just if you just kind of have, like, some mild anxiety that you're worried about, you know? It's not necessarily a clinical level of anxiety, but some anxiety that just bothers you.

• 57:34Mark Manson?

  Yeah.

• 57:34Speaker 01

  Probably not gonna get a whole lot from that using any sort of probiotic. Several studies have found, like, there's a fairly big effect size, like, anywhere from 0.5 to 0.7 for people with psychiatric anxiety disorders. So, yeah, so this is one of those definitely depends situations, for sure.

• 57:53Mark Manson?

  It is kind of mind-blowing that for some people, depending on their situation, might get better results. From a probiotic you buy over the counter than

• 58:03Speaker 01

  Yeah.

• 58:03Mark Manson?

  Say a prescription dog.

• 58:04Speaker 01

  The science is still kind of out on like which strains.

• 58:08Mark Manson?

  Yeah.

• 58:08Speaker 01

  Of probiotics actually help because so when they try to do these meta-analyses, it's really hard because there's always different strains, there's always different methods that go into these, different samples that they're using or different, like the participant pool they're pulling from is very different. So it's really hard to make generalizations from a lot of these studies.

• 58:24Mark Manson?

  Yeah.

• 58:24Speaker 01

  We don't have like big pooled data that we can pull from. There's definitely some evidence that a few different strains and a few different populations do respond pretty well to them.

• 58:32Mark Manson?

  There was a term in one of the meta-analyses for this that I absolutely love. I've never come across it before. It was quote catastrophic heterogeneity.

• 58:41Speaker 01

  Yeah.

• 58:41Mark Manson?

  Which is like, basically, it's like such a large variance in results for people that.

• 58:47Speaker 01

  And methods that they use too.

• 58:49Mark Manson?

  That researchers called it catastrophic.

• 58:51Speaker 01

  Yeah, right.

• 58:51Mark Manson?

  That that gives you an idea of how all over the map this is. It is interesting though. This is one that I would not have guessed. I would have.

• 58:58Speaker 01

  Oh, okay.

• 58:59Mark Manson?

  I would have guessed that this was kind of more on the CBD side. I know gut health is like a real thing as it relates to mental health, but my understanding was that, or my assumption, I should say, is that it would not be as simple as just taking certain probiotics.

• 59:13Speaker 01

  Yeah, sure.

• 59:14Mark Manson?

  You know, like it would be something more drastic potentially.

• 59:18Speaker 01

  I mean, yeah, it does make a lot of sense. Ninety percent of the serotonin neurons and ninety percent of the serotonin in general is produced in your gut.

• 59:25Mark Manson?

  Hmm.

• 59:26Speaker 01

  You know, we all know serotonin is probably pretty important some way for mental health. We'll get to this a little bit later too. We don't know exactly how, but there's got to be something there probably.

• 59:34Mark Manson?

  Right.

• 59:34Speaker 01

  Yeah.

• 59:35Mark Manson?

  So this is, would you say this is just too soon to say? Or is it like, like promising too soon?

• 59:43Speaker 01

  I think as medicine gets more and more individualized, this is going to be more and more important.

• 59:46Mark Manson?

  Okay.

• 59:46Speaker 01

  And prove to be like, for certain people that we can pinpoint and be like, you would be a very good candidate for this. I think this is one of those treatments.

• 59:54Mark Manson?

  Number nine. Yoga.

• 59:57Speaker 01

  Hmm. I'm a big fan of yoga.

• 59:59Mark Manson?

  I know, you're a huge yoga head.

• 1:00:02Speaker 01

  Yeah, well, well, it's interesting. I've been thinking about this more, especially putting this together. I'm not like into yoga.

• 1:00:08Mark Manson?

  Yeah.

• 1:00:09Speaker 01

  I go to yoga, I do yoga, I do it pretty regularly, about twice a week usually. I do hot yoga.

• 1:00:14Mark Manson?

  Okay.

• 1:00:14Speaker 01

  Um, for one, so I get the exposure to it too. But I don't think I would say that I am like, I'm not into the whole like yoga culture necessarily.

• 1:00:24Mark Manson?

  Hmm.

• 1:00:25Speaker 01

  I do it as more like a fitness thing, right?

• 1:00:27Mark Manson?

  Yeah.

• 1:00:27Speaker 01

  Let's talk a little bit about what they found with yoga though first, okay? So there is an effect.

• 1:00:32Mark Manson?

  Yes.

• 1:00:32Speaker 01

  Okay, it does help with anxiety.

• 1:00:34Mark Manson?

  Yep.

• 1:00:35Speaker 01

  Small effect, most likely. There was a clinical trial where they, they had people perform some yoga versus therapy. Yoga, about 50% of the people responded to it. Uh, but with therapy, about 70% did. So it's not as good as therapy, but it would be a good compliment, I would say. And I don't think it's for the reasons that a lot of yogis will tell you, you know, the whole maybe centering or whatever it is, the kind of supernatural side of things. Obviously, I'm not gonna probably argue for that. But for me, anyway, one of the things I think that it does is it gives you a real awareness of the internal states of your body. Brought this up a couple of times already, but I think yoga is actually a really good vehicle to experience that kind of interoception.

• 1:01:19Speaker 01

  So that your internal states, your internal bodily states. And not only that, but when I first started doing yoga, you know, the instructors would usually cue you up like, you know, if this is uncomfortable, try this or, or, or sit with the discomfort a lot. And I didn't, I was always kind of like, I don't want this to be uncomfortable. I'm here to be comfortable. But the more I got into it, the more I'm like, oh, they're telling you, okay, this is, you're gonna push your limit, get to a comfortable position of whatever pose you're doing, and then push that and get a little bit uncomfortable. That I found was a big like, oh, this, this helps you sit with a little bit of discomfort for a little bit longer.

• 1:01:51Mark Manson?

  Interesting.

• 1:01:51Speaker 01

  So it's like practicing that kind of muscle, that discomfort muscle a little bit. That's what I think the actual value of yoga is. I don't think it's anything beyond that. It doesn't address maybe the underlying ruminating thoughts you have.

• 1:02:03Mark Manson?

  Yeah.

• 1:02:03Speaker 01

  That is why I think like the therapy in that study I mentioned, the therapy actually did a little bit better is because it's actually addressing the underlying.

• 1:02:10Mark Manson?

  Yeah. So it's funny. I was actually just about to ask, like, I generally associate yoga with meditation. Those two, those two often go side by side. They happen together. People do them at the like, at the same time, at the same retreat. But it's interesting because I always kind of saw yoga as like the physical form of meditation, right? It's like that the same way meditation like has you focus in on like a cognitive experience. Yoga has you focus in on a physical experience in your physical body. Like I'm not going to give it, give it away, but like meditation's on this list. It's higher than yoga. Exercise is on this list. It's also higher than yoga. And so I was, I was curious to ask, like, why do you think yoga placed lower? I think in the case of meditation, I think what you said about the cognitive, right?

• 1:02:54Mark Manson?

  Anxiety is very cognitively driven. So that makes sense that meditation is more targeted towards managing your thoughts and coming to terms with your emotions and all that. My guess on the exercise front is just the dosage level, like yoga's pretty, I mean, compared to like, say, doing a CrossFit workout, like yoga's pretty relaxed. It's like not super strenuous, low intensity. It's relatively easy.

• 1:03:19Speaker 01

  Hot yoga can be.

• 1:03:22Speaker 01

  You know, one thing, one thing I'll say is that you get into a room with a whole bunch of other people. And in the case of hot yoga too, like everybody's half naked in there, basically, you know? And so there's a lot of like self-conscious feelings, I think, that come up. The thing is, is that with a lot of these poses that you're doing, if you're super worried about what everybody else is thinking, you're going to fall over on your mat in front of everybody and make a huge ass out of yourself. And so it almost like forces you to be like, no, no, no, come back and be present with you.

• 1:03:50Mark Manson?

  That's interesting.

• 1:03:50Speaker 01

  And so the, you're right, the physical side, it is very much a physical like awareness around you, right? That, that you're practicing, but I think that's still good enough practice of for that situation to kind of like tamp down a lot of those self-conscious thoughts that you have.

• 1:04:04Mark Manson?

  Did you find it, it helped you feel more confident or?

• 1:04:10Speaker 01

  I think it's just

• 1:04:12Mark Manson?

  Why do you like it so much?

• 1:04:13Speaker 01

  I do CrossFit, which is a very high intensity, short, you know, heavy weights. I like this whole kind of barbella strategy.

• 1:04:23Mark Manson?

  Yeah.

• 1:04:23Speaker 01

  You know, you go and do something low intensity that's longer. There's a meditative side to it for sure. But I just find it's a really good balance between like that high intensity. You know, usually I'm a little bit sore from a workout, maybe, or something like that. And then I can get in, get a good, deep stress. It's really low. There's also just no pressure too. Like I'll stop in the middle of some yogas and just lay down for a while and while everybody else is going. I think it's just a good, kind of, it balances you out between those two extremes anyway.

• 1:04:52Mark Manson?

  Yeah. So it sounds like a nice supplement to

• 1:04:55Speaker 01

  I would not use this as like a, this is my go to anxiety

• 1:04:58Mark Manson?

  Yeah.

• 1:04:58Speaker 01

  remedy for sure.

• 1:04:59Mark Manson?

  Right.

• 1:05:00Speaker 01

  But it would be a great supplement.

• 1:05:01Mark Manson?

  Right. It's definitely gonna, it's good, but it's not gonna fix anything

• 1:05:05Speaker 01

  Right.

• 1:05:05Mark Manson?

  on this front.

• 1:05:06Speaker 01

  The other thing too is, I mean, it takes a lot of time too. You know, hour long classes, generally speaking, that's a pretty standard yoga class. Usually they're expensive.

• 1:05:14Mark Manson?

  Yeah.

• 1:05:14Speaker 01

  You know, so yeah, I wouldn't, I just wouldn't use it as like a first line of defense. Yeah.

• 1:05:19Mark Manson?

  Moving along, we're about halfway through. We're, we're now in the top half.

• 1:05:22Speaker 01

  Okay.

• 1:05:23Mark Manson?

  This one surprised me.

• 1:05:24Speaker 01

  Yeah.

• 1:05:25Mark Manson?

