College student sits in a cafe, reading something on their laptop

The transition from adolescence to adulthood represents a critical developmental period marked by significant changes in brain development, mental health, and life circumstances. The brain finishes developing and maturing in the mid-to-late 20s, making this period particularly important for understanding mental health challenges and opportunities for intervention.

Young adulthood, typically encompassing ages 18-25, is characterized by major life transitions including higher education, career development, relationship formation, and increasing independence. 12.5 million people between the ages of 18 and 25 experienced a mental, behavioral, or emotional health issue in the past year. This amounts to 1 in 3 (33.8%) young adults. Understanding these challenges is essential for mental health professionals, educators, and families supporting young people during this transformative period.

Table of Contents

  • Defining Young Adulthood
  • Brain Development in Young Adults
  • Common Mental Health Challenges
  • Life Transitions and Milestones
  • Risk Factors and Protective Factors
  • Treatment Approaches
  • Frequently Asked Questions
  • How Therapy Can Help

Defining Young Adulthood

The period of young adulthood has evolved significantly over recent decades. These are (1) identity exploration via imaginal and active means, (2) instability of roles and relationships, (3) a confusing and ambiguous sense of feeling caught in-between adolescence and adulthood, (4) a notable focus on self as young adults build their future and make big decisions, and (5) an optimistic and proactive focus on future possibilities.

Recent research identifies this developmental stage as "emerging adulthood," reflecting the extended transition to adult roles and responsibilities in modern society. However, these results show that for more recent generations of men and women, family formation is more often foregone during emerging adulthood than just 18 years ago.

Brain Development Timeline

Two young adult couples walking in public

The understanding of brain development has advanced considerably with modern neuroimaging technology. The part of the brain behind the forehead, called the prefrontal cortex, is one of the last parts to mature. This area is responsible for skills like planning, prioritizing, and making good decisions.

Brain Development in Young Adults

Neurological Changes

Brain development continues throughout the young adult years with significant implications for behavior and mental health. As the gray matter decreases in volume, the white matter increases in volume. The white matter is composed of myelinated axons that conduct neural information rapidly. The volume of white matter increases continually from childhood into early adulthood. This expansion is presumed to be due, in large part, to the progressive myelination of axons by oligodendrocytes. Myelination tends to proceed from inferior to superior brain areas, and from posterior to anterior.

Executive Function Development

The anatomical reorganization processes of the adolescent brain that are described above are associated with profound emotional and cognitive changes. In particular, there is progressive development of executive functions, i.e., cognitive processes that control thought and behavior and thereby allow the individual to adapt flexibly to new, complex situational tasks.

Impact on Decision-Making

The ongoing brain development during young adulthood has important implications for decision-making and risk assessment. Whether or not adolescence should be treated as a special period, there is now no doubt that the brain changes much during adolescence. From an evolutionary perspective, the idea of an underdeveloped brain which is not fit for purpose until adulthood is illogical. Rather, the adolescent brain is likely to support the challenges specific to that period of life. New imaging techniques show unequivocal, striking changes in the white and gray matter which take place between 11 and 25 years of age. There is increased connectivity between brain regions, and increased dopaminergic activity in the prefrontal cortices, the striatum and limbic system and the pathways linking them. The brain is dynamic, with some areas developing faster and becoming more dominant until other areas catch up. Plausible mechanisms can be postulated for linking these changes to the cognitive and behavioural features of adolescence.

Common Mental Health Challenges

Depression and Anxiety

Mental health challenges are particularly prevalent during young adulthood. The latest national data from the Substance Abuse and Mental Health Services Administration finds that in 2023 among adolescents aged 12 to 17, 18% had a past year major depressive episode, with many of these conditions persisting into young adulthood.

Nearly 1 in 5 (18%) youth ages 12 to 17 have had at least one major depressive episode in the past year — about 4.5 million adolescents — according to a 2023 federal survey. A larger share, almost 1 in 4 (23%), had either a major depressive episode or a substance use disorder in the previous year. While these rates reflect youth who meet the criteria for clinical diagnoses, other teen mental health statistics indicate that far more young people are struggling with emotional problems. For instance, the latest 2023 CDC Youth Risk Behavior Survey found that 2 in 5 (40%) high schoolers report persistent feelings of sadness or hopelessness, with rates particularly high for girls (53%) and LGBTQ+ youth (65%). While the 40% figure for 2023 is a slight improvement from 42% in 2021, the 10-year trend shows an alarming 10 percentage point spike from 30% in 2013.

