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The Twentysomething Treatment: A Revolutionary Remedy for an Uncertain Age

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The author of The Defining Decade explains why the twenties are the most challenging time of life and reveals essential skills for handling the uncertainties surrounding work, love, friendship, mental health, and more during that decade and beyond.

Seventy-five percent of all mental health disorders emerge by the age of twenty-five, and twentysomethings are more likely to face depression, anxiety, and substance abuse than any other age group. The pandemic has intensified this crisis, but it was underway well before 2020, in large part because young people and the professionals who treat them have rushed to prescribe pills, rather than helping them develop essential life skills for dealing with the uncertainties that abound in our twenties.

Medication is sometimes, but not always, the best medicine. For twenty-five years, Meg Jay has worked as a clinical psychologist who specializes in twentysomethings, and here she argues that most of them don’t have disorders that must be they have problems that can be solved. It is time to upend the medicalization of young adult life or else we risk hobbling—even sickening—an entire generation.

In The Twentysomething Treatment , Jay teaches us how to acquire essential skills such
-How to be social when social media functions as an evolutionary trap.
-How to befriend someone and why this is more crucial for survival than ever.
-How to love someone even though they may break your heart.
-How to make sex more fulfilling than you thought was possible.
-How to move, literally, toward happiness and health.
-How to face, rather than avoid, bad feelings so they won’t haunt you.
-How to cook your way into confidence and connection.
-How to change a bad habit.
-How to decide when so much is undecided.
-And how to choose purpose at work and in love.

Along the way, Jay shares dozens of rich, revealing stories of students and clients who are learning to embrace uncertainty and live full lives. The Twentysomething Treatment is essential reading for anyone who wants to find out how mental health gets better when we get better at life.

288 pages, Hardcover

Published April 9, 2024

199 people are currently reading
2349 people want to read

About the author

Meg Jay

11 books429 followers
She is a clinical assistant professor at the University of Virginia and maintains a private practice in Charlottesville, Virginia.

Dr. Jay’s book, The Defining Decade, was a 2012 Slate.com Staff Pick and her 2013 TED talk “Why 30 Is Not the New 20″ has been viewed more than 2 million times. Her work has appeared in the New York Times, Los Angeles Times, USA Today, Forbes, Psychology Today, and NPR.

Dr. Jay earned a Ph.D. in clinical psychology, and in gender studies, from the University of California, Berkeley.

At Berkeley, Dr. Jay was a research associate on the Mills Longitudinal Study, one of the longest-running studies of female adult development in the world. Her research on women, depression, and gender was funded by the National Institute of Mental Health, and was published in the Journal of the American Psychoanalytic Association and as the Symonds Prize article in Studies in Gender and Sexuality. Her work on the assessment of depression has been published in Psychological Assessment.

An award-winning lecturer, Dr. Jay served as adjunct faculty at Berkeley where she taught Clinical Psychology, Personality Psychology, Social Psychology, and Psychology of Gender. Dr. Jay currently supervises doctoral students in clinical psychology at the University of Virginia.

Dr. Jay has served as a fellow for the American Psychoanalytic Association, the Center for the Study of Sexual Cultures, and the Robert Stoller Foundation.

Dr. Jay earned a B.A. with High Distinction in psychology from University of Virginia. She spent her own early twentysomething years as an Outward Bound instructor.

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Displaying 1 - 30 of 160 reviews
Profile Image for Gauri Nguyen.
79 reviews2 followers
May 4, 2024
I had really high hopes for this book after reading The Defining Decade in my early 20s. It felt revolutionary at the time. The TwentySomething Treatment is really just harping everything most of us know - our generation is over medicated, we need to exercise, build relationships, meet people, etc. to be cope with uncertainty in our 20s. It didn’t feel like any new information was presented. Overall the book felt a little bit regurgitated, as if you took every self help book about uncertainty and gave it to ChatGPT to summarize. I suggest picking up Dr. Jay’s The Defining Decade instead and skip this one.
Profile Image for Jillian Lightbown.
95 reviews2 followers
June 17, 2024
This was a comforting read for me bc the main message throughout was that the 20s are for figuring it all out and it’s normal for that to feel uncertain and uncomfortable. This book gives guidance on how to accept the uncertainty and how to build some essential skills to not feel as bad in your 20s lol.

