How to Overcome Anxiety, Solved

0:00 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 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

0:45 going to talk quite a bit about that, about the the relationship between the 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, benzoazipines, 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 they work, how longasting the benefits are, whether there are any benefits or not, and how strong the actual research behind them

1:32 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 sorted depends category, the stuff that maybe works for some people, not for others, maybe works in some situations, but not 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 the effect is so minuscule that like you're not really doing anything, but you're not hurting anything either. And then finally, there's the [ __ ] category, which is the pseudocience, the stuff that is potentially harming you, and the stuff that is counterproductive.

2:17 We will start with the [ __ ] 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 everpresent these days, Drew. Seems like everyone in their dog has anxiety. I use that saying a lot. Everyone in their dog. But like in the case of anxiety, >> literally. >> 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?" >> And they're maybe even on meds, too, their dogs. Yeah. Yep. >> Is this This is how far we've come. >> This is This is where we're at. >> This is where we're at. All right. Everyone on their dog has anxiety. So, we will inevitably get into many of the mechanisms and processes behind anxiety. We will get into a lot of the cultural

3:04 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 allaround sick man, Drew Birdie. >> Uh, in more ways than one. >> Yes. Yes. And this is the Solve Podcast, where we are the most overressearched and comprehensive personal growth and life advice podcast in the world. If you love the show, please like and

3:50 subscribe. Leave a comment. Share with some friends. Follow us at solpodcast.com. >> You ready? >> I'm ready. >> Let's do it. >> 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 sematic 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

4:38 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 going to happen. >> 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. Okay. >> 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

5:23 that doesn't really work is just trying to >> uh apply to the emotion whereas the things that tend to work a little bit better >> are a little bit more cognitively >> address those underlying thoughts. Yeah. Exactly. So it's kind like it's our ability to predict or or our our penchant for prediction where you're saying marrying that with our our negativity bias almost too, right? Yes. >> You could define 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. That's 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. Right? This is how anxiety differs from fear. >> Fear is present-based and it's very

6:09 specific. Let's say we're on the savannah 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 savannah 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, like 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

6:55 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? >> 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 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. Women are consistently more anxious than men across the board. All ages, all

7:42 cultures, regardless of how much equality, gender equality, socioeconomic equality there is, women are just always more anxious. The 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, struggles, etc., etc., that they've probably developed scar tissue where they're like, I'm going to be fine. I don't need to worry about this. So when it comes to environmental factors, obviously trauma gets talked about a

8:28 lot. Trauma or other early childhood adverse experiences. Um they sensitize the amydala and they often disrupt our prefrontal cortex from help 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. And so, again, kind of that cognitive intervention of actually thinking to yourself, is this threat reasonable? Is there really a line that's going to 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 I have not really seen

9:13 talked about much in 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 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 Kirkagard in the 19th century. So Hagard 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 and that that seemed to be kind of a new thing and it and throughout his life it appeared to be getting worse. Kirkagard 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

10:00 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 uh 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. 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 >> because you might make the wrong one. >> Because you might make the wrong one and it'll [ __ ] up your future forever. And so it's better to just like be really scared and stay at home and doom scroll

10:46 for another six hours. >> Anything you want to add, Drew, before we get into it? >> Um, I have anxiety. >> Do what what what's been your history, I guess. Uh, I like I have panic attacks when I was younger for sure. I've been into my mid20s, I would say. Okay. Too. So, it's definitely This is hits close to home. It runs my family, too. So, Okay. >> Yeah. >> Well, and I know you have a lot of sleep problems too. I imagine that's doesn't help. Yeah, >> that's attached to it. >> Yes. Yeah. >> A lot of rumination at night. >> There's definitely a lot of that. Yeah. >> My anxiety is pretty limited to social anxiety. I had a lot I had a lot of social anxiety when I was young. But interestingly, like outside of social anxiety, I I experienced very little. And I I think

11:32 the social anxiety was just [ __ ] trauma. >> Oh yeah. Yeah. I think a lot of people can relate to that though, too. Yeah, >> it's probably the most common source of anxiety is social anxiety. For sure. >> 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 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

12:17 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. >> For sure. >> I don't know. Sometimes I think anxiety helps me. That's something that never gets talked about. >> Sure. Yeah. >> 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 to perform really well or work really hard or but on the other hand, it does potentially produce better outcomes. I I don't know where I completely land on

13:02 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. >> I think this is a common fear a lot of people have is if I don't have my anxiety, then how how am I going to get anything done, right? How how am I going to 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 I definitely do it. I think it honestly got me through >> a lot of university. Yeah. uh 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 to people. So, I mean, I get it. It's it's a tricky one. And I think people are like, "No, my anxiety actually helps me in some