  And I think

• 1:05:25Speaker 01

  I'm not so sure about this one.

• 1:05:28Mark Manson?

  Adaptogens. This is another one. I mean, if this came low, I'd, I'd have to leave the studio again and go apologize to a bunch of people around West LA because everything out here has a fucking adaptogen in it these days. There's actually this like bougie fruity drink that I, I get at the grocery store here that has ashwagandha in it. Actually, the energy drink I drank this morning had rhodiola in it. So it's, this stuff is showing up everywhere. Afghanda, rhodiola, holy basil. Early numbers were shockingly good.

• 1:06:00Speaker 01

  Right.

• 1:06:01Mark Manson?

  Some incredible effect sizes, but it seems like we're still early days on this.

• 1:06:05Speaker 01

  Yeah, I think we have a, it's a similar problem with CBD though too, is that quality varies a lot. It's kind of hard to pin down which ones are the better ones. The study designs are very Very variable.

• 1:06:17Mark Manson?

  Yeah.

• 1:06:17Speaker 01

  So you just get a huge, a lot of heterogeneity there.

• 1:06:21Mark Manson?

  What do you mean by study design? Like, explain for the audience, people who haven't read a lot of research or done research. Like, what's the difference between, say, a good study design and a bad? If we're like testing Ashwagandha for anxiety, like, what's an example of a good study design and a bad study design?

• 1:06:37Speaker 01

  Some of the basics are just like having an actual random sample of people.

• 1:06:42Mark Manson?

  Yeah.

• 1:06:42Speaker 01

  Who show up to this, not like.

• 1:06:43Mark Manson?

  Not just college students.

• 1:06:44Speaker 01

  Not just college students, or even like, for some reason, your experimental group and your control group are completely different types of people.

• 1:06:52Mark Manson?

  Right.

• 1:06:52Speaker 01

  You don't want that, you want a good mix of people between them. You want a control group, too. This is the other thing, you know, we talked about like with magnesium earlier, where they just had two different kinds of magnesium and they didn't compare it to a placebo.

• 1:07:03Mark Manson?

  Right.

• 1:07:03Speaker 01

  We don't know if that's a placebo or not at that point.

• 1:07:05Mark Manson?

  Yeah.

• 1:07:05Speaker 01

  There's that, size of the study matters, too. So how many people are in it?

• 1:07:09Mark Manson?

  Yeah.

• 1:07:09Speaker 01

  The more, the better, obviously, because you can make more generalized inferences from those populations. And then, I mean, just all sorts of methodological stuff, too. Is that a blinded study as well?

• 1:07:19Mark Manson?

  Yeah.

• 1:07:19Speaker 01

  You know, like, a lot of these, especially with supplements, are going to be funded by the supplement company.

• 1:07:25Mark Manson?

  Yeah.

• 1:07:25Speaker 01

  And even if it's a blind study, that can still, that can still influence.

• 1:07:30Mark Manson?

  Tilt things, yeah.

• 1:07:31Speaker 01

  Things one way or the other. Those are some of the big ones.

• 1:07:33Mark Manson?

  Yeah.

• 1:07:34Speaker 01

  For sure, but if, I mean, even if you do have smaller studies, though, but they're well-done, over time, that can help, right? Because you can do a meta-analysis, include those studies if they're well-done, they have proper controls, they have proper blinding, where the researchers don't know which condition the participants are in. Those sorts of things help a lot.

• 1:07:52Mark Manson?

  It's probably worth noting, too, that like, one of the biggest barriers to really good research is just funding. Like, to get a good sample size, to get a nice variability of people in that sample. It costs money. You like, you need to go find thousands of people, tens of thousands of people that are, come from all different walks of life. That like, that takes a long time. There's, you know, lots of recruiting. You've got to put out ads. You've got to like onboard people, interview people. It requires just a lot of administration and a lot of researchers and a lot of help. And it's costly. It takes a long time. And so it's

• 1:08:26Speaker 01

  So sometimes the incentive is that to take shortcuts, which is why, like you said, with adaptogens, those early studies, oh, they look really promising. Well, it's because they were like, well, we can't do the perfect study. So we're going to do

• 1:08:37Mark Manson?

  Yes.

• 1:08:37Speaker 01

  A good enough study. And then those headlines get picked up and

• 1:08:41Mark Manson?

  Yeah.

• 1:08:41Speaker 01

  Out of proportion. So, yeah.

• 1:08:42Mark Manson?

  And then you also get this situation where there is, say, Ashwagandha drink company, like a health drink company that has Ashwagandha as their primary ingredient, and they really want to market that. And so they come to researchers and they're like, and I think maybe this is a misconception because sometimes people think that this is way more diabolical than it actually is. I mean, maybe it is sometimes, but my sense is that like, it's not like the drink companies come and say like, we need these numbers to line up this way. I think it's more just like

• 1:09:09Speaker 01

  That was a tobacco company.

• 1:09:10Mark Manson?

  Yeah.

• 1:09:12Mark Manson?

  I think it's more just like, hey, we'll fund a study, but this is kind of what we think it should look like, or this is how much we're willing to give. There's a muddying of incentives, I think. Yeah.

• 1:09:23Speaker 01

  Yeah. There's like a few, like, pretty good quality studies. They're just small.

• 1:09:27Mark Manson?

  Yeah.

• 1:09:28Speaker 01

  Like, they do find a good effect size on anxiety and even some other mental health conditions, but they're, they're small. And so it's just, I'm cautious, I would say.

• 1:09:38Mark Manson?

  Yeah. I've been drinking this Ashwagandha drink quite a bit lately, especially at social events, now that, now that I don't drink alcohol.

• 1:09:44Speaker 01

  Yeah.

• 1:09:44Mark Manson?

  It's actually, in fact, a lot of mocktails now have Ashwagandha in it because supposedly it's supposed to give you a little bit of, a little bit of a buzz and help you relax.

• 1:09:52Speaker 01

  Okay.

• 1:09:54Mark Manson?

  I don't really notice anything. At this point, I feel like it's probably just placebo. Like, I just, I'll have one sometimes at night before bed because it's like, I've been marketed to that it helps me unwind. So it probably just helps me unwind a little bit. But yeah, I'm not convinced that there's anything going on here. All right. Next one. This one might get us canceled.

• 1:10:12Speaker 01

  Okay.

• 1:10:14Mark Manson?

  SSRIs.

• 1:10:15Speaker 01

  All right.

• 1:10:15Mark Manson?

  So these are your classic antidepressants. Prozac, Xolo, Lexapro. I guess in the pharmaceutical world, these are kind of like your first line defense for depression and anxiety. Maybe the first thing we should do is just dispel the myth that antidepressants don't work. Like, I don't know. I don't know how that became a meme at some point.

• 1:10:33Speaker 01

  Well, for some people, they don't.

• 1:10:34Mark Manson?

  Well, of course.

• 1:10:36Speaker 01

  Okay. I got you, yeah. But it's like, there's nothing there. That's not true.

• 1:10:41Mark Manson?

  Yes.

• 1:10:41Speaker 01

  There's absolutely nothing there. No, they work for some people, for sure.

• 1:10:43Mark Manson?

  Correct. So like, the Cochrane Review did a review of SSRIs. And Cochrane is, for people who don't know, Cochrane is like the gold standard of like reviewing research, coming down saying, does this thing actually work or not? Are these results actually legitimate? Cochrane Review said, it's legit. There is an effect size here. They do something.

• 1:11:04Speaker 01

  Right.

• 1:11:05Mark Manson?

  On the one side, it's like, they absolutely do help people. And I think certain people in certain situations, it can be absolutely life-changing. That said, they are also probably over-prescribed. Like, I think both of those things can be true simultaneously. I think it's, it's like, they are very useful and in some cases, life-saving for people, and they're probably giving out way too much. That is my non-medical opinion. Don't come at me. And by the way, like, I've had doctors prescribe antidepressants for me for like, basically no reason. My wife's had antidepressants prescribed to her for like, fucking headaches. Like, it just, doctors, doctors in the US definitely do give them out like candy at times, and there are some documentaries around the incentive structure around that.

• 1:11:48Speaker 01

  And not only that, I mean, they've been detected like in river water, you know, and wastewater before, so I guess it could be, that could be true.

• 1:11:55Mark Manson?

  Maybe it's, it's useful to start like, how do they work? You know, what's the mechanism going on here? What are the discussion items around like, you know, why they're good, why they're bad?

• 1:12:06Speaker 01

  Yeah, SSRIs, selective serotonin reuptake inhibitors, right? Technically, what they do is they increase the amount of serotonin that's in the synapse between neurons, okay? The space between neurons. And serotonin has been implicated in all sorts of different mental health conditions and just in general, right? Like I said, a lot of it is produced in your gut, though. Really going back, I don't know, 60s, 70s, 80s, probably. There's this chemical imbalance theory of mental health disorders, right?

• 1:12:38Speaker 01

  We're really going away from that.

• 1:12:40Mark Manson?

  Yeah.

• 1:12:40Speaker 01

  There's been several kind of high-profile meta-analyses that have looked at decades and decades worth of data. They really can't establish a link between serotonin specifically and say depression or anxiety.

• 1:12:52Mark Manson?

  Mm-hmm.

• 1:12:52Speaker 01

  Okay? Depression was supposed to be the one that is like, yeah, definitely, definitely for depression, there's something going on, maybe for anxiety. But really recent studies have found that, no, they're actually, we can't really find any association between the level of serotonin in somebody's system and their mental health outcomes. That said, SSRIs do work.

• 1:13:11Mark Manson?

  Yeah.

• 1:13:11Speaker 01

  We, we know they work for some people at least. We don't know why they don't work for others, okay? We don't really know why they work for these people though either. Now, for the longest time, we thought it just was, we need to just increase serotonin. That's not the case.

• 1:13:22Mark Manson?

  Yeah.

• 1:13:22Speaker 01

  We don't know what it is. There's probably some downstream effect. Serotonin can be kind of like a signaling molecule too for downstream, further downstream chemicals that might be influencing

• 1:13:33Mark Manson?

  Yeah.

