Therapy for Young Adults in the In-Between Years
There is a particular kind of difficulty that belongs to the years between adolescence and settled adulthood. It does not have one name. It is sometimes called the quarter-life crisis, sometimes emerging adulthood, sometimes just "feeling behind." But whatever it is called, the people living through it often describe a similar experience: the sense of being unmoored without quite knowing why, surrounded by the appearance of forward motion and unclear about whether they are actually moving.
According to analysis of the Census Bureau's Household Pulse Survey published by KFF in 2023, 50% of adults ages 18 to 24 reported symptoms of anxiety or depression -- compared to about one-third of adults overall. This is not a marginal experience. It is the dominant experience of this age group, and it is happening largely in silence.
What Makes the In-Between Years Hard
The difficulty of this life phase is not primarily about dramatic crises. It is about the quiet weight of a transition that lacks external structure.
School provides scaffolding. It tells you where to be, what to do, how you are doing, and who you are doing it alongside. The social world of school -- even when it is difficult -- is a world with clear edges and regular feedback. Identity formation happens in relation to others who share your context.
When school ends, most of that disappears. The professional world provides some structure, but far less of the identity scaffolding that school provided. Friendships have to be actively maintained across distances and diverging life paths. Romantic relationships carry more weight when they are not surrounded by a natural peer community. Family of origin dynamics often intensify as young adults try to differentiate from their families while still needing connection with them.
And underneath all of this is the expectation -- absorbed from cultural messaging, social media, family narratives, and comparison to peers -- that by a certain age you should have figured out who you are and what you want. When you have not, the conclusion many young adults draw is that something is wrong with them, rather than that the process takes longer and is harder than the cultural timeline suggests.
What Young Adults Are Actually Dealing With
The specific struggles that show up most often in therapy with young adults tend to cluster around several themes.
Identity uncertainty. The questions of what you actually want, separate from what you were told to want or what you thought you were supposed to want, are harder to answer without the structure of school to organize them around. Many young adults arrive in therapy not knowing what they care about, or knowing but not believing they are allowed to act on it.
Comparison and perceived inadequacy. Social media has made the in-between years harder by making it easy to compare your internal experience to others' curated external presentation. The result is a sustained sense of being behind a standard that is, in fact, not real. Feeling behind in life is one of the most common presentations in this age group.
Loneliness in transition. The loss of the natural community structures of school -- the automatic proximity, the shared context -- produces a specific kind of loneliness that is often unacknowledged. It is not dramatic isolation. It is the quieter experience of being technically connected but not deeply known. Life transitions and anxiety covers the anxiety dimension of this experience.
Early burnout. Young adults are increasingly burned out before 30 -- not from age and accumulated responsibility, but from sustained performance anxiety, overwork as identity, and the effort of maintaining the appearance of having it together. Burned out before 30 addresses this pattern directly.
Family of origin work. The in-between years are often when the effects of childhood and family of origin become clearest -- in relationship patterns, self-concept, anxiety, and the ways people manage connection and autonomy. Therapy at this stage can interrupt those patterns earlier, before they are as deeply entrenched.
Why Young Adults Often Do Not Seek Help
Despite the high rates of anxiety and depression in this age group, many young adults do not seek therapy until the difficulty has become significantly worse.
Several things get in the way. There is a persistent sense that problems need to be severe enough to warrant help -- that struggling with ordinary life transitions is not a real reason. There is the cost, which is a real barrier that telehealth and expanded insurance access to mental health care have begun to address. And there is the residue of a cultural message that this age is supposed to be exciting and full of possibility, which makes it harder to acknowledge that it is also genuinely difficult.
The reality is that the in-between years are one of the best times to engage with therapy. The patterns are more malleable than they will become with time. The questions being worked on -- identity, values, relational patterns, family of origin dynamics -- are ones that get harder to address later. What feels like being lost in the in-between is often the work of becoming someone.
What Therapy Offers
Therapy with young adults in this phase addresses the specific difficulties of the transition: building identity outside of external validation, developing clarity about values and direction, understanding where anxiety and relational patterns came from and how to shift them, and learning to tolerate the uncertainty that belongs to this life stage without treating it as evidence of failure.
Blue Square Counseling & Wellness specifically serves young adults, college students, and adults in transition, with individual counseling and life transitions counseling available in Billerica, Lexington, and throughout Massachusetts via secure telehealth.