Ask a parent what’s going on with their Gen Z son, and you’ll usually get a shrug, a worry, or both. On this episode of the Men’s Therapy Podcast, host Marc Azoulay reconnects with an old friend, Joanna Lilley. She is a therapeutic consultant and host of the podcast Success is Subjective. She spends her days working directly with young adults navigating exactly this territory.
Joanna explains what a therapeutic consultant actually does (spoiler: it’s not crisis intervention, and it’s not long-term therapy either), then walks through what she’s seeing across hundreds of conversations with Gen Z men: rising anxiety, isolation, screen-fueled body dysmorphia, and a wave of self-diagnosed mental health labels borrowed from 30-second TikTok clips. The conversation gets into the real danger of medicating a teenager based on an Instagram diagnosis, why young men are splitting into two extremes (rejecting masculinity entirely or diving headfirst into the manosphere), and why Joanna thinks the fix isn’t more labels or more information, it’s teaching young people how to actually think through a problem. It closes with concrete, practical advice for any parent wondering how to talk to their son about masculinity, gender, and mental health without shutting the conversation down.
This episode is for parents of teenage and young adult sons who sense something is off but don’t know where to start. It’s for anyone who has watched a young man self-diagnose on social media and wondered how seriously to take it. And it’s for therapists, coaches, and anyone working with Gen Z who wants a clearer read on why this generation responds to labels, screens, and mental health language so differently than the ones before it.
Joanna describes her role as sitting between crisis intervention and long-term therapy: she assesses a young adult’s situation, researches the right resources, and works with them over roughly three months to build and start executing a plan. She’s clear that she isn’t the person for a 24-hour emergency; her work is for the slower-burning situations where something clearly isn’t working, parents have tried everything they know, and a neutral third party might be able to get through where family conversations have hit a wall.
Joanna points to a generation navigating a genuinely unstable set of outside forces, economic uncertainty, political noise, and climate anxiety, at the exact developmental moment they’re supposed to be building independence and identity. The result, she says, is avoidance, isolation, loneliness, and anxiety that often spirals into obsessive or ruminating thought patterns, compounded by a level of social disconnection that persists even when people are standing in the same room together.
According to Joanna, COVID pushed an entire generation onto video calls for the first time, forcing young people to stare at their own faces for hours a day in a way no generation has before. Combine that with a constant diet of fitness influencers and easily accessible porn, and Joanna says it creates close to ideal conditions for OCD and body dysmorphia to take hold, a pattern she now sees as one of the most common issues young men bring to her.
Joanna sees young people arriving with a list of self-diagnosed or algorithm-fed labels, narcissism, ADHD, and bipolar disorder, often absorbed from short-form content rather than any clinical assessment. Her concern isn’t that young people are talking about mental health; it’s that they’re building an identity around labels that may not even apply to them, and that this becomes especially dangerous once medication enters the picture.
Joanna is direct that psychiatric medication prescribed off a self-applied label, rather than a real clinical picture, can put a developing brain on a path toward genuinely serious mental health issues. She draws a sharp contrast with how carefully parents talk about substances like marijuana affecting a teenage brain, while sometimes moving quickly toward prescription medication for the same developing brain.
Marc and Joanna discuss how young men, watching a stream of public figures behaving badly, often respond by either disowning masculinity altogether or doubling down in hyper-masculine online spaces. Joanna connects this to a broader pattern she sees in young adult thinking: very little tolerance for the grey area, it’s all-in on one identity or all-in on its opposite, which she says mirrors patterns she’s read about in fanaticism and cult psychology.
Joanna’s advice starts with parents managing their own reaction before trying to manage their kids’ choices, since a parent’s fear and overwhelm tend to shut communication down rather than open it up. Marc adds his own framework here: seek to understand before lecturing, model the behaviour you want to see, and expose your son to other adults you respect, since young men are often more receptive to guidance from someone outside the immediate family.
Joanna offers three starting points: listen to podcasts (including her own, Success is Subjective) that normalize nonlinear paths and asking for help, get outside and moving while doing it, and get yourself a therapist or coach before trying to fix your child. Her core point is that you can’t ask a young adult to put their oxygen mask on if you haven’t put on your own first.
Joanna Lilley can be found at her website. You can also find her podcast, Success is Subjective.
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