• 1:13:34Speaker 01

  uh, neural processes, we don't know. There is some sort of functional difference between like people who have mental health disorders and people who don't. Okay? And we don't know exactly how serotonin affects that or not, but it does, for some people, it does help. We don't know. That's what we're saying. The more, the more we, the more we uncover, the more we realize we don't know about these.

• 1:13:54Mark Manson?

  Yeah.

• 1:13:54Speaker 01

  Um, for sure. And so, you know, SSRIs were very, very promising when they first came out, especially as the, the newer ones in the eighties. Very, very promising.

• 1:14:02Mark Manson?

  Yeah.

• 1:14:02Speaker 01

  Early studies were, had big effect sizes. We've maybe talked about this a little bit before, but a lot of times when something, a new intervention comes out, they use it on kind of the worst cases. And you, which usually there's kind of a floor effect going on there, right? The only, only direction they can go is up.

• 1:14:18Mark Manson?

  Right.

• 1:14:18Speaker 01

  Or if you're using it for people who are the, the, the illest, you're gonna see, you'll see a, a bigger jump.

• 1:14:24Mark Manson?

  Yeah. With those people. It's, you always start with the hardest cases and so you get the biggest effect sizes early. Not to spoil anything, we're gonna talk about psychedelics soon, but there, there's a little bit of

• 1:14:33Speaker 01

  Same kind of thing.

• 1:14:34Mark Manson?

  similar thing going on. As it spreads out to the general population, you start to see a moderation in those, those effect sizes.

• 1:14:40Speaker 01

  The effect sizes have actually, they've shrunk over the years because of, because of that.

• 1:14:45Mark Manson?

  Yeah.

• 1:14:45Speaker 01

  Using on educationism, maybe people who don't need them as much or don't respond to them as well. And so the effect size decreases just based on that.

• 1:14:52Mark Manson?

  Yeah.

• 1:14:52Speaker 01

  If we could identify like who would respond better to SSRIs versus not, that would be great. And they, they're working on that.

• 1:14:58Mark Manson?

  Yeah.

• 1:14:58Speaker 01

  It's not a one-size-fits-all. Uh, the, the effect sizes, yes, they've gotten a little bit smaller, but, and they've kind of topped out.

• 1:15:04Mark Manson?

  Mm-hmm.

• 1:15:04Speaker 01

  We can't seem to get them to go up or down from there, so. You know, more has to be done on this. So yeah, they're not without their risks, right? For instance, sexual dysfunction is a problem. It's fairly common in the short term sometimes, and kind of rare in the longer term, but it is still a thing. And it's something that worries people and is one of the like leading causes for people to just stop using them as well.

• 1:15:26Mark Manson?

  It would just make you depressed all over again.

• 1:15:28Speaker 01

  Exactly, right, right?

• 1:15:31Speaker 01

  And then you have emotional blunting too. That's pretty common as well.

• 1:15:35Mark Manson?

  That's, yeah, that's, so the people in my life who have taken antidepressants, like that's, that's been very apparent. You get kind of like, it's almost like they become kind of zombie-like.

• 1:15:45Speaker 01

  Everything's gray. That's what people tell me. It's like, everything is just kind of gray.

• 1:15:48Mark Manson?

  Everything's just blah.

• 1:15:49Speaker 01

  Yeah. The people I know that take them and use them successfully say it's more like just a window opening for me. It's like, you know, I was just so despondent or so anxious or whatever, that anything to kind of just open me up or lift my mood a little bit for a little while for something else to get in, that's where SSRIs shine, if they can work for you.

• 1:16:07Mark Manson?

  Yeah. I think this is probably an opportune point to take a little bit of a sidebar and just talk about like, where does anxiety come from for different people? For the layman, like, you probably just lump it all together. Like, some people are really anxious and some people are moderately anxious and some people are very little, have very little anxiety. Anxiety is one of these areas of mental health, personal growth. There's kind of like, there's like a serious version and then there's kind of a mild version. There's like a high-quality problem version and then there's like, like an actual serious kind of psychiatric version. It's similar with depression as well, right? Like, it's, there are people who kind of chronically struggle with depression and it's probably biologically based, like there's some genetic

• 1:16:51Mark Manson?

  predisposition. It's something they're going to struggle with for their entire lives. And I think for those people, the conversation around something like SSRIs is probably a little bit different. Whereas like, just mild depression, like you just went through a divorce, or a parent died, or you lost your job and you're feeling lost, like everybody feels depression at some point. And but it's generally transitory and it's generally for a good reason. And I think it's it's similar for anxiety that like there's there are people who experience a lot of anxiety throughout their lives. But that anxiety is is always contextual. It is based on kind of what they're going through at the moment. Maybe they're predisposed to a little bit more anxiety in certain situations than than other people.

• 1:17:36Mark Manson?

  But it is it is something that overall they're managing. It comes and goes in in waves, whereas there are other people that are just kind of like predisposed to lots of anxiety all the time. And and I kind of mentally just put these people in two different categories, especially like, you know, as somebody who's been writing to a large audience in the space for a long time now. Anybody who seems to be in the latter category of like, oh, this is probably a diagnosable clinical thing. I'm always very clear of like, you should probably go talk to a doctor. Like, this is not, you're not going to solve this listening to podcasts and doing yoga on weekends, right? Whereas like, if you're just a little bit of an anxious person who's going through a lot in life right now, under a lot of pressure, got a lot of stress going on, and you're

• 1:18:21Mark Manson?

  a little bit more prone to anxiety than other people, like, there are plenty of practices that you can implement to manage that anxiety in your life. I'll come back to the framework that I often come back to, which is the bad to okay people and the okay to great people, right? There's like a, there's some people who are just like trapped by their anxiety and it is seems to be baked into their their neurological wiring to a certain extent, and they just like, they really need a long term solution just to feel normal. Whereas there are other people who like, their lives are by and large normal, but they experience a lot of anxiety and they just want to be able to excel. And they feel like their anxiety is like one of the things that's kind of holding them

• 1:19:06Mark Manson?

  back. The other factor here is that like generally the severe cases of anxiety, you're probably looking at more of some sort of genetic predisposition. It's more of a permanent thing. Whereas the mild, milder forms of anxiety, those waves of anxiety that come and go throughout life, you know, that's when you get into, you know, environment, social experiences, where you grew up, you know, maybe some trauma you had when you were young. And those are generally things that you can work through, that you can like process and use some of these techniques and practices to like help you get through the tough periods. Thanks for coming to my TED Talk on anxiety.

• 1:19:46Speaker 01

  It's important to distinguish between like the clinical and subclinical for sure. And then the lines have gotten so blurred.

• 1:19:53Mark Manson?

  Yes.

• 1:19:53Speaker 01

  Though too.

• 1:19:54Mark Manson?

  Yes, and this comes back to the labeling thing, right? Because it's like, I think what, what happens these days is you have a lot of people who are, let's say they're probably highly neurotic, right? Which is a personality trait, but, and they're prone to anxiety. Maybe they're prone to panic attacks. So they experience anxiety above, at an above average rate. But then what happens is, is because like we're, therapy culture is just fucking labeled everything, they label themselves as an anxious person, somebody who struggles with anxiety, somebody who is like doomed to struggle with anxiety. And so that identification with the issue then like calcifies it. It like hardens it into, into who they are.

• 1:20:37Mark Manson?

  They start bringing anxiety to their experiences rather than, you know, waiting for anxiety to happen to them. I think SSRIs are a perfect example of like, if you are in kind of the, the clinical territory, like they can be life-changing. If you're in the subclinical territory, it's probably overkill.

• 1:20:59Speaker 01

  Right.

• 1:20:59Mark Manson?

  And I think one of the issues is that it's, it's largely being over-prescribed to people in the subclinical territory. Like there are downsides and, and side effects and, and I've known a lot of people who have, who have gone on them and felt relief for a month or two, and then a year later they're like, I fucking hate this and they, they want to get off them. And it's, it's, I think most people, at least most people I've known have, that's kind of the cycle they've gone through. Number six, Mr. Bernie. I believe this is the last of our some depends maybe category.

• 1:21:30Speaker 01

  Yeah, I think so.

• 1:21:31Mark Manson?

  And it is a big one. Psychedelics, psychedelic assisted therapy. This had the single biggest effect size of everything we researched, but the research is still scant and there's not enough trials that have been done yet, but it is very promising and this is very trendy, very exciting in our space. A lot of people are doing it, talking about it. It is slowly becoming mainstream accepted and I do think there's a lot of potential here. It is very exciting and interesting, but we have to put that caveat of like, it's still early days. Generally, these earliest studies are done on the hardest cases. So you get the biggest effect sizes.

• 1:22:15Mark Manson?

  As it spreads out to the general population, that effect size moderates and you start to see a lot more complications. You start to run into a lot of people it doesn't work for. You start to run into negative side effects. And of course, you just run, you start running into practitioners who have no fucking clue what they're doing, you know, like my guru Steve out in Malibu.

• 1:22:34Speaker 01

  Yeah, you have a guru Steve in Malibu. Is he your guy?

• 1:22:37Mark Manson?

  Uh, well, he was last week shaman. This week I'm switching to.

• 1:22:43Speaker 01

  Business coach.

• 1:22:47Mark Manson?

  Yeah, that was last week. This week I have a new shaman. Her name is Zoe of Infinity and she's gonna help me trip on a $10 million estate to find myself.

• 1:23:01Speaker 01

  Okay.

• 1:23:01Mark Manson?

  This is the world I live in, Drew. This is LA.

• 1:23:04Speaker 01

  Okay, yeah, that sounds West LA to me. I've been somewhat of a proponent, a cautious proponent of psychedelics for a while. It is still pretty high on our list, so we're giving it some cred here. Very similar to the early days of, of the antidepressants like SSRIs. We see these big effect sizes, but we don't know how that's going to play out in like a larger population. There's been some very interesting studies early on. One in particular from Johns Hopkins. Okay, this was done by Roland Griffiths, who was a serious neuroscientist, okay? And working at Johns Hopkins University, did this study on people with late-stage terminal cancer. They didn't have much time left.

• 1:23:40Mark Manson?

  Right.

• 1:23:41Speaker 01

  And as you can imagine, around. A situation like that, you're gonna have a lot of anxiety around your own mortality.

• 1:23:47Mark Manson?

  Yeah.

