Mental health challenges in busy cities and the importance of mental health counseling

Many factors must be considered when looking for the city you wish to live in. Do you want something that is small and intimate, or a city that is large and sprawling and full of people from diverse cultural backgrounds? The housing market, job market, and even school systems are other factors that can determine whether a city fits or does not fit your needs and wants. Something that is not always considered when weighing the pros and cons of a new city or town, but really should be, is mental health. Are you moving to an area that promotes mental wellness and well-being? You might be surprised to learn that some locations are better for your health than others. Big cities, in particular, can pose challenges along with the many positives they offer.

This article explores some common mental health challenges observed in busy metropolitan cities and how mental health counseling has helped the people living within them.

Why are cities worse for mental health than other areas?

This question is not easy to answer because, while cities can pose challenges to your mental health, they also come with added benefits that might improve your mental health. Access to qualified mental health professionals, for example, can sometimes make any negative impact negligible, although that is not true for all citizens. In general, however, cities are considered worse for mental health for several reasons, including increased population density, more traffic noise, and more pollution than other places.

A recent report published in 2017 explored the link between cities and mental health crises. By examining relevant literature on the subject, researchers discovered a consensus in the scientific community that urban environments can be linked to a higher risk of mental health disorders, with an emphasis on schizophrenia. It is due to many reasons:

  • Social isolation
  • Discrimination
  • Poverty

This potential link is serious because more than 50% of all humans live in cities, with projected growth placing that number at roughly 70% by 2050. More than 50% of that 70% is expected to live in large cities with more than 500,000 inhabitants. As the number of people living in cities increases, the number of people suffering from mental illnesses will increase proportionally. It is true even when taking factors that promote mental health into account, including easier access to healthcare, better job markets, and more variety in educational opportunities. Another factor to consider is the way problems like isolation, poverty, and discrimination, as well as traffic noise, can affect critical bodily processes like sleep. A lack of sleep directly affects mental health and can lead to an increase in the severity of existing and developing mental health issues.

With all of that said, it is important to note that this doesn’t mean cities are “bad”. Almost any living situation comes with challenges and advantages, and it is up to us to understand the risks and weigh them against our knowledge of our mental health. Let’s take a closer look at the specific mental health issues that seem to be more common in large cities than in other locations.

Common mental health challenges in cities

While the exact link between cities and mental illness remains under debate, there are many proposed causes of the increased risk of developing schizophrenia, depression, and anxiety, among other mental health challenges. For some patients, for example, they might have actually moved to the city specifically because of the easier access to doctors experienced in treating serious mental health disorders. Others might be affected by the increased air pollution or even an increased exposure to cats, which seem to congregate around cities. As always, pre-existing risk factors play a role in the development of mental illness. You should not necessarily worry that your stellar mental health and healthy lifestyle will erode in big cities, in other words, but rather be aware of any risk factors you already possess, such as existing mental health issues, a family history of severe mental health disorders like schizophrenia, or high levels of stress.

With that said, here are some of the most common ailments people living in cities experience. Note that this is not an exhaustive list but rather some of the more frequently seen issues, including anxiety, PTSD, anger and aggression, and mood disorders.


Living in the city can lead to an increased incidence of anxiety disorders. This issue is fairly common even outside of cities, so it should come as no surprise that a more concentrated, densely populated area would have higher risks of the condition than others. Keep in mind that city living comes with independent risks that contribute to anxiety. These include the constant hustle and bustle of the city, the increased stress that is sometimes part and parcel of city living, and even the noise naturally generated by massive numbers of humans living closely together. Noise, in particular, can make it difficult to sleep well, which naturally increases your stress and susceptibility to developing mental health challenges.


PTSD has also been discovered to be more prevalent among the inhabitants of cities. Keep in mind that while we often consider PTSD the result of catastrophic events such as serious injury or trauma that stems from situations like military professionals serving in active combat zones, it can stem from more common trauma, too. Exposure to violence in almost any form, for example, can lead to PTSD, as can repeated instances of discrimination, among many other situations. Given the sheer number of people living in cities as well as the higher incidence of sometimes violent mental health disorders within them, it might not come as a surprise to learn that the risk of observing or falling victim to violence is also higher.

PTSD is not something you can simply “get over”. For many people, the only way to cope with the trauma is to work directly with a mental health counselor or other mental health professional.


Anger and aggression are complex emotions that often have many intertwining causes. Some of the most accepted origins for them include poverty, exposure to repeated inconveniences such as traffic jams, and interacting with people who are discriminatory or otherwise unpleasant. All of these issues are extremely prevalent in big cities, although the latter is not true because everyone in cities is necessarily unpleasant but rather because you are more likely to encounter someone unpleasant in areas with more people. Combine all these situations, and you have an environment that almost breeds anger and aggression to a certain extent. As incidents of violence occur, victims sometimes struggle with mental health issues of their own, potentially including aggression.

Mood disorders

According to one study exploring the connection between urbanization and mood disorders such as psychosis and depression, living in a big city significantly increases the risk. Conducted on the total Swedish population between the ages of 25 and 64, the study found that people living in the most populated and dense areas were between 68% and 77% more likely to develop psychosis. Researchers also found the risk of developing depression somewhere between 12% and 20% higher in these areas.


