Something has gone seriously wrong with the emotional well-being of women—particularly young women.

In his article, “Well Being: ‘Mental Illness’ in Women,” Robert Malone begins with a striking statistic. In a large 2020 survey, 56.3 percent of white liberal women between the ages of 18 and 29 reported that a medical professional had diagnosed them with a mental-health condition. Among moderate and conservative white women of the same age, the corresponding figures were 28.4 and 27.3 percent.

Other measurements point in the same troubling direction. Only 15 percent of American women between 18 and 29 surveyed from 2020 through 2024 described their mental health as excellent, compared with 48 percent a decade earlier. An analysis of the 2024 American Family Survey found young liberal women markedly less satisfied with their lives and considerably more likely to report frequent loneliness than conservative women.

These findings do not establish that liberal beliefs cause mental illness. People who are already anxious, unhappy or socially alienated may be drawn toward certain political explanations. Some groups may be more willing to seek treatment or describe their distress in psychiatric language. When researchers asked about mood rather than “mental health,” some of the ideological difference reportedly diminishes.

Nevertheless, the broader deterioration in women’s reported well-being cannot be dismissed as merely a difference in vocabulary.

Malone proposes that much of what we call mental illness may be an understandable response to a culture that has deprived people of meaning, connection, responsibility and belonging. Women, he argues, have been encouraged to postpone marriage and children, prioritize professional achievement, regard dependence as weakness, and approach relations between men and women as a contest for power. When loneliness, anxiety and purposelessness follow, the medical system assigns a diagnosis and frequently supplies a prescription.

There is considerable truth in this analysis. But it also stops too soon.

Malone identifies one cultural script that may be harming women while coming close to prescribing another. He questions whether the pursuit of independence, career and self-realization has produced fulfillment, then answers with “More family. More marriage. More children.”

But what if both prescriptions can become traps?

What if a woman can end up living the wrong life by rejecting motherhood because she was taught that it would obstruct her fulfillment—and also by becoming a mother because she was taught that it would provide her fulfillment?

What if some forms of mental distress arise not because women have chosen careers or motherhood, independence or interdependence, but because the life they are living was written by someone else?

One of the most influential stories told to modern women is that autonomy is the foundation of a successful life.

Leave home. Obtain an education. Establish a career. Become financially independent. Delay permanent commitments. Do not allow a husband, family or child to restrict your possibilities. Discover yourself before allowing anyone else to need you.

Much of this arose as a legitimate reaction to conditions that severely restricted women’s choices. Economic independence can protect a woman from exploitation and abuse. Education can expand her intellectual and practical possibilities. No woman should be compelled to marry, bear children or remain in a destructive relationship because she has no viable means of survival outside it.

The problem begins when freedom to pursue a career becomes an obligation to define oneself through one.

A liberation movement can gradually turn into another system of measurement. Professional status becomes achievement. Domestic work becomes wasted potential. Marriage becomes dependence. Motherhood becomes an interruption. Needing other people begins to look like personal failure.

Yet human beings do need other people. We arrive helpless, live through networks of mutual dependence, and frequently leave life dependent once again upon the care of others. The completely self-sufficient individual has never existed.

A culture that celebrates independence while neglecting interdependence may leave women economically productive but relationally impoverished. Careers can provide purpose, accomplishment and community, but employers cannot necessarily provide love, permanent belonging or the assurance that one’s existence matters beyond one’s productive usefulness.

Some women will discover, too late, that the life they were encouraged to postpone was the life they actually wanted. Biology places limits on female reproduction that it does not place on professional advancement. A woman may receive a promotion at 42. Having her first child at that age is less certain.

This possibility deserves honest discussion. Treating motherhood as an inferior ambition is not liberation. Downplaying the biological limits of fertility does not expand women’s choices; it prevents women from making those choices with full knowledge of their consequences.

But that is only one side of the problem.

For generations, women have also inherited a very different message:

Become a mother because that is what women do.

The Cyber Care Café series Not This Time: 9 Cultural Scripts Unraveled examines some of the reasons women may become mothers without fully recognizing what is guiding them:

• Because That’s What Women Do
• To Keep a Relationship Together
• To Feel Like Someone Needed Me
• To Fix What Was Broken in Me
• I Wanted to Be the Parent Mine Couldn’t Be
• Because I Thought It Would Make Me Whole
• Because My Body Said So
• I Didn’t Mean To—It Just Happened
• Because I Thought It Was My Spiritual Purpose

These are not arguments against motherhood. They are questions about what we ask motherhood to accomplish.

