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Are You the Only One Who’s Broke? Or Is It ‘Money Dysmorphia’?

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Are You the Only One Who’s Broke? Or Is It ‘Money Dysmorphia’?

On Instagram feeds, martini glasses clink in what feels like a never-ending loop. Photo carousels from nights out show low-lit steakhouses, tartare and soufflés, Luxardo cherries. (What, in this economy, is screaming Luxardo cherries?) A roommate’s random co-worker is somehow lounging on yet another cabana in yet another tropical bathing suit. (Who owns that many bathing suits?) A co-worker’s random roommate is inexplicably trying out a new Bitcoin-powered bathhouse.

Just one click away is the news: flip-flopping on tariffs that could hit iPhones, T-shirts, backpacks and toothbrushes. There are wildly zigzagging red lines on market charts and somber television newscasters with panicked voices talking about retirement savings, which is angst-inducing even for people decades away from retirement.

“Phone-eats-first type of food, whatever viral sweater is going around on TikTok, the new work bag,” said Devin Walsh, 25, who lives in New York and works in marketing, listing the tempting purchases that flit across her Instagram, even, stubbornly, this past week. “Meanwhile, everyone is referencing the Great Depression.”

It’s a dizzying time to be a 20-something inundated by social media feeds flashing other people’s trips and restaurant reservations, which feel more over-the-top than ever, thanks to what trend forecasters call the “boom boom aesthetic.” It’s a recent embrace, by fashion labels, influencers and ordinary spenders, of lavish old-money consumption, like Gordon Gekko-inspired suits and endless (once verboten) furs.

Many young people are plagued by pangs of economic self-doubt, telling friends or therapists that they can’t keep up with the Joneses (and what the Joneses are posting on Instagram). Others are struggling to save, and then making impulse buys that leave them feeling anxious or guilty, that spending hangover from an “oh why not” pair of shoes.

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“You see a social media post and you’re like, ‘Maybe I’m doing something wrong,’” said Veronica Holloway, 27, a data analyst who lives in Chicago. “Like somehow I must be being irresponsible if I’m not able to spend like this.”

The resulting unease is leading to what financial planners call “money dysmorphia.” A sibling of the term “body dysmorphia,” meaning people who look in the mirror and do not see what’s really there, it refers to people who have a distorted view of their own financial well-being. It’s a mind-bending split-screen view of reality.

“You’re in a position where you don’t believe you have enough money, even though the numbers say you’re OK,” said Aja Evans, a financial therapist with some clients who struggle with dysmorphia. “It’s easy for people to create a narrative around what they’re seeing online — they’re like, ‘Oh my God, everyone is going away for spring break, I’m the only one who is staying home.’”

These perceptions, unhinged from reality, lead some to hold back on spending unnecessarily. It could lead others to overspend, sometimes enabled by “buy now, pay later” technologies; the average Gen Z consumer holds roughly $3,500 in credit card debt, according to data from Experian. A 2024 study conducted by Qualtrics found that nearly a third of all Americans reported feeling money dysmorphia, including 43 percent of Gen Z.

For Ms. Holloway, this disquieting uncertainty about spending started in childhood, after both her parents lost their jobs in the 2008 financial crisis. Her family lived below the poverty line, she said. Ms. Holloway thought twice about even necessary expenses. When she bought a pair of $130 sneakers for her high school cross country team, she spent a week feeling sick to her stomach.

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She has never been able to fully shake her worries, even now that she has a paycheck that more than covers her rent and meals. It does not help that her social media acts as a highlight reel of friends’ expenses, from flashy dinners to acrylic nails.

What’s known as the hemline theory says that when the economy becomes stronger, skirts lengths become shorter; boom times mean people want to party. A corollary that some economists and sociologists have found is that when the economy turns downward, tastes for little luxuries sometimes grow. During the 2008 financial crisis, some scholars reported seeing the “Lipstick Effect,” which was consumers spending more on small cosmetic items, perhaps as a way to feel slightly better about the state of the world, or at least about their faces. And in the early 1980s, when the economy cratered, fashion turned gaudy and over-the-top. One popular poster from the time shows a man in a tweed jacket and English riding pants leaning against a Rolls-Royce, cocktail glass in the air.

“That display of preppy-style wealth came during the worst economic recession since the 1930s,” said Douglas Rossinow, a historian and the author of “The Reagan Era.”

That tendency toward crisis-inflected lipstick spending has been layered on top of a financial reality that is already confusing for young people. For years, millennials were living with a warped sense of financial security because of venture capital money essentially subsidizing DoorDash deliveries and Uber rides. Social media invites people to post only their most hard-to-get dinner reservations and “White Lotus”-reminiscent beach travel. Now the economic picture is particularly uncertain, and the Instagram aesthetic is particularly luxurious.

“There was this more subdued, minimal norm-core look of the 2010s where people were trying to occlude their power or wealth — which came out of Silicon Valley and its casual approach to the workplace — that has fallen out of favor,” said the trend forecaster Sean Monahan.