13:48 ways." And there's some truth to that, too. >> 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. You should always have some anxiety. Like anxiety exists for a reason. It's adaptive. Like it we evolved it because it actually helps us. It helps us do things that are important for our survival, >> 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. >> Misapplied. Yeah. >> 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 >> I I don't 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

14:34 people who takes care of things sometimes. You know what I mean? >> So, so like I get it when people are kind of like, "No, actually you do need to worry about it." Now, but 100% on on board with you there where it's when it's misapplied or just generalized to everything. Yeah. That >> the optimal amount, you're right, is not zero, but it's also not, you know, >> 100%. >> 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.

15:20 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 uh 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 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 an like on an evolutionary historic

16:06 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. >> Okay. So like an anxious system is so fundamental to like the human species. You're saying that it just goes it's it's online at all times. >> So there's a great quote in in subtle art that I I love which is uh it comes from Jose Marty where he said um 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

16:53 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 or it's producing some better outcome. If you don't have a a place to apply it, if you don't have a direction to to point your anxiety, then your mind will just start inventing places to point it and it will start finding reasons to to to worry and 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. >> Okay. >> Anyway, let's get into the ranking. Okay, >> this episode is brought to you by Wealthfront. You know what's a massive source of anxiety that nobody likes to

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19:13 there's only one item in our [ __ ] 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, >> right? >> And this one will probably not surprise many people, which is alcohol. It's the anxiety cure that two 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

19:59 actually creates more in the long run. >> Yeah. I mean, about one in four people uh who have a some sort of anxiety disorder, they confess at least to self-medicating with alcohol, right? And it's honestly probably much higher than that um just because it's such so accessible and it you're right there's such a quick fix for 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. I 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 two or three days my anxiety was just off-the-wall. Wow. Right. Just it was terrible. comp.

20:50 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 it again, it does work in the short run. Yeah. >> Okay. And it has like it's probably the same mechanism as a lot of uh drugs that we'll eventually get to here. This this bounceback effect is actually strongest in the people who are most likely to uh 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. >> Okay. There's some evidence that has for a long time pointed out, you know, you

21:36 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. Uh, 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 health issues their health issues and so they're they're just naturally less healthy, right? In the United States anyway, Arizona has like the highest um respiratory illness rate. >> Okay, >> which is weird because everybody moves to Arizona because >> they have >> the clear air and all that, right? But it's because a lot of people with those diseases will move to Arizona, right? Same thing with like alcohol. People who quit alcohol usually it's because of health issues or problems around their

22:22 alcohol use. But the thing is is that bounce back. I know I would just have terrible anxiety, you know what I call it, the next day just feel awful. >> 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 embarrassing or shameful. I just feel >> Mhm. >> like I had an awkward convers 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 it's part of the alcohol. It's like [ __ ] with my emotions. The interesting thing for me around this I noticed this back when I was a dating coach and it 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

23:09 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. 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

23:56 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. 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.

24:42 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 100% believe that alcohol is one of these because I just I noticed it in 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 in and of itself would freak them out. But >> it's easy to see how this just becomes a crutch, right? You 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

25:28 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 uh negative negative ranking in our our book here. >> Yeah. So, I was actually curious and I ran the numbers on what would stopping drinking, where would that land on this list? >> Oh, like as an intervention, you're saying right? >> Yeah. Exactly. So, if you took like heavy drinkers with anxiety and you got them to stop drinking, what 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? >> I don't know. Middle of the pack somewhere. Probably >> number four. >> Really? >> Number four. Which again, as like somebody who stopped drinking three years ago, one of the

26:14 >> biggest and first benefits I noticed is just like a steady emotional state. Like >> true. >> Super steady. Nothing like very few things faze me. >> And your ability to regulate emotions too. Yes. Just in general. Yeah. >> Yeah. Just like not getting upset over stupid stuff, not worrying about dumb stuff. Like it I >> Okay, >> I definitely feel that. >> Yeah. >> All right. Number 16. Magnesium. >> Ah, >> I'm a boomer. >> Yeah. >> I don't I don't really get I don't really get on Tik Tok, but apparently this is a huge thing on Tik Tok. >> All the rage. Yeah. 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 [ __ ] It's not a thing.

27:00 Apparently, it's just not a thing. It's like very very very modest effect um >> 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 necessarily. I mean there are a lot of people who are magn deficient in magnesium. Okay. And so if that's why you're you're anxious then taking some magnesium will get you back to baseline. I don't think it's going to fix your anxiety. Yeah. 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 uh 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. Sure.

