What Are The Most Common Mental-Health Issues Among People In Their 20s And 30s?

Q&A with David Janeway, DO, associate medical director for behavioral medicine and psychiatry at WESTMED.

What are the most common mental-health issues among people in their 20s and 30s? 

Anxiety, depression, and stress—coupled with the risk of substance abuse. “The stressors this group faces are unique: living on their own, finding direction, and facing overwhelming expenses. The real danger is that habits and behavior that started in high school and college will develop into addiction and self-medication for underlying mood disorders. Patients will request a prescription for Adderall or Ritalin, believing they have adult ADD. There’s also the problem of substance abuse, especially among the unemployed. Illicit drug or alcohol abuse in this age group is 20 percent among the unemployed. Forty percent of heavy drinkers in this age group report binge-drinking. There’s a real danger in combining prescription psychiatric meds like Xanax, Adderall, and Ritalin with alcohol and street drugs. There’s also the risk of suicide, or suicidal thinking, among severely depressed patients—provoked by break-ups and disappointments as well as biological disposition.

Should a person see a psychiatrist of the same gender? 

If a woman has encountered sexual trauma, abuse, or rape, she may be comfortable seeing a female psychiatrist, but, generally speaking, it shouldn’t matter. All psychiatrists are trained to work with the full spectrum of mental health. But it’s a personal preference based on comfort level.

What’s the best way to find a psychiatrist? 

Ask your primary-care physician or a trusted friend for a recommendation. There are sub-specialties within psychiatry, such as addiction psychiatry for substance-abuse disorder, or sleep medicine. The first session is a diagnostic interview and evaluation where a treatment plan is set up; and then it’s determined whether the patient needs therapy, medication, or both. 

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Why don’t more psychiatrists take insurance? 

It’s difficult to get reimbursed from insurance companies for therapy.

Should a psychiatrist offer therapy as well as medication?

Most of the time, treatment is split between a social worker or psychologist providing therapy and the psychiatrist handling the meds. Ideally, it’s better for the psychiatrist to do both, to better determine when to taper off or increase the meds.

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