BUT big secondary message that people in their 20s are over medicated and instead of buildings skills we are given pills. I don’t have the background to comment on the truth of this statement but it felt like a bit of a dangerous claim IMO

2.5 xx
Profile Image for Alexandra.
42 reviews2 followers
November 21, 2025
I love a Dr Meg Jay book, big UVA pride and also the way she explains psychology is so accessible. I liked this one less than The Defining Decade but not bc of the writing, but likely because I didn’t know how much the TDD would resonate with me and this one I came in knowing she is filled with bars. This made me think about how we need to redefine the expectations and language surrounding our 20s. Glamorizing them and not heeding the level of uncertainty and change makes light of what is really challenging. This causes isolation and suffering. We need to talk more and talk more authentically. I love how she weaves her personal story in throughout this book along with the lessons. This story matters to her and you can tell! But also you can tell that she cares about this age range and not overly medicating and underly caring. This book has already prompted conversations for me and has challenged me to be gentler when I reflect on my 20s. Great book!
Profile Image for Paige Bruland.
76 reviews
August 1, 2024
I feel like I have a lot to say about this one (but when have I ever written a short book review 🤪)

I’ll start off by saying I really had no idea what this book was going to be about, but just got it recommended to me from a friend. I thought it was going to be really similar to her book “the defining decade”, and that it would talk more about actions to take/advice for how to make our 20s great. It really wasn’t like that at all. The overall message of the book was that most people don’t need medication for anxiety/depression like they think they do. After that, it followed the same structure as “Maybe You Should Talk to Someone”, and was her interviewing her patients and talking them through their problems. I liked this portion, but it wasn’t as groundbreaking as I was maybe expecting it to be?

Her claims and opinions on medication for anxiety/depression being overprescribed are very bold. She doesn’t tread sensitively around this topic and it was kind of hard for me to read as it challenged my belief system a lot - I believe medication can be super helpful for mental health struggles. She does have a very interesting viewpoint and I agree with her “skills over pills” statement; that without “skills” (therapy, reading mental health books, journaling, chatting with friends/family about our mental health troubles), pills (depression/anxiety meds) will not cure your mental health troubles long term/essentially won’t fix your problems at all.

Her way of writing (and the type of therapist she is) is no-nonsense. She does not coddle her patients at all, which personally wouldn’t work for me - she’s a little too frank for my liking. However, she offers really great viewpoints and is obviously an excellent professor, author, and therapist.

I especially liked the chapter on work, and how work is a very helpful tool and learning experience for those in our 20s. She talks about how it is the only certain thing for twenty somethings, and how no matter what else is going on in life (relationships, health troubles, mental health concerns, etc.), just get up and go to work and that will help you through it. She also really emphasizes the importance of hope for your future, and not putting too much pressure on yourself for making decisions/the what-it’s which is something I really struggle with.

Not my favorite mental health book ever (No Bad Parts still takes the cake on that one, Take Back your Brain, and Burnout are light years ahead of this one for me), but I really did like it, learn from it, and love the work that she does. Ok I’m done :)
Profile Image for Jessica Lelli.
40 reviews
January 24, 2025
It rlly helped me get my head straightened during a really stressful time. It helped me think through the things that made me anxious (i was making myself anxious), and helped me break things down and realize that what I’m feeling is normal. It was a good book to start with during the perfect time (I’m 23).
Profile Image for Sydney Eshbaugh.
135 reviews11 followers
June 17, 2024
The Defining Decade remains a personal favorite of mine, so I had high hopes for The Twentysomething Treatment. While this book may not have lived up to its predecessor, it still serves as an important reminder for twentysomethings. The recommendations presented are not necessarily groundbreaking, but the emphasis on functional health and embracing uncertainty is still impactful and very much needed in this generation. I remain a big fan of Dr. Jay!

