The Deteriorating
Social Self in Younger
Generations
Rapid Report
Mental Health Million Project
May 2022

Rapid Report
Executive Summary
In our recent Mental State of the World Report (2021), we showed that one of the most alarming trends
was an increasing decline in the mental wellbeing of younger generations in the Internet-enabled
population of virtually every country around the world. In this Rapid Report, we detail this decline further,and bring into focus the nature of mental health challenges that define it. We show that 16 aspects ofmental wellbeing out of 47 elements captured were rated as having a severely negative impact on theirability to function by half or more of those age 18-24. Of these, 14 were substantially worse than older
adults (ages 55+) by 2 points or more on the 9-point rating scale suggesting that these are the factorsthat describe the decline of younger generations. These include growing problems with (in order ofmagnitude): Unwanted, strange or obsessive thoughts; Feelings of sadness, distress or hopelessness;
Suicidal thoughts, Mood swings; feelings of Guilt and self-blame; Confused or slowed thinking; Feelingsof being detached from reality; and Avoidance and withdrawal, and conversely diminished Self-image,Self-worth and confidence, Relationships with others, Energy levels, Focus and Concentration andEmotional resilience. Altogether, the range of challenges in young adults point not just to declines in
Mood and Outlook – as have been typically described – but to a substantial disintegration of the Social
Self, an aggregate metric of how individuals see themselves and relate to others. We suggest that
this diminished Social Self may have developmental origins associated with both a lack of sufficientsocial engagement and distorted social development arising from the large number of hours spent on
the Internet. Altogether, we suggest that this mental health crisis cannot be viewed through the lensof traditional disorder definitions and advocate for a preventative approach that facilitates the healthy
development of social behavior in future generations.

Introduction
In the early part of the twenty-first century, data suggested that adolescents and young adults had strong
psychological wellbeing often doing better than the generations immediately above them and about aswell as seniors. For example, Stone et al. (2010) reported 2008 data from the United States showingthat late teens and young adults were on par with younger seniors in their mental wellbeing and better
than those in their forties and fifties, representing a U-shaped curve of psychological wellbeing. However,since then, evidence indicating the beginning of a serious decline in the mental functioning of younger
age groups has emerged. For example, Keyes et al. (2019) showed a decline in depression amongst
adolescents from 1991 to 2011, but a reversal of that trend by 2018. In a nationally representative sample2

of U.S. adolescents and adults, Twenge et al. (2018a) discovered increasing rates of major depressive
episodes from 2009 to 2017 and increased serious psychological distress and suicide-related outcomesfrom 2008 to 2017 among young adults ages 18 to 25. The authors did not find such increases among
adults ages 26 and over. So also, in the recent Mental State of the World Report (2021), based on datafrom more than 223,000 people across 34 countries, we showed that one of the most alarming trends
was an increasing decline in the mental wellbeing of young people in the Internet-enabled populationof virtually every region of the world. In this Rapid Report, we detail the pattern of decline in the mental
health of younger adults relative to older adults.
We show in Figure 1 a comparison of the global trends that we have outlined in the recent Mental Stateof the World Report (2021) along with a comparison of psychological wellbeing by age described in the
United States in 2010 by Stone et al. The difference is stark. Where once young adults reported the best
psychological wellbeing, primarily along dimensions of happiness and optimism, today they have a muchdarker mental wellbeing profile, substantially lower than every other age group across a multitude ofdimensions.
Figure1: A changing pattern of mental wellbeing by age
Psychological wellbeing by age in 2008

Mental wellbeing by age in 2021
140

7.6

Age alone

7.4

120

with Covariates

100

7

MHQ Score

WB Ladder

7.2

6.8
6.6

80
60
40

6.4

82-85

78-81

74-77

66-69

70-73

62-65

58-61

54-57

50-53

46-49

42-45

38-41

34-37

30-33

0
26-29

6
22-25

20

18-21

6.2

United States
Average of 34 Countries
18-24

25-34

35-44

45-54

55-64

65-74

75+

Age Group

Age Group
Reproduced from Stone AA et al PNAS, 2010

* Note that the MHQ Scale goes from -100 to +200 where negativescores reflect a negative impact on life function.

Here we outline the nature of the mental health factors that have seen the most substantial declines andare most significantly different compared to older adults. Altogether, in addition to challenges of Moodand Outlook our findings paint a picture of a disintegrating Social Self in young adults that includes adiminishing sense of self and increasing dissociation from our social fabric.

