Summary
When you first see the figure "about 1.17 billion people with a mental disorder worldwide in 2023," it feels like way too many.
But that doesn't mean 1.17 billion people are severely ill and in the hospital. It's an estimate of mental disorders and mental health difficulties in the broad sense, including depression, anxiety disorders, ADHD, autism spectrum disorder, eating disorders, schizophrenia and more.
Even so, about 14% of the world's population, roughly 1 in 7 people, is a big number.
What's more surprising is that the health burden from mental disorders is especially heavy among 15- to 19-year-olds.
But when you think about it, that's not so strange.
At 15 to 19, you still can't choose your own environment. You don't really know what jobs exist in the world. You haven't had a chance to find out what you're good at. And yet school, test scores, entrance exams, career paths, family, friendships, comparing yourself on social media and worries about the future all land on you at once.
On top of that, in Japan, if you step even slightly off the standard path, you're expected to explain yourself.
Going to a correspondence-style high school. Dropping out of high school. Failing an entrance exam. Spending a year as a rōnin, retaking exams after failing. Not going to university. Having a gap before your first job.
Just from that, a teenager easily feels like "it's over for me."
It's actually not over.
But a 15-to-19-year-old can't see the map of escape routes. So failing an exam or a career plan doesn't feel like "I didn't get into that school." It feels like "my worth just dropped."
This article looks at why people aged 15 to 19 are so prone to mental breakdown, and why using AI like ChatGPT as an "external brain" has become a way to protect yourself today.
1. The "1.17 billion" is a 2023 estimate, not a running total
A Mainichi Shimbun article (a major Japanese newspaper) reported that the number of people with a mental disorder worldwide reached about 1.17 billion in 2023.
This is not a cumulative count from 1990 to 2023.
In the GBD 2023 research it comes from (the Global Burden of Disease study), it means there were an estimated 1.17 billion cases of people living with these conditions worldwide in 2023.
One caution, though.
It does not mean 1.17 billion severely ill people are being treated in psychiatric hospitals. The scope is broad. It includes depression, anxiety disorders, persistent mild depression (dysthymia), bipolar disorder, schizophrenia, ADHD, autism spectrum disorder, eating disorders, intellectual disability and more.
So, roughly speaking, an awful lot of people around the world are struggling in some area: mood, anxiety, development, behavior, eating, thinking or day-to-day functioning.
The age-standardized prevalence (adjusted so that differences in age makeup don't distort the comparison) is said to have risen 24.2% between 1990 and 2023.
That doesn't mean the share went up by 24 percentage points. It means cases per 100,000 people rose by about 24% in relative terms. In numbers, think of it as going from the equivalent of about 11.4% to about 14.2%.
Even so, that's big enough.
People whose minds are on the verge of snapping are no longer the exception. They're a pretty ordinary part of society.
2. Why is the burden heavier at 15 to 19?
Some people may find it surprising that the mental health burden is heavy at 15 to 19.
To adults, teenage worries look like "exams," "friends" and "what to do after school." Adult problems such as work, household money, marriage, childcare, caring for parents and mortgages seem heavier.
But how hard the late teens are can't be measured by the content of the worries alone.
The problem is that the teen still can't choose their environment.
An adult who doesn't fit in at work can think about changing jobs. There are other cards to play: transferring to another department, taking leave, moving, side jobs, putting some distance between you and the problem, looking up support systems.
Of course, adults don't have it easy either. In reality they have few escape routes, and it's rough unless you carve one out yourself.
Even so, adults at least usually know that "society has more than one route."
At 15 to 19, it's different.
Home and school make up most of your world. What teachers and parents say carries a lot of weight. It's hard to get away from your classmates. You get priced every day by test scores and pass/fail results. You don't know what jobs exist in the world. You haven't had the chance to try out what suits you. And still you're told to "decide your future."
It's like being told to pick a destination without being handed a map.
3. "Have a goal" is like "pick a destination without a map"
At school and at home, you hear "have a goal" all the time.
But for a teenager, having a goal is itself very hard.
To have a goal, you need at least the following information:
- What kinds of jobs exist in the world
- What those jobs are really like
- What you're actually good at
- What you hate
- What risks come with each path
- What detours are available if you fail
- Where your values differ from your parents' and teachers' values
Most high school students don't have this information.
And yet they're told, "Work hard now for your future."
That's a lot to ask.
People who are good at studying, whose families are stable, who sleep well, who fit in at school and who happen to suit the rules of the exam game might manage to get through.
For everyone else, it's easy to get stuck all at once.
I have to study. But I don't know what I'm doing it for. If I don't, my future looks bad. But I can't do it. I escape into games. I feel guilty for escaping. I'm sleepy. I can't get up in the morning. I barely make it to school on time. And I hate myself again.
This loop is dangerous.
It's less about a lack of willpower and more about having too many variables to process at once.
4. Test scores and pass/fail turn into "my price tag"
What makes exams hard isn't only the amount of studying.
What's really hard is that pass/fail results and deviation scores (hensachi, the score that ranks you against everyone else who took the test) stop feeling like "one part of my ability" and start feeling like "the price of me as a person."
