Why Self-Care Isn't Enough

As a psychiatrist, people come to see me for help with their anxiety, depression, addictions, or any other label that fails to adequately describe why we suffer. These diagnoses take on a life of their own when we try to treat “the anxiety” instead of addressing the problem it’s attempting to signal.

We too often misplace the cause of our mental health challenges as problems within the individual, rather than symptoms of the ailing systems we’re all entangled within.

Yet our distress isn’t the problem; it alerts us to problems. It signals that the dynamic systems we depend on to survive—from our bodies to our social worlds, wider communities, countries, geopolitical relations, and ecosystems—need attention and care to bring them back to balance.

Because self-help alone only bandages a cut without stopping the source of the bleeding. We can’t be healthy by only trying to feel better in a sick world. We need to make a better world through actions that fix the problems that keep making us sick.

And right now, as our world is pushed to the brink of collapse, we need everyone’s alarms to sound loud and clear to bring all our systems back into balance.

We’re on the brink of World War III and the collapse of our climate; of runaway inequities and spiralling divisions; of the unraveling of our social structures and, ultimately, the self-inflicted extinction of our entire species.

These stresses harming our health aren't isolated: they’re all connected. When one system collapses—whether our health, social systems, global relations, or ecosystems—the entire system collapses, not just within our own bodies and borders, but for the whole world. We’re all in it together.

As each of us connects to every part of our planet through invisible links, “self-care” can’t only focus on what’s held within the boundaries of our bodies. To help ourselves, we must care for our collective — for all living beings and the ecosystems that support us all. An injury to any one part of our systems is an injury to ourselves. As UN Secretary-General Antonio Guterres explained at the 75th UN General Assembly, “Solidarity is self-interest. If we fail to grasp that fact, everyone loses.”

The first principle of ecological systems is how we’re all mutually interdependent within complex networks of life. We shift our perspective from parts to the whole, from objects to their many relationships, from a linear model of cause and effect to the complex ripples of multiple feedback loops, where altering any one part or linkage in the system impacts the whole in a myriad of ways.

As a result, we have both differentiated and linked selves, teaches Dan Siegel, a psychiatrist and researcher at the University of California, Los Angeles (UCLA). We inhabit a body that we traditionally define as "me." But our body is an open system, constantly communicating through invisible links to its environment. There is no us and them. We’re all intimately connected.

When the diseased dynamics of domination, division, and indifference corrupt our larger systems by severing our links, over-extracting and hoarding resources, and failing to share, our entire system spirals into disorder. If even a minority of us intrude on our living systems’ natural balance in this way, the whole world struggles to right itself back to health.

The fallacy of the competitive brand of individualism, with its divide-and-conquer approach to victory, is that even when we exert power over the other members of our living systems and “win,” everyone still loses. As the victors are part of the collective they’ve defeated, their actions are suicidal, and they’re taking everyone else down with them.

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Instead, self-care requires collective-care.

Caring for our collective doesn’t take away from our freedom. It’s not about conforming to the group or repressing our individual needs and desires. The rules of ecology demand diversity for our systems to survive. Our systems become more resilient by increasing the diversity of their individual parts, with each functioning in different yet overlapping ways to overcome the wide variety of challenges in our environments.

Collective care is simply recognizing that the healthiest living systems consist of diverse parts that work together to create a whole that’s greater than the sum of its parts. It’s knowing that we belong to something bigger than ourselves and honouring all our important differences and relationships in this web of life so that we can be healthy because the systems we inhabit are healthy.

As a therapist, I refuse to promote strategies that simply soothe our distress by “becoming more resilient” — so that we can continue to ignore our heathy alarms that our wider systems are spiraling out of balance. Instead, true resilience requires us to build our capacity to stay alert to these alarms and respond to their signals so that we can be healthy because our world is healthy.

This piece is adapted from my book, It's Not You, It's the World: A Mental Health Survival Guide for Us All (Harper Collins/Hachette/CanonGate 2026).