Substance Use Disorders

The percentage of people with a drug use disorder in the past year was highest among young adults aged 18 to 25 (18.0%). The overall prevalence of substance-use disorders was higher in males (17.57%) than in females (10.89%) and higher in young adults aged 18-21 (15.38%) than those 22-25 (13.86%).

Suicide Risk

Suicide remains a critical concern for young adults. Suicide is the second-leading cause of death for teens and young adults, ages 10-34.

Suicide rates for people aged 10–24 increased from 2007 through 2021 (from 6.8 deaths per 100,000 to 11.0), while homicide rates declined from 2006 through 2014, and then increased through 2021. For people aged 10–14, the suicide rate tripled from 2007 through 2018 (from 0.9 to 2.9), and then did not change significantly through 2021.

Risk factors for suicide in young adults include:

  • History of previous suicide attempts
  • Family history of suicide or mental health conditions
  • Depression and other mental health disorders
  • Substance use disorders
  • Stressful life events and trauma
  • Social isolation and lack of support

Life Transitions and Milestones

Educational Attainment

College enrollment patterns have shifted significantly in recent years. 41 percent. Looking at enrollment rates by institution level over the same period, the rate for 2-year institutions decreased from 13 to 9 percent. In contrast, the rate for 4-year institutions increased from 28 to 31 percent during this period. The overall college enrollment rate for 18- to 24-year-olds fluctuated over the last decade but was lower in 2022 than in 2012 (39 vs. 41 percent). Looking at enrollment rates by institution level over the same period, the rate for 2-year institutions decreased from 13 to 9 percent. In contrast, the rate for 4-year institutions increased from 28 to 31 percent during this period.

Gender differences in college enrollment have become more pronounced: And the drop has been greater among young men than women. Today, only 39% of young men who have completed high school are enrolled in college, down from 47% in 2011. And the drop has been greater among young men than women. Today, only 39% of young men who have completed high school are enrolled in college, down from 47% in 2011. The rate at which young female high school graduates enroll has also fallen, but not by nearly as much (from 52% to 48%).

Marriage and Relationships

The timing of marriage has shifted dramatically over recent decades. Both men and women are marrying later in life. In 2024, the median ages for a first marriage were 30.2 for men and 28.6 for women. In 2014, they were 29.3 for men and 27.0 for women; in 2004, 27.4 and 25.3.

This study documented change in the midlife first marriage rate for U.S. adults aged 40-59 between 1990 and 2019 and assessed the sociodemographic correlates of midlife first marriage formation for today's women and men. Median ages at first marriage are at record highs for women and men, signaling that marriage may be increasingly occurring at older ages. However, first marriage formation among midlife adults remains largely overlooked.

Financial Independence

Young adults today face unique economic challenges that affect their transition to independence. Increases in job turbulence and economic downturns, for example, have resulted in some young adults navigating more volatile and uncertain economic environments. Growing aspirations for higher levels of education reflect increases in college enrollment among young adults, which increased until the early 2010s and has since remained stable. Furthermore, young adults are more likely to pursue degrees beyond a 4-year bachelor's as the share and number of college students who are in graduate school has expanded. These higher levels of educational attainment result in contemporary cohorts spending a longer portion of their young adult lives enrolled in higher education, potentially delaying other markers of adulthood such as entering the labor force or marriage.

Risk Factors and Protective Factors

Environmental Risk Factors

The COVID-19 pandemic has had significant impacts on young adult mental health. An NIMH-supported study suggests that adolescents living through the COVID-19 pandemic may be experiencing more anxiety and depression symptoms and accelerated brain aging. The coronavirus (COVID-19) pandemic caused significant stress and uncertainty. This was particularly true for young people, who faced school shutdowns, severed social channels, and amplified stress at home and in their communities. Given the unprecedented disruption caused by the pandemic, it is crucial to understand its impact on health and development, especially among adolescents. The coronavirus (COVID-19) pandemic caused significant stress and uncertainty. This was particularly true for young people, who faced school shutdowns, severed social channels, and amplified stress at home and in their communities. Given the unprecedented disruption caused by the pandemic, it is crucial to understand its impact on health and development, especially among adolescents. New findings from a study funded by the National Institute of Mental Health shed light on how adolescents living through the COVID-19 pandemic and its accompanying shutdowns compare, both psychologically and biologically, to their peers before the pandemic.

