Actually, Everyone *DOES* Need Therapy

Even if you have "normal feelings of stress and sadness."

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Let me preface this by saying that I am not in the business of coming after fellow writers or writing “hot takes” just to get views on my own writing. I am, however, in the business of accuracy in reporting—aka I’m a professional journalist with a degree in journalism from a top university and 18 years of experience behind me.

So here’s the thing: I just read a Substack article titled “No, Not Everyone Needs Therapy” and I am absolutely bursting with anger at this claim.

While I value the opinion of others, I don’t value that opinion when it is based on grandiose, oversimplified statements with no facts or basis in the truth behind them (like when the author puts words into someone else’s mouth). Sure, maybe that’s what an opinion should be, but this particular opinion irks me because it is vocalizing the same ole mental health stigma in a pretty new Gen Z-approved package.

Simply put, this is a very, very flawed argument.

Photo by Nathan McDine on Unsplash

“Toxic Therapy Culture” isn’t a thing

First, I want to say that

Paula Ghete

wrote an incredible Note that details all of the flaws in this writer’s argument (who I prefer not to name, sorry). I highly encourage you to read it in full, and if you’re curious, read my initial response to Paula’s beautifully written and highly detailed Note.

What bothers me most about the post is that the author puts a lot of words into the universe that no therapist or therapy company has ever said. The author begins by describing “toxic therapy culture” as “a culture that pathologizes normal distress, and presents therapy as the solution to all problems.” And then goes on to say:

It’s this very modern vision of mental health that implies that you can achieve a perfect psychological state, that every emotion is diagnosable and solvable with some product or service. And it’s something I see as just another source of pressure on Gen Z. There’s pressure from the beauty industry to have the perfect face. Pressure from social media to have a perfect life. And now pressure from the mental health industry to have a sort of perfect soul.

Now, I don’t know about you, but I’ve seen all of the same Better Help, Talkspace, etc., ads that the author talks about in the piece, and not one of them have ever claimed to solve all of my problems, tell me that every emotion is diagnosable, that I can achieve a “perfect psychological state",” or that I can have a perfect soul. If the author has actually seen these exact claims written out, I implore them to send the evidence to me at raisingenalpha@gmail.com. I will immediately retract what I’m saying here.

I do get the point about Big Pharma and “Big Therapy” wanting folks to pay up, but as my new BFF Paula points out: “The pharmaceutical industry has saved many lives, it has cured many diseases, and helped prolong people’s lives while also making them better. Few industries do so much to help humanity.”

As someone in recovery from alcohol use disorder who also has friends who have dealt with addiction to opioids and other drugs, I agree that Big Pharma is problematic. But I’ll also happily tell you about how Lexapro saved my life when I became a mom in the early days of the COVID-19 pandemic and that my spouse probably wouldn’t survive without his thyroid medication. And those are mild issues compared to, say, a teen who is suicidal or an older adult with heart disease.

Statistically, adolescent girls *are* suffering

The author says that many of the ads they have seen seem to target adolescent girls. Now, as a mom, I am definitely uncomfortable with any ads targeted towards children and teens whose brains haven’t fully formed all of the neural connections they need for the rest of their lives.

But.. if someone is struggling, whether they know it or not, healthy neural connections won’t be made anyway. Then, an even worse argument appears.

Which worries me because I think this idea that everyone needs therapy for every problem is unhealthy. I think it’s especially unhealthy to teach those young girls who aren’t mentally ill but are increasingly sad, anxious and risk-averse. The way I see it so much of mainstream culture is teaching them that they can’t cope with life. We’ve got a progressive movement rewarding them for feeling like victims and seeing everything as an injustice. We’ve got TikTokers telling them they are traumatised and mentally ill. And less talked about is this booming therapy industry indulging their every fear and anxiety, permanently there to remind them that they need professional help. I don’t know about you but I really don’t think being able to message a therapist 24/7 from your room is going to do anything for the resilience of an anxious, socially awkward generation.