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Key Results
The decline of mental wellbeing in young adults over the years
The Mental Health Million Project commenced in 2019 with a

Figure 2: Change in mental
wellbeing by age since 2019

sample of a few thousand people across four major Englishspeaking countries (US, Canada, UK and India), growing to
223,000 across 34 countries in 2021. In 2019, prior to theMore young adults fell into a mental wellbeing zoneof distressed or struggling during the pandemic

COVID-19 pandemic, the fraction of young adults 18 to 24 who
were struggling with their mental health in the four countries
aged 45 and above (Figure 2). The onset of the pandemic
dramatically amplified this difference with a huge increase
from 21% to 50% among this cohort in 2020, followed by asmaller increase from 50% to 54% in 2021. In contrast, older
adults 45 to 64 saw a smaller though still substantial increase,18-24% Distressed or Struggling(Negative MHQ SCores)measured was 21%, already almost twice as high as those60%

while those age 65 and older stayed fairly stable. Altogether
this data shows a mental wellbeing gap between younger andolder generations, already prevalent in 2019, that has been

50%
40%

25-44
45-64
65+

30%
20%
10%
0%
2019

2020

Year

amplified by the pandemic.

The major elements of mental health challenges in young adults
Aggregating across 48,033 responses in 2021 from young adults age 18-24 across 34 countries, inFigure 3.1, we show those factors rated by over half as problems that had an impact on their ability
to function (median ratings >5 on the 9-point problem rating scale where 5 refers to Sometimes
causes me difficulties or distress but I can manage and 9 is Has a constant and severe impact on
my ability to function). These included - in order of severity - Fear and anxiety; Unwanted strange or
obsessive thoughts; Avoidance and withdrawal; Guilt and self-blame; Feelings of sadness, distress andhopelessness; Mood swings; and a Sense of being detached from reality. Conversely, aspects such as
Hallucinations, Aggression, Physical health issues and Addictions were least problematic for young
adults, with median ratings less than 3. Interestingly, only physical health issues were rated better byyoung adults compared to older adults.
Similarly, Figure 3.2 shows other factors rated on a spectrum scale that most young adults rated as
detracting from their ability to function (median rating of <5 on the 9-point spectrum scale where 1 is
A real challenge and impacts my ability to function effectively, 5 is Sometimes I wish it was better but
it’s OK, and 9 is It’s a real asset to my life and my performance). These include Sleep quality, Appetite
regulation, Self-worth and confidence, Self-image and Focus and Concentration. In contrast, older adults
generally rated these as OK or positive assets to their functioning (median ratings >5). Conversely, most

4

2021

young adults rated their Ability to learn and Empathy as among the most positive to their functioning(median rating >6).
Figure 3.1: Mental health challenges experienced by over 50% of young adults 18-24
Bars represent median ratings on the 9-point problem scale described below

Fear Anxiety
Unwanted Strange orObsessive Thoughts
Avoidance Withdrawal
Guilt Blame
Feelings of Sadness
Distress or Hopelessness
Mood Swings
Sense of being
detached from reality

1

2

3

Never causes
me anyproblems

4

5

6

7

8

9

Has a constant andsevere impact on myability to function
effectively

Sometimes causes
me difficulties or
distress but I canmanageFigure 3.2 : Diminished mental health assets in over 50% of young adults 18-24
Bars represent median ratings on the Spectrum scale described below

Sleep Quality
Appetite Regulation
Self Worth Confidence
Self Image
Focus Concentration
Emotional Resilience12

Is a real challenge
and impacts myability to function
effectively

5

3

4

5
Sometimes
I wish it was
better but
it's ok67

8

9It is a real
asset to mylife and my
performanceMental health challenges most amplified relative to older generations
What are those factors that are most compromised in younger adults relative to their parents generationand older?