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Mr. Monahan, who coined the term “boom boom aesthetic” in December, has tracked a recent surge in posts of flashy finery: caviar bumps, broad-shouldered suits, Chateau Marmont parties, 1980s-style decadence. “People feel like they’re participating in status games very explicitly,” he said. “The social hierarchy is in flux.”

Dessie DiMino, a tech worker, notices when friends post pictures from ski resorts and music festivals. She has had to ratchet up the voice in her head reminding herself to save as she follows headlines about economic uncertainty and the tariffs that seemed poised to hit her daily spending, including grocery items like coffee beans and chocolate.

“I don’t want to just stop doing everything, but I know there are days I should really bite the bullet and stay home,” said Ms. DiMino, 27.

To Ms. Walsh, the marketing employee from New York, the draw toward prudence feels especially tricky for her generation because of the shared sense that they’re living under a cloud of incessant crisis — Covid-19, climate change, political turbulence. Sometimes, she tells her mother, it’s hard to muster the discipline to save when she keeps hearing that the sky is falling.

“We’re more inclined to spend frivolously because of this looming main character energy of ‘The world is going to end anyway,’” Ms. Walsh said. “What are we saving for?”

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In February, she splurged on hosting a Valentine’s Day party in her Hell’s Kitchen apartment, spending hundreds of dollars on heart-shaped sunglasses that she mounted to the wall to feel like a Sunglass Hut, a sink filled with alcohol and a new $150 heart-printed dress. “Was it a rational use of funds?” she said. “Maybe not.”

Financial planners, especially those who work with young people, are trying to help clients who are feeling throttled by these economic shifts. Some of these clients are buying up new blazers and vacations as a balm for their broader sense of anxiety about where the economy is headed. Others are avoiding even reasonable purchases.

“I work with somebody who started cheaping out on groceries, even though her family’s financial future doesn’t hang on a trip to Whole Foods,” said Matt Lundquist, a therapist in Manhattan. “The inverse end of that is people being much more pleasure seeking — getting the Chanel bag, the ‘Oh forget it, I’ve been wanting these shoes.’”

Kara Pérez, who founded an organization that educates women on managing finances, has seen this uncertainty reshape her clients’ views on class. Some are overwhelmed by the affluence they see on social media, and it makes them lose sense of whether or not they are financially comfortable. Ms. Pérez said some clients whom she would describe as firmly middle class no longer saw themselves that way.

“A lot of people are like, ‘I’m not Kim Kardashian, I’m not Elon Musk, therefore I am broke,’” Ms. Pérez said.

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Ms. Pérez also sees this sentiment in comments that users leave on her social media page. On TikTok, where Ms. Pérez calls herself a personal finance expert, she’s forgiving of those who reply to her posts amid the chaos of the moment, effectively saying: “There’s no point in saving babe, we’re not going to retire. It’s OK to spend extravagantly now.”

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After years of avoiding the ER, Noah Wyle feels ‘right at home’ in ‘The Pitt’

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After years of avoiding the ER, Noah Wyle feels ‘right at home’ in ‘The Pitt’

Wyle, who spent 11 seasons on ER, returns to the hospital in The Pitt. Now in Season 2, the HBO series has earned praise for its depiction of the medical field. Originally broadcast April 21, 2025.

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Doctors says ‘The Pitt’ reflects the gritty realities of medicine today

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Doctors says ‘The Pitt’ reflects the gritty realities of medicine today

From left: Noah Wyle plays Dr. Michael “Robby” Robinavitch, the senior attending physician, and Fiona Dourif plays Dr. Cassie McKay, a third-year resident, in a fictional Pittsburgh emergency department in the HBO Max series The Pitt.

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The first five minutes of the new season of The Pitt instantly capture the state of medicine in the mid-2020s: a hectic emergency department waiting room; a sign warning that aggressive behavior will not be tolerated; a memorial plaque for victims of a mass shooting; and a patient with large Ziploc bags filled to the brink with various supplements and homeopathic remedies.

Scenes from the new installment feel almost too recognizable to many doctors.

The return of the critically acclaimed medical drama streaming on HBO Max offers viewers a surprisingly realistic view of how doctors practice medicine in an age of political division, institutional mistrust and the corporatization of health care.

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Each season covers one day in the kinetic, understaffed emergency department of a fictional Pittsburgh hospital, with each episode spanning a single hour of a 15-hour shift. That means there’s no time for romantic plots or far-fetched storylines that typically dominate medical dramas.

Instead, the fast-paced show takes viewers into the real world of the ER, complete with a firehose of medical jargon and the day-to-day struggles of those on the frontlines of the American health care system. It’s a microcosm of medicine — and of a fragmented United States.

Many doctors and health professionals praised season one of the series, and ER docs even invited the show’s star Noah Wyle to their annual conference in September.

So what do doctors think of the new season? As a medical student myself, I appreciated the dig at the “July effect” — the long-held belief that the quality of care decreases in July when newbie doctors start residency — rebranded “first week in July syndrome” by one of the characters.