Thank you to NetGalley and the publisher for the eARC in exchange for an honest review!
Profile Image for Jensen.
16 reviews
July 26, 2024
For content this is a 5, but it’s a lot of obvious stuff that’s probably not going to blow your mind, albeit written in a concise and compelling style. The Defining Decade was more focused and had a more unique approach to thinking about young adulthood, whereas this is more general and focused on overall well being, especially psychological. In the end it’s a good quick read and did make me feel better about living with uncertainty!
Profile Image for Sidney.
156 reviews
December 17, 2024
Meg jay does it again! I love her writing, research, and approach to living in your twenties. It is insightful without being too prescriptive and really got me thinking. I can’t recommend this (and the defining decade) enough

Quotes that stuck out to me (brain dump)

- Being in your twenties can feel like being in the middle of the ocean and not knowing which way to swim
- Being a twentysomething is like being an airplane soaring up into the sky just after takeoff. It's a time when a small change in course can make an enormous difference in terms of where you land with work, and love, and life.
- the best way to navigate that uncertainty and wind up somewhere better is to learn how to fly your plane. The skills you gain in your twenties accompany you wherever you go and y hey never run out.
- Key routes to better mental health: education, experience, expectation
- The brain interprets uncertainty as danger (evolutionary it was unsafe to not know what’s around the corner)
- One way to reduce the unknowns is to INCREASE what we know how to do (skills)
- Their own sense of incompetence left them feeling unsettled and insecure
- Having more skills will not only lead to higher income, but also a better work-life balance, leadership opportunities, and greater purpose
- Reassurance junkies: looks to others for reassurance of what is “right” (no one knows)
- Every time we reach out for reassurance we undercut our self assurance (confidence building skills)
- Owning your choices is how you own your life
- No one has the answers to your life, the answers will come from your experiences (with other people)
- The body prepares for what the brain perceives is coming (placebo effect AND if we believe we have a diagnosis that can become entrenched with our personality instead, even if it is a self diagnosis) this is dangerous
- In 2022, one is FOUR (25%) of young adults were taking a psychoactive medication (“they do help anyone grow”)
- By around age 35, most young adults report feeling less depressed, less anxious, less angry, less moody, and less reactive-and they also report experiencing more of the good stuff. By your mid-thirties, you're likely to feel more confident, more responsible, more decisive, more positive, more intentional, more ambitious, more persistent, more socially competent, and more future-directed

- Smart wiring: what your brain sees, hears, and does every day (outside experiences become who you are on the inside)
- Young adult struggles are normal and purposeful: they prepare us for what’s ahead

- Mindfulness is NOT about getting rid of discomfort, it’s about ACCEPTING discomfort. Don’t try and cleanse your breath, there is nothing dirty about what you feel
- Normalizing is so importance

- GO INTO THE OFFICE: power of proximity
- Only practice will help you get better at talking to people you don’t know
- FRIENDS are how we move from our attachment from parents to partners
- If you want to have a friend; you need to be a friend.


