Our Mysterious Epidemic of Despair Has a History

By now, we have all heard of the surging mental health crisis. The struggles of teen girls have been of particular concern, with reports of persistent feelings of sadness or hopelessness, along with suicidal thoughts and self-harm, spiking upward in recent years. But the numbers for adults are not much better. All the distress has understandably prompted a hunt for some recent development to explain it. 

In an arresting tweet this summer, the former CFO and entrepreneur Robert Sterling wonders if the typical explanations go far enough. “There is something deeply unwell in our society right now,” he writes. “I’m sure social media, economic malaise, Covid lockdowns, fentanyl, and every other reason we hear about factor into it.” Yet, these reasons, “in aggregate, still feel insufficient.” Something “metaphysical,” in the psychic climate, seems to have shifted.

Sterling’s tweet went viral, and for good reason. His articulation of the problem—“a sense of apathy that you feel emanating from far too many people—especially from the young,” and “a lack of aspiration” and “purpose”—gave voice to widely felt perceptions. Some mysterious, debilitating change has occurred, and many people, especially the young, are experiencing an alarming estrangement from the world around them.

Adrift

Something is deeply wrong. But shifts in the climate don’t happen overnight. While feelings of emptiness and alienation are spreading to more and younger people, this mode of despair has been growing steadily for some time. We may have passed a tipping point.

In the parenting literature in recent decades, case reports of the young person who feels chronically empty, paralyzed by a sense of inadequacy and lack of purpose are common. In their 1981 study The Adolescent, for instance, Daniel Offer and colleagues observed that “with respect to almost every self-image dimension, teenagers in the [late] 1970s feel worse about themselves than did teenagers in the [early] 1960s.” Over this roughly 18-year time period, a sharply higher percentage of teens reported worries about their health and feeling “empty emotionally most of the time.”¹

Or consider these remarks by the Italian writer Pietro Citati in the newspaper La Repubblica in 1999. Young people, he noted, “are always wondering who they are… They have no will, no desire to act … They prefer to remain passive … They live wrapped in a mysterious inertia…. Their time is a series of moments that are not linked together in a chain or organized into a story.”

Writing in The Atlantic in 2011, an American psychotherapist described a type of  patient she was coming to see all the time: “Imagine a bright, attractive 20-something woman with strong friendships, a close family, and a deep sense of emptiness.” This woman does not report any conflicts, any deprivation, any specific stresses, or family history of mental illness. Her parents are “awesome.” Yet, she is “indecisive” and “unable to trust her instincts and stick to her choices.” She feels “‘like there’s this hole inside’ her,” and describes “herself as feeling ‘adrift’…”

In her new book, Never Enough, Jennifer Breheny Wallace presents a body of evidence showing that many young people, even when they excel by all the meritocratic measures and “seem to have it all,” still feel “utterly vacant inside.” 

A dismal picture, now widespread. Looking back further, we can see its features in patient complaints that psychoanalysts began to encounter as early as the 1950s.

Disorders of the Self

Initially, the new and ill-defined complaints of their patients left those pracitioners perplexed. Their healing art is premised on the idea that patient struggles are based on internal conflicts. Mental tension and painful emotions arise from the strain of controlling impermissible desires and wishes. Gaining insight into and easing this conflict is a key goal of treatment. Then along came a new type of patient for whom such inner conflict was absent.

While our malaise seems new, it goes back decades. Looking back helps us to see deeper causes in the wearing away of enabling institutions and traditions.

These patients, according to analysts’ accounts, did not know who they were and struggled to maintain a “consistent picture of themselves.” The were besieged by a sense of their own valuelessness and “frustrated unfillfulment” and subject to chronic feelings of emptiness and anxiety. They suffered from what the analysts began calling “disorders of the self.” Their amorphous symptoms were disorienting to the analysts, and their urban, affluent patients even had a hard time expressing them, because they reflected an absence of something vital, not a discontent with social constraints.²

Something was missing that had been there before. The psychoanalysts thought they knew what it was. 

No Firm Footing 

For many analysts and other observers, the disorders of the self were the result of complex changes, social, economic, and technological, that were working their way through society in the postwar period. Old-style psychoanalysis dealt with what Freud called “potent individuals,” people with strong desires and well-developed “superegos”—demanding, internalized convictions formed by tradition and social mores. But as the societal transformations weakened the strong ideals, bonds of obligation, and social norms that structured this “inner core,” many people, wrote analyst Allen Wheelis, could “find no firm footing.” Without some solid ground, some stable reference point, their developing sense of self remained “diffuse” and “elusive.”³

The 1960s and 1970s saw a sea change as new self-psychologies arose in response to the “decline of the superego” and the struggles of the enfeebled patient. No longer focused on conflict, each therapy aimed to strengthen the vitality and coherence of the self and the powers of conscious self-control.

But what the old psychoanalysts recognized was that a robust self required an enabling social foundation. Deplete the foundation and people were often left with a depleted sense of self. 

In the intervening years, the world has become progressively more precarious, open-ended, and risky. The public frameworks that gave life direction and meaning—prescribed roles, rites of passage, compelling life scripts, stable occupational trajectories—continue to fade away. The defining web of institutions, norms, and social mores further erodes. 

This is the climate change in a nutshell. We feel empty, inadequate, and adrift because we have been thrown back on ourselves, forced to face the challenge—at younger and younger ages—of trying to establish an identity, make commitments, live with conviction, desire life, and find meaning without the very sources that make these things possible in the first place. 

The symptoms of the problem—“social media, economic malaise, Covid lockdowns”—are important to be sure. But until we also recognize what has washed out, we can make no progress in understanding or addressing this epidemic.

Joseph E. Davis is a Research Professor of Sociology and Moderator of the Picturing the Human colloquy of the Institute for Advanced Studies in Culture at the University of Virginia. His new book is Chemically Imbalanced: Everyday Suffering, Medication, and our Troubled Quest for Self-Mastery. 

Editor's Note: This essay appeared first at Psychology Today. It has been reprinted here with permission.

1. Daniel Offer, Erik Ostrov, and Kenneth I. Howard, The Adolescent: A Psychological Self-Portrait. New York: Basic Books, 1981, pp. 102, 49, Table E-10.

2. See, for example, Heinz Kohut, The Restoration of the Self. New York: International Universities Press, 1977.

3. Allen Wheelis, The Quest for Identity. New York: W.W. Norton, 1958, pp. 18-19.