The paradox driving Gen Z's mental health in India

Coping mechanisms among Indians are changing. Alcohol, once the default social outlet, is losing its grip on younger Indians. Between 2005 and 2021, the percentage of Indian men who reported drinking fell from 32 per cent to 22 per cent, and surveys suggest Gen Z is turning away from alcohol altogether in favour of “feeling better for longer.” As conversations around Gen Z mental health in India grow louder, one form of chemical coping is receding, and another is quietly replacing it. ADHD medications, antidepressants, and mood stabilisers are slipping from clinics into daily life. Global sales of drugs for the central nervous system are rising by nearly 10 per cent each year, and in India, the ADHD therapeutics market alone is projected to reach USD 278 million by 2030.

The rise of Gen Z’s pill culture in India

“A decade ago, patients hesitated to even say the word ‘antidepressant,’” says Dr Meenakshi Chatterjee, consultant psychiatrist at Mumbai’s Masina Hospital. “Now, 20-somethings come in asking for Adderall-equivalents or stronger focus pills. They’ve already Googled the molecule.” The impulse, she adds, isn’t indulgence but the pursuit of safety, dignity, and belonging in a world that feels increasingly unstable. For a generation raised on savage amounts of digital noise,psychiatric medication in India offers the illusion of balance—a way to keep up when exhaustion feels like a failure. 

Therapy, by contrast, is slow, emotionally demanding, and often inaccessible. India has fewer than one psychiatrist per 100,000 people, making consistent, affordable care rare. The cost of therapy in India adds another barrier, with urban Indians spending ₹4,000–₹7,000 a month on sessions. The tension between therapy and medication in India mirrors the one between slowing down and wanting to stay functional.

“The young folks aren’t wrong about their suffering,” says Chatterjee. “They live in systems that scatter their attention spans and drain their nervous systems. A diagnosis gives them language; a pill gives them stamina, even if that stamina is borrowed and lab made.”

 “YOUNG FOLKS AREN’T WRONG ABOUT THEIR SUFFERING. THEY LIVE IN SYSTEMS THAT SCATTER THEIR ATTENTION AND DRAIN THEIR NERVOUS SYSTEMS”  - Dr Meenakshi Chatterjee

Gen Z, meanwhile, speaks fluent therapy—the hard-won result of years of destigmatisation efforts of those that came before. Terms like bipolar, OCD, burnout, dysthymia, and neurodivergent now move easily across social media. The language of care becomes commonplace, and the line between illness and the ordinary ache of being alive is beginning to blur. In this environment, Gen Z mental health in India is increasingly shaped by online narratives around ADHD diagnosis, the debate around therapy versus medication, and the broader wellness culture. 

ADHD diagnosis and treatment in India: The algorithm effect

India’s Gen Z is coming of age in a culture that turns distress into diagnosis. Across algorithms, wellness brands, and therapy influencers, the same message keeps repeating: If you can’t focus or slow down, the fault lies in the wiring of your brain. The intention might be empathy, but the effect is isolation, convincing people that exhaustion is a personal defect rather than a collective condition. On social media, videos tagged #ADHD have drawn more than 4.3 billion views; studies show over half of the most-viewed clips contain misleading or oversimplified information about mental health diagnosis and treatment.

India’s booming brain-health market complicates this further. Brands like Himalaya Wellness, Cureveda, and Neuherbs now push  “focus” and “memory” supplements as quick-fix g cognitive enhancers. It’s a reflection of the optimisation culture in India, where burnout, distraction, and anxiety are reframed not as symptoms of systemic overload but as proof of personal inadequacy—evidence that you need fixing. And the fix, conveniently, can be bought, swallowed, or subscribed to.

Across Instagram and YouTube, “mental health” content loops the same logic: snippets offering therapy, dopamine hacks, ADHD checklists—each one repackaging vulnerability as self-improvement.

Inherited anxiety: Decoding Gen Z’s mental health in India

The pressure didn’t start with Gen Z. Each generation inherits a particular kind of pressure—economic, cultural, and emotional. Gen X carried the stress of economic liberalisation; the opportunities arrived, but so did the pressure. Millennials absorbed globalisation’s promise and turned ambition into identity. Gen Z, raised in an always-on world, lives in a state of persistent alertness and fatigue. 

It’s termed ADHD, sometimes anxiety, occasionally depression, and often it’s simply the body adapting to survive. Somatic theorists call this generational imprinting—emotional patterns passed across generations. Gen Z, raised in constant  stimulation, has inherited an overactive nervous system, responding to a world that never stops demanding attention.

“We’re too quick to medicalise what are often biopsychosocial responses to pressure,” says Dr Soumit Pathare, psychiatrist and director of the Centre for Mental Health Law & Policy, Pune. “The brain doesn’t exist outside culture. Economic insecurity, digital overload, and the pressure to be endlessly productive reshape how we cope.”

Meditation can’t undo a 70-hour work week. As psychiatrist, researcher, and author Bessel van der Kolk writes in The Body Keeps the Score (2014), no amount of resilience can undo the pace that leaves people exhausted. When work, education, even leisure run on acceleration, coping stops being a choice and becomes a reflex. 

“It’s like my brain is always buffering,” says Tania Gupta, 29, a design student in Bengaluru diagnosed with ADHD last year. “I don’t even know if the pills make me focus better or if they just slow the world down.” 

“WE’RE TOO QUICK TO MEDICALISE WHAT ARE OFTEN BIOPSYCHOSOCIAL RESPONSES TO PRESSURE” — Dr Soumit Pathare

Gupta is part of a growing number of young individuals turning to psychiatric medication in India as a way to stay functional rather than to feel better. So, when teachers, parents or clinicians observe “attention deficits” or “mood dysregulation,” the question isn’t only about what’s wrong with them but rather what’s happening to them. If the outer world is disordered, the inner world will inevitably mirror it. 