Protective Factors

Research has identified several protective factors that support mental health during young adulthood:

Being physically active for ≥60 minutes/day on ≥5 days was associated with lower prevalence of having experienced persistent feelings of sadness or hopelessness (aPR = 0.92). Getting ≥8 hours of sleep was associated with lower prevalence of all mental health and suicide risk indicators (aPR range = 0.53–0.67) as was having a household adult who always tried to meet their basic needs (aPR range = 0.41–0.80). High parental monitoring was associated with lower prevalence of all mental health and suicide risk indicators (aPR range = 0.51–0.74) except poor mental health. High levels of school connectedness were associated with lower prevalence of all mental health and suicide risk indicators (aPR range = 0.63–0.70). Playing on ≥1 sports team was associated with lower prevalence of all mental health and suicide risk indicators (aPR range = 0.84–0.90) except attempted suicide.

Social Support Systems

Strong social connections and support systems play a crucial role in young adult mental health. This paper proposes family social capital as a relational mechanism for driving the early career development of emerging adults. Cultural and community support also provides important protective factors, particularly for minoritized young adults facing additional stressors.

Treatment Approaches

Cognitive Behavioral Therapy (CBT)

CBT remains one of the most well-researched and effective treatments for young adult mental health concerns. For example, one recent meta-analysis of 76 studies and 106 CBT treatment groups examining outcomes in the treatment of anxiety, depression, posttraumatic stress disorder, and obsessive–compulsive disorder in youth found that 77.1% of participants at posttreatment and 81.9% at follow-up (ranging from 1 to 89 months) showed significant improvements in target symptom measures compared to pretreatment (considerable heterogeneity between studies; I2 = 80.8–83.8%). Another study conducted several meta-analyses to examine the effects of CBT for youth anxiety disorders. An analysis of 39 studies (N = 2697) that examined remission of a primary anxiety disorder diagnosis at posttreatment found that youth in CBT had a remission rate of 49.4% compared to 17.8% for those in waitlist or no treatment conditions (moderate heterogeneity; I2 = 52%).

Internet-Based Interventions

Technology-assisted treatments have shown promise for reaching young adults. We conducted a comprehensive search of seven electronic databases for eligible randomized controlled trials published from January 1995 to July 2024. The NMA incorporated a total of 27 studies involving 3,451 participants. Among these studies, 18 assessed internet-based cognitive behavioral therapy (iCBT) interventions, whereas 12 employed a waitlist as a control group. At the end of the interventions, internet-based acceptance and commitment therapy (iACT), iCBT, internet-based dialectical behavior therapy (iDBT), and internet-based psychodynamic therapy (iPDT) all showed significant effects compared to control conditions.

Acceptance and Commitment Therapy (ACT)

This meta-analysis integrated the findings on the efficacy of acceptance and commitment therapy (ACT) for transitional-age youth (TAY; youth aged 15 to 25) on psychopathology (i.e., internalizing, externalizing and other psychological problems), ACT related processes (i.e., psychological flexibility and self-compassion), well-being (i.e., general and social well-being) and coping (i.e., emotional and cognitive coping). Based on 65 studies (n = 5283), we found a moderate effect (Hedges's g = 0.72) of ACT compared to the control conditions on psychopathology, ACT related processes, well-being and coping.

Interpersonal Therapy (IPT)

For adolescents, cognitive behavioral therapy (CBT), interpersonal psychotherapy (IPT-A), CBT in combination with antidepressant medication, and collaborative care programs were all classified as well-established. IPT focuses on improving interpersonal relationships and addressing role transitions, which are particularly relevant for young adults navigating changing relationships with family, peers, and romantic partners.

