When my anxiety became unmanageable, I faced the question directly: meditation or medication?
I’d resisted medication for years. It felt like admitting defeat, like I should be able to handle this myself. Surely more meditation, better self-care, stronger willpower would fix it.
Eventually I tried medication. It helped. So did meditation. They worked better together than either alone.
Here’s what I’ve learned about these approaches — from personal experience and from reviewing what research actually shows.
The research comparison
Let me start with what we know:
Meditation for anxiety
- Meta-analyses show moderate effect sizes (approximately 0.3-0.5) for mindfulness-based interventions treating anxiety
- 8 weeks of consistent practice produces measurable benefits
- Effects appear to persist if practice continues
- Minimal side effects
- Requires time and consistent effort
Medication for anxiety
- Effect sizes for SSRIs (common anxiety medications) are also in the 0.3-0.5 range — roughly comparable
- Effects typically begin within 2-4 weeks
- Sustained relief while taking medication
- Side effects vary by medication (weight changes, sexual dysfunction, sleep changes, etc.)
- Stopping medication sometimes leads to symptom return
Head-to-head studies
In direct comparisons, meditation and medication often perform similarly for moderate anxiety.
A notable 2022 study in JAMA Psychiatry found that mindfulness-based stress reduction was as effective as the SSRI escitalopram for treating anxiety disorders over 8 weeks.
This doesn’t mean meditation replaces medication for everyone. It means they’re both evidence-based options with comparable efficacy at the population level.
Individual factors matter
The population-level comparison doesn’t capture individual variation.
Some people respond better to medication: Particularly those with severe anxiety, biological predispositions, or who struggle to maintain consistent meditation practice.
Some people respond better to meditation: Particularly those who dislike taking medication, have mild to moderate symptoms, or value developing self-regulation skills.
Many people respond best to both: Combination approaches often outperform either alone.
What works for you specifically depends on:
- Severity of your anxiety
- Your biology and medication response
- Your ability to commit to regular practice
- Side effect tolerance
- Personal values and preferences
- Access to quality therapy alongside either approach
My experience with both
I can only speak to my own journey:
Meditation alone: Helped my baseline. I was somewhat calmer, caught spirals slightly earlier, had more tools for difficult moments. But severe anxiety episodes still overwhelmed me.
Medication alone: Took the edge off dramatically. The physical symptoms reduced. I could sleep. But I didn’t feel like I’d developed any skills — I was just suppressed.
Both together: Medication created a stable enough foundation that meditation practice could deepen. I wasn’t fighting constant activation. The skills I built felt more accessible. As I stabilised, I (with my doctor’s guidance) was able to reduce medication.
Your path may look entirely different. This is one data point, not a prescription.
When medication makes sense
Consider medication seriously if:
- Anxiety significantly impairs daily functioning
- You’ve tried meditation and other approaches without sufficient relief
- You can’t maintain practice because anxiety is too overwhelming
- Physical symptoms (racing heart, panic) are severe
- You’re at risk of serious consequences from anxiety (job loss, relationship damage, self-harm)
Medication isn’t failure. It’s treatment for a condition. The brain is an organ; sometimes organs need medical support.
When meditation may be preferred
Consider prioritising meditation if:
- Anxiety is mild to moderate
- You want to develop lasting self-regulation skills
- Side effects from medication are a concern
- You value drug-free approaches
- You can commit to consistent daily practice
- You have access to good guided instruction
Meditation requires effort and consistency. If you can provide that, it’s a reasonable first approach for non-severe anxiety.
The combination approach
Many practitioners and patients find the best results from combining approaches:
Medication creates stability. It reduces the intensity of anxiety enough that you can function and practice.
Meditation builds skills. It develops capacity that persists after medication.
Therapy adds understanding. CBT or other approaches address thought patterns and behaviours.
Lifestyle supports everything. Exercise, sleep, diet, social connection.
The comprehensive approach is typically more effective than any single intervention.
What about coming off medication?
Some people use medication temporarily as a bridge:
- Start medication when anxiety is severe
- Simultaneously begin meditation practice
- Build skills and stability
- With medical supervision, gradually reduce medication
- Maintain stability through continued practice
This works for some people. For others, long-term medication is appropriate. There’s no shame in either path.
Do not stop medication without medical guidance. Withdrawal can be difficult, and relapse is possible.
The integration I recommend
If you’re facing this choice:
Don’t think either/or. Think “what combination of supports works for my situation?”
Start with what’s accessible. If you’re not ready for medication, try meditation and therapy first. If anxiety is severe now, medication might provide the quickest relief.
Consult professionals. A psychiatrist or doctor for medication questions. A therapist for overall treatment planning. Your own experience for what feels right.
Stay flexible. What you need may change over time. The approach that works at 25 may differ from what works at 45.
Reduce stigma. Neither medication nor meditation is the “enlightened” choice. Both are valid tools for human suffering.
AI meditation alongside medication
For those using medication who also want to build meditation skills:
At InTheMoment, sessions adapt to whatever you’re dealing with. If you’re on medication and working on anxiety, tell the AI. The session can focus on skill-building — not rapid symptom relief that medication is already providing.
Two free sessions per day. A supplement to your overall approach, not a replacement for medical care.
Honest conclusion
I can’t tell you whether to choose meditation or medication. That depends on your circumstances, your severity, your values, and your resources.
What I can say:
- Both have evidence supporting their use
- They’re roughly comparable for moderate anxiety
- They often work best together
- Neither is morally superior to the other
- Professional guidance helps with the decision
Anxiety is treatable. You have options. Choose the approach that fits your life, remain open to adjusting, and get support along the way.
Want to build meditation skills alongside other anxiety treatments? Get started with two free sessions per day — tell us what you’re working on and the session adapts.