in: Behavior, Character, Podcast

• Last updated: April 29, 2024

Podcast #982: Skills Over Pills

Over the last decade, there’s been an increase in the number of people, particularly young adults, who struggle with low moods, distractibility, and anxiety, and consequent difficulties with getting their life on track and making progress in work, friendship, and romance.

In addressing these difficulties, people are often given or adopt a mental health diagnosis, and look for a solution in therapy and/or medication.

My guest isn’t opposed to these remedies. She is herself a clinical psychologist who’s maintained a practice for a quarter century that specializes in treating clients in their twenties. But Dr. Meg Jay, who’s also the author of The Twentysomething Treatment, believes that a lot of what young adults, and in fact adults of all ages, struggle with, aren’t disorders that need to be treated, but problems that can be solved.

In the first half of our conversation, Meg explains what’s behind the decline in mental health for young adults and how it’s bigger than just smartphones. We discuss the dangers of self-diagnosis, the potential downsides of using medications to treat mental health issues, and why she advocates for “skills over pills.” In the second half of our conversation, we talk about how mental health gets better when we get better at life, and what skills twentysomethings, and many older adults, need to develop, including the skills of thinking, feeling, working, socializing, and even cooking. We also discuss how porn is affecting the young men in her practice and an alternative to being a self-assurance junkie.

Resources Related to the Podcast

Connect With Meg Jay

Book cover featuring the title "The Twentysomething Treatment" by Meg Jay, PhD, with subtitles "A revolutionary remedy to shape lives in an uncertain age" in black and purple text on a

Listen to the Podcast! (And don’t forget to leave us a review!)

Apple Podcast.




Listen to the episode on a separate page.

Download this episode.

Subscribe to the podcast in the media player of your choice.

Podcast Sponsors

Click here to see a full list of our podcast sponsors.

Read the Transcript

Brett McKay: Brett McKay here and welcome to another edition of The Art of Manliness podcast. Over the last decade, there’s been an increase in the number of people, particularly young adults, who struggle with low moods, distractibility and anxiety, and consequent difficulties with getting their life on track and making progress in work, friendship, and romance. In addressing these difficulties, people are often given or adopted mental health diagnosis and look for a solution in therapy and/or medication. My guest isn’t opposed to these remedies. She’s herself a clinical psychologist who’s maintained a practice for a quarter century that specializes in treating clients in their 20s. But Dr. Meg Jay, who’s also the author of The TwentySomething Treatment, believes that a lot of what young adults and in fact adults of all ages struggle with, aren’t disorder that need to be treated, but problems that can be solved. In the first half of our conversation, Meg, explains what’s behind the decline in mental health for young adults and how it’s bigger than just smartphones.

We discussed the dangers of self-diagnosis, the potential downsides of using medications to treat mental health issues, and why she advocates for skills over pills. In the second half of our conversation, we talk about how mental health gets better when we get better at life, and what skills 20-somethings and many older adults need to develop, including the skills of thinking, feeling, working, socializing, and even cooking. We also discuss how porn is affecting the young men in her practice, and an alternative to being a self-assurance junkie. After the show’s over check at our show notes at All right, Meg Jay, welcome back to the show.

Meg Jay: Oh, it’s so great to be here, Brett.

Brett McKay: So I was looking, the last time we talked to you was 2013. You’re one of our first podcast guests. You’re in episode number 51.

Meg Jay: Oh, I love it. Well, I said I feel like we’re old friends. I’ve always had a special place in my heart for the Art of Manliness.

Brett McKay: Well, thank you so much. We talked about your book the last time, the Defining Decades, about your 20s, when that book actually inspired a few articles that we wrote on the site and it really resonated with me at the time, ’cause I was in my 20s when I first came across that book.

Meg Jay: Nice.

Brett McKay: And you got a new book out. It’s called The TwentySomething Treatment, A Revolutionary Remedy for an Uncertain Age. So, background on you, you are a clinical psychologist who specializes in working with 20-somethings young people.

Meg Jay: Yep.

Brett McKay: And one thing we’ve been seeing in the zeitgeist a lot recently in blog post articles, news articles, etcetera, is that young people today, we’re talking teens, people in their 20s are in the midst of a mental health crisis. What do the statistics say about the mental health of young people today and what are you seeing with the patients you are encountering?

Meg Jay: Yeah. Well, I’ve been specializing in 20-somethings for 25 years, believe it or not. And you might remember from your 20s. It’s a tough time. So I think people hear, oh, these are gonna be the best years of your life, really, I’m sorry to say. They’re actually empirically speaking a mental health low point. That has been the case for a while. I think now. I mean, that’s why I’ve always been working in the space. I think people are talking about it more now, which is potentially a good thing. But I think part of the conversation about young adult mental health too quickly becomes, what’s my diagnosis? What’s the medication that I need? So a lot of what I do is really normalize a lot of the problems that 20-somethings and adults of all ages have, and talk about strategies for looking at those that aren’t just necessarily therapy or medication.

Brett McKay: So yeah, we’re seeing a lot of young people and a lot of people, just even older people talking about anxiety, depression, ADHD, things like that. When psychologists try to explain like what’s behind this uptick in mental health, what are the reasons they give?

Meg Jay: I mean, I think what you hear people saying a lot is phones and the pandemic. And those certainly played a role. I think what I see a lot with young adults and adults of all ages. But everything that I see is just sort of more acute with young adults is just how uncertain, 21st century life is. The brain really doesn’t like uncertainty. So in your 20s, everything is uncertain all at the same time. You’re uncertain about work and love and friends and where you’re gonna live and who you’re gonna be. And that’s a lot. The brain doesn’t like that. And it tends to respond to uncertainty by perceiving it as danger and then therefore feeling stressed and anxious. But that doesn’t mean that you have an anxiety disorder. It means you’re feeling anxious. There’s a lot in your life that’s uncertain. So let’s help you sort of pin some things down and feel more sure of yourself.

Brett McKay: Yeah. You call uncertainty a trans-diagnostic stressor.

Meg Jay: Yep. That’s a mouthful of a word and maybe a boring label. But, in the research, that’s what uncertainty is known as. And what that means is that it’s a stressor that shows up differently in different people. So when people are feeling overwhelmed by uncertainty, some people get anxious, some people feel hopeless and lay in their bed and feel depressed. Other people reach for substances, other people eat too much or eat too little. So it’s definitely a stressor for most human beings. And how it manifests depends on the individual.

Brett McKay: Oh yeah. I can see that in my own life. Uncertainty causes so much stress. When I remember when I was in my 20s, one stressor that I had that’s caused by uncertainty was when I was in law school and I took my final exam, ’cause your whole grade depended on one exam.

Meg Jay: Right.

Brett McKay: For the semester.

Meg Jay: No stress.

Brett McKay: No stress. So you took the test and then after you’re done, you do these postmortems in your head ’cause you didn’t know how you did.

Meg Jay: Right.

Brett McKay: And then you’d go down this spiral where you’re just like, oh my gosh. I probably…

Meg Jay: What is this? What is that? Yeah.