Arjun Nihalani, a 38-year-old creative director based in Mumbai, knows this cycle well. He was prescribed anti-anxiety medication during a prolonged period of sadness and an inability to get out of bed for weeks. ““I was working 12-hour days from my one-bedroom apartment,” he says. The pills helped at first. “It felt like respite, but after a year, the numbness made me feel lifeless.”  

The grief, he realised, wasn’t from avoidance anymore, it was from the medication that had become his survival mechanism. With therapy, Nihalani began tapering off, replacing the pills with small, slow, and deliberate shifts: evening walks, no-screen Sundays, reconnecting with old friends. “The hardest part wasn’t stopping the meds,” he says, “but learning to create boundaries at work and to spend free time connecting rather than isolating.” 

The World Health Organization estimates that 80 per cent of India’s workforce experiences some level of mental-health challenge. It is important to note, this doesn’t mean eight in ten people have chemical imbalances. It points to a society under chronic stress of digital overload, job insecurity, and isolation disguised as connectivity. What’s emerging isn’t a failure of individuals, but the collective exhaustion of an environment.

The Inequality of Coping

Access defines recovery. Mental health care in India follows privilege.  In cities, therapy is an app away where one  can consult a psychiatrist over video, get a diagnosis in 15 minutes, and have a prescription delivered the next morning. In smaller towns, even finding a licensed psychiatrist can take months. “It was disturbingly easy,” says 34-year-old Aishwarya Kaur, a Gurugram-based corporate lawyer. “I filled out a two-minute questionnaire on a mental health app, had a 10-minute video call on Practo with a doctor, and by the same evening, I had a prescription for antidepressants in my inbox.” 

Under India’s Telemedicine Practice Guidelines (2020) and Telepsychiatry Operational Guidelines (2020), registered psychiatrists are legally permitted to diagnose and prescribe certain medications via video call. The policies were designed to improve mental health access across India, but, in practice, they’ve also enabled a new kind of drive-through psychiatry—fast, efficient, and often detached from deeper clinical evaluation.

In most urban centres, mental health has become part of aspirational living: therapy, curated retreats, mindfulness apps, and, increasingly, medication. Meanwhile, in lower-income or rural settings, the same symptoms are often met with spiritual interpretation or stigma. “When my cousin in Delhi said she was taking antidepressants, everyone called it brave,” says Neeti Mishra, a 32-year-old UX designer from Indore. “When I told my family I was thinking of the same, they said I was weak.”

Among the privileged, a diagnosis can be a means to rebuild their identity; among the less privileged, it can be isolating. In cities, over-diagnosis and over-prescription are growing concerns; in rural India, under-diagnosis and untreated distress fuel the crisis. Both reflect the same systemic neglect.  

Pathare notes that lack of access in semi-urban and rural areas, while tragic, may have inadvertently protected these populations from over-medicalisation.  “The irony,” he says, “is that our broken system, by not making prescription drugs easily available everywhere, may have spared many young people from unnecessary medication.” 

Those with social and financial capital can narrativise their distress through therapy-speak—burnout, high-functioning anxiety, ADHD. Those without access absorb the same stress in silence, through faith, fatigue, or sheer survival. The real question isn’t about medication, but about whose pain is allowed to be treated. 

Connection, Not Correction

For some, medication truly is a bridge. “When I first started my anti-anxiety pills, I finally felt like I could breathe,” says Rhea Nagrani, 27, a Mumbai-based public relations manager. “Looking back, I’d been silently struggling for years. I was terrified that meds would change who I was, but my psychiatrist assured me that the meds were‘here to steady you, not to keep you stuck’.Once I began treatment, we added somatic practices and small lifestyle shifts–volunteering at an animal shelter, cooking for myself, cutting back on social media, and reconnecting with friends.” 

“Medication steadies the chemistry [in the brain],” explains Chatterjee, “but it is connection that rewires it. The nervous system co-regulates in the presence of safe connections, not in isolation.” Research in social neuroscience supports this: Sustained social connection lowers cortisol levels, improves immune function, and enhances long-term emotional regulation. In other words, healing is not just chemical but it’s relational. 

When the Culture is the Patient

Across schools, clinics, jails, and community settings, the author -with two decades of experience working as a therapist— of this feature believes most young people wouldn’t meet the formal criteria for ADHD or bipolar disorder, yet they find comfort in the label and function better on the pills. In this culture, that often feels like survival. “It’s not that I love taking meds,” says Kaur, “it’s that without them, I can’t keep up.”

The dilemma isn’t the medication; it’s the medicalisation of the obvious. It’s unsurprising that people feel anxious or exhausted in a world that never allows them to slow down. The pace of work, digital noise, and widening inequality all take their toll. But making psychiatric medication in India the default response to collective stress risks ignoring the conditions that cause it. In the United States, stimulant prescriptions doubled between 2012 and 2023, as “diagnosis by algorithm” started taking hold online. By 2022, Adderall shortage exposed how easily treatment blurred into performance enhancement. 

As van der Kolk writes in his book, symptoms are stories of how the body adapts to an unbearable world. When those stories are medicated instead of understood, the possibility of change disappears. The real patient isn’t Gen Z. It’s the culture. 

Editor’s note: Deepti Dadlani is a Mumbai-based integrative psychotherapist with over two decades of experience across schools, clinics, jails, and community settings, working at the intersection of culture, identity, and mental health.