In truth, an exam result is just an exam result.
You got into that school. You failed that test. You were able to study during that period. You weren't able to study during that period.
Originally, that's all it is.
But that's not how it works in a teenager's head.
The me who passed has value. The me who failed has none. What have I even been doing all this time? Is it my parents' fault? No, it's my fault, isn't it? Maybe it's too late to fix anything.
Thoughts jump to that place in an instant.
That's dangerous.
You can't say educational background doesn't matter at all. It can affect getting hired, your first assignment, your options and how others see you.
But educational background is not a person's worth.
It's really more like an entry ticket, a pass, a card that widens your options a little, or a bit of initial credibility.
For a teenager in exam season, though, it swells into something that looks like a "pass certificate for being a human being."
That's why some people walk home after failing an exam feeling that "it's all over."
It isn't over.
But at that moment they can't see enough concrete examples or escape routes to know it.
5. Step off the standard path and you're made to answer "why?"
One reason career anxiety weighs so heavily in Japan is the pressure to explain yourself once you leave the standard route.
Going to a correspondence-style high school. Dropping out of high school. Taking a year or more to retake exams. Not going to university. Going to a vocational school. Having a gap before your first job. Taking a leave of absence partway through school.
In reality, none of these is rare.
According to a survey by the Ministry of Education, Culture, Sports, Science and Technology, a certain number of students drop out of high school every year. In fiscal 2023 (Reiwa 5), there were 46,238 dropouts, and about 40% of them gave a change of direction as the main reason.
In other words, plenty of ordinary people waver on their path.
Still, the mood in society is that once you leave the standard route, people ask "why?"
That "why?" is heavy.
What the person really wants isn't a question that blames them for leaving. They want a map to help them work out what to do next, together with someone.
In reality, though, the demand to explain comes first.
Why a correspondence school? Why did you drop out? Why did you take a year off to retake exams? Why that university? Why aren't you going to university? Why is there a gap?
Making someone aged 15 to 19 carry all that is really tough.
6. Escaping into games isn't laziness, it's also taking shelter
Lots of people can't stop playing games during exam season.
If you just call that "laziness," you miss the structure behind it.
Games are sometimes designed to be far kinder than real life.
Clear goals. You can retry after failing. When you act, you get a response. Your growth shows up in numbers and gear. You know what to do to get stronger. Beat an enemy and you get a reward. Your effort comes back to you in a fairly readable way.
Exams and career paths are different.
You don't know what you're studying for. You don't know how things will turn out. You can study hard and still not know if you'll pass. You don't know which path suits you. Failing feels like the end. Pressure comes from parents and teachers. You're sleepy. But you have to study.
In that state, it's pretty natural for the brain to flee to the game side.
Of course, this isn't saying you don't have to study for exams.
It's just that blaming yourself with "I'm hopeless because I can't quit games" doesn't fix anything. What you need isn't a total ban on games. It's to create ways to win on the real-life side too.
Exams and career paths also need to be broken down the way a game is.
What to do today. What not to do. The minimum line. A plan B if you fail. How to explain it to your parents. Fixing your sleep. Targets to reach, not hours studied. Escape routes. People to consult.
Unless you build a map and an interface on the real-life side too, people can't move.
7. Social media isn't so much the cause as an amplifier of comparison
I think social media has a big influence on the decline in young people's mental health in recent years.
But explaining everything with social media alone is sloppy.
An OECD report also says that young people's mental health got worse during the pandemic, but that it had already been declining before COVID in many countries. It also lays out several overlapping factors, not just social media and digital devices, but economic insecurity, academic pressure, anxiety about the future and general social instability.
What's really hard about social media is that the people you compare yourself to go haywire.
In the past, the people you compared yourself to were at school, at work, relatives, neighbors and celebrities on TV.
Now it's different.
People your age who earn a lot. People who succeeded young. People who seem to have stepped off the work treadmill. People who reached FIRE (financial independence, retire early). People living freely overseas. People who are strikingly good-looking. People who seem to have it all: education, income and side businesses. People who look like they're having fun every single day. The "I quit my corporate job" crowd.
Highlight reels like these flow endlessly onto your phone.
That's bad for the brain.
You have to work every day to survive. Or you're anxious about your future unless you study. But on the screen, you see people who seem to live without working, people who seem to live off what they love, people who've made it.
Of course comparing yourself wears you down.
Social media is also a source of information. It's a place to find friends. It can reduce loneliness.
But if you use it the wrong way, it becomes an automatic delivery service for a happiness debuff (a video-game term for a status effect that weakens you).
8. Bouncing between resenting your parents and blaming yourself
When things go wrong with exams or career plans, people sometimes end up resenting their parents.
I wish they'd supported me more. I wish they'd given me more freedom. I wish they'd told me sooner. Why did they only ever say "study"? Why did they only show me this one route?
You might think things like that.
But at the same time, self-blame kicks in right away.
No, I'm the one who played games. I'm the one who didn't study. I'm the one who overslept. In the end, isn't it all my fault?