Brett McKay: Basically, it all led to like, we’re gonna end up… I tell my wife like, we’re gonna end up, homeless and bankrupt.

Yes, of course. And that’s really… I mean, that’s such a great example of really the big picture of the 20s is that people don’t… Like it probably took you a week or two to find out the results of that exam.

Brett McKay: Yeah.

Meg Jay: But in your 20s, in terms of what am I gonna be? Is my life gonna work out? Will I be happy? Will anyone love me? Will I be successful? Can I pay my bills? Those are things that remain uncertain for a good five to 10 years of time. And so that’s a lot to cope with. And it does tend to make people feel anxious and stressed until they have those data points that give the feedback that, okay, you’re gonna work this out. This is moving in the right direction, but the brain just doesn’t like that.

Brett McKay: Yeah. And this uncertainty that causes things like anxiety or feeling depressed and just down, this can happen later on in life when you’re in your 30s, 40s, 50s, when you have those moments of uncertainty in your life, maybe you get laid off from your job and you think, oh my gosh, what’s gonna happen to my family? Or maybe there’s something with your kids you’re worried about same sort of thinking happen to you.

Meg Jay: Yes. I mean, I actually, I had a health issue last year and I was really feeling for my 20-somethings because suddenly there was this new piece of uncertainty in my life. And at this point in my life, my career is pretty sorted and my love life is sorted and I have kids and I know where I’m gonna live. So there’s not a ton of uncertainty in my life anymore. But I had this health issue come up and suddenly there was all this uncertainty. And it was really difficult until I got some information of, okay, this is the deal and this is what we do. And then I noticed how, sort of like with your law school exam, suddenly I was like, great, I know what to do now and I know what this means. So you’re going to have those periods again and again throughout life. Whether it’s health or changes in work or changes in your relationship, we usually get better at handling them over time, ’cause we have more experience of, okay, I’ve been here before. I’ve gotten through this. I’ll find a way, you feel like you can count on yourself. And the hard part about being in your 20s is you don’t feel like you can count on yourself yet. And you don’t have a lot of data points for how this works.

Brett McKay: And I can see this idea of uncertainty causing all this distress. I can see why the pandemic would exacerbate that. She was like, oh my gosh, what’s gonna happen? I don’t know if I’m gonna have a job. Is this ever gonna end? And I can also see how smartphones can exacerbate that ’cause you’re just constantly plugged into this thing that’s showing you all sorts of different information. You’re not exactly sure like, what should I act on? What’s the good stuff that can probably just cause even more uncertainty.

Meg Jay: Right. And it’s, we’ve all heard by now the social comparisons, that phones induce. We’re always looking at people on vacation or skydiving in Dubai. I mean, they’re having amazing time and amazing lives and amazing relationships. And so it’s hard when you feel like, I don’t really know if my life is going to work out, but look at all these other people’s lives who are working out beautifully. Your brain knows that this is not a fair fight in terms of the data being presented, but it still has to go through that process of, ugh, you can’t believe everything you see. And, maybe I’m not doing as badly as I think and that’s a lot. So I think, people of all ages have to decide what platforms they’re going to use, what makes them feel happy, what makes them feel unhappy or how they use them and how much they use them.

Brett McKay: Okay. So uncertainty. We don’t like uncertainty, can cause us to get anxious, feel just low and depressed. It can even cause us or nudge us towards using substances to alleviate some of the bad feelings we have when we’re facing uncertainty. We experience a lot of uncertainty in our 20s ’cause we’re figuring life out. But people in their 30s, 40s, 50s can also experience this. And one way people have tried to cope with the feelings of angst that come with uncertainty is they turn to psychology, which makes sense, right? Psychology’s there to help you deal with those sort of things. But you note in your book that there’s been a trend of young people, and I’ve seen this not just with young people, but even people my age in their late 30s, 40s, people self diagnosing themselves with mental health disorders. What are the dangers of self diagnosing?

Meg Jay: Yeah, I mean, I think when we’re feeling uncertain, we’re casting about for gimme something I can act on. I mean, it was a bit like what I was talking about with my health issue last year of, let me understand what this is and what we do. So I think it’s very tempting to say, what’s wrong with me? What’s my diagnosis? What’s the three point plan? Although, most mental health problems don’t have a three point plan or what’s the medication required? And the truth of the matter is, most young adults, most adults of all ages don’t have diagnoses. They have problems they’re trying to solve. They have changes they need to make, they have skills they need to build. And I think one of the drawbacks of looking for certainty in a diagnosis is that your identity can become pretty wrapped up in that. And then you see everything through that lens rather than through the lens of, Hey, I’m in a transition, or this is a tough time and what are the skills I need to build? What are the changes I need to make, rather than looking for, what’s the medication I need to take?

Brett McKay: Yeah. You talk about, giving yourself a diagnosis can cause a nocebo effect in you. What do you mean by that?

Meg Jay: Yeah. The nocebo effect is the opposite of the placebo effect, which of course is if you think you’re going to get better, you’re more likely to get better. The nocebo effect is really the power of negative expectations. So I have a lot of people come in my office and they say, I have this and I’m gonna have this all my life. And I’ve read this is a lifelong problem. And they see everything through that lens. And so it can get in the way of people actually getting better or having hope that, there’s nothing wrong with me. I’m not doing something wrong, I’m just having a hard time. So what is it I need to do to move forward? And people who have hope are more likely to take action to kind of move their lives ahead. They’re less likely to feel anxious and depressed, less likely to think about ending their lives. So I think sometimes people look for certainty and diagnoses and which they may not really have. And believe it or not, that can actually get in the way of finding hope that life could be better six months or a year from now.

Brett McKay: Yeah, ’cause you take on that, like you said, you take on that identity like, I’m depressed, I’m a depressed person, I’m always going to be depressed. And yeah, you might… Like you said, you might be feeling low ’cause you’re going through a hard time in college, or you just had a breakup, a lot of uncertainty. So, if you open up the DSM-5, the diagnostic tool, and you look at the sentence for depression and you say, well, I got that. Now like, you just kind of look at everything as like, well, I’m depressed. There’s nothing I can do about it.

Meg Jay: Right. Or, great. Now on top of, being laid off, now I’m also depressed. Rather than saying after loss, whether it’s loss of a job, loss of a relationship, loss of anything, it’s normal to feel sad and depressed. It doesn’t mean you have a disorder. I mean, that’s grieving. And so it helps often to say this is a normal reaction to a loss in your life. And what does that tell you about what it is that you value, that you wanna get back in your life? Meaningful work, close connections, what did you lose that you want to get back rather than let’s just alleviate the symptoms.

Brett McKay: How has social media exacerbated the problems of self diagnosing?

