Beyond a given point man is not helped by more “knowing,” but only by living and doing in a partly self-forgetful way. As Goethe put it, we must plunge into experience and then reflect on the meaning of it. All reflection and no plunging drives us mad; all plunging and no reflection, and we are brutes.
― Ernest Becker, “The Denial of Death”
A growing chorus of psychologists, educators, politicians, business leaders and influencers is sounding the alarm about an American mental health crisis. Many propose that we need more public conversations about mental health and are urging individuals to prioritize and advocate for their own well-being. Though such guidance is well intentioned, asking Americans to spend more time thinking and talking about their mental health may actually be part of the problem. As a society, we are fixating on our inner lives more than ever, yet we are becoming more, not less, psychologically distressed. We need a different approach, one that encourages more outward-focused action and less inward-focused talk.
Societal Implications of the Mental Health Crisis
Americans are increasingly struggling with mental health problems. Over the past decade there has been a persistent rise in anxiety and depression, especially among younger generations. In a KFF/CNN survey conducted in 2022, half of American adults under age 30 and one-third of adults overall reported that they often or always felt anxious in the past year. A 2023 Gallup poll found that one-quarter of American adults under 30 indicated that they currently have depression, up from 13% in 2017. The Centers for Disease Control and Prevention reports that suicide rates in the U.S. increased by 37% between 2000 and 2018. After a slight decline between 2018 and 2020, these rates continued to rise. In 2021, 1.7 million American adults attempted suicide and nearly 50,000 died by suicide.
The negative effects of poor mental health extend beyond individual psychological distress and self-destructive behavior. The psychological health of individuals plays a central role in the overall social and economic health of a nation. For instance, mental illness decreases social trust. This has important national implications because social trust fosters explorative, creative, innovative, collaborative and entrepreneurial activities, which are crucial for social mobility, business dynamism, economic growth and other markers of societal flourishing. Communities with higher levels of social trust have higher levels of entrepreneurship. And social trust supports economic growth and democratic stability.
Mental illness reduces labor force participation, work engagement and job performance. The U.S. economy loses nearly $50 billion annually in lost productivity because of Americans taking days off work due to mental health issues. Individuals with mental illness represent a large and growing share of Social Security Disability Insurance beneficiaries. According to a 2022 brief from the White House, “the mental disorder category accounted for 29 percent of the beneficiaries in 2020, or 2.4 million people—a share larger than beneficiaries who cannot work due to injuries, cancer, or diseases of the circulatory and nervous system, combined.”
Poor mental health is also a significant impediment to scientific and technological progress. Progress is powered by people. It relies on the creative cognitive processes involved in discovery, invention and innovation. Creative thinking and subsequent entrepreneurial and innovative activities involve taking risks, which can cause stress, uncertainty and other negative emotions. When people are overly anxious, they are less motivated to take such risks and less emotionally resilient when facing the negative emotional states inherent to taking them. Indeed, the more anxiety people experience, the less likely they are to engage in entrepreneurial endeavors.
Progress is also supported by people having optimistic mindsets and being confident in their personal agency. To solve the challenges of our time and build a brighter future, individuals need to believe they have the ability to improve their own lives and the lives of others. Depression, by contrast, is characterized by feelings of helplessness and hopelessness. This hinders the motivation to work diligently to improve the world, as well as the belief that progress is possible.
Problems With Our Current Approach to Mental Health
Considering the many harms that our mental health crisis is causing to both individuals and society, it seems logical to have more public discourse around mental health and to encourage Americans to spend more time thinking about their mental health. There are certainly benefits to bringing more awareness to mental health. For instance, it can help reduce the stigma associated with mental illness, which might persuade more people who are truly suffering to seek out social support and professional assistance. Indeed, stigma has been identified as a reason many people struggling with mental illness do not access mental health services.
Unfortunately, however, the effects of increased mental health awareness are not all positive. The more we make mental health a topic of public preoccupation, the more we might be inadvertently promoting a culture in which individuals think of themselves as mentally unwell, which makes them more, not less, vulnerable to psychological problems. Psychologists Lucy Foulkes and Jack Andrews shed light on this issue in a recently published article in New Ideas in Psychology. They detail how mental health awareness campaigns may be contributing to the rise in mental health problems by encouraging people to interpret mild forms of distress as being severe, which can become a self-fulfilling prophecy and make the distress worse.
For instance, consider a scenario in which a woman experiences minor levels of anxiety. If she is urged to pay more attention to her discomfort, she might start to view herself as someone who suffers from severe anxiety. Consequently, she might become hypersensitive to anxiety-provoking situations and avoid them altogether. This will make her mild anxiety worse, not better, because effectively managing anxiety requires confronting it directly, not ruminating about it. Excessive focus on one’s mental state can perpetuate and intensify psychological distress.