A woman may sincerely want a child while also hoping, perhaps without admitting it even to herself, that the child will secure a relationship, provide an identity, heal an old wound, relieve loneliness, create a sense of purpose or make her feel complete.

Those needs are real. But a child cannot safely be made responsible for satisfying them.

A baby can make a woman feel intensely needed, but the purpose of raising a child is eventually to help that child need her less. A child may bring joy and meaning, but cannot repair every injury in the mother’s past. A woman may become a better parent than her own parents were, yet her child cannot return her to childhood and supply what she never received.

Motherhood may expose unresolved wounds as easily as it heals them.

If a woman entered motherhood believing it would complete her, she may interpret exhaustion, ambivalence or unhappiness as evidence that something is wrong with her. She was promised fulfillment. Instead, she may experience isolation, lost identity, financial dependence, resentment, monotony and the relentless demands of caring for another human being.

Once again, understandable distress may be translated into psychiatric language without the underlying conflict being recognized.

The problem may not be that the woman is mentally ill. The problem may be that she entered an irreversible role carrying expectations no human relationship could fulfill.

The independent-career woman and the self-sacrificing mother appear to represent opposite ideals. Psychologically, however, the scripts can function in remarkably similar ways.

Each provides a ready-made answer to a woman’s search for identity.

One tells her:

• You will become whole when you are independent, professionally successful and answerable to no one.

The other tells her:

• You will become whole when you become a mother and devote yourself to those who need you.

Both locate fulfillment in a prescribed destination. Both can discourage deeper examination of the woman’s actual motives, temperament, circumstances and desires. Both can make doubt appear to be failure.

The meaningful distinction is not between career and motherhood. It is between a life consciously entered and a life unconsciously inherited.

A career may be the right life for one woman and a costly diversion for another. Motherhood may be the deepest expression of one woman’s being and an unwanted role reluctantly performed by another. Many women will want both work and family, although the economic and domestic arrangements surrounding them may make that combination punishingly difficult.

There is no universal arrangement that guarantees psychological well-being.

The more important question is whether a woman understands what she is choosing, why she is choosing it, what it will require, what it cannot provide, and what consequences may follow if the cultural promise proves false.

There is an even more consequential limitation in any discussion that presents motherhood as a remedy for women’s loneliness, purposelessness or psychological distress.

There is another person in the decision.

A child should not be brought into existence primarily as medicine for an adult’s unhappiness.

That principle must apply whether the adult seeks personal healing, marital stability, spiritual fulfillment, family continuity or the restoration of society. The child cannot consent to the arrangement, cannot withdraw from it and must live with the consequences long after the parent’s original need has changed.

When Malone calls for more family, marriage and children, he is thinking about the institutions that give adults meaning and hold communities together. Those considerations matter. But they do not complete the ethical calculation.

We must also ask:

• What kind of life and what kind of world are adults asking a child to enter?

This is not an argument that the world must become safe or perfect before anyone has children. No generation has received such a guarantee. Children have been born during wars, famines, depressions, epidemics, migrations and periods of political upheaval. Many have nevertheless experienced life as worthwhile and contributed to making the world better.

But uncertainty does not remove responsibility. It increases it.

A prospective parent today must consider a world of economic insecurity, weakening community, pervasive surveillance, algorithmic manipulation, artificial intelligence, environmental strain, geopolitical instability and institutions increasingly capable of reaching directly into children’s minds and lives.

At the same time, a child born today may inherit extraordinary medical, intellectual, technological and creative possibilities. The future is neither wholly dark nor reliably benign. No parent can know in advance what balance of suffering, joy, loss, discovery and meaning a child will experience.

The responsible question is therefore not simply:

• Is the world good enough for children?

It is something more personal and demanding:

• Knowing what this world is and what it may become, am I prepared to help a new person understand it, withstand it and eventually act freely within it?

That requires much more than wanting a baby. It requires a willingness to raise an autonomous human being rather than create a permanent dependent.

“Because the world needs more families and children” can itself become another cultural script.

A child may be unconsciously assigned the task of giving a woman meaning, keeping two adults together, continuing a family line, reversing demographic decline, resisting modern feminism, restoring traditional civilization or proving that the parents still have faith in the future.

Some of these may be understandable reasons for wanting children. They do not necessarily justify creating one.

A child should not enter life already burdened with a mission to repair the adults or the civilization that produced her. She is not an instrument of maternal completion, political resistance, religious obedience, demographic policy or cultural renewal.