Meg Jay: Well, when I first started doing this 25 years ago, for better or for worse, the DSM, the kind of psychiatrist bible you were talking about a minute ago, that that was only available or, no one would go out and purchase that. It was a $100 door stop of a book and extremely boring and dry. So no one really had access to what are these mental health disorders and how do you diagnose them? And now, for a lot of reasons that are good, that information is widely available on the internet or on social media in quick little tidbits and quick videos. And it’s actually what we used to call medical student syndrome, that people would go into medical school and they would read about illnesses and disorders and decide they had all of them because, they could see themselves in so many. So something similar happens on social media. People hear about anxious attachment style and they decide they have it or, panic disorder and they decide they have it, or bipolar disorder or borderline personality disorder, which is very rare, but people decide they have it. And so then, it’s sort of a misunderstanding of what’s going on. They’re locating the problem in their brain rather than in their everyday life.

Brett McKay: Yeah. You say about the social media mental health stuff that goes on on TikTok and Instagram reels, whatever, there’s a fine line between social awareness and social contagion. What do you mean by that?

Meg Jay: Yeah, I mean, I think it’s cool that people are becoming more aware of, Hey, the 20s or many points in adulthood are difficult and people have these struggles and this is very normal, but it’s not so great when everybody decides that, oh, I have this disorder. Or we’ve even seen how “disorders” can literally spread on social media. There was a lot of research done around during the pandemic around these ticks. Like, that people were developing in terms of, squinting or saying words over and over again that young adults or teenagers would see these videos of people saying, I can’t stop doing this. And then they started doing it. And so there was this unprecedented number of people going into neurology clinics with ticks that were specifically the ones that were circulating on TikTok. So that was a very concrete example. But I see the same thing with right now, I can’t tell you the number of people who keep coming in and telling me they have anxious attachment style, and they don’t. They’re just feeling, uncertain about, gosh, I don’t know if this person likes me or I’m not sure who my friends are. And that’s a pretty normal way to feel in your 20s. It doesn’t mean that you have anxious attachment style.

Brett McKay: Yeah. I’ve seen… I get this like mental health stuff that pops up in my Instagram feed. And when I look at this, ’cause I’ve read… I’ve talked to enough psychologists and I’ve read enough books about this ’cause of the podcast, I can look at some of the stuff like, this is not legit. Like, this is just some person who maybe had some problems and now they’re trying to like help other people, whatever. One thing I’ve seen is like this idea that procrastination is a trauma response. And I’m like, ah, I don’t… Maybe, but probably not. You’re probably just… You’re like anybody who procrastinates, it’s just, you don’t like doing the thing. It’s not pleasant to do, so you’re putting it off.

Meg Jay: Right. And I think, I actually haven’t even seen that, Brett, so I’m curious of A, what’s the connection? And B how is that helping people to say, oh, great, not only do I procrastinate, but I’m also traumatized. So I’m not sure what’s going on there. But yes, I see procrastination in my office all the time. And I think sometimes people panic and say, oh no, that means I have ADHD or that means I have, fill in the blank. And often, like you’re saying, it’s young adults and adults of all ages trying to grapple with the reality that they have to do things they don’t wanna do. And the brain would like to avoid that as long as possible. But eventually, hopefully we learn through experience much of it painful, that it’s actually just easier to not procrastinate to do stuff in small bits starting sooner rather than later. That this is part of growth and development.

Brett McKay: Okay. So instead of being quick to take on a mental health diagnosis, if you’re feeling anxiety, just feeling depressed, maybe scattered brained, etcetera, you try to help people figure out, they come to you, whether those feelings they’re having can be attributed to some situational stressor, like, maybe you’re not depressed, maybe you’re just… You’re feeling low ’cause you got a bad grade this semester in college, or maybe you lost your job or maybe you’re having some problems in your relationship.

How do you… I mean, one thing I’ve noticed when it comes to mental health, people can get really touchy about questioning diagnostic labels they’ve given themselves, because it’s like tied up with their identity. So how do you do this as a practitioner, help them maybe look at things differently and kind of nudge them to look at maybe the feelings or problems they’re having can be attributed to a situational thing and not to a disorder?

Meg Jay: Yeah. Well, I mean, it may be because I do this day in and day out. So I usually just very, matter of factly with a smile say, well, I’m not so sure this is a disorder. Maybe this is something going on in your day to day. So let’s talk about your day to day. And I usually ask people to tell me a lot of detail about their work and love and life and health and sleeping and substances and porn and everything. I get real familiar with the details of people’s lives. And then I start to maybe help them connect the dots between what’s going on day to day and how they’re feeling. And then obviously only can go off of what clients tell me, but you’d be amazed. Most people tell you what their problem is, even if they don’t realize they’re telling you that they tell you, where the gaps are, where things are going sideways. And then they end up basically suggesting their own solutions. And so, you say, well, why don’t we start there? Why don’t we start by addressing this issue or having this or that conversation or changing who you live with or talking to your boss at work? And then just sort of work on it on the ground through a life intervention rather than through a medical intervention.

Brett McKay: And you make it clear in the book, you’re not against mental health diagnoses, but you’re only going to provide one if you think it’s going to be useful for the person.

Meg Jay: Yeah. Yep.

Brett McKay: You’re going to try these life interventions first.

Meg Jay: Yeah. I mean, I’m thinking, I’m always thinking with a client, do I need to diagnose this person in order to help them? Because oftentimes, what difference does it make? What you do or don’t call it, the question is what you do about it is really the important thing. And so, I’m thinking, do I need to diagnose this person in order to help them? How could a diagnosis help them understand what’s going on? Or how could a diagnosis limit their understanding of what’s going on? And I mean, these are not black and white issues. I mean, I’ve been doing this 20 years, so there’s some finesse involved in trying to decide when is a diagnosis helpful, when might it be limiting. And I’m also not for or against medication. I’m just for people understanding that medication has upsides and it has downsides. And I like for people to be educated about what those are when they make decisions about whether to start or continue or to stop a medication for a mental health problem.

Brett McKay: Well, let’s talk about mental health medication because that’s another thing you’re seeing an uptick in. People turning to psychoactive medication to relieve feelings of sadness, angst, feeling scatterbrained. Do we know how many people are taking psychoactive medication today?

Meg Jay: Yeah, about one in five are taking a mental health medication. And actually, among adults of all ages, antidepressants, this is a kind of a shocker of a data point, are the most likely prescription medication to be in your medicine cabinet from the age of 20 to 60. If you’ve got a medication in your medicine cabinet from age 20 to 60, it’s most likely to be an antidepressant. So, they’re quite widespread. They have upsides and they have downsides. And I think about 80% of prescriptions for mental health meds are made by general practitioners. And I don’t have anything against general practitioners either, but they don’t specialize in these medications. They don’t specialize in young adults. And often because of no fault of their own, they’re limited to 15-minute appointments. And so oftentimes young adults and adults of all ages are given medications after very brief conversations where you’re not able to get a lot of context of, Hey, what’s going on in your life? Is there something we might wanna work on there before we give you medications that do have side effects?

Brett McKay: What does the research say about the efficacy of these drugs, like the upsides and the downsides of it?