27:46 >> But uh 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 bloodb brain barrier or not. The evidence out there is very scant for this because of these methological issues. Okay. And so supplement companies have come out and they've said, "Oh yeah, that magnesium works." Because they point to one small orally done study. >> We're going to see this this uh happen quite a bit. But that's definitely happened with magnesium here. >> You want to hear my conspiracy theory about magnesium? >> Yes, let's do it. >> So the Israeli government >> No, I'm just joking. There's this new thing that's happening in social media marketing. Yeah, mo most people are probably not aware of this, but if anybody works in online marketing, you've you probably are. There's this

28:33 new 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. >> Yeah. >> I can go to one of these platforms and I can what you do is you pay social media creators on a perview basis. So, basically what what you do is you go and you like set a bounty. You're like, I'm willing to spend $100,000 to get 10 million views on social media uh 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 Tik Tockers and people who post on Instagram and stuff

29:20 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. >> I see. So they're incentivizing trends basically. >> Exactly. And so and and the reason it works really well for brands and products is that you can kind of get this like >> fake feeling of grassroots. Yeah. >> Right. So it's like people are people are see 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 Tik Tok is talking about >> some big study that just came out >> 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 um just by paying dozens and dozens and dozens of small creators and I say this as someone who [ __ ] has like three giant bottles

30:07 of magnesium in his in his cupboard and takes them every night >> because I 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. >> 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 was back in 2021, uh where they found uh 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 hawk 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. Yeah.

30:53 >> And so if coupled that with your conspiracy theory, you know, where it's like there's 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 hawk 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 sciencebacked uh finding uh which is actually just a marketing thing. >> Yes. >> All behind it. Yeah. >> I would say this is actually the the rule not the exception in the supplement industry. Shout out to Salt Orwell. So the the I'm old friends with the founder of examin.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

31:39 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." >> Oh, really? >> That was it. This was pre like creatine boom. >> Okay. >> Um but yeah, I think he he was just like, "Yeah, just take fish oil." >> Mhm. don't worry about anything else. And he was like, "Oh, and protein if you like, you know, if you want to get stronger." Yeah, that was it. >> Okay, >> 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 journ Why is journaling this low?" >> Well, okay. There's It's a little bit of

32:26 a nuance story here, right? >> 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 uh, 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, journ 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

33:11 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 I'm curious what uh what you found like digging deep into the research. >> I think you're absolutely right. It's the uh 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. Yeah. 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 uh with anxiety. >> Venting like more catharsis. We talked about that too. That doesn't really work

33:58 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 is the least likely for anxious people to use. >> Okay. >> And or stick with. >> Y >> okay. Which is a form of kind 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 um >> it's it's the negative visualization exercise that that's we talked about it on the stoicism episode because it's um I believe uh Senica 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, >> right? and like basically mentally rehearse all the things that could go

34:43 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. >> There 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, um probably most people with anxiety give up after the first one. Yeah, that's another problem that they have with it. Like even in a very simple online study that they did where it was uh internet based, it 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, but >> it's not that much. >> It's bad enough where people with anxiety don't like to do it. >> I don't have the study in front of me. I do remember early on in the research process coming across a study that uh one of the things they said is that like

35:31 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 >> that it's just not super practical. >> Right. >> Yeah. And for most people with with anxiety again they're just they're they're reticent to even go around that or to do that. So, in the emotions episode, we talked about a effect of labeling that can help with emotional regulation for sure. It's usually a short-term fix, though. It's usually 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

36:16 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 is a quick fix, >> right? They want to feel better, >> right, then >> within five minutes. >> That's not going to happen. >> Yeah. >> Yeah. You have to like really put a lot of time and thought for sure >> into it. Yeah. >> 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 hairbrain 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

37:03 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 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 of getting rid of the anxiety. I think at a certain point you have to like this is going to sound really obvious when you say it out loud, but it it's quite profound that like part of the way of getting over anxiety is deciding you're not anxious anymore.