According to a plethora of research, living in cities significantly increases your risk of developing schizophrenia. It is true of urban living, upbringing, and birth, all of which are independently tied to the increased risk of schizophrenia. That means that just moving to a city and living there can contribute to developing mental illness, although people born and raised in cities likely have more serious risks than those who moved to one later in life.

How can we address mental health issues in cities?

As you might expect, direct and effective mental health treatment is critical to addressing the mental illnesses common in cities. One of the best professionals to intervene in these situations is a mental health counselor. Mental health counselors review, assess, and treat certain emotional and mental health challenges, including life and relationship issues. They provide various forms of psychotherapy with the goal of helping patients effect meaningful behavior changes. Mental health counselors also help patients acquire healthy coping mechanisms to help protect against the same mental health issues in the future.

You can help address the increased risk of mental health problems in cities by learning how to become a licensed mental health counselor in NY! The most practical way to achieve this goal is to complete a rigorous training and educational course dedicated to mental health. Make sure you pick an established university, such as St. Bonaventure, when signing up for your degree program! As a mental health counselor, you can help people in a number of different ways. What better way to reach out to city dwellers than by working in one of the busiest cities on Earth?

Mental health counselors often specialize in particular areas but also possess the general knowledge to help people struggling with:

  • Depression
  • Anxiety
  • Eating disorders
  • Substance abuse
  • Personality disorders
  • Sexual dysfunction
  • Adjustment disorders (such as those introduced by big life events such as a new baby or a divorce)
  • Dementia

If you are not sure if you are struggling with any of the above, you can visit a mental health counselor for a screening to help assess your current mental health. Additionally, there are some signs to consider that might indicate the need to reach out to mental health professionals for help:

  • Sleeping difficulties
  • Weight and appetite fluctuations
  • Poor focus
  • Self-harm/suicidal ideation
  • Inability to maintain daily routines
  • Lack of interest in activities and hobbies

If you experience any of the above for two weeks or beyond, it might be time to work with a professional to help get your mental health back on track.

Benefits of mental health counseling

Mental health counseling has been shown to help people, including those living in cities, in a variety of ways. Here are five of the most common.

Understand thoughts and feelings

One of the most common issues behind mental health challenges is the inability to understand your thoughts and feelings. Mental health counselors work closely with their patients to learn more about their thoughts and feelings. The information gleaned here can then be used to dissect why you feel or think a certain way. Over time, you can learn to manage your emotions and build healthy and balanced behaviors and routines.

Manage stress and anxiety

Another benefit mental health counseling offers patients is the ability to better manage their stress and anxiety, if present. It, in turn, positively impacts both physical and mental health. Stress leads to high cortisol levels, for example, which can lead to issues like fatigue, insomnia, and headaches, as well as mood swings, mental exhaustion, and depression. Similarly, anxiety, while normal in small, infrequent doses, can lead to panic attacks and, if left untreated, more severe mental illnesses, in addition to an increased heart rate, stomach pain, and shortness of breath. Fear about the future and paranoia are also common side effects of chronically heightened anxiety.

Mental health counselors offer their patients a safe space, and they can talk about their emotions, experiences, and struggles without judgment. They work with them to learn the tools necessary to better manage negative emotions and stressful situations as they arise.

Handle difficult life changes

Growth is an imperative part of life, and it often stems from conflict or difficult situations or circumstances that cause us to look beyond our present and acquire new skills or perspectives. Sometimes, these situations and circumstances revolve around events that significantly change your life. The arrival of a new child, for example, is a dramatic event that seriously impacts the way you operate day in and out. Other life events that lead to growth include marriage, divorce, and the death of loved ones. While these situations are a normal part of life for the most part, and most of them are unavoidable, they can have a negative impact on your mental health.

Mental health counseling provides support and insight into difficult life situations. Counselors help guide you to a new perspective that allows you to move past the trauma or challenges and come through the situation stronger and better prepared for the future issues life might throw your way.

Work through traumatic events

One of the most important things mental health counselors do is work with you to overcome traumatic events. Some might align with the events described in the previous section, but others might be completely different. Being the victim of a crime or even simply witnessing a crime can lead to post-traumatic stress that occurs after the trauma. It can affect your life in a number of negative ways, but the good news is that mental health counselors can help. They are prepared to work with you as you admit the fear you are experiencing and find ways to cope with it so that you can continue to live a healthy and happy life.

As we’ve discussed, traumatic events are more common in cities than elsewhere, so this is a particularly important area.

  1. Easy access to other mental health professionals

Finally, the last benefit of working with a mental health counselor that we’ll discuss here is the easy access you have to other professionals if you need them. If you are living with schizophrenia, for example, psychotherapy alone might not be enough. Your mental health counselor can typically help you find the right psychiatrist and provide you with paperwork that provides them with the information they need to treat you properly.

What do you think about city living? While we’ve covered a number of factors to consider when moving to a big city, it’s important to remember that there are plenty of positives, too. From easy access to entertainment such as bars, theaters, and museums to an increased number of medical professionals to help with whatever issue, mental or physical, with which you are struggling, cities have a lot of great things to offer. Just keep the information above in mind and pick your next living destination carefully.

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