7
6
5
4
3
2
1

8

9

Unwanted Strange orObsessive Thoughts

6
4

5

Avoidance
Withdrawal

Sense of being
detached fromreality

Feeling of Sadness
Distress or
HopelessenessSuicidalThoughts
or Intentions

1

Never causes
me anyproblems

2

3

Sometimes causes
me difficulties or
distress but I canmanage7

Has a constantand severe impact
on my ability tofunction effectively

Figure 4.1: Growing problems in younger adults relative to older generations

Confusion or
Slowed Thinking

Mean Rating 18-24
Mean Rating 55+

Mood Swings

Traumatic Flashbacks

Figure 4.1 shows the mean or average ratings for those problems most amplified in young adults relative
to older adults (ages 55+). In order of the magnitude of difference, these were Unwanted, strange or
obsessive thoughts; Feelings of sadness, distress, or hopelessness; Suicidal thoughts; Mood swings; Guilt
and self-blame; Confusion or slowed thinking, a Sense of being detached from reality; and Avoidance andwithdrawal. All of these had median ratings on the problem scale that were higher by 2 points or morein young adults relative to older adults. While many of these also represented aspects that were mostproblematic for the majority of young people (as shown in Figure 3.1), others such as Suicidal thoughts
and Confused or slowed thinking were not rated as problematic by the majority of young adults but
nonetheless were substantially higher for younger adults.
Similarly, those factors on the spectrum-scale where ratings were substantially worse or diminishedin young adults compared to older adults (a difference of >2 points on the 9-point scale) were Self-

6

9

Self Image

5

Emotional
Resilience

8
7
6
5
4
3
2
1

Self Worth
Confidence2
1

Is a real challenge
and impacts myability to function
effectively

34Sometimes
I wish it was
better but
it's ok6

7

8

It is a real
asset to mylife and my
performance

Figure 4.2: Diminishing capabilities and assets in younger adults relative to older generations

Focus
Concentration

Relationships
with others

Mean Rating 18-24
Mean Rating 55+

Energy Level

image, Self-worth and confidence, Relationships with others, Energy level, Focus and concentration, andEmotional resilience. These same factors were also the greatest challenges for the majority of young
people. In contrast the majority of older adults rated these factors positively, as being an asset.

A breakdown of the Social Self in young adults
Altogether, across the 47 elements of the MHQ, many of those that were the greatest challenge to themajority of young adults, concerned how people see themselves in relation to others and how they feel
about where they belong within the social fabric. Correspondingly, the Social Self score, an aggregate
metric that describes how we see ourselves and interact with others, was lowest compared to all otherdimensions of mental wellbeing (Figure 5.1). The Social Self dimension also showed the biggest decline
relative to older generations ages 55+, at 27% lower down on the MHQ scale (Figure 5.2). We note that
this was also the dimension that declined most substantially over the pandemic. A close second was
the dimension of Mood and Outlook, where scores were only a few points higher than Social Self with adecline of 25% compared to older generations.
In contrast, young adults fared better on the dimensions of Drive & Motivation, Cognition, and Mind Body
Connection, although they still scored lower on these than did older adults. The decline relative to older
adults was least for Mind Body Connection (17%), a dimension that aggregates the physical problems
that often manifest with mental health challenges.

7Figure 5.1: Dimensional scoresin young adults 18-24

Difference in the average scores of 18-24 year olds and55+ shown as as percentage of the 300 point MHQ scale

Average Score*

60

40

20

Figure 5.2: Differences in mental wellbeing
dimensions of young adults relative to older adults

Drive & Motivation
Mind Body Connection
Cognition

Social Self
Mood & Outlook

Mood & Outlook
Social Self

Drive & Motivation
Core Cognition
Mind-Body Connection0* All dimensional scores are on a scale from-100 to +200 where negative scores represent asignificant negative impact on life function

0%

5%

10%

15%

20%

25%

30%

Decrease as a % of the MHQ scale

Putting these findings in perspective
Beyond Depression and Anxiety
For at least the last five years, there has been a deterioration of the mental health of successively
younger generations. However, previous studies have largely focused on depression and anxiety, which
neglects some of the most significant symptoms experienced by this population. The constellation ofserious symptoms experienced by young adults do not, in the aggregate, map to any one disorder as
defined by the DSM. Instead, they represent symptoms associated with many disorders (e.g., Obsessive,
strange, and unwanted thoughts can be associated with anxiety disorders, psychotic disorders, PTSD,
etc.). It is therefore misleading to conceptualize the problem in terms of these diagnostic categories.
One significant advantage of the MHQ is that it provides a comprehensive view of the various elementsof mental function and goes beyond specific diagnostic criteria to provide a dimensional view. Thisdata shows that in addition to challenges of depression and anxiety (the dimension of Mood & Outlook),many of the challenges that dominate young adults relate to how they see themselves in relation toothers and how they relate to others, i.e. the Social Self. Correspondingly, the Social Self metric wasmost compromised in young adults age 18 to 24 relative to older generations in a trend present alreadyby 2019 but amplified during the pandemic in correlation with the stringency of lockdowns and thecorresponding social isolation (Newson JJ et al, 2022). These findings suggest that the decline of mental
health in younger generations may reflect an increasing failure of young people to develop a strong Social
Self.

