MENTAL HEALTH: “Failure To Launch?”

failure to launch



Brian Evans, a 22-year-old young man, visited his Primary Care Physician, Dr. Greene, who has cared for Brian and his family over the past 15 years. Brian had been complaining of episodes of shortness of breath and pain in his chest. His labs and physical exam did not show a physical cause for the symptoms. Dr. Greene wanted to rule out Anxiety and Depression so he referred Brian to a clinical therapist.

In the assessment, the therapist oted remarkable “psychological stressors” related to his significant challenges of transitioning into adulthood. Brain has been living with his parents since he withdrew from Texas State University in San Marcos during his first semester. Although he was on the honor roll in high school, he was failing all his first semester classes. Brian was experiencing severe emotional difficulties, including self-harmful behavior, not attending classes, and isolating himself from other students. After he moved home, he unsuccessfully attempted to attend the local university and started a cycle of enrolling then dropping out of his community college 3 times over the past 2 years. Brian has tried working minimum wage jobs and has been fIred from 3 jobs within a 6-month period. Brian has given up. Society now has a name (although derogatory in nature) known as “Failure to Launch.”


“Failure to Launch” is a syndrome that describes young adults like Brian who have not been successful in transitioning into adulthood. We are seeing an alarming number of young adults who have significant difficulties after graduating from high school. Often, they have undiagnosed or misdiagnosed psychiatric disorders which result in an inability to be successful in college or maintaining a job. Their symptoms interfere with their success, leaving them with extreme feelings of frustration and identifying themselves as failures.


Dr. Melissa Quinn is a Psychiatrist in San Antonio with a well- established private practice specializing in the mental health treatment of young adults. She states, “One of the main reasons that we are seeing an increase in the number of young adults not transitioning into adulthood is undiagnosed mental health disorders.” According to Johns Hopkins’ most recent statistics, of the 26% of American adults suffering from mental disorders, the young adult population (early mid-twenties) is the average age for onset of Major Depression, Bipolar Disorder, and Panic Disorder.

Dr. Quinn reports that “young adults who are predisposed to having a mental health disorder often present with symptoms after graduating from high school. The young adults are overwhelmed with lack of structure, too many choices, and stressors from society.” The lack of structure and loss of “safeness” (knowing what tomorrow will bring) often results in the presentation of the disorders. Dr. Quinn continues, “It is devastating for the young adult who is continuing to struggle to find independence. They often feel shame, isolation, and loneliness.”

These young adults feel rejected because they can’t meet their family’s and society’s expectations. They develop poor self-esteem, feelings of worthlessness, sadness, and a strong sense of failure. One young adult says, “I feel like I am constantly letting my parents down and that I am a burden to them. I really feel horrible about myself, and I think I will be stuck like this forever. I just can’t believe this is my life.”

They watch their peers graduate and start their careers while they feel ashamed of themselves for their lack of achievement. Eli Leibowitz, Ph.D. from the Yale Child Study Center states, “They frequently suffer shame and alienation as same-aged peers accumulate accomplishments while they accrue increasing disability.”

The “failure to launch” syndrome also affects the relationship between the adult child and their parents. It is very challenging for parents as they often do not understand or validate mental health disorders and the need for treatment. A young woman says to her therapist, “I am so tired of hearing my parents say that they do not understand how I can be so lazy and unmotivated to get a job or go to school. They just don’t understand how difficult it is for me and how every day I feel worse about myself.”


Often a young adult’s physician is the first line of defense. Specifically, Primary Care Physicians and Gynecologists have developed a bond with the family and young adult through years of treatment. It is important to be extremely cognizant of symptoms of depression and anxiety when treating these young adults. Parents and doctors should continue to ask questions regarding their education, employment, and daily routines. It is important to be proactive in referring these patients for treatment. Often, there is a great relief for them and their families when they are informed by a mental health professional that there is an actual diagnosis that is treatable.


There is a tremendous opportunity for successful treatment. The Psychiatrist will do a thorough Psychiatric evaluation of the patient which will often result in the diagnosis of a psychiatric disorder such as untreated ADHD, Depression, Anxiety (specifically social anxiety), Bipolar Disorder, and/or other mood-related disorders.


In addition to medication management, counseling is vital and a necessary component of treatment. Individual therapy with a clinical licensed social worker provides a safe platform. It is here where the patient utilizes their own strengths; developing tools and strategies to achieve the successful “launch” into adulthood. Family therapy is also necessary for the parents to learn the parenting skills specifically designed to help support and empower their young adult child.

Group Therapy is a highly effective modality of treatment. A young adult group led by an experienced clinical therapist significantly addresses the patient’s feelings of isolation and rejection in society. It allows the young adult to feel support from other group members and develop appropriate therapeutic skills. It also is an excellent vehicle to reduce social anxiety by practicing social interactions.

Accurate diagnosis and treatment can create needed accomplishments for our young adults. They develop positive feelings towards themselves as they transition into adulthood and begin their contribution to society.


Deborah Levi Lane, LCSW is a clinical therapist in private practice. She provides individual and group psychotherapy to children, adolescents, and adults. She also consults with medical groups, hospitals, and schools about the treatment of patients with bipolar disorder, depression, anxiety, ADHD, and other psychiatric disorders. For more information, please contact Deborah at 210- 326-4294 or email or visit www.


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