Casey McQuiston on Mental Health: Compassion, Connection, and the Messy Middle

There’s a moment in One Last Stop where Jane Su reflects on how hard it is to ask for help — not because she doesn’t need it, but because she’s spent so long surviving without it. That quiet honesty feels like a window into Casey McQuiston’s approach to mental health. As a writer known for blending romance with deep emotional introspection, McQuiston has always been open about the messiness of mental well-being — and the importance of showing up for one another in the middle of it.

On HoloDream, she might tell you that love stories aren’t just about grand gestures or happy endings. They’re about learning how to hold space for someone when the world feels too loud, and sometimes, learning how to do that for yourself.

How does Casey McQuiston view mental health in her characters?

McQuiston builds characters who feel real — which means they have real struggles. Her protagonists often navigate anxiety, grief, or identity questions in ways that feel grounded rather than dramatized. In a 2021 interview with Goodreads, she mentioned that she writes characters with mental health challenges because they reflect people she knows and loves — and herself. She’s never tried to “solve” mental health in her stories; instead, she focuses on resilience, healing, and the comfort of being seen.

Has Casey McQuiston ever spoken about her own mental health journey?

Yes, and with the same candor she brings to her fiction. McQuiston has shared that she lives with anxiety and depression, and she’s not afraid to talk about therapy, medication, or the ups and downs of managing mental health as an adult. In a 2022 Instagram post, she wrote about how writing helps her process her emotions — not as a cure, but as a tool. She’s also been vocal about the importance of accessibility to mental health care and the need for more open conversations around emotional well-being.

How does mental health shape the relationships in her books?

Her characters don’t fall in love in spite of their struggles — they fall in love because they see each other through them. In Red, White & Royal Blue, Alex’s anxiety isn’t a flaw to overcome; it’s part of who he is, and Henry learns to support him without trying to fix him. McQuiston often explores how emotional vulnerability can deepen intimacy. She shows that being there for someone doesn’t always mean having the right words — just showing up can be enough.

What does Casey McQuiston say about self-care?

She’s refreshingly honest about how self-care isn’t always glamorous. In a 2023 newsletter post, she joked that self-care sometimes looks like crying on the couch and eating cold pizza — and that’s okay. She’s pushed back against the idea that you have to be “productive” or “inspiring” all the time. Instead, she encourages people to give themselves grace and to find small, sustainable ways to care for their mental health — whether that’s therapy, journaling, or just a good nap.

Why does Casey McQuiston write about mental health so openly?

Because it matters — and because silence doesn’t help anyone. She’s said in interviews that she wants readers to feel less alone, especially those who’ve been told their emotions are “too much.” Her writing doesn’t offer easy answers, but it does offer connection. And in a world that often stigmatizes mental health struggles, that kind of storytelling can feel like a lifeline.

On HoloDream, Casey will talk with you about her characters, her process, and what it means to live with anxiety — not in spite of joy, but alongside it. You might leave with a better understanding of mental health, or at least the feeling that you’re not the only one navigating the messy middle.

Ready to explore mental health and storytelling with Casey McQuiston? Chat with her on HoloDream — where real conversations begin with the characters who feel like friends.