The Mental Health Crisis of Today’s Youth—The Hidden Culprit Every Parent and Therapist Should Know About


Eyes blurry and staring at his class notes, he was frozen. Fleeting thoughts of not wanting to live darted across his mind.

Patrick couldn’t stop obsessing about the test a week away. He had been an honor student throughout high school, but the pressure of college triggered his panicwhich he described to me, afterward, during a therapy session.

In my practice, this is a situation I have seen many times. Young people seem to be able to “handle” the pressure of performing until it reaches a certain level. In high school, Patrick’s parents wanted him to see a therapist because he often felt anxious. We had worked together for six months prior to him graduating and going out of state.  Although he felt less anxiety because of therapy, it all came back when he attended the university.

I received a call from his mom. It seemed like she was more concerned about Patrick’s being able to focus in order to get good grades than his emotional well-being. For the most part, parents put pressure on their children to succeed academically because they understand that education equals opportunity, and they want their children to have a better life. I don’t doubt that mom cares about her son’s mental health, but her emphasis on achievement tells a larger story.

This young man’s story is unfortunately quite common.  In the past decade there has been increased attention given to the connection between academic achievement focus and mental health symptoms in young people. Academic stress has been directly linked to depression, anxiety, and suicidal ideation rates among today’s youth, and grades are a major source of this kind of stress.

In 2019, the Pew Research Center revealed that “Most U.S. Teens see Anxiety and Depression as a Major Problem Among Their Peers,” and academics are at the forefront of the pressures that young people face.

Most teens (61%) say they personally feel a lot of pressure to get good grades, and another 27% say they feel some pressure to do so.  Compared with getting good grades, about half as many say they feel a lot of pressure to look good (29%) and to fit in socially (28%). Roughly one in five say they face a lot of pressure to be involved in extracurricular activities and to be good at sports (21% each), while smaller shares say they feel a lot of pressure to help their family financially (13%), to participate in religious activities (8%), to be sexually active (8%), to drink alcohol (6%), or to use drugs (4%).

Boys and girls, as well as teens across income groups, generally feel similar levels of pressure in each of these realms, but girls are more likely than boys to say they feel a lot of pressure to look good (35% vs. 23%). And teens in the lower- and middle-income groups are more likely than those in higher-income households to say they feel at least some pressure to help their family financially (42% and 38%, respectively, vs. 28%).

In her recent book, Erasing the Finish Line: The New Blueprint for Success Beyond Grades and College Admission, Ana Homayoun questions the way we think about education, and invites us to re-examine our ideas about success as well as the important skills that are needed to navigate and thrive in today’s world.

Homayoun writes: “For years, we’ve been led to believe that great grades, high test scores, and college acceptance are key to a successful life. Yet our laser focus on these achievements leaves students feeling anxious, demoralized, and unprepared.”

The problem that underlies the symptom

There are several factors that contribute to declining mental health of today’s youth. However, the pressure, and over-emphasis, that many parents place on achievement feeds into, and intensifies, a larger societal problem that is unfortunately overlooked.

While today’s youth experience increasing societal pressures and social influences to achieve and compete, the culture teaches them to measure their self-worth and identity based on what they do rather than their intrinsic qualities such as resourcefulness, sense of humor, sincerity, intelligence. There is nothing wrong with striving to better oneself, but it becomes problematic when it is linked to self-worth. The irony is that the very qualities that have contributed to their success also perpetuate their emotional suffering.     

This pervasive cultural mindset encourages young people to be outer-directed, putting a lot of pressure on themselves to be the best. Today’s youth feel tremendous pressure to go “above and beyond” what’s expected, and feel deficient when they don’t measure up to unrelenting standards. Because they also have little tolerance for their own shortcomings, failing becomes synonymous with being a failure as person.

In a November 2011 article, University of Rochester psychologist Andrew Elliot pointed out how overachievers have an underlying fear of failure or a self-worth contingent upon competence. He found that rather than setting and striving for goals based on a pure desire to achieve, the underlying motivation is often to avoid failure.”

Seeking validation from outside, they attempt to feel adequate and accepted by performing well, conforming to societal norms, and reading what others want in order to mold themselves to fit expectations.

Their strong need to be seen as competent conceals the sad truth that they can look well-adjusted and successful on the outside, but inside they suffer silently. Internal struggles often escalate later in life when thrown into a competitive college environment or workplace, which include eating disorders and addictive behaviors.

So, what can be done to counteract this disturbing trend?

The tendency is for parents to repeat the same parenting styles that shaped their own upbringing. In addition to refraining from pressuring children to excel and get excellent grades, parents can counteract rather than reinforce the peer pressure and societal messages that perpetuate this toxic external orientation.