Meg Jay: Yeah. So antidepressants are not a silver bullet. They’re estimated to work about 50% of the times, and by work, I mean, the effects that people appreciate, so the upsides of them is they can make people feel less sad. They make kind of the lows less low and the anxiety less intense. So that’s why people take them. I think what many people don’t realize is that they don’t just work on one end of the emotional spectrum, that they basically kind of turn down the volume on emotions in general. So they make the lows less low, but they make the highs less high. So you’ll hear people say, yeah, I’m less depressed and anxious than I used to be, but I’m also, I don’t really enjoy my life much. I’m also not that happy. I don’t have a lot of motivation. They can really cause a lot of sexual side effects. So people just aren’t that interested in sex or don’t feel like they could get much pleasure out of it. And they can also cause some weight gain, which is, you know, a big issue, especially for young adults while they’re trying to kind of start their life and have relationships. So, most young adults don’t know about the negative side effects when they go on the medications. And often, there isn’t a plan for, well, how long am I going to be on this? So most people go on mental health medications thinking like, maybe I’ll do this six months to a year, whereas in the end, the majority of people end up staying on these medications for five to 10 years.

Brett McKay: Okay, so antidepressants work 50% of the time, like it’s 50-50 chance that it could work.

Meg Jay: Yeah, it’s not… They’re not a silver bullet. They’re absolutely not. You know, some people find that they are. Somewhat helpful. And just as many people find that the side effects really outweigh the positive effects. So, I think people have heard or imagine there’s this kind of like, well, why not? We know it’ll work. We know it’ll help. There’s no downsides, but none of what I just said is the case. So we don’t know they’re going to be that helpful and there are downsides.

Brett McKay: Yeah. We had a podcast guest a few weeks ago who said that antidepressants don’t work much better than a placebo. And I got a couple of comments from some listeners who said something like, Hey, you shouldn’t have let him say that. That was misinformation. But that’s what the evidence shows. I mean, you can Google, are antidepressants more effective than a placebo? And you’ll find articles on it. And in a recent study, this was a reanalysis of a meta-analysis on the effectiveness of antidepressants. And I’m going to link to it in the show notes. This study concluded, it is unclear whether antidepressants are more efficacious than placebo. And as you said, it works for some people. What I’ve read, and correct me if I’m wrong, is that antidepressants, they particularly work well for people who have severe depression, like they can’t even get out of bed depression. And then you take the antidepressant, they’ll hopefully get you going. So you start doing the things like exercising, socializing, doing those things that’ll help you start alleviating your depressive symptoms.

Meg Jay: Right. Yes. I mean, I think at this point, physicians who really know what they’re doing, that’s… That is the suggestion. However, I mean, I see all the time that the first hint of, I feel anxious, I feel depressed, physicians saying, well, try this. Why not? I mean, that is the medical model. If you diagnose something and you give someone medication, I mean, it is not their model to say, let’s talk about lifestyle interventions or what’s happening in your relationship or what’s going on at work. That is not what they’re trained to do. That is not what they have time to do in 15 minutes. But I am not a anti-medication person, and it’s not misinformation. The data is there that if you look at all the studies that have been done on antidepressants, they work about half the time.

And it’s very unclear who they’re going to help and who they’re not going to help. So they’re just… They’re really not a silver bullet. So I think at this point, people who are careful and really know what they’re doing, they reserve them for those whom you feel like we’ve got to really try everything. For me, I mean I’m a psychologist, so prescribing meds is not my lane in the first place, but I’m looking at what else, I’m looking at skills over pills. What are the skills this person needs? What are the experiences they need to be having, the changes they need to make? Because oftentimes there’s plenty to work with there, and those sorts of interventions have no negative side effects.

Brett McKay: Okay. So there’s downsides to things like antidepressants. You also talk about other drugs, benzos for anti-anxiety, but those are extremely addictive. And you said, yeah, the group most likely to wind up in a hospital, emergency department, young adults because they took too many benzos. Another one I’ve been reading about is stimulants like Ritalin and Adderall for ADHD. I guess there’s like a shortage in the country because everyone wants these things. What’s going on there?

Meg Jay: I mean, there’s no question. I have worked with so many ADHD folks over the years in college, young adulthood, very difficult time for people with ADHD. And there’s no question if you have a real diagnosis of ADHD, stimulant medication will help you. And I’m the first person to say, let’s do skills plus pills in this situation for students, especially with ADHD. College is very difficult to get through without stimulant medication if you’re neurodivergent. However, there’s some really interesting research just very recently about when you’re a neurotypical person and you take stimulants, they found that people will work harder and longer. So there is that feeling of, oh, if I take stimulants, I can pull an all-nighter, I can study more, I can really lean into my paper or my test more. You will study or work longer and harder, but the quality will be lower. It’s like going to the SAT, jacked up on too much caffeine if you don’t usually drink caffeine. It’s not actually what the neurotypical brain needs. So, this article is talking about how smart drugs aren’t that smart for people who have neurotypical brains. It’s not what your brain needs. And so you’re not probably going to get the results you’re going for.

Brett McKay: Okay. So medications, not always the best medicine. They can be useful in certain circumstances, but you need to be working with a trained practitioner with this. And again, you talked about how social media has exacerbated the problem of people relying on medications to treat these underlying mental health disorders because of uncertainty, not even disorders just feeling not great, because with this… Again like on my insta… I don’t know what my instagram feed thinks about me the algorithm thinks about me but I get these ads for like ADHD medication and like you just got to have like a 15-minute consult online and then in a few days you get and pick up a prescription at Walgreens.

Meg Jay: Yeah, it’s a big problem. We talk about social media as not being great for mental health in terms of all the comparisons and looking at other people’s lives. But not enough is said about how much it’s really funneling people into diagnoses and medications where they’re really not getting the best information about whether that’s really the right treatment for them.

Brett McKay: Okay, so instead of spending time diagnosing themselves or looking for a doctor to give them a prescription or even spending lots of time in therapy, you mentioned this phrase earlier, you recommend skills before pills. And you argue that people who are feeling distressed might be better served in developing skills. Why is that?

Meg Jay: Yeah, well, like I said, I specialize in young adults. So, they still have a lot to learn. A lot is new. People are in their first jobs, first relationships, first apartments, first conflict resolution. So there’s a lot that 20-somethings don’t yet know how to do. And that’s okay. This is not a judgment. This is just developmentally normal. So when you ask people what’s going on in your life, they often can point to areas where they’re struggling, areas where they’re not feeling confident or competent, or where they’re not sort of feeling able to gain ground. And usually if you take on those areas, then people start to feel better. Without medications that, you ask people about the ins and outs of their lives and what does a day look like? What does a week look like? What’s going on? And you can see that there are areas for growth.

Brett McKay: Okay. So, when you develop skills, you’re able to reduce the uncertainty in your life. It’s like, well, I know how to handle this because I got the… I know how to make a decision. I know how… I know what I need to do to fix the problem that I encounter at school or my relationship.