Family-Based Approaches

Family therapy can be particularly beneficial for young adults dealing with shifting family dynamics. As young adults navigate increasing independence while often maintaining close family ties, family-based interventions can help address:

  • Communication patterns
  • Boundaries and autonomy
  • Cultural expectations and values
  • Support during major life transitions

Frequently Asked Questions

What makes young adulthood different from adolescence?

Young adulthood represents a distinct developmental period characterized by greater independence, continued brain maturation, and unique life challenges. Unlike adolescents, young adults typically have more autonomy in decision-making but may still be developing the neurological capacity for optimal executive functioning. The brain finishes developing and maturing in the mid-to-late 20s, which means young adults are still undergoing important neurological changes even as they take on adult responsibilities.

Are mental health issues in young adults increasing?

Recent data shows mixed trends in young adult mental health. Mental health among youth in the U.S. improved significantly from 2023 to 2024. The percentage of youth (ages 12-17) who experienced a major depressive episode (MDE) in the past year decreased from 18.10% in 2023 to 15.40% in 2024. However, this rate has increased significantly over the past several years (from 22.1% in 2016), indicating that while recent improvements are encouraging, overall rates remain higher than historical levels.

What are the warning signs that a young adult needs professional help?

Warning signs include:

  • Persistent feelings of sadness or hopelessness lasting more than two weeks
  • Significant changes in sleep, appetite, or energy levels
  • Withdrawal from friends, family, or previously enjoyed activities
  • Difficulty functioning at school, work, or in relationships
  • Thoughts of self-harm or suicide
  • Increased use of alcohol or drugs to cope
  • Extreme mood swings or behavioral changes

How effective is therapy for young adults?

Research consistently shows that therapy can be highly effective for young adults. Analyses by multiple independent review teams have concluded that depression effect sizes are modest in magnitude, with only half of youths showing clinically significant improvement in active treatment conditions (54%) and substantially fewer (39%) showing robust recovery from depression. While these statistics might seem discouraging, they represent significant improvements over no treatment, and many young adults experience substantial benefits from therapy even if they don't achieve full remission.

What role do parents play in young adult mental health treatment?

The role of parents in young adult mental health treatment varies based on individual circumstances, cultural factors, and the young adult's preferences. While young adults have the right to confidential treatment, involving family members can often be beneficial when appropriate. Family involvement might include:

  • Providing historical context about symptoms
  • Learning how to offer appropriate support
  • Addressing family dynamics that may impact mental health
  • Participating in family therapy sessions when indicated

Can young adults "grow out of" mental health issues?

While some mental health challenges may improve with maturation and life experience, most benefit from professional intervention. Common adolescent mental disorders: transition to adulthood. Mental health conditions are not simply phases that young adults outgrow. Early intervention during young adulthood can prevent conditions from becoming chronic and can provide skills and strategies that support long-term mental health.

How Therapy Can Help

Therapy provides young adults with a safe, confidential space to explore the unique challenges of this developmental period. A skilled therapist can help young adults:

Develop Coping Skills

Learn evidence-based strategies for managing stress, anxiety, and depression while navigating major life transitions.

Explore Identity

Work through questions of identity, values, and life direction in a supportive environment without judgment.

Improve Relationships

Develop healthier communication patterns and boundaries in relationships with family, friends, and romantic partners.

Build Executive Function Skills

Strengthen planning, organization, and decision-making abilities as the brain continues to develop.

Process Life Transitions

Navigate major changes such as leaving home, starting college or career, or shifting family dynamics.

Address Trauma and Past Experiences

Work through past experiences that may be impacting current functioning and well-being.

Find a Therapist

If you or a young adult in your life is struggling with mental health challenges, professional support can make a significant difference. GoodTherapy's directory can help you find therapists who specialize in working with young adults and understand the unique challenges of this developmental period.

When searching for a therapist, consider looking for professionals who:

  • Have experience working with young adults and emerging adults
  • Offer evidence-based treatments like CBT, ACT, or IPT
  • Understand developmental considerations of young adulthood
  • Provide culturally responsive care
  • Offer flexible scheduling options, including evening or weekend appointments
  • Accept your insurance or offer sliding scale fees

Remember that finding the right therapist may take time, and it's okay to meet with several providers before finding the best fit. The therapeutic relationship is one of the most important factors in successful treatment outcomes.

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