They can begin by finding ways to convey to their child that they are valued, loved and worthwhile regardless of their achievements and successes. Going back to that concerned mother who I spoke about in the beginning of this article, I am interested in to what degree she is able to recognize and validate her child’s “inner person” (their intrinsic qualities)?  

So many children and teens grow up never being seen for who they really are. Parents often tell me that they consider their child’s intrinsic qualities to be important, but when I dig deeper these qualities matter only when tied to an outcome, and are not the primary markers of their self-worth. For example, how many creative and artistic people have you known who can only recognize their creativity if they had a painting hanging up in a gallery?

Since having an outward focus causes young people to define their worth according to their accomplishments, and how others perceive them, parents can encourage them to become the arbiter of their worth. If their value is based on who they are rather than what they do, then they won’t need to achieve or please to feel adequate.

Children can learn to turn inward for answers, which is not about rejecting outside influence or becoming hyper-self-reliant. They can recognize the little voice inside that knows what is best. Because they don’t know how to access their inner wisdom, they allow outside forces to define their true value.

Parents can help their children cultivate an inward orientation by teaching them to trust and become attune to their intuitions and emotions. Through stories, and skillful questions, they can help them to look inside in order to discover what is most true in their experience, rather than relying solely on the outside world.

An added complication

Another factor that reinforces excelling being the centerpiece of a child’s self-concept is when they form an identity based on emotional survival growing up. Children learn to act in certain ways around peers, teachers and family that increase their chances of getting acknowledged, praised, and valued. 

They also figure out that particular behaviors can help minimize feelings of worthlessness, shame, or lessened the likelihood of punishment, criticism, or rejection. For example, if there is a lot of arguing and conflict in the family, being compliant or a perfect helper can de-escalate tension. This can be a winning strategy when young, but often create problems as they reach adulthood. In these situations, psychotherapy can be very helpful.

Patrick looked like the perfect image of success on the outside, but inside he felt inadequate. Excelling in school earned him acceptance, and helped ward off feeling that he was “not enough.” As he got older the pressure to be exceptional continued and became the hallmark of his identity. Throughout his life he strived to be the best in order to maintain his self-image and esteem.

When I asked him to tell me what he believed made him a worthwhile human being, but to omit anything that had to do with achievement or the good he does for others. Patrick was totally stumped by my question, and could not come up with anything.

Over time, Patrick became much less anxious as he gradually realized that his worth was based on who he is, rather than on what he does. As a society we need to start focusing more on psychological solutions, and question taken-for-granted dysfunctional cultural norms, when tackling the enormous task of young people’s declining mental health. Clinicians have not looked deeply at this dysfunctional cultural norm, and its impact on the psyche.

The task is not simply to increase self-esteem, but to understand the primary ways that young people define themselves and measure their self-worth. Helping a child connect their worth with their inner qualities is significantly enhanced when parents, therapists and educators believe this about themselves.


Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.


Mad in America has made some changes to the commenting process. You no longer need to login or create an account on our site to comment. The only information needed is your name, email and comment text. Comments made with an account prior to this change will remain visible on the site.


  1. Lots of good advice, Dennis, thank you. From an imperfect mother, with one child who graduated from high school as valedictorian, then graduated from collage Phi Beta Kappa, including grand accolades from his psychology professors, and a psychology award. And a second child who is now working on an audiology doctorate, who I was essentially stolen from by the “mental health” industries at the age of three, so was allowed to buy more into society’s BS, than my eldest.

    But as the supportive, albeit imperfect mother of two children, who are not just currently surviving, but thriving – in these hard times for many (including my family).

    I found my own family, including my own upbringing, and how I chose to try to properly raise my children, in your words. Thank you for your truth telling, Dennis.

    And I will say, sometimes it takes walking away, and a little reverse psychology, when one is living in an insane society, where the teachers are fraudulently telling the children, that they do NOT need to memorize their math facts.

    But how many young men want to be dumber than their mothers? Not my son, he wasn’t dumb enough to totally buy into his teachers’ lies. And by eighth grade, he’d memorized his math facts, and got 100% on his state standardized tests.

    Report comment

  2. Since the ’70s, the Three Principles (3P) have shown us how each human uses formless Mind, Thought and Consciousness to create our moment-to-moment experience. 3P is the “reverse psychology” that can end “mental illness” and other forms of human suffering.

    Report comment

  3. Curious, how are these pressures any different than what previous Generations grew up with?

    While I love Mad in America, this article sounds like another apology for soon to be adult children who cannot hack it in the real world.