37:49 >> Oh, it episode over. >> No, >> it's incredibly difficult and complicated to do it, but like that 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 to be aware of that. >> 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

38:36 >> kind of hell for a long time if you're not careful, you're not aware of it. >> And and what's worse is that you get the sense that you're doing something, right? And like this is and we talked about this in the self-help techniques like in many ways the worst self-help techniques are 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. 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 I do think there are other things in life that our journaling can be very beneficial for. This episode is brought to you by Shopify. There's a specific flavor of anxiety that hits when you're trying to actually build something. You have an idea, you

39:23 believe in it, and then the panic starts. It starts creeping in around all the stuff that has nothing to do with the thing that you're good at. Payment processing shipping inventory taxes some sketchy checkout page that a guy in Bulgaria made for you. And this is the part that kills most small businesses before they get going. No, not the guy in Bulgaria. All of the anxiety and panic, the friction around the idea. And that's where all the whatifs and what should I do start to overwhelm us. What if the site looks amateur? What if their checkout page breaks? What if I spent 6 months and then I launch and I wake up the crickets? Those questions don't go away because you talked yourself out of them. They go away because you started the right way. And the right way is

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40:56 All right, moving on. Number 14, CBD. Sorry, California bros. Let me 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 tell us about this one, Drew. >> CBD. So, cannabol. Okay. It's a it's a it's a product of the marijuana plant, right? It's a but it's 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? Yeah. >> It's a$5 billion market. The CBD uh supplements market is5 billion dollars. Okay. There was a a meta analysis in 2024. So a very recent meta analysis. >> They looked at 1550 studies of CBD.

41:42 Okay. >> And so they're like, "Okay, we're going to the meta analysis. Again, you find all the studies about the studies, right? Or it's a study about the studies. of those 1550 research papers that they found, they could only include eight of them in their analysis because they said all the other ones just are they're so poor quality suck. They suck. We can't like >> improper controls, too small, uh bad methodologies. There was eight studies that were like these these fit the bill for for our criteria, stringent criteria, >> which by the way, listeners, eight studies is nothing >> is nothing. >> That's nothing. >> Uh it total 316 participants out of those eight studies, too. nothing. >> It's a very very small sample size what we're going on here. >> Okay. >> Again, all the others were so poorly done they were just like we're not even going to include them in this. Okay. >> They did find now in this study they

42:28 found a a big positive effect size. Okay. But the thing was is that there 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 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 >> or nothing. Like that's that's that's the best they can do. >> It's kind of useless at that. >> Right. So useless information. Yeah. >> With magnesium too. There it makes sense. Like the CB-1 receptor, which is what the the the receptor in your neurons that um 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 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

43:14 couple of studies found that exactly 300 milligrams is what you need. Anything more, anything less doesn't either doesn't do anything or makes you more anxious. >> That doesn't make sense. >> Doesn't make a whole lot of sense to me either. >> And and then 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. >> So you'd have to take six doses. >> Well, yeah. Maybe, maybe, maybe because because then the other problem is quality of these supplements. They've uh a 2022 study took 80 different CBD products that were commonly found on the market today uh and tested them and only just over half of them have what they actually the the amount of CBD they said they had in it. So, you don't even know how much you're getting even if it does work as an oral supplement.

44:01 >> I'm surprised this is higher than magnesium. >> Yeah, this honestly this one we probably could have switched with magnesium. I mean I think it got skewed by that one study that found strong results. Yeah. >> Huge effect size. Yeah. But the again that the uh 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. Yeah. >> It might work. But what we have so far is >> it's kind of garbage. >> Okay. >> 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. Yeah, I I mean I know there's still some people, you know, was like CBD in your coffee or CBD and butter. >> I feel like it blew up kind of late 2010s. I I remember taking it. I remember I went to some event and and one of the sponsors, it was a CBD

44:47 product and they gave me a bunch of >> a bunch of supplements and um 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 >> and it came out. Yeah. >> Uh but I remember taking it for like a week or two and I'm like I don't think this does a [ __ ] thing. I think I'm just pissing this out every day. Not not surprised by this one. I got to like given everything I know and understand about the supplement industry and I I took I I took one look at the the research summary for this and I just kind of chuck like eight good studies out of 1600. Okay. So, yeah. I guess I I don't think we need to dwell on this too much. Um this this is probably nothing. It's probably a placebo. But number 13, I think is gonna shock a lot of people.