• 1:23:47Speaker 01

  And so they tried some psychedelic assisted therapy with them with psilocybin, active ingredient magic mushrooms.

• 1:23:52Mark Manson?

  Yeah.

• 1:23:53Speaker 01

  And they did find that actually like they had this huge effect size. It was a small sample, but again, it was very, very consistent. Almost everyone in the, in the study said it was one of the most significant experiences of their lives. They, it helped them with their depression and helped them with their anxiety. This was awesome, right? Sadly, and I, and a bit ironically too, Roland Griffiths actually passed away in 2023 of cancer, which was, you know, kind of one of those cruel jokes that the universe played on us. But his legacy lives on. People are still, you know, they're, they're hopeful and I think they have reason to be hopeful. That said, one of the problems with psychedelics is that it's really hard to do a, a blind control study with this, right? Cause if, if you take a tab of acid or a big old handful of mushrooms, I can guarantee you one thing, something is going to happen.

• 1:24:37Mark Manson?

  Yes.

• 1:24:37Speaker 01

  Right?

• 1:24:37Mark Manson?

  Yes.

• 1:24:38Speaker 01

  You're gonna know whether or not you're in the experiment.

• 1:24:40Mark Manson?

  The control group or not, yeah.

• 1:24:41Speaker 01

  Yeah, yeah. That's been the biggest hurdle to actually figuring out what's going on here because now there's gonna be some people will say, well, well, who cares? It works. Well, yes, but why does it work?

• 1:24:53Mark Manson?

  Right.

• 1:24:53Speaker 01

  We need to know that because we like.

• 1:24:55Mark Manson?

  You can't just start handing it out like.

• 1:24:56Speaker 01

  You can't be handing out incredibly powerful psychotropic drugs.

• 1:25:00Mark Manson?

  Yeah.

• 1:25:01Speaker 01

  And not know what's going on.

• 1:25:02Mark Manson?

  Yes.

• 1:25:02Speaker 01

  Right? Like there's, there's a safety issue, especially if we're going to be, you know, regulating this with a regulatory framework and everything like that, right? In 2024, the FDA actually pulled MDMA. They were doing trial studies on MDMA for PTSD. And a few other disorders as well. They ended up not approving it in 2024. There was a lot of excitement. A lot of people thought, no, this is a shoe and it's gonna happen. The FDA said, no, and it was because of this. There was just, there, we can't induce proper controls and figure out what's going on. The small number of studies that they have done look very promising. They're very consistent. They're very big effect sizes. Low variation in the results too, which suggests that it's a real effect. We just don't know what we're comparing it to at this point.

• 1:25:41Mark Manson?

  What's interesting about this, I think, is the mechanism, right? Like, it's every, everything else on this list is either some sort of lifestyle intervention, or it's some sort of substance, some sort of chemical that you're introducing into your, your biology that's supposed to like, kind of have a domino effect across things. What's interesting about psychedelics is that it actually somehow like, triggers neuroplasticity.

• 1:26:07Speaker 01

  Right, yeah.

• 1:26:08Mark Manson?

  And for people who aren't familiar, neuroplasticity is, you know, when you're young, your, your brain is more easily able to rewire itself and develop new patterns of thought and identity and understanding. And as, as you grow older, you know, neuroplasticity never ends, but it becomes harder the older you get. And you're, a lot of your beliefs and feelings and habits and behaviors just become more entrenched in, in your mind. And so, it's, it's almost like psychedelics just come along and kind of kick all that up and like, reset your ability to like, lay new patchwork in terms of like, who you are, what you believe, what you find important. And so, that, that's super interesting and exciting. I'm gonna go anecdotal here for a second because I,

• 1:26:51Mark Manson?

  I did a lot of psychedelics when I was younger, and I have spent a lot of time around people who've done a lot of psychedelics. I would actually say that I, I probably know two or three people, I would call it like, a low-level addiction. They're, they're people who take psychoactive, like, these psychedelic substances like, pretty regularly, like, on a weekly basis, I would say, to some extent, whether it's microdosing, macrodosing. What I notice about these people, and I, and when I think back to my early 20, my late teens and early 20s, when I took a bunch of psychedelics, I think one of the things that psychedelics does is that, that it, it really activates salience. It like, helps you imbue things with meaning. It helps you see kind of, the cosmic significance of stuff.

• 1:27:34Mark Manson?

  So I was just gonna say, sometimes that is incredibly profound, right? Because if you are kind of meditating on your family, or your place in the universe, or like some talent or gift that you have that you're able to contribute to the world, like, it can be incredibly profound. And it can have a lasting impact in terms of how you see yourself, and how you see your place in the world and all that. It also can cause you to find a lot of meaning and salience in stupid shit like a ballpoint pen.

• 1:28:03Speaker 01

  Right.

• 1:28:03Mark Manson?

  If you've ever spent time around people who've taken a lot of psychedelics, or been on a lot of trips or journeys, as they call them these days, they will come out saying some kooky things, with like some strange ideas around like, what's very powerful and important, and you're like, hmm, I'm not sure that passes the reality test. You know psychedelics have been around for millennia, and in many cases, they've, I think for most of human history, they were, they were used as like, kind of religious ceremonies and rituals, which makes a lot of sense to me, given what they do. Even going back to like the 60s and 70s, they were seen, it's interesting because back then, they were seen more as a mind expander. And I do believe, I don't have this research in front of me,

• 1:28:46Mark Manson?

  but I do believe that one of the things that they, they have noticed on it is that people who take a bunch of psychedelics, like their openness to new experiences increases afterwards.

• 1:28:55Speaker 01

  Yeah, yeah.

• 1:28:56Mark Manson?

  So it's interesting that in the, in the 1960s and 70s, it was kind of all about like, opening yourself up to possibilities, and opening yourself up to the world. So I find it fascinating that today, it's, it's much more about like, therapy and calming people, and bringing them out of depression, and bringing them out of PTSD, and, and healing their trauma and everything. There's almost like a cultural reading into what's going on. And especially given the fact that I think there is, we are living quietly in a little bit of an epidemic of nihilism at the moment. It makes sense to me that

• 1:29:36Mark Manson?

  Our particular brand and flavor of anxiety and depression that most of us struggle with in the 21st century is perfectly suited to be solved by psychedelics.

• 1:29:47Speaker 01

  Yeah.

• 1:29:47Mark Manson?

  If your anxiety is actually rooted in a deep existential dread, like a pervading sense that your life is meaningless and nothing you do is meaningful, and that is actually what is undergirding your sense of anxiety and stress about life, then it makes sense that a substance that comes in and imbues a ballpoint pen with cosmic significance can be incredibly therapeutic.

• 1:30:12Speaker 01

  Yeah. What psychedelics will do, you're right, is it kicks whatever kind of rut you're in or kind of mind space that you're in, it kind of kicks that open. The studies where they have tried to look at this more carefully, it's usually the post-processing. It's not during the trip necessarily. Like, that's the experience that, again, opens you up.

• 1:30:31Mark Manson?

  Right.

• 1:30:32Speaker 01

  I think. So anxiety, a lot of times we talk about it as like you're reminiscing about the future, depression, you're worried about the past, right? You're processing the past. I think psychedelics, what they can do is kind of kick you out of that whatever spiral you're in, right? If you're in a depression spiral or an anxiety spiral of some kind, it opens you up at that point, like you're talking about. But the processing afterwards is actually what's the most important part. So when you are opened up, because I've seen this too, seen people, like people who are very much stuck in their ways and they go and do this, and for a short period of time afterwards, they're like, it's kind of weird, right? And I think where people mess up is they don't take advantage of that time period,

• 1:31:16Speaker 01

  the one to two months following this experience where they're just like, I don't know what's real anymore, almost, you know? Like, I don't know, the way I've been seeing things obviously isn't right, and now I'm open to thinking about things differently.

• 1:31:28Mark Manson?

  Yeah, the post-processing...

• 1:31:31Mark Manson?

  Makes a lot of sense to me because it's like you get that window, right? After the trip of actually like change is going to stick or it's far more likely to stick during that period. You know, when I think about the people I know or have known who like kind of chronically do psychedelics, they're just always living in that window, right? And what I've noticed about those people is that they have a tendency to just kind of believe whatever, like the last, whatever the last person's, the last person, the last thing they heard from somebody is probably what they believe. And that's probably like their new philosophy on life. And it's, it's, it reminds me of the Carl Sagan quote of like, have an open mind, but don't have a mind that's so open, your brain falls out. And I think

• 1:32:12Mark Manson?

  you and I are in the same boat and that like, I'm very excited about the possibilities. I do think it, under the right circumstances for the right person, this can be utterly life-changing. Maybe I'm biased by living in California around all these fucking hippies, but it's one of those things that is, I think is both underrated and overrated simultaneously.

• 1:32:33Speaker 01

  Yeah. And I mean, just a word of caution too, if you're, if you're going to do this, especially if you're an anxious person, I would do it in a structured environment.

• 1:32:40Mark Manson?

  Find a professional, for the love of God, find a professional who knows what they're doing. The nice thing is, is there are a lot of doctors and psychiatrists that are like,

• 1:32:50Speaker 01

  They're on board with it now.

• 1:32:51Mark Manson?

  Yeah. And they're getting trained in it and they're like, there's processes being developed and standards and all sorts of stuff.

• 1:32:57Speaker 01

  It's still pretty illegal in most places though, so.

• 1:32:59Mark Manson?

  Yeah, you know, we just won't, we won't mention that.

• 1:33:08Mark Manson?

  Moving into the top five, this is where we get into legitimate territory. This is, everything from here on out is going to help with your anxiety, probably if not 10 times out of 10, very close. It's probably going to help everybody. It's probably always going to work to some extent, whether a little bit or a lot. It's really just a question of. Your particular issues, how much you need, how much you do it, and what you prefer. What we're also going to notice in this top five is that these things are going to get incredibly boring very quickly.

• 1:33:43Speaker 01

  Right.

• 1:33:43Mark Manson?

