In this op-ed, Ross Szabo, wellness director at Geffen Academy at UCLA, explores how perfectionism impacts the mission to destigmatize mental illness.
The youth mental health crisis is massive and has been building for a long time, but a lot has changed since I was a teenager. More people are talking about mental health, and doing so isn’t as scary as it once was. That’s because young people, parents, behavioral health providers, and policy-makers are calling attention to the issue through awareness campaigns and efforts to increase the availability of quality mental health services. We’ve done a good job decreasing stigmas, but a culture of perfectionism has infiltrated the advice young people receive, leading some to believe they have to have their mental health completely figured out.
We often view mental health as a binary: You either have a serious mental health disorder, or you don’t and you’re fine. The reality is more complex. Some people have life-long disorders, some struggle with mental health conditions for a few months or years, some people have situational anxiety or depression. No matter the reason for treatment, it’s also true that getting help for a mental health condition is more complex than we often believe it to be. As someone living with bipolar disorder, I understand the nuances of improving mental health outcomes over time. My journey with mental health has been just that — a journey, with ups and downs. But, I fear some young people are internalizing the opposite message. Well-meaning advice that young people need to get enough sleep, regulate their emotions, and prepare for adulthood leads some students to feel they’ve failed before they’ve even really started.
Recently, I had a conversation with a student who had been engaging in self-harm and wanted to stop. She had tried new strategies for a few months, but didn’t see a significant change. She felt dejected and overwhelmed by what she saw as her failure to improve. The new coping mechanisms didn’t feel as good to her as self-harm, so she returned to her old behaviors. When she spoke to me, it seemed clear that the negative feelings she’d experienced before were compounded by shame at not having gotten better.
Stories like this one aren’t unusual. During adolescence, the emotional regions of the brain are overactive, while the logical portion of the brain — the prefrontal cortex — is not yet fully developed. This is not to say that young people aren’t capable of being logical, but sometimes younger brains are more susceptible to being influenced by emotion. Research has shown that even young adults in their early 20s may demonstrate difficulty regulating negative emotions. This can make sticking to treatment hard when it doesn’t seem to work immediately.
Environmental factors also play a part. What 60-second TikTok wellness videos can’t capture are the increasing daily pressures, constraints, and triggers facing teens and young people today. Between academic competition, social anxieties, and life-altering current events, many students don’t have the time or energy to seek help or try out new routines. Mental healthcare resources can be scarce, and many schools and parents still don’t teach kids about mental health.
Speaking of social media, these wellness posts can compound the problem. On Instagram and TikTok, wellness influencers model elaborate, multi-step morning routines, featuring hours of journaling, yoga, meditation, and other activities meant to improve mental health. Even when it’s not intended, the takeaway is often that if you try hard enough, you can solve your own mental health problems.
This message of perfectionism is replicated in wellness tech, which is becoming more popular with younger generations. Meditation apps give prizes for perfect “streaks,” and fitness trackers encourage users to hit daily metrics without fail. Don’t get me wrong, daily meditation and fitness are great coping mechanisms, but pressure to meditate for 30 consecutive days is often an unrealistic expectation that, when not met, could even increase anxiety. Teens can benefit instead from knowing how to identify feelings of anxiety, and take deep breaths when they feel overwhelmed.
I believe in the power of creating healthy routines in advance of a crisis, which is why I’ve created evidence-based curriculums for educators to teach kids how to care for their mental health. But, when I talk to high school and middle school students, I’m consistently struck by the number of teens who feel dejected that their mental health problems didn’t improve as soon as they started trying to address them. We live in a quick-fix society, so this response is understandable. It’s okay to feel frustrated, but too often these feelings lead to a cycle of shame that can reinforce dangerous coping mechanisms.
Even getting enough sleep — a proven factor in improved mental wellness — can be hard. A lot of teens I work with can’t naturally fall asleep until after midnight, but need to wake up between 5 and 7 a.m. to get to school on time. According to the Centers for Disease Control, in 2019, less than a quarter of teens were getting the recommended eight hours of sleep or more. The percentage for female students and students of color was even lower. Teens and young people increasingly face pressures that make it difficult to easily incorporate wellness routines, and economic privilege, race, and gender are all factors that impact this. For teens from lower income backgrounds, mental health interventions like private therapy or meditation classes may be inaccessible. For students of color, young women, LGBTQ+ youth, and other marginalized groups, pressure to be perfect is often intertwined with systemic oppression. These teens may feel they have to overcompensate or perform perfection, to avoid being perceived as negative stereotypes.
Instead of pretending these external factors don’t exist, we can speak more openly about the different circumstances we’re all navigating, and the trial-and-error nature of improving one’s mental health over time. Because feelings of inadequacy, shame, and overwhelm can exacerbate existing mental health issues, we should promote advice on small changes teens can make when tackling mental health, and make clear that it’s okay to be imperfect. We can start by sharing our own stories and holding space for moments where our loved ones may feel they’ve “failed” at mental wellness.
The good news is that many of us have already embraced a less stigmatized approach to mental wellness. My students talk openly about mental health, cheer for celebrities who do the same, and even incorporate it into their fashion – teens today are embroidering “Wellbutrin” on their tote bags and wearing mental health diagnoses on necklaces. Younger generations understand that mental health issues can’t just be erased, and many are proud to have found acceptance. What we need now is more messaging that mental health journeys contain both successes and false starts, and that failing to remain mentally healthy 100% of the time is not a personal failure.
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