Welcome to Overshare, Highsnobiety's deep dive into the role social media plays in our mental health. From a close look at how Gen Z does therapy to a personal essay from the viral comedian Jake Shane to a glossary of words, phrases, and diagnoses that get thrown around on #TherapyTok.

When he was 16 years old, Irvin, a 25-year-old former tech worker and aspiring writer, got in trouble with the law. As part of his state-mandated probation in Texas, he had to attend therapy sessions. “Being a rebellious teenager, I didn’t see how it was helpful,” Irvin says. 

Fast forward to 2023. Irvin, confronting questions about what he wanted to do with his life, and dealing with issues he knew were related to past traumas, he decided to give therapy another try. “Through therapy, I realized that a lot of it was to do with my relationship with my parents, more particularly my mom,” he explains. Eventually, Irvin worked up the courage to quit his job and move to El Salvador, where his parents are from. Now, he’s reconnecting with family members and pursuing a new career as a writer. “If it weren't for going to therapy, I wouldn't have done something like this,” he says; “taken a leap of faith and bet on myself.”

Not so long ago, talking about our mental health was a taboo. But as more and more young people like Irvin see the impact therapy has on their lives, the more normalized it’s become. A 2019 report from the American Psychology Association (APA) found that Gen Z is more likely to say they have received treatment or therapy from a mental health professional than other generations (37% compared to 35% of millennials, 26% of Gen Xers and 22 % of boomers). Yet, the same APA report cites that Gen Z is more likely to say that their mental health is fair or poor, compared to millennials (15%) and Gen X (13%).

If Gen Z is going to therapy more than other generations, why are they still struggling so much with their mental health?

Finding the right therapist might be part of the issue. Arianna Stalteri, a 26-year-old co-owner of a vintage shop in Toronto, Canada, first saw a therapist when she was 18. “I have pretty bad ADHD and seasonal depression, which I’m currently unmedicated for, so I do rely a lot on therapy, the people that love me, and genuinely connecting with nature and the outside world so that I’m not just listening to the thoughts in my head,” Stalteri explains. She had sessions with three different therapists before finding the right one. “I think deciding if someone is trustworthy is really a gut feeling,” she says. “I’ve had therapists in the past where I was like ‘Hmmm I don’t think this is necessarily good advice or right for me,’ and went with my initial gut response and got a new one.” Putting in the time necessary to connect with the right therapist can be a real barrier. 

But, with the proliferation of virtual therapy, accessing mental health support – and bouncing around different therapists until you find the right one for you – is also easier than ever. Kara Fox, a clinical psychology PhD student at the University of North Carolina, explains, “If you're in a more rural area, and there are not a lot of therapists there that you could go see in person, telehealth is helpful.”

There’s a flip side to all this access though that Fox says might explain the higher rates of mental health struggles among Gen Z. “There is more awareness, so maybe [mental health disorders] are being recognized more often,” she says. “A good example is ADHD. Women and girls have been historically underdiagnosed. Now people are starting to be more aware and get diagnosed more. These people have always had ADHD, but it's just getting recognized later.” In other words, if statistics show us that more people are struggling with their mental health, it might be because more people now know what to look for where previous generations didn’t (and suffered silently). 

Another factor is just what kind of treatment people are accessing. Fox says that popular telehealth platforms, such as BetterHelp, can be quite problematic, possibly doing more harm than good. Former patients of the platform have taken to TikTok to describe poor experiences, like therapists missing scheduled meetings or arriving late, making and eating popcorn in a public lounge during a session, and congratulating someone who suffered from an eating disorder on their recent weight loss (and thus retraumatizing them). “They’re not very well regulated,” Fox says of BetterHelp. “People have had unethical experiences with therapists.” The platform was recently under fire by the Federal Trade Commission for selling patients’ sensitive health information to companies like Facebook, Snapchat and Pinterest.

A big reason why platforms like this one have become popular is their price point – a typical session at BetterHelp might cost around $65 compared to the more standard $100 per session for in-person therapy and up to $200 for a psychiatrist. 

For Irvin, cost was a factor. He had to quit after a couple of months: “I was paying about $150 per session after benefits,” he explains. “$150 a week accumulates very quickly.” 

A December 2023 survey conducted by the Thriving Center of Psych found that 58% of people aren’t going to therapy because it’s too expensive. And the cost barrier is pushing many Gen Zers to alternative sources for support. While B.M., a 28-year-old singer-songwriter in Canada, attends therapy when he can afford it, he finds support through social media to supplement the times when he’s not attending or can’t afford therapy. Two of his favorites are @flynnskidmore, a holistic therapist based in Southern California and @therapyjeff, a licensed professional counselor based in Portland, Oregon. “@therapyjeff was recommended to me by a friend who I opened up to about the hard work that goes into a romantic relationship,” B.M. explains. “Jeff does an amazing job at creating short lists of questions to ask yourself and your partner. He has allowed me to have very important and constructive conversations with my partner.”