Let’s set aside that no therapist or therapy service ever uttered the words “everyone needs therapy for every problem” and focus on those girls who are not mentally ill but “increasingly sad, anxious, and risk-averse.”

What is “mental illness”?

Let’s first consider that the definition of “mental illness", according to the American Psychiatric Association, is this: Mental illnesses are health conditions involving changes in emotion, thinking, or behavior (or a combination of these). Mental illnesses can be associated with distress and/or problems functioning in social, work, or family activities.

By that definition alone, if a young girl is feeling increasingly sad and that is leading her to not be able to pay attention in school or interact with her peers, then she could very well have a mental illness. Or perhaps she’s so anxious that she stays up studying all night before a big test, making her less likely to succeed on said test since sleep is crucial for memory and comprehension.

According to the National Institute of Health: “Research has shown that memories of certain procedures, like playing a melody on a piano, can actually improve while you sleep. Memories seem to become more stable in the brain during the deep stages of sleep. […] That’s why a full night of sleep may help with problem-solving.”

Note: I’m not going to engage in the “seeing everything as an injustice” because there is a long, long, long history of those of us who are BIPOC, LGBTQIA+, neurodivergent, have visible and invisible disabilities, etc., experiencing injustice in a way than a young, able-bodied, white person simply cannot ever understand. My lived experience as a Latina, immigrant, bisexual woman, and person with a generalized anxiety disorder and ADHD (which is an invisible disability) is just not the same as the author’s, who I would make an educated guess is not a part of all of these marginalized groups.

Teen girls and depression/suicide risk

Let’s go back to the point, though: There is study after study whose results conclude that teen girls are suffering. It’s not just something made up by TikTok or Talkspace. It is actually a fact. In a recent CDC report from earlier this year, “Nearly 1 in 3 (30%) [teen girls] seriously considered attempting suicide—up nearly 60% from a decade ago.”

And as I recently wrote in a Parents.com article about The Trevor Project’s latest report about Latinx LGBTQIA+ youth, and something that also appeared in the CDC’s report, queer youth are at much higher risk of anxiety, depression, and thoughts of and attempts at suicide.

Here’s some math for you: About two-thirds of teens use TikTok, according to Pew Research Center. That’s 72% TikTok use among teen girls. This means that, in theory, all of those 30% of teen girls who seriously considered attempting suicide are on TikTok. But wait… According to another Pew Research Center study, back in 2017, before TikTok became the most downloaded app in the US in 2018, 1 in 5 (20%) of teen girls had experienced a depressive episode. Additionally, the rate of depression experienced by teen girls grew by 66% between 2007 and 2017.

Are we seriously going to blame TikTok (founded in 2016), Talkspace (founded in 2012), and BetterHelp (founded in 2013) for such a sharp increase from 2007-2017? Never mind that a 13-year-old girl today was probably still potty training when BetterHelp came out and barely starting elementary school when TikTok was released.

Basically, teens’ mental health issues have been on the rise since long before TikTok and “Big Therapy” came along.

While social media isn’t at all blameless for the growing teen mental health crisis, factors such as an overwhelming pressure to figure out their future, the need to be superstars in sports, demanding schedules that don’t allow enough time for rest, bullying online and in-person, fears about climate change and global conflict, discrimination based on the usual mix of race/gender/sexual orientation/weight/religion/disability/etc., and problems related to poverty such as lack of money for safe and stable housing and nutritious foods are also major contributing factors to the worsening of teen mental health. These are universally acknowledged areas of life that have worsened over the past decades, hence why teens’ mental health seems to be getting worse every year.

And in case you’ve been living under a rock: We’re just barely getting over a major global health crisis, the economy isn’t doing so well, there are currently two significant wars killing children (Ukraine vs. Russia and Israel vs. Hammas), and every year there is more anti-LGBTQIA+ legislation proposed across the U.S., with many bills targeting queer teens.

