Podbit · The Diary Of A CEO with Steven Bartlett
America prescribes antidepressants at 10x the rate of other countries. 85% of those prescriptions come from non-psychiatric physicians in 7-minute visits, meeting standard of care only 12% of the time. The drugs don't heal — they suppress symptoms while rewiring the brain to need them.
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At 32:50 · chapter starts 26:27
The legalisation wave sweeping the US has been accompanied by a cultural narrative that marijuana is safe, natural, and good medicine. Dr. Amen is having none of it. He recounts watching Senator Cory Booker publicly shame President Biden on a debate stage in 2019 for saying 'the science isn't settled' on marijuana — and feeling furious, because his own published research showed the science was very clear. [1] — Dr. Daniel Amen "Marijuana linked to 300% rise in psychosis: Psilocybin-associated psychosis has risen 300% in recent years, illustrating the danger of wide…" 27:46 Amen's study of 1,000 marijuana users found decreased activity in every brain area; a contemporary JAMA study of 1,027 users confirmed hippocampal damage affecting memory. For teenagers, the stakes are even higher: marijuana use in adolescence is associated with significantly higher rates of anxiety, depression, and suicide in the 20s. The chapter then pivots to psilocybin, where Amen is equally cautious despite the therapeutic excitement around it. He has seen the same pattern before: benzos were 'mommy's little helper,' the opioid crisis was sparked by declaring pain 'the fifth vital sign,' and marijuana was sold as innocuous. Now psilocybin-associated psychosis has risen 300% in just a couple of years. His argument is not that these substances have no therapeutic value — it's that rolling them out without understanding which vulnerable individuals they could harm is reckless.
Dr. Amen has watched the same cycle repeat: benzos were 'mommy's little helper,' opioids were prescribed for 'the fifth vital sign,' marijuana was 'innocuous.' Now psilocybin-associated psychosis is up 300%. For vulnerable people — who can't be identified in advance — one dose can trigger a psychotic break.
Psilocybin-associated psychosis has risen 300% in recent years, illustrating the danger of widespread psychedelic use without understanding individual vulnerability.
Self-help fails because people are sold one universal cure by the hyper-responders who had a transformative result from it. The real problem is context: every method works for the right person at the right time, which is almost never you just because the author says so.
Spencer Greenberg was once so socially anxious his heart pounded just approaching a stranger. His therapist gave him homework: go to a bar alone, talk to 5 strangers. Starting with asking for the time, he worked up to asking men for hugs — and his anxiety fell dramatically in 6 months.
A person who flies regularly but obsessively checks weather forecasts before every flight is not doing exposure therapy — they're teaching their brain that flying is only safe with the ritual. Safety behaviors prevent the brain from ever learning that the feared thing is actually fine.
The worry-time technique assigns all worries to one scheduled slot (e.g. 5 PM). Every time a worry surfaces, you write it down and ban yourself from engaging with it until that time. When 5 PM arrives, most worries feel trivial and the act of batch-worrying exposes how little it actually accomplishes.
In a randomized study of 20 habit techniques, 'habit reflection' stood out: recall a past habit you successfully built, write down what helped you succeed, then apply those same strategies to your new habit. It works because it's self-adapting — it uses whatever worked for YOU.
The tiny habits technique — always having a minimal version of your habit you can do when life gets in the way — keeps the mental machinery of habit formation from breaking. Paradoxically, people given a tiny-habit fallback option were MORE successful at the full habit, not less.
Fears and worries act like playground bullies — they want to ambush you. But when you deliberately seek them out and choose the time of engagement, they lose their power. The volitional act of starting the fight on your own terms is one of CBT's most underappreciated insights.
Most downtime defaults are things you regret immediately after — phone scrolling, binge TV. 'Glad you did it' activities meet the same need for rest but leave you feeling like you spent your time well. The switch from a bad screen to a documentary, a book, or a walk costs almost no extra effort but compounds into identity over time.
You rarely control your first reactive thought. But you can train your second thought — the response to the trigger — by asking whether your initial reaction is the most helpful one and replacing it with something equally true but more constructive. Over time, that second thought becomes automatic.
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