Meg Jay: Yeah, that it’s… I say a lot to my clients, mental health gets better when life gets better. And also when we get better at life. And so, I try to work with people to help them improve their situation and or improve how they’re handling their situation that, if there’s a lot of uncertainty out in the world that you can’t change, one thing you can change is feeling more sure of yourself of saying, oh, I can count on myself that I know I can get through this, or find another job or have a better relationship next time or handle this distressing situation that you start to feel just more sure and more certain of yourself. And that’s a normal thing to be developing in your 20s. I mean, I would say by the time you’re where you are in life Brett, you probably feel like you can’t control everything that happens in the world, but you probably feel pretty confident that you’ll manage, you’ll figure it out, you can handle it. And that is amazing. And that’s not the way 20-somethings feel. So they feel like they can’t control anything out in the world and they have very little confidence that they can handle. Anything from, I don’t know how to ask my boss for time off to go to a wedding to, I don’t know how to find love or make friends. I mean, there’s just a lot they’re learning. They’re on a very steep learning curve.

Brett McKay: Is this idea____ this confidence, is this identity capital? You’ve written a lot about identity capital.

Meg Jay: That certainly helps. So in my previous book, In the Defining Decade, I talked about identity capital as a lot of 20-somethings talk about they’re having an identity crisis. They need to figure out who they are and who they’re gonna be and, what life is going to be like. And you really can’t, you can’t really forecast that. But one thing you can do in your 20s is get out there and have experiences, especially at work is the leading driver of positive personality change in the 20s. Because, there’s so much skill building that goes on at work. And so a lot of those skills that we gain, not just at work, but also in experiences, life, hobbies, etcetera, is what’s called identity capital. And it’s just this feeling of, okay, I know how to do things. I feel confident, I feel competent. My job can go sideways, but I’ll find another one. Or this relationship may not work out, but, there are other people in the world that might love me. It’s that sense of that I know how to do things.

Brett McKay: We’re going to take a quick break for a word from our sponsors. And now back to the show. Okay, so in your book you talk about various skills that 20-somethings need to develop, but as I was reading it I thought, man these are skills all people need to keep working on even as they get older.

Meg Jay: Absolutely, yeah.

Brett McKay: And the first skill is how to think. How do people mess up their thinking you?

Meg Jay: Yeah. So, people may hear that and think, well, I know how to think. I think all the time. But, if you really dig into it, thinking is complicated that when we’re in an uncertain situation, the brain is wired to think negatively. So, your brain is wired to keep you alive, not happy. So if it’s not sure what to think about a job interview or like you said, the law school exam you took or a first date that you’re going on. It’s going to assume the worst, and that’s kind of the better safe than sorry approach to life, which we really can’t stop our brains from doing. It’s evolutionarily programmed to do so, to keep us alive. But what you have to do after that is to say, okay, I see how my brain just did that. Those are my fears. Those are my what ifs. But can I spend some time thinking about some facts, some what is? So what do I actually know about this situation? Have I ever been in a situation like this before? What happened last time? What if this difficult thing came to pass?

Meg Jay: What would I do about it? How could I solve that problem? So it’s really helping our brains not just get stuck on the catastrophic what-ifs, which is the first place they’re going to go, but to say, I’m going to force my brain to spend some time also thinking about what is, what is happening in this situation or what else, what else might be happening. Besides the worst case scenario. But that takes work. Your brain is not going to want to do that naturally. The older you get, the more data points and experience you have, the more your brain will feel like, yes, I can think more flexibly about this situation. But when people are younger, it’s very difficult. They have a lot of negative thoughts and feelings.

Brett McKay: Yeah, and you gave a lot of examples of patients you’ve worked with. You changed the names or maybe there’s an amalgamation of different people. But what you do is when they come in with the problem, they’re like, oh my gosh, I’m depressed. And here’s this thing. And then you just, what you do is you just walk them through as well. Let’s find out the situation, what’s going on in your life. And then you help them just by asking questions. Like, are you just getting stuck in creating these hypotheticals in your head that aren’t going to happen? Let’s just focus on what are the facts on the ground?

Meg Jay: Exactly. And that is, it’s something that I’m helping someone do, but something that you don’t need a therapist to do that. You just need to recognize that as a good, coping mechanism or a good skill to practice of, okay, I often jump to the worst case scenario and I cause myself a lot of stress and anxiety, hanging out there. So what else could I be saying about this situation? And sometimes people, thumb type that onto their phone. Sometimes they write it down on a piece of paper in a journal or talk it through with a friend who can often help you say, well, okay, that’s one possibility. What are the other possibilities? And just to sort of let it be a little bit more open until we find out what is actually going on.

Brett McKay: One thing you try to do… Another tactic you use to help people when they get stuck in this catastrophic thinking, ’cause that usually happens when we’re in our default mode network, and it’s kind of like we’re mind wandering.

Meg Jay: Yeah.

Brett McKay: And that’s why at night, that’s why you usually feel like the most angsty and existential… Existential angst is at night time you’re laying in bed and you’re like, “Oh my gosh, what am I doing with my life?” That even happens to me still ’cause you’re in that default mode network, but one thing you try to do is you help people shift over to the task positive network.

Meg Jay: Yeah.

Brett McKay: Where it’s basically your brain… It’s focused on something. Not mind wandering.

Meg Jay: Right. Exactly, well, that is… So one thing you can be focused on in the task positive network or, okay, what are other possibilities? You’re giving your brain a job, which is let me think about something else other than the worst case scenario. Sometimes the task positive network can be distraction by focusing on something else of, “You know I’m gonna go run an errand. I’m gonna watch something on Netflix. I’m going to call a friend on the phone”. You just wanna give your brain something else to do besides just going down the rabbit hole of the worst case scenario and hanging out in that default mode network. Your brain’s default mode is to imagine the worst. And then even better is when the task positive network is focusing on, “Well, what else could be happening here? What are the facts? How can I problem-solve?” And so you give your brain something to do that’s constructive rather than just imagining the worst.

Brett McKay: Okay, so another skill people need to develop is how to feel. How do people mess up managing their emotions?

Meg Jay: Yeah, so when we’re feeling uncertain, not surprisingly, because we tend to think negatively, this happens in a nano second, we also feel negatively, so we feel anxious or stressed or overwhelmed or depressed. That’s normal. I think oftentimes when young adults are struggling, they panic of, “I shouldn’t feel this bad, something is wrong, I need to… ” Like these sort of feelings shouldn’t exist, and oftentimes you see that their parents panic of, “my kids crying, this is terrible. Something bad is gonna happen”. And so, just helping people understand that emotions are a part of life, and so-called negative emotions aren’t necessarily negative, their sources of information, so they’re telling us, this is something you’re worried about, this is something that’s important to you, or this is something you’re sad that you’ve lost in your life. And so helping people just accept even the negative emotions in their life as sources of information, not as something they need to panic about, actually, it paradoxically helps emotions pass more quickly.

So it’s, when we stop kind of wrestling with our negative emotions and say, “Okay, part of life, what is there for me to learn here?” Those negative emotions tend to move on along, whereas if we get into this fight with them where we panic and keep trying to get rid of them, they actually tend to hang around longer.

Brett McKay: Yeah, you call this, you’re just kind of being comfortable with the negative emotions, paradoxical intervention.

