Chapter 1: What is anxiety and why do we experience it?
Hey guys, Mark here. So have you ever had a real breakthrough, like actually understand something about yourself and then two weeks later you're doing the exact same shit again? That's the problem with online courses and content in general. They can give you the plan, but they can't coach you through the moment when life gets in the way. And then there's another problem with AI tools.
They don't actually know you. They just give you generic advice that sounds smart, but doesn't translate into your actual life when it really matters. So I tried to solve both of these problems separately. I built nine courses on the stuff that people actually struggle with, boundaries, procrastination, emotions.
And then I co-created Purpose, an AI coach that actually learns who you are and challenges you when you need it. Now they're together for the first time. You do the exercise from the courses, you talk to the coach about what came up, and then the coach already knows your patterns, your blind spots, what you've been working on, and all of the other exercises that you've done.
That's how this stuff can actually stick. So for a limited time, I am selling both of my flagship products, the Solve membership courses and the Purpose AI app together once and for all. So check it out. Go to purpose.app slash solve. Link is in the show notes below. Welcome to Solved, everybody.
I'm your host, Marc 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 Burney, 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 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, 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.
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.
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Chapter 2: What are the common misconceptions about anxiety interventions?
justify that emotion after the fact. I think to a certain extent, anxiety, because it is an outcrop of us trying to predict the future, it is somewhat cognitively induced.
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 or a little bit more cognitively.
Address those underlying thoughts. Yeah, exactly. So it's kind of like, it's our ability to predict or, or our, our penchant for prediction. Yes. What you're saying, marrying that with our, our negativity bias almost too, right? Yes. You could define an anxiety almost like that.
Like it's our, we have this like strong, just like desire to predict the future and, and try to figure out what's going to happen. But we're also very negatively biased towards bad things happening as well, which is an anxiety.
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. 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 line? 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, the more you worry about something, 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 when anxiety is actually useful, you don't get to experience that usefulness. Right? Because all you know is that like the bad thing didn't happen. So let's talk about causes. Like 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 percent of anxiety 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. I think in personality research that you would just call this a highly neurotic person.
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Chapter 3: What are the cultural perceptions of anxiety today?
You know what's a massive source of anxiety that nobody likes to admit? Money. You know, where you know you should be doing something smarter with all your savings, but you don't have the time or energy to figure it out. So you leave it in some big bank account earning basically nothing and try not to think about it.
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For more information, please see the episode description. 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. 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 going to 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 anxiety. in the long run.
Yeah, I mean, about one in four 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. There's such a quick fix. 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.
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Chapter 4: How do genetics and environment influence anxiety?
Really? Journaling.
Mm-hmm.
Why is journaling this low? Well, okay. It's a little bit of a nuanced story here, right? Yes. What do you mean by journaling, I guess, first? That's the first question you have to ask yourself.
Pulling out a piece of paper, writing out your thoughts. Okay. 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.
This is specifically for anxiety. 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. 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.
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.
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Chapter 5: What is the role of sleep in managing anxiety?
Moving along, we're about halfway through, we're now in the top half. This one surprised me.
Yeah, I'm not so sure about this one.
This episode is brought to you by Waking Up. So here is something that took me a long time to understand about anxiety. Anxiety isn't really the problem. The problem is that when you're anxious, you're controlled by the anxiety. You can't see it. You are it. The thought is driving and you are just along for the ride, which is actually the thing that got me into Waking Up.
and why Drew and I both still use it. It's the only meditation app that I've ever stuck with, and I've been meditating for over 20 years now. It doesn't teach you to calm down or think positive. It teaches you to watch your own mind in real time, to catch the anxious thought the moment it shows up, instead of being 10 minutes deep into a spiral before you realize that you're spiraling.
It was created by Sam Harris, the neuroscientist, philosopher, best-selling author, and you can feel that inside the app.
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Chapter 6: How does exercise help with anxiety?
They're grounded lessons from world-class teachers, no religious dogma, and just people who are serious about understanding how their mind actually works. I curated a playlist of my favorite waking up content for you to sample, and they're giving Solved listeners a free 30-day trial so you can try it with no risk.
And if you keep it, you'll get $30 off your annual membership, meaning it's only $119 a year, which is a great offer. So if you want to check it out, go to wakingup.com slash solved. That's wakingup.com slash solved. Adaptogens. This is another one.
I mean, if this came low, 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 get at the grocery store here that has ashwagandha in it. Actually, the energy drink I drank this morning had rhodiola in it. So this stuff is showing up
Everywhere, Afroganda, Rhodiola, Holy Basil. Early numbers were shockingly good. Some incredible effect sizes, but it seems like we're still early days on this.
Chapter 7: What are the benefits of meditation for anxiety?
Yeah, I think we have 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 variable, right? So you just get a huge, a lot of heterogeneity there.
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?
Some of the basics are just like having an actual random sample of people who show up to this. Not just college students. Not just college students or even like for some reason your experimental group and your control group are completely different types of people. 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 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. Right.
Chapter 8: Why is therapy considered the most effective intervention for anxiety?
We don't know if that's a placebo or not at that point. There's that size of the study matters, too. So how many people are in it? 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?
You know, like a lot of these, especially with supplements, are going to be funded by the supplement company. And even if it's a blind study, that can still influence things one way or the other. Those are some of the big ones, for sure. But 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.
It's probably worth noting too that one of the biggest barriers to really good research is just funding. To get a good sample size, to get a nice variability of people in that sample, it costs money. You need to go find thousands of people, tens of thousands of people that come from all different walks of life. That takes a long time. There's lots of recruiting. You've got to put out ads.
You've got to 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.
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, that's because they were like, well, we can't do the perfect study. So we're going to do a good enough study. And then those headlines get picked up and going out of proportion.
So yeah. And then you also get this situation where there is, say, an 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 – That was the tobacco companies. Yeah, yeah.
Yeah, yeah, yeah.
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