The prevalence of trigger warnings in educational institutions is one example of how our society’s current approach to solving mental health problems is counterproductive. Trigger warnings are alerts intended to warn individuals that they are about to be exposed to potentially distressing content. In a national survey, over half of U.S. college professors indicated they have used trigger warnings in their classes. However, trigger warnings are ineffective at reducing anxiety, both among trauma survivors and among people who have not experienced trauma. On the contrary, trigger warnings actually increase anxiety for individuals with more severe symptoms of posttraumatic stress disorder. Furthermore, trigger warnings increase the extent to which individuals think of past traumatic experiences as playing a central role in their personal life story. This causes greater psychological suffering in the long term; studies show that the more people perceive traumatic experiences as central to their life story, the more likely they are to develop posttraumatic stress disorder symptoms in the future.
Promoting cultural messages that encourage people to be more sensitive to their own and others’ mental health vulnerabilities might intuitively feel like a good way to combat our nation’s escalating mental health issues. But this strategy is potentially contributing to these problems more than helping solve them. This doesn’t mean we should ignore our growing mental health crisis, but it does mean we should reevaluate our approach.
I believe we need an alternative strategy to tackle our nation’s mental health challenges: what I call the outward action approach. Instead of urging Americans to turn inward, ruminating on and talking about their mental health, we should inspire them to turn outward, engaging in the actions that ultimately promote flourishing for individuals and society.
For example, physical exercise is an outward and action-focused activity. When people are actively exercising, it is harder for them to passively dwell on their problems. Simply walking in nature has been shown to decrease rumination and neural activity associated with mental illness. A recent large analysis found that physical exercise is more effective at reducing depression, anxiety and stress than therapy or medication. Exercise reduces the risk of experiencing depression even for individuals who have high genetic vulnerability to depression.
The psychological benefits of working out also apply to children and teenagers. Those who engage in physical exercise are less likely to have mental health problems than those who are sedentary. Participation in team sports predicts lower risk of anxiety and depression among teenagers. Even light physical activity across the teenage years reduces the risk of developing depression.
Physical exercise may have unique physiologically mediated benefits to psychological health, but it is just one example of a more outward and action-oriented approach. Outward action focused on other people is likely the most powerful tool individuals can use to improve their own mental health. Humans have a fundamental need to belong. Loneliness and other forms of social disconnection cause great psychological suffering. People cannot satisfy their need to belong by passively turning inward and dwelling on their own concerns. Meeting the need to belong requires outward action, engaging in activities that positively affect the lives of other people.
Research in existential psychology may be especially useful for appreciating the power of social action to improve mental health. Finding meaning in life is vital for achieving and sustaining good mental health; the more people view their lives as meaningful, the less they are at risk of depression, anxiety, substance abuse and suicide. And when people experience life events that compromise their mental health, meaning in life motivates them to recover.
But how do people find meaning? Some might think of meaning-making as a contemplative exercise that involves deep deliberation about one’s philosophy of life, but it is actually an outward and action-oriented endeavor. A certain amount of self-reflection is required to identify and plan life goals, but what ultimately generates and maintains meaning is going into the world and taking action to make a positive difference. Meaning is about social significance. Even activities that appear on the surface to be self-focused, such as building a successful career, elevate meaning most when they are directed toward serving other people. For instance, people are more likely to derive meaning from their work when they focus on how it serves a greater good than when they focus on how it advances their personal ambitions.
Recent research offers a direct comparison between an inward-oriented approach (using cognitive behavioral therapeutic exercises to identify and revise negative thought patterns) and an outward-oriented approach (engaging in acts of kindness that improve other people’s lives). Both interventions were found to reduce anxiety and depression symptoms weeks after research participants completed them. However, performing the acts of kindness led to the greatest mental health improvements. The study also found that acts of kindness are especially effective at improving mental health because they take people’s minds off their own problems.
Further highlighting the distinct utility of outward social action, other research demonstrates that acts of kindness focused on others (outward oriented)—but not acts of kindness focused on the self (inward oriented)—boost psychological well-being and reduce symptoms of depression and anxiety. This conclusion may be surprising in an era that extols the necessity of “self-care,” but the more people direct their energy toward having a positive impact on the lives of others, the more they will reap benefits for their own mental health.
From Mindset to Action
An outward-action approach to mental health doesn’t eliminate the need for inward-focused thinking. Afterall, humans are a distinctly contemplative species. Our high levels of self-consciousness give us a considerable amount of personal agency. We can think deeply about our life priorities and goals and make decisions that help us regulate our behavior in the service of these priorities and goals. Our advanced cognitive capacities have allowed us to improve our lives in countless ways and build flourishing societies.
But these same capacities have also created the potential for great mental suffering. The power of introspection, combined with other cognitive abilities that allow us to mentally replay and simulate distressing life experiences, make it easy for us to get stuck in our own heads, overly fixated on our fears, regrets, self-doubts and disappointments. As we spend more and more time online, it has become even easier to get stuck in our own heads. In this digital age, it may be more necessary than ever to champion the importance of outward action.
There are many voices encouraging people to dedicate more time to thinking about their own distressing thoughts and feelings. And we are reshaping our educational, professional and social environments to be highly sensitive to people’s psychological vulnerabilities. Yet these efforts don’t appear to be effectively addressing our mental health challenges. They may even be making them worse. Talk therapy can be beneficial to the extent it helps people identify and overcome barriers to outward action. Paradoxically, the path to good mental health is not found in our own thoughts and feelings. It is discovered in the actions that cultivate thriving families, friendships, communities and societies.