Meg Jay: Yeah. Because it’s… When you say, I don’t need to get rid of this feeling, it actually tends to pass more quickly, so you’re sort of doing a mind trick on negative emotions, but it really is just about not being upset about being upset, or anxious about being anxious, or sad about being sad, or stressed about being stressed, but just to say, okay, you are not going to get through your life and certainly not through your 20s without having these emotions quite often, that’s normal, 20-somethings have more negative emotions than older adults, and so it’s really about understanding what are they trying to tell me? What am I worried about? Where do I need to gain competence or what am I sad about? What do I need to get more of into my life.

Brett McKay: Yeah, and again, you’re also trying to normalize these feelings instead of saying, “What’s the diagnosis, ’cause I’m feeling anxious, depressed, whatever”. It’s like, “well, no, congratulations, you’re a human being, you’re feeling things that all human beings feel and have felt”.

Meg Jay: Well, right. And again really everything that I do with 20-somethings, like you’ve said, it’s adult development, it’s relevant to us at all ages, I just am the kind of person that, I try to get in there as early as possible in that trajectory, but if you think about going to the doctor for something in your 30s or 40s and you’re having a pain here or a flutter there, and the doctor says, “Oh yeah, that’s normal. It’s this thing that happens when X, Y, Z. It doesn’t mean anything or it’ll pass”. We forget how helpful that is, that that is very helpful. When someone says, “Oh yeah, I know it hurts. But it’s normal. Nothing to be worried about”. That also has a function. My daughter actually had a sports injury a couple of years ago, and it really persisted, so I took her to a specialist, and the guy said, “Oh yeah, I’ve worked with big tough ice hockey players, and this can hurt for months, but trust it will get better”. And I thought, “Great, that’s all I needed to know”. And I think we forget the value of telling someone, “I believe that what you’re experiencing is real, I know it hurts, I know it’s difficult, but I have every confidence that things are going to get better”.

Brett McKay: You also talk about the skill of working, how can work help us become emotionally healthy?

Meg Jay: Yeah, well, work actually is the number one driver of positive personality change in your 20s, and I think if we think about at any age, it’s a pretty important source of confidence and competence, so it’s probably what we spend more hours doing per week than anything else, so there are lots of opportunities to learn new skills and gain new competencies, become more confident, everything from the concrete skills you need for work to the social skills of dealing with bosses or interns or co-workers, I mean, there’s just so much growth happening on the job when you’re in your 20s. Or it should be, and if there isn’t, you need to go find a job where you feel like you’re going to have those growth opportunities. I know from the research, it’s the number one leading source of stress and anxiety in the 20s, but it’s also the number one source of growth and change, and those two things go together obviously, because if you’re gonna be growing and changing, you’re gonna be putting yourself into situations that are new and uncomfortable. And that you don’t know how to do.

Brett McKay: Yeah, I think all of us have this idea like, “Man, I wish I didn’t have to work”. But then when you look at the studies of people who get laid off from a job, they’re unemployed for a while, this happen to middle age, like depression just… It’s off the chart, it’s one of the most debilitating things that can happen to someone when they’re unemployed.

Meg Jay: Yeah, there was a lot of talk a couple of years ago about young adults are quiet quitting, and what did I think about that? And what I thought is I want to help them find jobs they don’t wanna quiet quit, because maybe people imagine, “Oh, my life would be so great if I didn’t work”. But like you said, it actually usually isn’t, people feel quite bored and under-stimulated, and so I think the idea is to find work that you feel good about, and now with hybrid possibilities, I think that’s more possible than ever, that people can find work that really works for them.

Brett McKay: Okay, so another skill that you think people need to develop is how to be social, and then, this is another thing we been hearing a lot about that might be contributing to the mental health crisis in the United States, is people are lonely, they’re isolated. Why do you think we’re having such a hard time making friends and socializing these days?

Meg Jay: Yeah, I think that it’s a little bit like working from home, it has upsides and has downsides of that when people feel like they can sort of semi scratch the edge of connecting with people over their phones or on their screens, then they’re less likely to get out there and do that in person, even though we know that in-person interactions are different than interactions that we’re having on screens. And so I think a lot of young adults, they moved to new cities, they need to meet new people. And that’s a different skill set than picking up your phone and texting someone or DMing someone on Instagram, you’ve gotta sort of get out there and figure out, “Where are my people and how do I make conversations with them”. But that most people don’t realize this, but your 20s are actually the loneliest decade of life. We imagine 20-somethings are, they were having so much fun, they have so many friends, are just out and about all the time, it’s really not true, you’re most likely in that age group to be “between families.”

So you wake up in the morning alone in an apartment or in an apartment with people that you may not know well, or may not get along with that great, and it’s a lot of work to be constantly trying to find someone to go out with on Friday night or find somebody to go shopping with on a Saturday, so most young adults are actually quite lonely.

Brett McKay: And I think part of the problem is when you’re in high school, your friends are just pretty much given to you, you show up to school every day…

Meg Jay: There just right there.

Brett McKay: And they’re right there, and then when you’re an adult on your own, it’s up to you, you have to make it happen.

Meg Jay: Right. And that’s same for college, you have people in the hall, you have people in your classes, but then you may go to a workplace where there aren’t that many young adults, or you may be working from home where you really aren’t interacting with anyone, and so people have to sort of figure out, how do I meet people? Is it… Okay, what is it through joining a gym? Well, that’s one step, but then you have to figure out how do I talk to people or say, “Hey, do you want to get coffee or let me give me my number”. That there’s a lot of steps in there and it requires… There’s a lot of uncertainty involved in that, and it requires a lot of courage.

Brett McKay: So yeah, one of the things you do is you do social prescribing. So if you have patients that come in saying, “I’m feeling anxious, I’m feeling depressed”. One thing you might turn to is like, “Hey, why don’t you go out and try to make some friends”. So what kind of things do you tell them to do or recommend that they try doing?

Meg Jay: Yeah, this probably just sounds so obvious or so basic to someone listening, but you would be surprised at how many people will say, “I’m so lonely”. And then you ask about their day and it’s… You can easily see, now some relatively low hanging fruit of, “Well, why don’t you try this?” But I think I write in the book about a guy who came in my office who I really liked a lot, he was a great guy, and he had a steady girlfriend, but she had moved state for a job or something, and so ever since she left, I think she was sort of his leading form of social interaction, which often happens with young males, so she left and he was spending a lot of time on his phone. So, I said, “Well, let’s pull it up, let’s see how much on his screen time”. I believe it was 10 hours a day, because he was eating all of his meals in front of his phone, he was lying in bed on his phone, that’s where everything was happening.

And I said, “Well, what are you doing on your phone?” And he said, “Oh, I like sports, I’m watching this and this game, those stats”. Whatever. And I said, “Well, what sports do you like to do?” He said, “I like to play basketball”. So I said, “Okay, I prescribe your homework between now and the next time I see you is to get out and go play basketball with other people”. And so it wasn’t very long that he was doing that, that he said, “Yeah, I feel better now. I think I just needed to adjust better and differently to my girlfriend leaving and find healthier ways to get through my day”. So it may seem pretty obvious and pretty basic, but you would be surprised how many people aren’t sort of trying the solutions right in front of them.