This back-and-forth is the hardest part.
It's a sideways shuffle between blaming others and blaming yourself.
Blaming your parents doesn't save you. Blaming yourself doesn't save you either.
What you really need is not a search for the cause, but to take the structure apart.
Was the you of back then simply being lazy? Or were sleep, career anxiety, pressure at home, the exam system, self-image, escaping into games and the school environment all tangled together until you crashed?
In most cases, it's the latter.
That doesn't mean you bear zero responsibility.
But there are too many variables to stuff all of it under "lack of grit."
9. Society is designed for people with strong mental health, and that's rough
Society is built pretty much on the assumption that people are mentally strong.
Decide on a career path. Have a goal. Study. Accept whether you pass or fail. Even if you fail, shake it off and move on. If you did a correspondence school or dropped out, explain why. Explain the gap, too. Work. Put up with the comparisons. Put up with the anxiety about the future. Gather information on your own. Create your own escape routes.
That is a very high bar.
And 15- to 19-year-olds still have little information and little experience.
Saying "have a goal" to someone in that state is pretty harsh.
What they need isn't a goal pushed on them.
What they need is for the options to be made visible.
The route to university. The route to vocational school. The route to higher education from a correspondence school. The route of getting a job right after high school. The route of earning a qualification. The route of retaking exams. The route of taking a break. The route of working first and studying later. The route of rebuilding after failure.
They need a map like that.
Before "have a dream," it should be "know your routes."
10. Conclusion: use ChatGPT, but don't hand over your whole life
Here we reach a very modern conclusion.
High school students are exactly the people who should use AI like ChatGPT.
That doesn't mean "let AI decide your life."
It means putting something outside yourself: someone to talk to, a search helper, an options generator, a tool that puts your thoughts into words, a comparison-table maker and a drafter of explanations for your parents.
When people try to process career anxiety only inside their own heads, they break easily.
That's why you need an external brain.
For example, you can ask like this:
I'm in my second year of high school. I don't have anything I want to do in the future. Ask me about what I'm good at, what I dislike, my grades and my family situation, one at a time, then give me 10 possible career paths.
Make a table of the pros, cons and escape routes if it goes badly for each of these: going to university, vocational school, a correspondence high school, getting a job, earning a qualification and retaking exams.
I failed my entrance exam. I feel like my life is over. Lay out my realistic options in the short, medium and long term.
Write a message telling my parents I'd like to consider a correspondence high school, worded in a way that won't start a fight.
I have to study but I can't stop playing games. Make me a realistic schedule that doesn't ban games completely.
Sort my current anxiety into school, family, friends, exams, sleep, social media and worries about the future.
With just that, a vague lump of anxiety turns into problems you can take apart.
A monthly subscription is expensive for a high school student. So free is fine to start with. You could also consider a paid plan only when you need it, such as during exam season or a major career decision.
The important thing is not to treat AI as a god that hands you answers.
It's to use AI as an external brain that widens your options.
11. But when things are dangerous, connect to a human, not to AI
This part matters.
If you're so cornered that you feel "I want to die," "I want to disappear" or "I want it to end," it's dangerous to carry that with AI alone.
AI can help you sort things out.
But when your life is at risk, you need to connect with real people, medical care and support hotlines.
In Japan, the Ministry of Health, Labour and Welfare's site "Mamorou yo Kokoro" ("Let's Protect Hearts") collects phone and chat-based counseling services.
It introduces services such as #Inochi SOS, Yorisoi Hotline, Inochi no Denwa (Lifeline), the Kokoro no Kenko Sodan Tōitsu Dial (a unified mental health consultation number), Childline and the 24-hour Children's SOS Dial.
These are not things "only weak people use."
When you've hit your limit, they're a safety valve that lets you move some of the load off your own mind.
Use AI. Ask an adult other than a teacher. Have someone to talk to outside your family. Connect with medical care. Look up the support systems available. Build escape routes.
All of these are ways to protect yourself.
12. What teens need is a map, not grit
It's not surprising that the mental health burden is so heavy at 15 to 19.
You still can't choose your own environment. You don't know the options society offers. You don't know what you're suited for. And still you're told to decide your future. You get priced by test scores and pass/fail results. Leave the standard path and you carry the burden of explaining yourself. There's no escape at home or at school. Social media shows you other people's success and freedom. Games look more beatable than real life. Failing feels like the end.
If your mind snaps under those conditions, it isn't personal weakness.
The way society is designed is brutal.
So what's needed isn't "be stronger."
What's needed is a map.
A map of options. A map of escape routes. A map of what you're good and bad at. A map of detours after failure. A map for explaining yourself to parents and teachers. A map of who to turn to when your mental health is in danger.
And today, AI can be used as a tool for drawing that map.
Before telling a teenager to "have a goal," adults should first show them the options and the escape routes.
And the teens themselves should get it out of their heads, whether into AI, a person or a sheet of paper.
Life isn't so simple that it ends with a single exam.
It's just that a teenager can't see that.
That's exactly why someone, or something, needs to show it to them in a way they can see: it isn't over.