Therapy for “normal” emotions

The author goes on to say: “Of course there are people who need help and are still ashamed to ask for it. But I also think there are people who now feel pressured to get professional help for normal negative emotions—teens and pre-teens convinced the reason they’re sad sometimes is because they’re broken and haven’t paid enough to be healed.”

I’m sorry, but since when is getting professional help for “normal negative emotions” a BAD thing? I have never seen any ads saying, “you’re broken if you have typical, everyday anxiety.” But an ad that says, “if you have everyday anxiety and want help dealing with it, try therapy” is simply giving teens and adults alike an option to reduce their anxiety and stress so that they can have more success in life.

Perhaps the author has never felt anxiety before a test and then that stress led them to sleep badly, which then led them to not do as well on the test as they wanted… or perhaps they have never exploded at a loved one after a shitty, stressful day that had nothing to do with the other person, and that’s super amazing for them. But, like, don’t then go around shaming someone because they want or need help to lower that daily stress and its repercussions on a person’s life.

I’ll take a session with a therapist who can help me come up with a coping strategy for my “normal negative emotions” over a bubble bath any day. (Perhaps we should talk about the commercialized self-care industrial complex, instead?)

Note: I’d also encourage you to read about what chronic stress does to the body. I would argue that adolescent girls feel a lot more stress due to the pressures of the future and the state of the world than by seeing a TikTok talking about someone’s experience with anxiety. I’d still encourage anyone who believes they are having mental health issues to go to a qualified professional for a diagnosis and help, but most of the TikToks I’ve seen about therapy and mental health discuss the creator’s lived or professional experience. I’ve never seen one saying, as the author claims, “you are traumatized and mentally ill.”

P.S. Let’s also remember that nobody is innately born with a knowledge of how to deal with their “normal negative emotions” or how to de-stress. We learn all this from our parents, peers, and the media we consume. It’s OK if you don’t want to go to therapy, but it’s unlikely that you’re able to deal with that daily stress on your own based on what you learned from the previous generations who stigmatized mental health and therefore were unlikely to have (and teach their offspring) healthy coping mechanisms.

Yes, more human connection, please… but that won’t solve all your problems, either

The only part of this post that isn’t incredibly flawed in its argument and that I actually agree with is at the end, when the author says that what we all need is human connection.

YES, YES, YES.

But the author provides no advice, help, or encouragement on how to find or create more human connections. Know why? Because it is unfortunately incredibly difficult to find “actual communities, stable families, and meaningful relationships” these days.

That is not the fault of adolescent girls. That is not the fault of Gen Z. That’s not even the fault of Millennials like me or the generations that came before. The author is correct that human connection helps with depression and anxiety (something you can read about in the excellent Lost Connections: Why You’re Depressed and How to Find Hope by Johan Hari). But you can’t just snap your fingers and instantly have the kind of deep human connection that’s required to help with depression or even daily stress. That can take years and years to establish, and many of us don’t have all the time in the world to solely work on this.

This part, in particular, made me laugh at the flawed argument the author presents throughout this article:

Because I would argue there are a lot of young people struggling right now not because they are mentally ill but because they have no friends, barely go out and spend all of their time online. And they are being told the solution is to sit inside and talk to a stranger on a screen.

I’m not sure the author actually understands that having no friends can often lead to depression. But also that people don’t have friends for many reasons, including that they are suffering from depression. And by the way, plenty of people have parasocial and incredibly social lives even when they “spend all their time online.” In an increasingly digital world, spending time online often means interacting with our friends. Sure, it’s not the same as an in-person hug, but I’ve sent many an Instagram DM or text talking with a friend about something that’s causing me stress or anxiety, and I felt better afterward.

This isn’t an either/or solution, y’all.