Brett McKay: And another thing you point out is that young people and even adults need to realize that making friends, it’s gonna take a long time. You cite research from Jeffrey Hall, we’ve had him on the podcast.

Meg Jay: Nice.

Brett McKay: And yeah, he talked about it takes like about… You have to spend 50 hours with somebody to be considered as kind of a casual friend, and it takes about 150 hours or more to make that person a best friend.

Meg Jay: Right.

Brett McKay: When you’re in high school and college, that was easy to do ’cause you’re probably… You get those 50 hours in a few weeks, right?

Meg Jay: Right. You might get five hours a day with somebody.

Brett McKay: Yeah. And when you’re an adult, you might just get an hour a week with somebody. So it’s gonna take… It could take a year or two to make a really good friend, so you gotta be patient.

Meg Jay: Right, and people are often saying, “How do I make friends?” And you know the best way to make friends is to go out and live your life, outside of your house whenever possible, that you usually make friends over something. So friends from grad school or friends from the playground when you’ve had little kids or friends at your job or friends in the wine tasting class that you decided to take, or in the running club. So rather than people imagining there’s some separate program of things they need to do to make friends, the best way to make friends is to get out and do you, and you will meet people who are interested in the same things, have the same values, have the same interest, that’s where friends come from, but to your point, it takes a while.

Brett McKay: Yeah, and one of the side effects of getting out there and making friends is it can actually help you find love. You talk about a lot of young people you’re seeing, they wanna get married, but they can’t find… Having a hard time dating, but what the research shows, and people know this anecdotally, if you’re hanging out with lots of different people, you’re gonna be put in the path of people who might be a potential partner for you.

Meg Jay: Right. Friends are great practice for being partners, if you don’t know how to be a good friend, I find it hard to imagine how you could possibly be a good partner.

Brett McKay: Yeah.

Meg Jay: So, it’s great practice because you start to think about, “Hey, it’s not just about me, it’s about… This is a two-way street here. And I need to think about another person, sometimes I need to resolve issues”. So friends are great practice for being partners, and they are also a great way to meet partners that, the more you’re getting out and interacting with people, and again, I think… I don’t have anything against online dating, I’ve had plenty of clients meet people online, but it’s a little bit to what I said about making friends, is that rather than imagining there’s a separate program or a separate app or avenue for finding a partner, often get out and live your life, spend time with friends, and you’re likely to meet people who are interested in the same life, in the same future that you are.

Brett McKay: Okay, so making friends can help you practice the skill of love, of romantic relationships. Related to this idea in these chapters on the skills of love, and you also have the skill of sex, you devote a lot of time to an issue you’ve seen more and more in your patients in the past 15 years, I think it’s really relevant to men, porn use, how have you seen porn use change in your 20-plus years of working with young people?

Meg Jay: Yeah, people always ask me, “How are young adults of now different than when you started 25 years ago?” I would say as human beings, they aren’t very different, what’s different is the technology available to them, and so that’s created situations and problems maybe we didn’t have 25 years ago, but a couple of decades ago, everybody had seen porn, but it was harder to come by, you had to sort of have a Play boy or a penthouse or see it maybe on Cinemax, I mean, it just wasn’t that available. So watching porn was not something that came up a lot in sessions on either side of the room. Now it’s actually a routine intake or screening question that I have for all my clients. Young males are more likely than females to say, “Yes, I watch porn and probably too much”. But I ask every client how much porn they’re watching and whether that’s working for them, not working for them, to kind of take a look at that. And what I’ve really learned from listening to my clients, especially to my young male clients, is that what kind of started as a curiosity or as entertainment kind of became more consuming and maybe even a compulsion, and that people spend a lot more time watching porn than maybe they really want to.

And that it has created for a lot of young men this anxiety about getting out and being intimate with someone in person, having sex with a real person, because watching porn doesn’t necessarily translate to dating or to starting an intimate relationship with someone.

Brett McKay: Yeah, you talk about some issues that they’re seeing amongst young men who are habitual porn users, erectile dysfunction, performance issues, and also a lot of the patients you talk to who have a porn addiction or just use porn too much, depression and anxiety. What do you think is going on there? Why is there a connection between depression and anxiety and habitual porn use?

Meg Jay: Yeah, that’s really to me, the biggest connection because whether people can be addicted to porn or not is up for debate. But what I definitely see is that people will say, “I’m watching porn every day, and I don’t wanna be, so it makes me feel depressed about myself, why am I doing this? What’s wrong with me? I feel weird walking around knowing that I’m doing this thing that I wish I wasn’t doing, it makes me feel bad about myself, that I’m kind of watching other people have sex rather than figuring out how to go out there and have it myself”. And then there’s the anxiety piece where whether consciously or unconsciously people imagine, “Well, I’m supposed to know how to do all that, I’m supposed to be able to perform like that”. And the longer you spend watching sex rather than trying to participate in having sex, the more likely you are to have that sort of stage fright or performance anxiety. So I’ll have young male clients say, “Well, I just don’t even know how to start. What if I go out with someone and I can’t perform?” And I say, “Well, let’s take it back a few steps, what if you just go out with someone and get to know them, or go out with someone and make out, and don’t worry about sort of performing.”

Not to mention performing like a porn star, “Don’t worry about that on the first day, let’s just spend some time with someone and see what happens”.

Brett McKay: Yeah, you talk about how porn use can get in the way of a healthy sexual relationship once that’s part of your life with somebody, is that you have these weird expectations of what sex is supposed to be like, ’cause you’re trying to perform. You’re trying to mimic what you’re seeing there, and I’ve seen surveys with young people where, there’s a lot of young people who are doing things in the bed because they saw it on their TV screen or their computer screen, but they’re actually not comfortable with it, but they think, “Well, this is what I’m supposed to do is what I see”. And you are… You instead of trying to perform and trying to mimic what you see in these videos or whatever, sex and love should be like a jazz collaboration, you’re working with the other person to figure out what works for you two.

Meg Jay: Right, that it’s don’t try to imitate something you’ve seen other people do, just be in the moment with the person you’re with and figure out what that person wants to do and what you want to do, the best metaphor or comparison I ever heard… I think I heard it on NPR. It was someone, and I wish I could credit them ’cause I don’t remember who said it, but they said, learning how to have sex from watching porn is like learning how to drive by watching Fast and Furious movies, that is just not… It’s not gonna give you the best sort of scripts or playbook in terms of how most people actually want a sexual relationship to go.

Brett McKay: Do you have any advice on… Say that someone’s listening like, I got… I’m watching more porn than I want, any advice on helping them stop?