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Understanding the Social Self
Social functioning is correlated with various aspects of mental and physical health (e.g., Cruwys et al.,2014; Holt-Lunstad et al., 2010; Kawachi & Berkman, 2001; Maher et al., 2017; Perkins et al., 2015; Segrin,2019). More importantly, the ability to relate to and interact with others effectively has been crucial forhuman cooperation and the building of our modern world. The breakdown of this capability such that it isseriously impaired in over half of young adults across the world therefore has serious consequences forthe future of society.
Social interaction involves a complex set of functions: reading facial expressions and body language toassess intent, learning to respond appropriately within social norms, regulating one’s emotions and more.
While the capacity for social behavior may be an innate human trait, as is the capacity for language, it
requires practice to get to a place where we are confident in our ability to handle social situations of all
kinds. It is also only through repeated interactions with others that we build the friendships and otherrelationships that establish our place in the social fabric. From feeling detached from reality to avoidance
and withdrawal and suicidal thoughts, these symptoms represent the extreme of disconnection from or a
failure to integrate into the social fabric.

The Internet and the Social Self
Why would the Social Self be in such decline? A big part of the answer is likely the Internet, which has
seen a meteoric rise along with smart phones since 2010. Data now shows that around the world
people spend 7 to 10 hours a day on the Internet. This leaves little time for in-person social interaction
with friends and family. Where once children spent several hours a day engaged in in-person social
interaction, adding up to, in our estimation, 10,000 to 25,000 hours by the time they reached adulthood,for generations growing up in the Internet world that number is likely closer to 5,000 and for some, even
as low as 1,500. The lack of sufficient social engagement may even have neurobiological consequences.
In rhesus macaque monkeys for instance, the size of specific brain structures increases with more direct
affiliative social connections (Testard et al., 2022).
There is also the distortion of social perceptions by the Internet where adolescents compare themselves
to a virtual reality that does not match our physical reality. Furthermore, the virtual medium may noteffectively engage the neurobiological systems designed for pro-social behavior. The human mirror
neuron system, thought to support the learning and development of social behavior by enabling brainbrain dyads of observational learning and imitation may not function effectively, if at all, in the virtualenvironment (Dickerson et al., 2017). For example, adults demonstrate poor emotional fluency while
using video-based communication systems compared to in-person behavior.
Indeed, several studies with adolescents and young adults have shown the amount of time spent on adigital device (i.e., screen time) is correlated with poorer social skills (e.g., Kelly et al., 2018; Twenge et al.,9

2018). Furthermore, consistent with what we show here, these same studies have also found that moresocial media use was associated with poor sleep, poor body-image, and low self-esteem, lower selfcontrol, more distractibility, more difficulty making friends, less emotional stability, being more difficult
to care for, and inability to finish tasks. Twenge et al. (2018b) also found that increases in adolescentdepression and suicide rates between 2010 and 2015 were greatest for those who were most active on“new media” (e.g., social media and electronic devices such as smartphones) and that adolescents who
were on social media at least 7 hours a day were more than twice as likely than those who used social
media less often to have been diagnosed with depression and/or anxiety in the past year. Many studiesof young adults have also shown significant positive associations between frequency of social media use
and mental health issues, including depression and anxiety (Lin et al., 2016; Primack et al., 2017; Shensa
et al., 2017).

Tackling the source with a preventative approach
While there is substantial momentum around reducing stigma and increasing access to psychiatrictreatment and counseling services, the scale and profile of mental health deterioration calls for amore long-term preventative approach. If indeed the deterioration of the Social Self reflects both adevelopmental deficit and/or distortion of the development of social behavior, it will not be easily solved
with medication or therapy. While acute challenges or episodes may be managed in this way, the scaleof the challenge and the consequences for society are too significant to manage or solve post facto.
Rather, solving the crisis will require enabling the social environment and engagement required for properdevelopment of the Social Self. This could include things such as restricting the use of smart phones
during school hours, facilitating Internet-free forums for young people to engage with one another, as wellas providing early education on how to appropriately navigate and manage one’s behavior on the Internet.
While we acknowledge that much still needs to be understood, the urgency and pace of the generational
deterioration of the Social Self and mental wellbeing in general calls for rapid action. Altogether, wesuggest that this mental health crisis cannot be viewed through the lens of traditional disorder definitions,and advocate for both research and regulatory attention to understanding and facilitating the healthy
development of the Social Self in future generations.

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