She is a person.

A woman has every right to ask whether motherhood would make her life richer, more connected and more meaningful. But the question cannot end there. Motherhood creates someone whose existence is not merely an answer to the mother’s needs.

The prospective child has no voice in the decision, yet will bear the consequences of that decision for a lifetime. To bring a child into the world because she will make an adult feel needed, repair a relationship, restore a culture or protect against loneliness is to assign her a task before she has even been born.

The ethical question is not only whether a woman wants a child. It is whether she is prepared to welcome a separate human being into the world as it actually is—without requiring that person to justify the decision that created her.

This brings us back to the reported mental-health crisis among women.

Some women may be suffering because they postponed or rejected family life in pursuit of an individualistic model of success that did not satisfy them.

Others may be suffering because they entered marriage or motherhood under the influence of expectations that bore little relationship to their own desires or circumstances.

Still others may be attempting to perform both prescribed lives simultaneously: devoted mother, attentive wife, successful professional, financially independent individual, attractive sexual partner, household manager and emotionally available caregiver. Failure in any one area can then be interpreted as personal inadequacy.

Add insecure employment, unaffordable housing, expensive childcare, weak extended-family support, unstable relationships and continuous comparison through social media, and distress becomes unsurprising.

The medical system encounters the woman at the end of this process. It can describe her symptoms, assign a diagnosis and offer treatment. In some cases, psychiatric care and medication may be necessary and lifesaving. Serious mental illness is real, and criticism of overdiagnosis must never become a reason to withhold competent care.

But diagnosis alone cannot tell us whether the woman’s life is livable.

Medication cannot supply a trustworthy partner. Therapy cannot make exhausting work meaningful. A diagnostic label cannot create community, provide affordable childcare, restore lost years, resolve an unwanted pregnancy or turn an unconsciously chosen life into a consciously chosen one.

Sometimes the source of the symptoms reside within the person.

Sometimes they are a response to the conditions surrounding her.

Sometimes they express the conflict between who she is and who she has been told to become.

The alternative is not a return to compulsory motherhood. Nor is it continued devotion to compulsory independence.

The alternative is greater consciousness.

Women need truthful information about fertility, relationships, motherhood, work, economic dependence and the lifelong demands of raising children. They need permission to examine their motives without being told in advance what the correct answer must be.

A woman should be able to say that she deeply wants children without being regarded as unambitious. She should also be able to say that she does not want children without being treated as incomplete, selfish or unnatural.

She should be free to recognize that she wants motherhood and a meaningful intellectual or professional life. She should be free to recognize that a culturally celebrated career is leaving her empty. She should be free to acknowledge that motherhood cannot be relied upon to heal what was broken in her—and that asking a child to perform that healing would be unfair.

Real choice requires more than the availability of alternatives. It requires sufficient self-knowledge to understand which voice is speaking when a choice is made.

• Is it desire?
• Fear?
• Loneliness?
• Biological urgency?
• Family expectation?
• Economic necessity?
• Religious teaching?
• The need to be needed?
• The hope of repairing the past?

Or a genuine willingness to accept responsibility for another person without knowing who that person will become?

Perhaps a significant part of the mental-health crisis is indeed a crisis of meaning, belonging and human connection, as Malone suggests.

But the remedy cannot be to hand women another script.

Marriage is not automatically intimacy. Motherhood is not automatically meaning. Employment is not automatically purpose. Independence is not automatically freedom, and dependence is not automatically love.

Any of these can become part of a good life. Any can also become the structure within which a person disappears.

The deeper question is not whether women should choose careers or children, independence or family. It is whether they can recognize the forces choosing through them.

And when the choice involves creating a new human being, the standard must become higher still. The decision must include not only the life the woman hopes to gain, but the life the child will be asked to live.

Women may become distressed when they discover that the promised life did not make them whole. Children may suffer when they are born carrying the unspoken responsibility to make their parents whole.

Both consequences begin in the same place: with a human life being assigned a purpose by someone else.

What looks like mental illness may sometimes be the anguish of living inside that assignment.

The answer is not necessarily more treatment, more independence or more children.

It may begin with something society rarely teaches young people to do:

• Recognize the script.
• Question its promises.
• Consider everyone who will bear its consequences.

Then decide whether the life it offers is truly your own.

This article was developed in collaboration with ChatGPT, based on original concepts, research, and editorial direction by Tony Lutz.