  Which is another interesting thing, I think we should talk about it. But, number five, social connection. Socializing in general, I think. We talked about in our emotions episode last year, two or three ideas that we have uncovered on Solve that I think about on a weekly basis, is how socializing is our, like, humans' ability to regulate each other's nervous systems. And when I saw things in that way, it just unlocked so many connections and realizations and understandings. What's ironic about social connection and socializing is that often, people who have anxiety,

• 1:34:22Mark Manson?

  especially people who have social anxiety, it's, you get in this doom loop of like, you're anxious, so you're afraid to be around other people, you're afraid to be vulnerable around other people, you carry a lot of shame, so you disconnect from others, you isolate, you numb, you avoid contact and intimacy, which then causes you to feel even more anxious, feel more shame, to disconnect, isolate even further, and so on and so forth. So there's like, there's a little bit of a upward spiral, downward spiral, that comes with social connection and intimacy. Knowing everything I know about how good socializing, I mean, you and I have done so many episodes on loneliness and social isolation and the importance of socializing, and we

• 1:35:05Mark Manson?

  did a whole five-hour episode on friendships. It doesn't surprise me to see this this high. It makes sense to me that this is kind of bottom of the top five, just given that the problem of anxiety itself is likely to make this a little bit more difficult for people to pursue.

• 1:35:24Speaker 01

  I think one of the more interesting findings I found about this, anyway, was that Loneliness is really a predictor of anxiety, how anxious someone is, but having social support isn't necessarily a predictor of not having anxiety. So it's like-

• 1:35:39Mark Manson?

  It's a protective layer.

• 1:35:40Speaker 01

  Yes, yeah, right, right.

• 1:35:42Mark Manson?

  More than it is a healer.

• 1:35:43Speaker 01

  Right, yeah, exactly, exactly, which I found kind of interesting too. Makes a whole lot of sense though, too, you know, just as social, social animals.

• 1:35:50Mark Manson?

  Yeah.

• 1:35:51Speaker 01

  You know, obviously, the quality of your social network matters a lot, but the baseline is just, don't be alone.

• 1:35:57Mark Manson?

  Yeah.

• 1:35:57Speaker 01

  Don't be, don't be by yourself all the time, at least.

• 1:36:00Mark Manson?

  Yeah.

• 1:36:01Speaker 01

  Yeah.

• 1:36:01Mark Manson?

  One of the other interesting things that, that came up in the research that I saw is that often for people, just the belief that they have that support-

• 1:36:10Speaker 01

  Right, yeah.

• 1:36:10Mark Manson?

  Is actually more important than having the support itself, right? So it's just like trusting that there are people around you who have your back, who are going to take care of you if something goes wrong, moderates the anxiety far more than like actually having people who are showing up and taking care of things and doing things for you.

• 1:36:25Speaker 01

  That seems to just check out on a personal level for me. I have a good, strong friend network. I feel like a good social network, but I don't feel like I lean on them a lot. But just having them there for me, I think that does go a long way.

• 1:36:35Mark Manson?

  I just, I hate asking for help. Are you like that?

• 1:36:38Speaker 01

  Yes.

• 1:36:38Mark Manson?

  Yeah, I'm terrible about that.

• 1:36:40Speaker 01

  I, I do, I, I, I'm bad, yes. I'm very bad about it, but they're still just like, okay, I know it's there.

• 1:36:48Mark Manson?

  Yeah.

• 1:36:48Speaker 01

  If I needed it, it would be there.

• 1:36:50Mark Manson?

  All right, so number four, we're gonna call you out here.

• 1:36:54Speaker 01

  Yeah.

• 1:36:54Mark Manson?

  We're gonna shame you.

• 1:36:55Speaker 01

  Yeah.

• 1:36:56Mark Manson?

  Sleep optimization.

• 1:36:59Mark Manson?

  Who knew, sleep makes you less anxious.

• 1:37:02Speaker 01

  Right, right.

• 1:37:04Mark Manson?

  I can already see all the people like reaching to turn the podcast off because they're like, oh, this, we're, we're gonna get like sleep nutrition, exercise again. No, there's, there's a couple surprises, people, there's sleep, but yeah, sleep is, is huge. Socializing is huge and exercise is huge, but they're the, the one, the top, the top two are not, probably not what you would expect.

• 1:37:26Speaker 01

  Yeah, but it's, I mean, sleep is, it's bidirectional. If you lack sleep, then you're gonna be more anxious. If you get more sleep, you're gonna be less anxious. And there's pretty robust effects around this. They've shown this over and over again. This is for any mental health disorder, just about.

• 1:37:40Mark Manson?

  Yes, I mean, depression, anxiety, like, pick your poison. Again, there's another doom loop here, which is that the more anxious you are, the harder time you are to fall asleep because you're gonna be laying in bed, staring at the ceiling, worrying about the awkward thing you said six years ago. And then the fact that you're not sleeping is gonna make you more anxious, which is then gonna make you more likely to sit in bed and ruminate and stare at the ceiling and worry about the awkward thing you said four years ago. And on and on and on it goes. The other interesting thing that we found with the research is that your brain is basically doing therapy on itself every night while you sleep. And if you're not sleeping, then you're not letting it. You're actively worsening your mental health. So it's interesting, during REM sleep, the brain replays emotional memories with the amygdala turned down, that's your fear processing center.

• 1:38:25Mark Manson?

  Like, have you ever noticed that, you know, a lot of your dreams are like, are kind of like residual of some of the things you've been thinking about or experiencing lately? It's almost like there's a certain emotional processing that your brain is going through while you're asleep. And if you're not getting that deep sleep, that deep restful sleep, then you're robbing yourself of that emotional processing that happens when you're unconscious. Part of me wonders too, because there's a lot of studies and data showing like, that we're more underslept than we've ever been before, that like, just the average person's sleep is very bad. It makes me wonder, like, how much of the mental health crisis has been contributed by just people not sleeping enough?

• 1:39:06Speaker 01

  I mean, I would say with like, the teen mental health crisis especially, I would say this is a huge contributing factor.

• 1:39:11Mark Manson?

  Yeah, they're just like, kids laying awake, scrolling their phones all night.

• 1:39:15Speaker 01

  Yeah, that's gotta be contributing a huge proportion.

• 1:39:19Mark Manson?

  Yeah, and it creates a doom loop, right? Because it's like, if you're not, if you're laying in bed awake, doom scrolling, freaking out, you're not getting that sleep, so you're not getting that processing happening while you're unconscious. So then you wake up with all of this residual anxiety and unprocessed emotional baggage that you carry into the next day, which then makes you even more miserable and more freaked out and more stressed. And so then you lay in bed even longer doom scrolling and you get into this just, this ugly cycle that is really only broken if you can confront the anxiety itself. I mean, would you say this is probably like, socializing in that it's not, it's not necessarily an intervention, it's more like a protective layer, right? Like, it's like the same way having friends doesn't necessarily...

• 1:40:04Mark Manson?

  Remove anxiety, it like protects you in the first place. It sounds like sleep is kind of the same thing.

• 1:40:10Speaker 01

  I think it's a protective effect where it gets you to a baseline. I don't know, is it going to improve your anxiety? If you're sleep deprived, yes.

• 1:40:17Mark Manson?

  Yeah.

• 1:40:17Speaker 01

  Beyond that, I'm not so sure, but yeah.

• 1:40:20Mark Manson?

  Yeah, well, what's interesting is that some of the research has shown that the emotional reset that comes with sleep is lessened at higher anxiety levels. So people who experience extreme anxiety levels, sleep is less of a factor for them. But it's coming back to those, you know, kind of mild, subclinical anxiety issues. Like if you're just, if you're in a really anxious and stressed period of your life and you're not sleeping well, like that's probably one of the simplest levers you can pull. Again, what's mind blowing is, is like, this is free. You're already doing it every fucking day. It doesn't cost any money, yet like how many things on this list have people spent hundreds, thousands of dollars, like putting chemicals into their bodies, supplements, like, yeah,

• 1:41:05Mark Manson?

  just go to bed earlier.

• 1:41:06Speaker 01

  Yeah, yeah.

• 1:41:09Mark Manson?

  Try that, try that for a week.

• 1:41:11Speaker 01

  Consistent, yeah, consistent bedtimes, yeah, consistent beds. That's what I've realized lately anyways, consistent bedtimes help a lot.

• 1:41:18Mark Manson?

  Yeah.

• 1:41:18Speaker 01

  Consistent wake times. Listening to your chronotype too, we talked about this a little bit before too, if you're a morning person versus a night owl. If you're a night owl, don't try to be a morning person necessarily.

• 1:41:28Mark Manson?

  Yeah.

• 1:41:28Speaker 01

  It's okay, unless you have to be, I get it, yeah.

• 1:41:30Mark Manson?

  The other thing that I think makes this more foundational than it is maybe additive is just that like, if you're not sleeping, nothing else on this list is going to work or matter.

• 1:41:40Speaker 01

  Okay, yeah, that I think is a big one, yeah.

• 1:41:43Mark Manson?

  Right.

• 1:41:43Speaker 01

  Yeah. Yeah, you can optimize whatever.

• 1:41:46Mark Manson?

  You can have all the supplements, you can meditate till you're fucking blue in the face, but if you're not sleeping at night, doesn't matter.

• 1:41:53Speaker 01

  Right, yeah.

• 1:41:54Mark Manson?

  Does not matter.

• 1:41:55Speaker 01

  You can drop a bunch of acid. Doesn't matter, yeah.

• 1:41:58Mark Manson?

  I mean. Good psychedelics do interfere with sleep quality. I can tell you from experience. Moving on to everybody's favorite. Everybody's favorite, number three, exercise. Hit, go to the gym, bro. Hit the gym. Do you even lift?

• 1:42:15Speaker 01

  You know, I've heard it in several different forms and places and whatever, but tame the body, tame the mind. We talked about this in the resilience episode as well, though, too, right? Like, developing the discipline to work out or at least be active in some way.

• 1:42:28Mark Manson?

  Yeah.

• 1:42:28Speaker 01

  That has like this almost calming effect on your nervous system because it shows you have some control. Right? And what is anxiety if it's not a lack of control or a sense of a lack of control? And so I, I think more than anything, yes, there is the physical benefit of it. Like you're getting endorphin release and like all of that kind of stuff. But where I think the actual benefit of exercise comes in is that you are exercising that kind of control over your mind.

• 1:42:52Mark Manson?

  Yes.