- MOVE. especially with other people. It will put you in a better position to solve your problems
- Eating more plant based foods was equal to moving from unemployed to employed.
- Learn how to cook
- IT TAKES TIME TO BUILD A GOOD LIFE
- Do you want to be doing X in five years? Then why are /aren’t you doing it now?
- Estimated 80% of life’s most consequential decisions are made by around 35
- You have one big decision. Decide how to live
- Regret: we can never truly compare the choices we make with the ones we didn’t make. We can never know because those scenarios don’t play out for us
- Identify and prioritize your own success metrics (learning and expansion). Don’t score yourself with anything else
- Work on finding your purpose. It takes time so it’s okay, but get comfortable exploring g your WHY. There are different purposes for different seasons of life!
- Our purpose is what WE suggest matters more in our lives
- Hope is having positive expectations on the future. It is also the strongest predictor of wellbeing and mental health
- The evidence: you have a track record of making good things happen for yourself
- Hope strategies: think about your future self, make a plan for her, save money for her, spend time with her
- To be hopeful means to be uncertain about the future, to be tender towards possibilities, and to be dedicated to change. Hope begins with uncertainties and unknowns
- For life to exceed our expectations we MUST venture into the unknown (we enjoy things more when there is mystery/suspence)
- Reach for people instead of things, let them like you
31 reviews
July 9, 2024
Everyone in their 20s should read this book it’s like a research driven approach to feeling less terrified of being in your 20s but with easy-to-read writing🌟🌟🌟🌟🌟
Profile Image for Mina.
121 reviews1 follower
December 18, 2024
This was awesome. It is definitely one I will return to for myself and to equip me to better support others.
Profile Image for Lydia.
33 reviews23 followers
November 4, 2024
Meg Jay you have done it again. Your books always find me at exactly the right time. Useful, balanced, thought-provoking and above all else, hopeful.
Profile Image for Maggie Gottfried.
15 reviews1 follower
December 29, 2024
As a twentysomething, this was a great read and an interesting perspective on approaching uncertainty and the unknown. Definitely carrying some of this advice with me in the coming years. This being said, I think everyone’s approach to mental health is different depending on your needs and it is important to keep this in mind when deciding your own opinion about this read. <3
Profile Image for Helene Holland.
1 review
April 16, 2025
I think Jay successfully boiled down young adult struggles to their core, and she does so in a beautifully clear and digestible writing style. While not every idea may be groundbreaking to everyone, she does a good job of reframing perspective on issues like mental health and your twenties as a whole. The thing I most appreciated about this book is that she didn’t claim to offer a solution to all of your problems, or speak in an overly objective tone—Jay illustrates the power in accepting inevitable hardships while still guiding the reader towards their own path to a happier future. One thing I will say in terms of enjoyability is that I had difficulty finishing the book towards the end as it began to feel a bit repetitive, but overall I’m really glad I gave this a read.
Profile Image for Makala Irvin.
39 reviews1 follower
May 24, 2024
I think every 20 something who feels uncertain should read this book. Be kind to your mind, it’s still developing.
Profile Image for Nuria López .
6 reviews2 followers
March 18, 2025
Moito mellor do que me esperaba! O primeiro libro da autora tiña ideas interesantes, pero notabase o "desfase" ca actualidad; algo que non pasaba con este.

Suelo ser bastante escéptica cos libros como este con "self-help vibes", pero cada cosita que comentaba viña co seu apoio científico. Aínda así, mezclar con historias anonimizadas dos pacientes creo que baixa bastante "as teorías á realidad".

Non me fixo boom a cabeza con nada, pero paréceme un libro bastante hopeful.

Fun facto: resulta que "young workers will have, on average, nine different jobs by the age of 35" (contexto US, pero tranquilizador, para esta Barbie multiempleo 🥸)
27 reviews
November 6, 2024
I needed this book. I did not expect to be sobbing at work by the last chapter of a non-fiction book. But I did. The book felt like a reassuring hug that said I know it’s hard but it gets better. Although this sounds like coddling, but it was far from it. The book gives you practical tips to get better with uncertainties and does not in anyway encourage you to romanticise your suffering. So yes, if you’re a 20 something, this is worth the read
8 reviews1 follower
September 8, 2024
Overall helpfully to read and I took away some good titbits of wisdom. However, she made some very broad, bold and honestly insensitive claims about the use of medication to treat mental illness.
I have read her more famous book, the defining decade, and noticed lots of criticism that she is condescending, which I certainly found to be the case with this book.