While it’s great for awareness and combating stigma, the proliferation of mental health influencers has caused problems, too. “Some of the information [on social media] is very good,” Fox says. “It can make people feel less alone. But at the same time, there's also a lot of misinformation. We're seeing some self-diagnosis that is happening that is not helpful.”

And social media, in general, can have a huge negative impact on the mental health of young people. A 2002 McKinsey Health Institute survey of 42,000 respondents in 26 countries found that Gen Z is more likely than other generations to say social media negatively affects their mental health: 27%, compared to 19% of millennials and 14% of Gen X. Gen Z are also spending the most time on social media: 35% spend two hours or more a day, compared to 24% of millennials and 17% of Gen X. 

A love-hate relationship with social media is something that 23-year-old Malia Kellerman, a food and beverage entrepreneur based outside of Seattle, can relate to. “I always notice that the more time I spend on social media the more my brain is cluttered with junk, noise, and often not good or healthy thoughts,” Kellerman explains. She has removed apps and exited platforms, but the departures have never been lasting. “I’ve deleted all social media for months at a time before, and then I get this feeling of FOMO and wanting to see what distant friends are up to and I redownload. It’s the cycle that I’m always toying with.”

Organizations like the US-based non-profit #HalfTheStory are fighting for policy changes that would hold tech companies accountable for ensuring that their platforms promote digital wellness. While their advocacy campaigns, like Assembly Bill 2408 would have allowed parents and the state Attorney General in California to sue social media companies on behalf of children who were harmed because of a social media addiction, the bill was killed in 2022. 

Though Assembly Bill 2408 was focused on children, adults, including Gen Z, would still benefit. There are many ways that platforms could implement reminders and notifications to combat specific negative impacts, such as social comparison and hypercompetition. For example, if a platform senses that a user is scrolling through and lingering on a bunch of different profiles in a row, they could be required to show a notification to “jolt” users out of a so-called scrolling trance. “The pieces of the platforms that keep us hooked are the algorithms, endless scroll and speed at which content is received,” explains Larissa May, founder and CEO of #HalfTheStory. “Our brains don’t stop developing until we are 28, and these features prey on the limbic system and emotional center of our brain while it’s developing.” To help combat the addictiveness of social media platforms, May suggests putting your phone in grayscale, so your brain isn’t attracted to the colors, and organizing apps in folders so that they aren’t as easy to reach. 

As organizations like #HalfTheStory advocate for important policy changes, Gael Aitor, a 20-year-old co-founder of the Gen Z production company Astro Studios and a former co-host of the podcast Teenager Therapy, encourages researchers and lawmakers not to generalize his cohort. “I can't speak for an entire generation,” Aitor explains. “You think about the youngest Gen Z and the oldest Gen Z and those are two completely different people.” Aitor, who is based in Anaheim, California, also reminds us that, while Gen Z has more access than ever to therapy and resources, it’s only the first step toward improving mental health. “We might be really knowledgeable about all these therapy terms and words to use to describe, label and diagnose ourselves,” he explains. “But just because we're aware of that fact, doesn't mean that we are using the labels and diagnoses correctly, or that it is helping us more than it would harm us.”

While some young people are becoming more comfortable talking about mental health, unfortunately, it’s not yet a global phenomenon. Irvin says that mental health is not discussed openly in El Salvador, where the topic is still stigmatized. Aishan, a 28-year-old art curator who was born in China and moved to New York City when she was 18 to study art history, noticed the stark difference in how her peers viewed mental health after she arrived. “In college, I realized that a lot of people were actually going to therapy,” she says. “There was something very fashionable about it to me, like it was cool to have a therapist and to care about your mental health.” In China, Zhang says, there is little awareness or concern for mental health. “In Chinese culture, they ask you to tolerate things. If you have issues, you just deal with it, and I don't necessarily think that's right.”

Despite the mental health challenges that young people are currently facing, Aitor feels optimistic that increased awareness and access to therapy will lead to more and more positive impacts as Gen Z progresses further into adulthood. “I'm hopeful that our generation might become more educated parents,” he says. “We may be able to break cycles, because we’re more aware of toxic cycles and trauma and why we behave the way we do. That is an area that I'm particularly excited about.”

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If you’re experiencing symptoms you think may require treatment, or if you or someone you know is struggling seriously with their mental health, there are so many ways to find help. Start by talking to your medical doctor or calling your local clinic. You can also get help online. Get specific with your search terms, and when you find a site that looks useful, always check to see if it has proper accreditations (scroll all the way down and look for badges that have words like “accredited” or “rated”). A good place to learn about the different types of therapists and therapy modalities available is Psychology Today. Most importantly: Talk to your friends and family, and ask for help.