We can be online and be social. We can be online and be lonely. We can also never go online and be lonely. Just think about the trans teen who can’t come out to their peers because they live in a small community where they are likely to be shamed, stigmatized, and perhaps even have violence directed their way. That teen will find a lot more social support online, which may be the key to their survival.

Human connections through therapy

Last but not least, investing in deeper connections is great—but does not have to be the only thing you do for yourself and your mental health. You can both invest in deeper connections and talk to a therapist about your “normal feelings of stress and sadness” on the same day.

As for the author’s claim that these companies are using our need for human connection to “sell solutions that leave you more anxious and alone,” well… I’ve never come across someone who says that seeing a therapist left them more anxious and more alone.

If human connection is what we need, then the human connection and support you get from a therapist will innately fulfill that need. Like, come on! You’re telling us that we want to feel less alone… and then saying that talking with someone about your daily stress will make you feel more alone? Something just doesn’t compute here.

I’m clearly very pro-therapy, and there are many reasons for that. But I’m not just writing this because of that. I am writing this because I hate the idea of someone using a completely flawed argument to encourage others to not do something to help themselves. You don’t have to go to an online therapy platform to get help. You can get help from your pediatrician (if you’re an adolescent) or your primary care doctor in person. You can also see a therapist in person.

And as

Paula Ghete

said in her wonderful note:

Let’s compare going to a therapist with going to the doctor. Some people only go to the doctor when they are very sick, which is sometimes too late for them to get less invasive treatment or, in extreme cases, to save their lives. Instead of doing that, I would argue it’s smart to do get your bloodwork done and see a doctor early on if you have a problem – even if it’s not a big problem yet. Do you have a mole that looks suspicious? Don’t wait until it grows a lot to have a doctor look at it. The same with therapy: don’t wait until you’re so depressed you can’t get out of bed in the morning.

I come from a culture that is still very stigmatizing towards therapy (something that I also recently wrote about for Parents.com) but my uncle—who is a medical doctor—has talked about how his mentor said that we should have yearly mental health check-ins just as we have medical check-ins. I agree!

After all, do you know for sure that you don’t have a thyroid problem or are developing a vitamin deficiency or, worse, are in the early stages of cancer? No, you don’t. You know these things because you went to your doctor and they did your bloodwork. You may not even have any symptoms that would lead you to suspect an ailment, but that’s what your medical professional is for.

In the same way, how do you know for sure that your mental health is fine, that you’re OK, that you’re not exhibiting early symptoms of depression or anxiety? You don’t. You might think you’re totally fine, but you might also feel fine and have unhealthy coping mechanisms that will lead to long-term repercussions. Or maybe you simply cannot tell the difference between “normal” daily stressors and chronic stress.

Frankly, I can’t. And neither can this author. Normal, after all, means conforming to a standard set forth by others in our society. Let’s face it: normal is set by the dominant class in our society (yes, white cishet males) and likely those who grew up with mental health stigma that they still believe.

Your normal isn’t everyone’s normal. And whatever “normal feelings of stress and sadness” you have, they may not feel so “normal” to another person.

Plus, like I said… there is absolutely nothing wrong with getting a little bit of professional help to deal with those “normal feelings,” either. In fact, I’d argue that doing that can set you on a path for less mental health concerns and less risk of mental illness in the future.

It’s called preventative care, FYI. That’s why I do a breast self-exam once a month (or try to)—something that is generally recommended for women after they reach adulthood and certainly once we’re 30 and older. So why wouldn’t I also occasionally talk to a therapist or mental health provider as a form of preventative care?

Actually, as a form of true self-care. I take care of my body and I take care of my mind, as best I can. Let’s not encourage others to neglect their health, okay?

Join me in conversation… I’d love to hear your stories. What do you think of the author’s argument? Do you agree with them? Do you agree with my counter-argument? Are you somewhere in between? I’d love to hear from all of you!

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Talk soon,
Irina (she/her) - raising a March 2020 gen alpha kid