• 1:42:53Speaker 01

  And you're showing yourself that, oh, I have some agency here. When I, even when I don't want to do things or even when things are uncomfortable, especially when things are uncomfortable.

• 1:43:00Mark Manson?

  Yeah.

• 1:43:01Speaker 01

  Like I am exercising some form of agency here. And so tame the body, tame the mind.

• 1:43:06Mark Manson?

  Yeah.

• 1:43:06Speaker 01

  That's, that's how I see it.

• 1:43:08Mark Manson?

  I think that's a beautiful explanation of like the cognitive side of this. I, in the process of doing research, I came across a paper that described exercise in a way that I had never heard before, which blows my mind because I feel like exercises, people have talked about it frontwards and backwards, but it basically it was like every hard workout is practice for being afraid.

• 1:43:31Mark Manson?

  Like if you think about it, it's like, what happens when you're, when you're afraid, right? Elevated heart rate, shallow breathing, you start getting sweaty, adrenaline courses through your body. Like exercise, lifting really heavy weights is training your body and your nervous system to be afraid and be okay being afraid. Like you are, you are physiologically putting your body in the same state that it is. When you're experiencing fear, exercise is a controlled environment where you are training yourself to be okay, to act despite it. And then the cognitive piece comes in of like, I'm choosing to do this. I'm feeling, I'm feeling the strain, I'm feeling the adrenaline. I'm like, my heart rate is through the roof, but I'm not gonna stop. I'm gonna get that

• 1:44:15Mark Manson?

  last rep. And it's, it's every time you're pushing through that, that difficulty and that strain, every time you are feeling kind of that panic, that like, that fast heartbeat and the fast breathing and, and you know, your, your fingers are tingling and you're like, one more rep, one more rep. Like you're kind of training your mind to act despite the physiological signals.

• 1:44:41Speaker 01

  Yeah.

• 1:44:42Mark Manson?

  And so I just thought that was so fucking cool.

• 1:44:44Speaker 01

  Yeah, yeah.

• 1:44:44Mark Manson?

  I never thought of it that way.

• 1:44:46Speaker 01

  You're using the agency that you have to like, purposefully induce an anxious state in yourself and realizing that it's okay.

• 1:44:53Mark Manson?

  Yeah. As you would expect, there is just like, an absolute dump truck worth of research on this. The largest meta-analysis we found had over a thousand high-quality randomized controlled trials, over 128,000 participants, and just consistent moderate effect sizes across the board, across diverse populations, any country, backgrounds, age, gender, whatever. What's interesting is that exercise affects anxiety on a, on a number of neurobiological pathways, right? So it increases BDNF, which I don't know what the fuck that is. You wrote here fertilizer for neurons, so I'm gonna believe you. But it

• 1:45:35Mark Manson?

  spikes serotonin, norepinephrine, dopamine, decreases neuroinflammation. If I was to put on my, my Andrew Huberman glasses here and, and tell you the most effective exercise protocol for anxiety, you can literally do anything. It's aerobic resistance, intervals, like, any, basically anything that is moderate to high intensity, like. Anything that, anything that other than low intensity exercise, 20 to 45 minutes per session, three to four sessions per week. Basically, what they find is that the consistency is what matters more than what you actually do. So as long as you are showing up exercising on a consistent basis, doesn't even have to be that like 20 minutes is not that much.

• 1:46:15Speaker 01

  Yeah. See, and that's what I think, that's why I think it's more of a, like it's a practice. It's, it's more of a tame the body, tame the mind type of practices because the consistency is what matters, not necessarily what you do.

• 1:46:28Mark Manson?

  Yes.

• 1:46:28Speaker 01

  So to me, that's, oh, okay, I'm going, I'm, I'm going in and I have, again, I have some agency.

• 1:46:34Mark Manson?

  Yes.

• 1:46:34Speaker 01

  And I'm able to create some sort of discipline around this and that gives me a little bit of calm and peace of mind at least.

• 1:46:40Mark Manson?

  Yeah. I had this social media post a couple of years ago that went super viral. And it was basically like, imagine if there was a pill that improved your mood, helps you regulate your emotions, improves your sleep, helps you lose weight, helps you have better sex, decreases anxiety and depression and improves your longevity. Oh, and it's free and it's available 24/7. Yeah, that pill's called fucking exercise.

• 1:47:07Speaker 01

  Right, yeah.

• 1:47:08Mark Manson?

  It is like, when you think of it in those terms, it is just kind of absurd. And it's also even more absurd that so many of us don't do it regularly. Like I'm, I injured my foot a few months ago and so I'm like, I lost a lot of my exercise. Like I didn't exercise much over the, for two or three months and like now I'm trying, the foot's healed, so I'm trying to get back into the gym.

• 1:47:27Speaker 01

  It's, it's log, isn't it?

• 1:47:28Mark Manson?

  It sucks, man. It sucks.

• 1:47:31Speaker 01

  If I take a week or two off, I start feeling.

• 1:47:33Mark Manson?

  Yeah, I'm like.

• 1:47:34Speaker 01

  I, that's the other side of this though too, is like, once you start doing it, if you stop, I mean, it's like taking a benzo, man. You gotta keep going, you know?

• 1:47:41Mark Manson?

  Yeah, I mean, there, there's, there's inertia in both directions, right? So it's the, the longer you haven't done it, the, the harder it is to start. But the more you've done it, you know, the, the easier it is to keep going. All right, number two. I'm not gonna lie, this showed up higher than I expected.

• 1:47:59Speaker 01

  Okay.

• 1:48:00Mark Manson?

  Meditation. Little, little surprised. I mean.

• 1:48:04Mark Manson?

  I expected that it would have worked. I would not have expected that it would have been this high on the.

• 1:48:11Speaker 01

  Okay, why is that?

• 1:48:12Mark Manson?

  Maybe it's just because I'm not somebody who like struggles a ton with anxiety, but like, I don't know. It just, I've never found it from like a purely kind of mental health, you know, uh, mental stability point of view. I have not found meditation to be the most useful intervention. It's useful and I did it for a long time and I definitely recommend it, but it's like, I would have put exercise above it. Like I definitely feel like my mental health, my mood, my anxiety, my happiness, like everything is, my relationships like are noticeably better when I'm exercising consistently. I mean meditation too, but like it's not as like clear as that.

• 1:48:55Mark Manson?

  Like if I don't work out for a week, like I feel it.

• 1:48:58Speaker 01

  Yeah.

• 1:48:58Mark Manson?

  Whereas like meditation, you know, if I didn't meditate for a day, like I, I never really noticed.

• 1:49:04Speaker 01

  Well, okay, I think that might be the difference though, is that meditation is a little bit of a slower burn. Specifically too is that like, um, stress induced anxiety.

• 1:49:13Mark Manson?

  Yes.

• 1:49:13Speaker 01

  I think is pretty well taken care of with, with meditation. You know, we did, we had an episode on meditation.

• 1:49:18Mark Manson?

  Right.

• 1:49:19Speaker 01

  We talked about some of the common pitfalls and some of the hype around meditation, that it wasn't correct. Uh, you know, that it was overhyped essentially. But one thing we did say was that stress induced anxiety responded pretty well to, um, to meditation. Specifically like mindfulness based stress reduction.

• 1:49:35Mark Manson?

  Yes.

• 1:49:35Speaker 01

  Which is like an eight week program. I believe Jon Kabat-Zinn was very instrumental in, in developing it.

• 1:49:40Mark Manson?

  Founding it, yeah.

• 1:49:41Speaker 01

  There's a whole, it's very structured. It like I said, eight week program. There's physical aspects to it too. So there is some exercise involved with it. So I think you're right. I think in the moment, maybe like I would go for a workout or even just a walk. Um, that's going to help your anxiety more short term and long term, of course, too. Longer term, though, I think the cognitive benefits of meditation are going to come into play in a way that exercise might not.

• 1:50:10Mark Manson?

  Yeah.

• 1:50:10Speaker 01

  That said, I think you're right. I think they're, I mean, they're number two and number three. They're like.

• 1:50:13Mark Manson?

  Yeah, a lot of this research was done on the full MBSR protocol, right? Which is like eight weeks long, multiple hours a week, in some cases, full day meditation retreats. So the research, a lot of this research seems to be coming from pretty intense meditation practices. Like, it's not like, it's not like people pulling out the waking up app for 10 minutes and like, once a week. When they measure that, they don't see a whole lot. It's more from serious meditation over an extended period of time. That's my understanding of it at least. Whereas, I think exercise is more of the thing where it's like, you can start working out and like, probably within a week, you're going to feel better.

• 1:50:55Speaker 01

  Yeah, yeah, okay. Yes, I would agree with that, too.

• 1:50:58Mark Manson?

  So it's like, it's more of a dosage thing, I think.

• 1:51:00Speaker 01

  Okay.

• 1:51:01Mark Manson?

  Right? Where it's like, it seems like meditation is super effective, but also the dosage is pretty high. Like, you can't just sit for five minutes.

• 1:51:11Speaker 01

  Yeah.

• 1:51:12Mark Manson?

  Do you agree with that? I don't know, like, I.

• 1:51:14Speaker 01

  Yeah, oh, yes. You know, I agree. Like, a five or 10 minute meditation, even once a day, yeah, that's probably not going to do a whole lot for your anxiety specific.

• 1:51:21Mark Manson?

  Yes.

• 1:51:22Speaker 01

  That said, I'll go back to.

• 1:51:22Mark Manson?

  Doesn't mean you shouldn't do it.

• 1:51:24Speaker 01

  Again, yes.

• 1:51:24Mark Manson?

  Again, we're talking about anxiety, but yeah.

• 1:51:26Speaker 01

  Yeah, yeah. Like I said in the meditation episode, I don't think that's why you shouldn't necessarily meditate either. I think it will help you with your anxiety. It changes your relationship to your thoughts, whether those thoughts are anxious or.

• 1:51:38Mark Manson?

  Yes.

• 1:51:38Speaker 01

  Whatever they are. And so you can see them more clearly and there's, I think, it gives you a sense of what you can do with those feelings and those thoughts.

• 1:51:47Mark Manson?

  Yes. Yeah, meditation does not reduce anxious thoughts. It doesn't actually, meditation doesn't change any of your thoughts. It changes your relationship to your thoughts.