45:34 >> The digital detox, the getting out in nature, getting rid of your phone, getting out in nature, going for a walk, >> going outside. >> I want this one to work. >> Yeah, I Yeah, I'm >> It kind of does. Well, we'll get to that. But >> yeah, I'm not going to 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 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

46:20 phones and turning their phones off for multiple days and like all this stuff and then swearing that it's like such a a detox and a relief and it they it cleared their mind and everything. It's a very common meme at the moment. I think one of the issues might be though is that replacing like a your your digital habits with going outside um it it does actually make you less anxious in the moment. It's just not a long-term fix. Yeah. >> What they found like you can decrease anxiety like in the short term, right? 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 bounceback is usually really really hard >> is that people go back like as soon as you're out then you just go right back into it. You go right back into this like digital morass or like you're

47:06 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 uh different anxiety profiles for sure. The problem is is that bouncing back and forth between the two, that's going to be an issue at some point. >> 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. >> I mean, I think that's great. Yeah, sure. >> Yeah, >> do that. I mean, it's it will it will help your anxiety in the in the very short term. It's not going to like cure if you're having a panic attack. I'm not saying, "Oh, just go for a walk." That's not going to happen, right? It's not

47:52 like a long-term fix. It's probably like add it in as part of your routine. Sure. I go outside, touch grass. Absolutely. But it's like it's not a fix for anxiety. >> Yeah. >> Maybe this is kind of what this is actually doing what people think alcohol is doing, right? Take take the edge off a little, right? >> Help you unwind after a busy day. help you decompress after like maybe a stressful meeting. >> I could get on board with that. Yeah. >> Yeah. But 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 it's not there's no sustainability here. I just finished apologizing to all the weed dispensaries here in West LA. Uh

48:40 telling them that the CBD there's no evidence showing that it works. Um I'm going to have to go back out and apologize to a lot of people because uh number 12 on our list is breath work. >> Okay, >> this one has a lot of caveats though. Yeah, the important caveat here is that breath work is 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 breath work techniques work equally. That's the headline that people should take away from this section. Um, there's a lot of nuance going on here. And as somebody who, by the way, uh, has had friends and loved ones, uh, go to breath work classes where the administer clearly had

49:25 no [ __ ] clue what they were doing. You can have very adverse effects. Like the breath work when done incorrectly or when done with the wrong person with the wrong technique, it can induce panic attacks. So, it is like actually counterproductive when done poorly. So, that that's all just like a PSA for people listening to this that yes, breath work can be super helpful and there are people I I I know people who swear by it. It's been life-changing for them. I also know people that like [ __ ] hate it. It was one of the worst experiences they ever had. So, be aware. >> Yes, it can induce a panic attack. It's also it can help a panic attack too when done correctly. So, >> depending on how it's done. >> 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

50:11 was just >> that's not good. >> Awful. Yeah. 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 1:2 ratio of in to out breath, right? 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. >> Yeah. >> Uh and that seems to help just as like a kind of general maintenance thing for anxiety. doesn't really like small >> 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

50:57 help with that. >> From what I've seen the most effective technique is what you just described. Sometimes it's called box breathing. >> Box breathing. Yeah. There's different second configurations, right? So the the one that I learned was 478, right? So you breathe in for 4 seconds, you hold for seven, you breathe out for eight, >> right? There's a 1 to2 ratio again. 48. >> Yep. And then you just repeat that. I've seen 488. I've seen 448. 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 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

51:42 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. In that moment, the last thing you want to do is breathe slower because it's you 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 breath work interventions at

52:29 his seminars. I've started seeing all sorts of like very big promises attached that simply by doing breath work for 20 minutes you can unearth childhood wounds and heal trauma and like uh you know 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 breath work classes you will see people who start crying you'll 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 emot

53:15 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 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 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 4 seconds 8 seconds in out this pretty

54:03 much 10 times out of 10 this will calm you down. Um it is super effective but it is like you said it's a shortterm solution. these longer session, 45 minute, 50 minute, 60 minute breath work sessions where you're like 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. I to me this feels kind of like it's like a new version of catharsis. M just because you're indulging an emotion like doesn't mean you're relieving 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 how emotions work. Emotions are feedback loops. And so if you are indulging anger you are actually training your body to become

54:48 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 are probably nothing at best, placebo at best, counterproductive at worst, and then if you do happen to be somebody predisposed to panic panic attacks, um it's a [ __ ] terrible idea, >> right? Yeah. Yeah. Yeah. If you are experiencing a panic attack and you're doing the breathing like you said though, um and and it and it is calming and it does calm you down there. 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. >> Mhm. >> 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

55:35 on in here? Oh, I can handle this. Then move on, right? >> Because if if if you sit and you dwell too long on it, that that is an anxious uh 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 and walk away because as soon as you start ruminating that becomes the counter uh productive part. >> 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. >> And this one, >> it's when it goes well, it goes really well. When it goes poorly, it goes very very poorly. And that is bzzoipines. And uh I should say for the record that you and I are not psychiatrists. We're not doctors. We're just reporting what

56:21 the research says. We're reporting, you know, at this point benzo, Xanax, Adavon, Valium, Clonopens. They've been

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