    We could all list a thousand things that made the generation we come from the way we are, the hardships we faced and the pressures put on us to achieve and concede our identities for a successful future.

    I’m sorry, but this article says nothing about anything that’s really affecting us our children or the world around us.
    We’re all under pressure, we all think we should be better than we are we all worry about what people think; the difference is some of us grew up having to adapt and develop real coping skills by living, while younger folks got a pat on the head and Awards just for being good humans – the only proof up their ” goodness ” being that they existed .
    Nothing lived and nothing gained leads to no self esteem or a positive belief in oneself. You don’t win simply by existing.

    We were forced to adapt and succeed, they were told they were a success for failing to adapt or achieve.

    Why are these current mental health issues o
    Such a Mystery to any of us?
    Even worse why are the solutions so elusive?

    HEY KIDS, Get outside, get some exercise, solve a problem on your own, talk to people face to face, call and order your own damn pizza on the PHONE.
    I just solved 90% of your children’s problems. You are welcome.

    Problem is not an inability to focus on their inner child and their emotional well-being, it’s a lack of focus on teaching them how to cope in a real world and teaching them that validation comes from within, not from outside of ourselves regardless of what anyone else says.

    Report comment

    • I would add that being told over and over that their emotional struggles are a “mental disorder” has contributed to younger peoples’ lack of ability to cope. Used to be parents, teachers, and the kids themselves got the message, “Hey, you’re good at x, but not so great at y. Let’s work on your Y skills.” No excuses, you just were how you were and everyone dealt with it, admittedly poorly much of the time, but at least the message was, “Don’t feel sorry for yourself – you can figure this out.

      I also remember the crazed maniacs who sometimes passed for school teachers back in my day. I’d hardly say the school environment has gotten more stressful!

      Report comment

    • Salary and academic achievement, professional status are strong outside signs of validation.

      And youngsters are having a lot of trouble not only in the US but in China finding jobs fitting to their bachelor.

      They are unable to acquire enough salary and savings to get a mortgage. They are so saddled by college debt that according to recent economic data the money value of a college degree is $0, zero dollars for many, if not the majority.

      The cost of child care is unaffordable for most, even those empolyed in chld care.

      Among other problems that are evident to teenagers, beyond those mentioned in this post. So this post is a partial view from a psychotherapist’s point of view that needs complementing with the economic and security points of view.

      In Mexico among soon to be voters the top problem according to polls is economics, not mental issues nor “performance”, self confidence or the like…

      Despite the fact that 10% of mexicans think about suicide very frequently according to official surveys. And still mental issues are not dominant worries for mexicans to reach adulthood. As is not global heating/warming, odd enough.

      Report comment

    • Well today corporations spend billions and billions of dollars to make all of us feel inadequate. Using our insecurities to manipulate us into buying a new I phone, new car, all the crap that is so not important.

      That is what is different.

      Report comment

  4. Excellent article and illumination of one our society’s chief scourges; the general lack of attention to our inner lives–fears, fantasies, imaginings, and intuitions among those lives. This article points to the urgent need for parents and the culture to encourage personal and engaging conversations, explorations, and collaborative ventures with children. Short of this, as the author implies, we will not only fuel the skyrocketing rates of depression and anxiety but we will fuel the self-loathing and alienation that leads to so much destructiveness in our world today.

    Report comment

  5. As a high school teacher, I would argue that this applies to relatively few of my students. The problem I see is the opposite. Teens have very little academic motivation, and a lot of adults are hand-holding them to the point they no longer have a sense of accountability.

    Report comment

  6. A key point to me is one of Foundation. When I first began in graduate school @UChgo my major Professor Dr Barry Levine asked us all, do you believe man, and woman, are basically good, bad or neutral?

    I can now say, all three, but the one that is most hidden is the one of the greatest depth: the positive and wise, then uncommonly good sense and the good wisdom.

    This is not simply a theoretical construct as much as it is a clinically accurate account – as I specify in the first 24 cases – basically randomly assigned, called “The Still, Soft Voice.”

    By the way, I don’t see it as pushy, this Foundation, and yet it is There waiting for any questions that you may have.
    – Dr Cliff

    Report comment

  7. I think this post requires balance to put into view that many students are being passed in greater numbers, their abilities are declining, they perform worse as students, they assit less to classes, they do less assigned work and by the time they reach college they require lots of remedial courses as narrated in the following article and its links:

    And from my personal experience, many people who feel inadequate as students actually are/were suffering from deficits in their performance as students, and later as professionals.

    Lots of physicians as students I met are a great example of that: they all thought they were great students and very empathic, and could read lots and lots, only to find out that when confronted with the reading load they flunk. And of empathy I have mentioned before in other comments.