• 1:51:57Speaker 01

  Right.

• 1:51:57Mark Manson?

  And so people will often come to meditation expecting meditation to kind of turn the volume knob down on their life and on their anxieties, when really, what it does is it just, it helps you. Better sit with the noise and understand the noise. I agree with you. There is like a lot of misconceptions around what meditation does. And I'm sure there is a certain calming effect, you know, of just sitting quietly for a certain period of time, but I do think the long-term benefit of meditation really is in that like cognitive reappraisal of like, what does this mean? Why do these thoughts keep coming up? Why do I resist them? Why do I fight them? What am I so afraid of?

• 1:52:39Mark Manson?

  Like, all of these kind of deep questions that you have to sit with for a certain period of time to like, resolve them.

• 1:52:47Speaker 01

  Yeah. You see the forest through the trees a little bit better, I think, with meditation. And I, yes, all the ancillary benefits you get with it, decreased anxiety, or, you know, better stress coping, whatever it is. Again, I think it's just, that's all secondary to just knowing your mind better. And yet, that takes some of the edge off right there. Just knowing your patterns and knowing why you do what you do.

• 1:53:08Mark Manson?

  I wonder how much of it too is actually kind of a bleed over of that digital detox. You know, going for a walk and getting rid of a screen, like, definitely makes you feel better in that moment. And then as soon as you come back, everything kind of comes back. Because I know a lot of people who do meditate for like, five minutes every, every two or three days, and they like it. So it makes me wonder if like, that's actually what they're experiencing, right? It's just like, sitting in a quiet room without their phone. It allows them from, to like, get away from all of the noise and chaos that's going on around them.

• 1:53:40Speaker 01

  Yeah. That's, I get, that's one of the benefits I get out of it, for sure.

• 1:53:44Mark Manson?

  Yeah. That said, if you do meditate, definitely recommend the Waking Up app. Because it's more serious courses, longer, in-depth, more philosophical. I think that's where you get more benefit, you know, rather than the quick hits that you get from a lot of other apps.

• 1:54:00Speaker 01

  The introductory course on Waking Up 2 is, it's fantastic. Like, just going through that alone will-

• 1:54:06Mark Manson?

  So good.

• 1:54:06Speaker 01

  Is, is worth it. And then, we've got to deal with Waking Up right now, where you can get thirty days for free, so you can take the whole introductory course for free-

• 1:54:12Mark Manson?

  There you go.

• 1:54:13Speaker 01

  So, I mean, it's no risk whatsoever.

• 1:54:16Mark Manson?

  What I love about that course too, is that it is exactly what you talked about. It's like, it's all about your relationship with your own thoughts. Because other apps, it's like, they, they try to just get you to-

• 1:54:25Speaker 01

  They have benefits, yeah. It's for the fit this crowd.

• 1:54:27Mark Manson?

  Yeah, they're like, oh, relax, breathe, you know, it's like, Waking Up is like-

• 1:54:33Mark Manson?

  Let's talk about your mind. Who's observing the thoughts right now?

• 1:54:35Speaker 01

  Right. Who are you?

• 1:54:37Mark Manson?

  Who are you? And then you sit with that for 10 minutes and it's like, it's pretty cool.

• 1:54:41Speaker 01

  I love it.

• 1:54:42Mark Manson?

  All right. Last but not least, drum roll, please. This is not gonna...

• 1:54:49Mark Manson?

  This is not gonna surprise anybody. Therapy comes out on top.

• 1:54:54Speaker 01

  Sorry.

• 1:54:58Mark Manson?

  What is interesting about this, though, is different modalities of therapy all perform well, but in slightly different contexts.

• 1:55:08Speaker 01

  Right.

• 1:55:08Mark Manson?

  So like the heavyweight, especially around anxiety, is CBT, cognitive behavioral therapy. And I do think it is pretty well established at this point that like CBT is probably the best intervention for anxiety issues. But I did find it interesting that ACT is also effective for certain individuals and certain flavors of anxiety. I love ACT.

• 1:55:28Speaker 01

  Yeah, ACT is pretty cool.

• 1:55:30Mark Manson?

  Yeah, I like ACT a lot. And then, and then of course, exposure therapy, which is taking bite sized chunks of your fear and exposing yourself to them. We've had a lot of kind of sidebars on therapy over the years on this show. You know, it's another one of those things that I think is both overrated and underrated, depending on the context and depending on the person. It definitely seems that for anxiety, it is not overrated. It is very legit, very consistent, helps a lot of people, very replicable findings across the board.

• 1:56:04Speaker 01

  And yet, which I found this pretty surprising too, fewer than 20% of people with an anxiety disorder get therapy for it, which I thought was pretty crazy.

• 1:56:13Mark Manson?

  That's so interesting.

• 1:56:14Speaker 01

  That's pretty wild, yeah.

• 1:56:15Mark Manson?

  Why?

• 1:56:16Speaker 01

  Well, I don't know. Yeah. And I don't know how accurate that number is necessarily either, but yeah, there's some numbers out there to suggest that it's very much undertreated.

• 1:56:24Mark Manson?

  One of the things that I found, you know, when we were doing market research for purpose, you know, I did a lot of research into kind of the therapy market, the mental health market, the counselors, coaches, life coaches, all that stuff. It is shocking how undersupplied the market is. Well, I didn't realize that is that like for every therapist or coach, there's like... Eight to 10 people who want access to a therapist or coach. And I think the biggest hurdles for a lot of people is is financial. Or they just live in a remote area. They don't have access to anybody.

• 1:56:55Speaker 01

  Right. CBT, therapy in general, too, is they, there's kind of what they call a durability advantage.

• 1:57:03Mark Manson?

  Okay.

• 1:57:03Speaker 01

  Which is, especially for CBT, though, the skills you learn during your CBT sessions, during your training, I guess, or your, your, your therapy. The whole point of it is to teach you how to manage your anxiety or any other uncomfortable emotions that you might have out in real life. And so the advantage of that is, is you get better at it over time, even after you stop therapy, because it gives you these tools and you go out and you practice them in the real world and you get better at it if you have a good therapist, anyway. So all these randomized control trials that they did a meta-analysis on, found that post, 12 months post-treatment with GAD, with generalizing anxiety disorder, a huge percentage

• 1:57:45Speaker 01

  of people, like, were still at, like, near post-treatment levels, anyway, of anxiety. So they, they basically had fixed it a year later still. So, pretty durable advantage, which in the mental health world, anything that lasts over a year, that's pretty, that's pretty good.

• 1:57:59Mark Manson?

  It's rare, yeah.

• 1:58:00Speaker 01

  Yeah. Other studies have found very similar results as well. So, you know, like, older adults even, too, you can find kind of full diagnostic remission, even, over, even more, more so than with medication. So if you start taking medication and stop it, there's a good chance later on, you're going to have to restart taking those medications. With CBT and ACT and some other modalities as well, they find that's not, that the, the failure rates aren't nearly as high as that, too. So it's much more durable advantage to it.

• 1:58:30Mark Manson?

  Interesting.

• 1:58:30Speaker 01

  Yeah.

• 1:58:30Mark Manson?

  I think the thing that most people miss about therapy is that the point is to eventually stop. Like, I-

• 1:58:39Mark Manson?

  Therapy is one of those weird industries where you can judge the usefulness by how many people quit.

• 1:58:46Mark Manson?

  I always get very wary when I meet people who are like, "Oh, I love my therapist. I've been going to them for 12 years." I'm like, "Wow, probably not a good therapist."

• 1:58:57Mark Manson?

  But what's interesting is that you see this in the research as well, is that like, when people enter therapy, they get a boost to their outcomes. But what's more surprising is that leaving therapy, many people often get another boost to their outcomes as well. And I think this is one of those things, I've written about this a long time ago, I wrote about this in some articles, that you start in this place where something's wrong in your life, you don't really know what it is. And so the first big improvement comes from just getting an understanding of what the problem is and how to approach it. But then, the fixing of the problem becomes a bigger problem than the problem, right? And so the next big level up comes from stopping fixing the problem.

• 1:59:40Mark Manson?

  And I think that second lever is where a lot of people get lost. They start to feel, I think, maybe dependent or addicted to whatever, you know, therapy or intervention that they're doing. You see this in the self-help world a lot, people just keep going to seminars forever. And it's like, well, actually, the fact that you keep going to seminars to fix yourself is the bigger problem than the things you're trying to fix. If you just stopped going to seminars, like, you'd probably be pretty happy. It's a very common problem, and not just the self-help industry, but just the mental health space in general. And I think the best therapists and coaches are the ones that recognize it, and they understand when to cut a patient off and when to say, "You know what? You're doing pretty well. I don't think you should be worrying about this so much.

• 2:00:25Mark Manson?

  Why don't you just go live your life and see?" I used to run into this all the time, where I'd get emails from people, and they're like, "I've read all the books, I'm like, taking all the courses, and it's just making me more anxious, and I'm more worried, and I'm like, judging myself because there's all these things I know I should do, and I'm not doing them," and on and on and on.

• 2:00:43Mark Manson?

  Reply to him, I'm like, so stop reading the books.

• 2:00:47Speaker 01

  The problem is not more information.

• 2:00:49Mark Manson?

  Like, I'm like, nobody's putting a gun to your head and making you read more books. Like, just fucking stop reading the books. Go live your life. I think a lot of people assume that you have to have some sort of like, action plan to like, implement all this stuff that you're not going to actually change unless you, you know, you have like a spreadsheet mapped out. And it's like, no, like, a lot of this stuff just kind of seeps into, into the background of your decision making. And, you know, if you don't have like, consistent opportunities to make different decisions, then you're never going to be able to implement those different decisions. So ultimately, self-improvement requires you to go back and live in the world.

• 2:01:27Speaker 01

  A couple of caveats we should mention here.

• 2:01:30Mark Manson?

  Okay.

• 2:01:30Speaker 01

  As well, too. You've already mentioned a few things like, you know, it's expensive, it's hard to access sometimes.

• 2:01:34Mark Manson?

  Yeah.

• 2:01:34Speaker 01

  Very true. Dropout rates are actually very high, too.

• 2:01:38Mark Manson?

  Yup.

• 2:01:39Speaker 01

  People, a lot of people start therapy and then they have the opposite problem where you were just describing, instead of staying too long, they don't stay long enough.