In the end, I think this book does have some very good honest advice for young adults, and I found it refreshing that it gives a different perspective than most of the self-help advice circulating right now (I.e- “put yourself first”, “if anyone disagrees with you they’re toxic and you should cut them off”).

In short, this is one of those books where it’s best to be a discerning reader and take the advice that you find helpful but leave the other advice behind.
Profile Image for Benjamin Booker.
12 reviews
November 4, 2024
Such an incredible book. Both this book and the defining decade by Meg Jay should be read by everyone 18-35. It's difficult to be comprehensive on the topic of mental health in your 20's and 30's but she touches on many topics that are typically difficult during this life period. In it she argues that this time period is one of the most difficult and stressful in life because of the exponential growth that is happening and the dangers of prescription medicine for misdiagnosed depression and anxiety and ADHD. She touches on depression and anxiety, ADHD, troubles making friends, romantic relationships, porn addiction, and many more topics. Reading these books is like having a therapist in your back pocket.
Profile Image for Erin O'Brien.
63 reviews1 follower
January 13, 2025
Dr. Meg Jay dominates again. If you liked The Defining Decade, you will love the twentysomething treatment. It was so spot on, prevalent, and relatable all while being backed by science and data. I highly recommend to anyone in their twenties - especially those who might be looking for guidance, reassurance, or support in just about anything. Whether it’s friendship, love, cooking, exercise, or medicine, Dr. Jay covers it all and empowers you to be the best you can be.
Profile Image for Flossy Bulsara.
18 reviews
January 14, 2025
This authors previous book had a profound impact on my life when reading in 2020, then again in 2023. I appreciated how this book had chapters you could come to and also skip if they weren’t necessarily relevant to you. Has chapters on ‘how to. ‘ There isn’t anything revolutionary about this book but I find this topic interesting. Her main point is to embrace uncertainty in your twenties
Profile Image for hunter.
96 reviews
September 6, 2025
4⭐️ another banger from meg jay herself. having read dr. meg jays other book, the defining decade, i knew what i was getting into with this. she taught a lot about the epidemic of twenty something’s being prescribed psychoactive drugs for symptoms that are likely very temporary. more than that, she dove into why a lot of the symptoms that could be perceived as a mental health condition (depression, social anxiety, etc) are likely just a reflection of the time of life we are in and not that there is something worth a clinical diagnosis and prescription. it had a lotttt of great reminders about our twenties being a time period where things will feel unstable and that it’s okay!
Profile Image for Sarah Taylor.
184 reviews
August 18, 2024
Dr. Jay's books are such a nice reset for my worrying mind - her main message is to embrace the uncertainty of your twenties. It's normal to be anxious and worry about the future, but the answer isn't to try to control every variable. Instead you should go out and live your life and accept that you won't always know what will happen. Great advice :)
Profile Image for ashe.
70 reviews
November 22, 2024
I haven’t read one of those self help/understanding books that I actually feel is helpful — but this, this is something completely different and I would easily recommend this to anyone even if you’re not “twentysomething”.
Profile Image for Margaret Lee.
104 reviews
July 27, 2024
A lot of this wasn’t groundbreaking — and some of it was pretty condescending…? But the chapters on decision making and purpose redeemed it from being a 2 star read.
Profile Image for Victoria Welker.
23 reviews1 follower
May 20, 2025
Not necessarily as relevant to my life as the defining decade was, but as always Dr. Meg Jay stands on business.
Profile Image for Caroline Lemieux.
78 reviews2 followers
July 16, 2024
so eye opening but also so validating, highly recommend for every “twentysomething”
Profile Image for Grace.
660 reviews
August 19, 2024
I enjoyed this one more than the Defining Decade since it felt less fear-tactic based. Interesting topics and a quick read.
Displaying 1 - 30 of 160 reviews

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