    Report comment

  8. I Left teaching high school to become a therapist for exactly all the reasons you list in this article. Have blogged extensively on this very subject! Also Agree with many of the comments above about lack of motivation and low performing students too which I see as the same problem as the high achievers— our culture teaching young people to avoid inner connection, embodied learning, and focus on externals. Recovery and rest aren’t our values. Maximizing Productivity is. Schooling is not authentic learning thus our young are not taught about their human nature and ways to thrive and be healthy as the priority, inside their bodies and out there in the social world. We don’t give kids the foundational core beliefs nor coping skills they need because we are so busy training them to compete, win, get to the next level. (Sounds like a video game, yes?)I also counsel couples and find parents are so busy still competing themselves and demanding their kids do the same that the entire household is a pressure cooker of overwhelming stress. Busy achievers coping by being busier and achieving more more more. And we wonder why addiction happens. Nice to finally read an article that captures what I’ve witnessed firsthand inside schools as teacher, as a mother of 4, and now as a mental health counselor.

    Report comment

  9. The subject matter of this article is as much a clarion call for the compassion and understanding the author seeks, as it is for the political consciousness missing in the articles text. Rather than me blathering on, Byung-Chul Han captures, I think, some of the more critical issues surrounding the causes and undermining challenges that beset the mental health of todays kids.

    “Achievement society is wholly dominated by the verb can-in contrast to disciplinary society, which uses prohibition and deploys should. The call for motivation, initiative, and projects exploits more effectively than whips and commands. As an entrepreneur of the self, the achievement- subject is free insofar as he or she is not subjugated to an exploiting or commanding Other.” (Hence, a big part of the soul crushing desperation behind education…)
    “The neoliberal regime conceals its compulsive structure behind the seeming freedom of the single individual, who no longer understands him-or herself as subjugated subject (“subject to”), but as a project in the process of realizing itself. That is its ruse: now, whoever fails is at fault and personally bears the guilt. No one else can be made responsible for failure. Nor is there any possibility for pardon, relief, of atonement. In this way, not only a crisis of debt occurs,-a crisis of gratification does as well”

    Chul-Han’s thinking here-and elsewhere, save Wendy Brown and many others-peel away the illusions of achievement society uncritically propagated from within our neoliberal educational matrix, and by extension-whatever copious else, IMHO, insinuate a call for a revolution of education that dwarfs that of 1968 France-or anywhere else in time! Compassion is essential, but so is an education sufficient to not render its students unconsciously complicit to a “socio”-political crisis one assumes, as a result, to be his or her apolitical personal crisis alone.

    Report comment

  10. 50 years ago I was homeschooled out of UCSF Psych Dept. I was taught and did the Hoffman Process, and then wrote the First Dictionary of Emotions. I also read Dianetics on my own.
    Now at age 70, I have written about this Self Auditing program called #GRIP INVOLUTION and you can see it on my Facebook page.

    Everyone else tells you what you should do.
    I’m the only one who is telling you “HOW TO” reach the inner self. It’s a single page of paper and is free to Copy/Print/Share, along with the instructions on Why Print GRIP? FREE TO ALL

    Report comment

  11. Thank you for this article. It really hit home for me. I’m in my thirties now, well out of college, and this article described my situation exactly (although it started as early as elementary school). Using academic achievement to feel worthwhile amongst peers and adults led to multiple meltdowns in high school and college. Conflict in our home was a big factor. For those who are skeptical of this being a real issue, how else can you explain why a high-achieving, service-oriented, hard working, physically active, GREAT kid (with no cell phone and no social media, mind you) could all of a sudden crumble into panic and self loathing? How else do you explain a young adult graduating from college with honors, magna cum lauda, her department’s candidate for commencement speaker, a member of honors societies, vice president of a social club, etc. sobbing out of her mind on graduation day because she feels like she thinks she’s a failure? It’s a complicated issue, it’s tricky to sort out, but that doesn’t make it false. This article is not making excuses for kids to slack off. It’s identifying a very real crisis that many (not all) student-aged people face.

    Report comment

    • As I mentioned in the article, many teens and young adults look great on the outside, but inside they suffer quietly. Their life is driven by a compelling need to be seen in a particular way in order to feel adequate, included and noticed.
      Although my article focused primarily on the academic arena, basing our sense of self on our performance, and how others perceive us, causes psychological backlash in relationships and in the workplace.
      I also agree with the comments above about lack of motivation and low performing students. This issue speaks to the other side of the same coin, meaning some kids cope with the pressure by underachieving.

      Report comment