Meg Jay: Yeah, I mean… Well, that’s a spectrum. So I’m hearing more and more from men who are saying, I have a hardcore porn addiction, I’m in deep, and so I think if you’re feeling that that’s your situation, that I think people are treating that the way they treat other addictions, so look for addiction resources that specifically gear to this. But what is more common is young males, and I see this all the time who are just saying, I don’t think I’m addicted to porn, but I’m really watching it too much, and so we come up with solutions together. When you’re leaning on a substance too much, no matter what it is, the first sort of line of defense is to figure out, well, how can we make this a little less available and how can we do something else?

And so that may be, I don’t bring my phone in the bedroom or I got rid of my desktop, depends on where are you accessing this, when are you most likely to look at it and can you kind of busy yourself at other times, and that may sound like not big interventions, but that’s a great thing about working with young adults, is that these are when difficult habits tend to crop up, but they also haven’t often been around all that long, and that they can be easy to shift and so sometimes you make some lifestyle adjustments, and they’re able to act on that pretty quickly, I have a client right now who came in a month ago and said he was getting high half the day, noon to midnight, and I was like, Well, that’s probably a problem.

So can we reduce that? And so he’s already been able to say, Okay, I’m gonna get my day done, I’m gonna get my work done, and maybe I’ll just be a night-time smoker, and for now that’s where he is, will he eventually become… Well actually, he said over the long haul, three to five years from now, he would rather be a weekend smoker or a not-at-all smoker, and he’s moving in that direction quite quickly and effectively without much intervention on my part, except saying, I think you can do this let’s talk about how.

Brett McKay: Two other skills that I was surprised to see pop up in the book was the skill to move, exercise and the skill to cook, why those skills? How do they help our mental health?

Meg Jay: Well, I think… I hope everybody’s heard by now that exercise is always great for mental health, and there really aren’t any downsides, so unlike medications, which can be a mixed bag, getting out and moving more, it’s good for our physical health it’s good for our mental health, it can be good for our social lives, it can be good for our work lives and creativity, there’s really no downside to moving more, and about a third to a half of doctors will prescribe movement for mental health struggles, but that also means a half to two-thirds don’t, and they should be, because often times clients are coming in and they’re saying, I wanna feel better right now, immediately, and that makes people think, Oh well, maybe medication, but if you wanna feel better right now, probably the quickest thing you could do to feel a little bit better is to move a little bit more, and you don’t have to exercise, you don’t even have to play a sport, it’s just whatever you’re going to do and enjoy, so maybe you walk your dog more, maybe you play frisbee, maybe you play pickle ball, or maybe you go for a hike, maybe you do salsa dancing on the weekend, the best kind of “exercise” is Whatever it is you’re going to do.

Brett McKay: Yeah, and we’ve had people on the podcast talk about that exercise as effective or even more effective than antidepressants without the downsides, without the side effects, cooking. Why cooking?

Meg Jay: That might sound like… That’s funny. Everybody’s commented on that, that I’ve got cooking in my book. A couple of reasons I do. One is young adults, they just eat like crap. Pardon my french, they really do not eat well, and so that’s not helping that we’re learning more about how processed foods, junk foods are not great for your mental health, not great for your brain, that the gut is called the second brain because it’s second only to the brain, in terms of the number of neurons that it contains, so what you put in your body matters, there’s also the issue of, I think just… And people who cook are more likely to eat more healthily, but just knowing how to cook, I think helps people feel more competent and more confident rather than feeling like they’re running around trying to get some of their most basic needs met by another person or that they don’t know how to do it, knowing how to make a breakfast smoothie in the morning or pack a sandwich, Or make a meal at night really does help people feel like there’s something that I can follow the instructions on and have a win on today, it also helps your social life ’cause you’re more likely to have people over or have a barbecue or a potluck. So again, no downsides to learning how to cook, and it can be incredibly grounding.

Brett McKay: Okay, so another skill, last skill I wanna talk about is the skill of how to decide, your 20s are filled with lots of big important decisions, how do 20-somethings and maybe even people beyond 20-somethings, how do they get decision-making wrong?

Meg Jay: Well, your 20s are when you move from what are called small world problems to big world problems, because it’s when you sort of move from school, of there are right answers and clear ways to get an A or a B to life after school where there isn’t a right answer to, who should I partner with? What should I do? Should I take this job or that job? Where should I live? There aren’t any right answers, there’s no algorithm, there’s no way you’re going to be able to sort of gain this or find out from another person what you should do, the good news is there aren’t any wrong answers, it’s really just what’s right or wrong for you, and I think when we’re looking for that answer, that’s where the asking your therapist or asking your parents What should I do, when really only you can decide, and I think that can be freeing when people recognize that there isn’t a wrong choice to make here, there’s only your choice, so you gather the best information that you can and you make it based on your own values and priorities.

Brett McKay: You talk about one problem that 20-somethings have is constantly looking for reassurance and that can actually get in the way of making progress in life.

Meg Jay: Yeah, actually in the psychology world, they have seminars now about reassurance junkies, people who sort of always want to know, Am I doing the right thing? Is this gonna work out? Am I okay. And when you reassure people, it’s actually a little bit like a drug that you’re giving them a hit of something that makes them feel better for about five minutes and then they come back and they want more, so rather than reassure people, I actually recently, and I think I wrote about it in the book, that this happens to me all the time. I will say something that is meant to inspire confidence, and people will say, Well, that’s very reassuring, and I said, No, no, no, I’m not trying to reassure you, I’m trying to say, based on the evidence, I believe in you, you’ve gotten through this situation before I think you can do it again. Recently, I was on a podcast and someone said, My life has been okay in my 20s, but what if it all goes sideways in my 30s? And I said, Well, why would that happen? And we talked about how she had already made progress at work and was in a healthy relationship and had some nice friends, so she clearly had the skills to be off to a great start, so I really couldn’t understand why everything would just go to pot in her 30s, and she said, Oh, that’s so reassuring.

And I said, No, I’m not trying to reassure you, I’m trying to give you confidence that based on the data, on the evidence, there’s no reason to believe your life is gonna go sideways, and that’s different from saying, Oh, everything will be fine. But that’s just sort of empty.

Brett McKay: Well, Meg, this has been a great conversation. Where can people go to learn more about the book and your work?

Meg Jay: Let’s see, the book is sold everywhere I hope, and on socials, I’m at Dr. Meg Jay. And then my website is

Brett McKay: Fantastic. Well Meg Jay. Thanks for your time. It’s been a pleasure.

Meg Jay: You too Brett, always great to talk to you.

Brett McKay: My guest here’s Dr. Meg Jay, she’s the author of the book, The TwentySomething Treatment, it’s available on and book stores everywhere, you can find more information about her work at her website,, also check out our shownotes at where you can find links to resources where we delve deeper into this topic.

Well, that wraps up another edition of The AoM podcast, make sure to check out our website at where you can our podcast archives, as well as thousand of articles that we’ve written over the years about pretty much anything you think of, and while you’re there, sign up for our email newsletter, it’s completely free, and there’s both a daily and weekly option, as always, thank you for your continued support, and until next time this is Brett McKay, reminding you to not only listen to AoM podcast but put what you’ve heard into action.

Related Posts

Tags: ,