• 2:01:45Mark Manson?

  Yes.

• 2:01:46Speaker 01

  So you, I think you do, I don't think there's a set number or a set time that you need to be in therapy necessarily, but, you know, I would say, give it six months, minimum, and try to stick with it, because they really don't, it's hard to fix somebody's life in just a few sessions, right? That's just, that's not gonna happen.

• 2:02:02Mark Manson?

  The other issue is some therapists suck.

• 2:02:05Speaker 01

  Yeah, yeah. Quality varies a lot.

• 2:02:08Mark Manson?

  Yes.

• 2:02:09Speaker 01

  In any profession like this.

• 2:02:11Mark Manson?

  Yes.

• 2:02:12Speaker 01

  Yes, quality's gonna vary a lot.

• 2:02:13Mark Manson?

  And

• 2:02:14Speaker 01

  You gotta shop around.

• 2:02:14Mark Manson?

  And there is some evidence that the best therapists actually drive most of the results. This is one reason why I'm bullish on AI in this area, and I don't think AI can completely replace therapists and coaches permanently, but like, I've been around long enough, I know how mediocre, how many mediocre therapists and mental health professionals there are out there. I've heard from so many fucking people of like, I was in therapy for years, like, my therapist was awful, I had no idea, and then I switched, and oh my god, my new therapist is so much better, and I'm, now I'm having like, all sorts of breakthroughs and stuff. There's also like, chemistry issues.

• 2:02:48Speaker 01

  Yeah.

• 2:02:48Mark Manson?

  So I just think it's, it's such a hard thing to scale, and it's such a hard thing to like, quality control, that I, I'm convinced that at some point, AI is just gonna take over most of it and go download purpose.app.

• 2:03:01Speaker 01

  Yeah.

• 2:03:03Speaker 01

  I mean, I, we definitely have hit a ceiling. And that's another, you said spinning your wheels. I think we, effects sizes have not improved.

• 2:03:11Mark Manson?

  Yes.

• 2:03:12Speaker 01

  For therapy in 30 or 40 years.

• 2:03:13Mark Manson?

  Yeah.

• 2:03:14Speaker 01

  About somewhere in the 30 to 40% range of people just don't respond very well to therapy. Again, that could be because they're dropping out too early or just not, you know, they're not putting in whatever. But we need to figure that out and we haven't figured that out in 30 or 40 years.

• 2:03:25Mark Manson?

  Yeah. So, yeah, it is, it is the fact that there have been no improvements on this front.

• 2:03:30Speaker 01

  Yeah.

• 2:03:30Mark Manson?

  Since you and I were born.

• 2:03:32Speaker 01

  Right.

• 2:03:32Mark Manson?

  Is a little.

• 2:03:33Speaker 01

  CBT in the eighties. Yeah.

• 2:03:34Mark Manson?

  A little bit of a red flag. The other thing that doesn't get broadcast a whole lot is that, that actually a small percentage of people actually respond negatively.

• 2:03:40Speaker 01

  Right. Yeah.

• 2:03:41Mark Manson?

  To therapy. Right. So it's like some people, you can go to therapy and be worse.

• 2:03:44Speaker 01

  Yeah.

• 2:03:44Mark Manson?

  And it is, that's not broadcast a whole lot. I think it's not broadcast because overall, not enough people are going. I also think you can overdo therapy. Like I think it's especially in, in some of the wealthier parts of like, say the US. I think people are over therapized, you know, especially young people, especially kids, you know, it's like a lot of kids. By the time they're, they graduate from high school, like they've already been through 10 years of therapy and like three different therapists. And it's like, you know, like, maybe you should just let a kid be upset.

• 2:04:19Speaker 01

  Being a kid's hard. Yeah.

• 2:04:20Mark Manson?

  It's fucking hard. It's fucking hard, but that's, that's another podcast.

• 2:04:31Mark Manson?

  Any, any final thoughts you want to wrap up with? Any observations in general?

• 2:04:36Speaker 01

  Well, I, we've been hitting at this the whole time, but I think if you are going to address your anxiety, the quick fix is not the.

• 2:04:46Mark Manson?

  Yeah.

• 2:04:46Speaker 01

  The one you should reach to first, for sure. Panic attacks and stuff like that aside, obviously you want to get through those, but you know, reaching for a drink is obviously, it makes it worse. That's the one we started with. It's the absolute worst one for a reason. And there's varying degrees as we go through this, you know, if just going for a walk or some exercise, yeah, it kind of helps with this, but maybe not that. The quick fix is not where it's at though. It's a long-term, probably lifelong thing for most people. I'm, I still struggle with anxiety at times. I just, I do. And it depends on my sleep and it depends on my, my exercise and all of these things that we've talked about today. Sure. But I will say, if you want like a durable lasting change to it, reaching for those quick fixes. It can't, it can't be the answer.

• 2:05:29Mark Manson?

  It is interesting in this episode, you know, the list is really clear. Everything in the top, everything that is in the legitimate category is a lifestyle change. Everything outside of the legitimate category is a quick fix.

• 2:05:42Speaker 01

  Right, yeah, a supplement, or yeah.

• 2:05:44Mark Manson?

  Yeah, or like a-

• 2:05:44Speaker 01

  Do this one thing, one time.

• 2:05:45Mark Manson?

  Yes.

• 2:05:45Speaker 01

  Not gonna work.

• 2:05:46Mark Manson?

  Yeah, I think my takeaway is that everything that actually works for anxiety is just uncomfortable. And I-

• 2:05:53Speaker 01

  It's anxiety inducing almost.

• 2:05:55Mark Manson?

  Right, like that's the thing nobody wants to hear or accept, that there's, there's, there's not a comfortable way out of this. And I, I think in a way you could say that chronic anxiety is kind of an unwillingness to tolerate discomfort, or a certain threshold of discomfort. And I think ultimately that's what exposure therapy is. I think that's, you know, you talked about it with yoga, we talked about it with exercise, like, everything that works to some extent is an exposure to discomfort, and an acclimation to a certain amount of discomfort, like raising your, your threshold of the amount of discomfort that you're willing to sit with. People don't like to hear that, people don't want to accept that, they don't, they don't want to deal with the consequences of that.

• 2:06:38Speaker 01

  It's why they leave therapy a lot of times, too.

• 2:06:40Mark Manson?

  Yeah.

• 2:06:40Speaker 01

  It's, it's too uncomfortable.

• 2:06:42Mark Manson?

  I also think part of it is probably why some of the pharmaceuticals are, are over-prescribed. I imagine there are a lot of people that just ask for it, "Just give me the pill, doc." Yeah, I don't want to talk about my problems, I, like, I'm stressed, like, you know, "Give me some Lexapro," or like, whatever, and the doctor's like, "Sure, here you go."

• 2:06:59Speaker 01

  Yeah, yeah, and, you know, doctor's caseloads are high, too, you don't want to, like, pin too much-

• 2:07:02Mark Manson?

  Yeah, yeah, we're not shitting on doctors.

• 2:07:04Speaker 01

  Yeah.

• 2:07:05Mark Manson?

  What's your biggest surprise and what's your biggest takeaway?

• 2:07:08Speaker 01

  Um, my biggest surprise, I mean, yeah, therapy.

• 2:07:16Speaker 01

  It was one of those things, I guess, though, I, I was surprised that ACT and CBT, like- What you mentioned that they were, they're, they're basically opposite approaches.

• 2:07:26Mark Manson?

  Yes.

• 2:07:26Speaker 01

  Get you to the same place, which is pretty wild.

• 2:07:29Mark Manson?

  It is interesting.

• 2:07:29Speaker 01

  The lesson from that is old school, like kind of like exposure to whatever you're anxious about. And just seeing, again, it goes back like with the exercise, you have some agency over it. Exercise that agency. No, you can't control all of it.

• 2:07:41Mark Manson?

  Yeah.

• 2:07:41Speaker 01

  That's also part of it too, is just accepting that you can't control part of it. Which is where ACT really shines, I think, but like the more you can build evidence. Right? That you have some sort of agency around whatever you're worried about. It might not be ideal. It might not be a perfect solution. But I think it's not so much that we're always worried about what's going to happen. It's that we're worried that we don't know what's going to happen or that we don't have any control over it. And while that's true, you don't have a lot of control over what happens to you. I, I think you just do have a lot of agency around how you approach it and how you see it.

• 2:08:16Mark Manson?

  It's funny. I feel like we're, we're just kind of landing back on Stoicism.

• 2:08:20Speaker 01

  Yeah. Yeah. I think Stoicism is a good philosophy.

• 2:08:23Mark Manson?

  A little, little bit of existentialism. I mean, we've noted before how much CBT seems to flow directly downstream from the Stoics. And CBT is the most effective, you know, anxiety intervention. The biggest surprise for me, I, I guess, I guess it would be meditation. And maybe I've been discounting it too much lately, but, and maybe also I discount it just because it's, it's for me. I never meditated for anxiety. That was never my issue. It might, for me, it was always more focus problems. And also like self-exploration, self-awareness. I was very interested in a lot of philosophical questions around consciousness and identity. I guess that was a little bit, a little bit surprising for me, or just the, the, the size, the significance of the effect size.

• 2:09:08Mark Manson?

  And therapy, a little surprised, not surprised. One of the things I do tell friends is I say like, the, the one thing that therapy really punches its weight is, is for anxiety.

• 2:09:20Speaker 01

  Yeah.

• 2:09:20Mark Manson?

  Like that I've seen over the years that consistently, CBT especially, like just for anxiety. It's, it's kind of the best thing you can go to. All right, everybody. That was another episode of the Solve Podcast. We have solved anxiety. Forever. Thank you, everybody, for listening. This was the Solve Podcast. I'm Mark Manson. This is Drew Bernie. We will be back in a couple of weeks. Go to solvedpodcast.com/anxiety to download some free, cool materials. If you haven't checked out Purpose, check out purpose.app. It is my AI coach that I co-founded, and we have a free seven-day trial, so you can talk to the AI about all of your anxiety problems, and it will, it will definitely let you know what it thinks. Like and subscribe,

• 2:10:03Mark Manson?

  review, follow us, be, be our friends. We love you. See you next time.