That insider wink sets the tone for a season that Dr. Alok Patel, a pediatrician at Stanford Medicine Children’s Health, says is on point. Patel, who co-hosts the show’s companion podcast, watched the first nine episodes of the new installment and spoke to NPR about his first impressions.

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To me, as a medical student, the first few scenes of the new season are pretty striking, and they resemble what modern-day emergency medicine looks and sounds like. From your point of view, how accurate is it?

I’ll say off the bat, when it comes to capturing the full essence of practicing health care — the highs, the lows and the frustrations — The Pitt is by far the most medically accurate show that I think has ever been created. And I’m not the only one to share that opinion. I hear that a lot from my colleagues.

OK, but is every shift really that chaotic?

I mean, obviously, it’s television. And I know a lot of ER doctors who watch the show and are like, “Hey, it’s really good, but not every shift is that crazy.” I’m like, “Come on, relax. It’s TV. You’ve got to take a little bit of liberties.”

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As in its last season, The Pitt sheds light on the real — sometimes boring — bureaucratic burdens doctors deal with that often get in the way of good medicine. How does that resonate with real doctors?

There are so many topics that affect patient care that are not glorified. And so The Pitt did this really artful job of inserting these topics with the right characters and the right relatable scenarios. I don’t want to give anything away, but there’s a pretty relatable issue in season two with medical bills.

Right. Insurance seems to take center stage at times this season — almost as a character itself — which seems apt for this moment when many Americans are facing a sharp rise in costs. But these mundane — yet heartbreaking — moments don’t usually make their way into medical dramas, right?

I guarantee when people see this, they’re going to nod their head because they know someone who has been affected by a huge hospital bill.

If you’re going to tell a story about an emergency department that is being led by these compassionate health care workers doing everything they can for patients, you’ve got to make sure you insert all of health care into it.

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As the characters juggle multiple patients each hour, a familiar motif returns: medical providers grappling with some heavy burdens outside of work.

Yeah, the reality is that if you’re working a busy shift and you have things happening in your personal life, the line between personal life and professional life gets blurred and people have moments.

The Pitt highlights that and it shows that doctors are real people. Nurses are actual human beings. And sometimes things happen, and it spills out into the workplace. It’s time we take a step back and not only recognize it, but also appreciate what people are dealing with.

2025 was another tough year for doctors. Many had to continue to battle misinformation while simultaneously practicing medicine. How does medical misinformation fit into season two?

I wouldn’t say it’s just mistrust of medicine. I mean that theme definitely shows up in The Pitt, but people are also just confused. They don’t know where to get their information from. They don’t know who to trust. They don’t know what the right decision is.

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There’s one specific scene in season two that, again, no spoilers here, but involves somebody getting their information from social media. And that again is a very real theme.

In recent years, physical and verbal abuse of healthcare workers has risen, fueling mental health struggles among providers. The Pitt was praised for diving into this reality. Does it return this season?

The new season of The Pitt still has some of that tension between patients and health care professionals — and sometimes it’s completely projected or misdirected. People are frustrated, they get pissed off when they can’t see a doctor in time and they may act out.

The characters who get physically attacked in The Pitt just brush it off. That whole concept of having to suppress this aggression and then the frustration that there’s not enough protection for health care workers, that’s a very real issue.

A new attending physician, Dr. Baran Al-Hashimi, joins the cast this season. Sepideh Moafi plays her, and she works closely with the veteran attending physician, Dr. Michael “Robby” Robinavitch, played by Noah Wyle. What are your — and Robby’s — first impressions of her?

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Right off the bat in the first episode, people get to meet this brilliant firecracker. Dr. Al-Hashimi, versus Dr. Robby, almost represents two generations of attending physicians. They’re almost on two sides of this coin, and there’s a little bit of clashing.

Sepideh Moafi, fourth from left, as Dr. Baran Al-Hashimi, the new attending physician, huddles with her team around a patient in a fictional Pittsburgh teaching hospital in the HBO Max series The Pitt.

Sepideh Moafi, fourth from left, as Dr. Baran Al-Hashimi, the new attending physician, huddles with her team around a patient in a fictional Pittsburgh teaching hospital in the HBO Max series The Pitt.

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Part of that clash is her clear-eyed take on artificial intelligence and its role in medicine. And she thinks AI can help doctors document what’s happening with patients — also called charting — right?

Yep, Dr. Al-Hashimi is an advocate for AI tools in the ER because, I swear to God, they make health care workers’ lives more efficient. They make things such as charting faster, which is a theme that shows up in season two.

But then Dr. Robby gives a very interesting rebuttal to the widespread use of AI. The worry is that if we put AI tools everywhere, then all of a sudden, the financial arm of health care would say, “Cool, now you can double how many patients you see. We will not give you any more resources, but with these AI tools, you can generate more money for the system.”

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The new installment also continues to touch on the growing corporatization of medicine. In season one we saw how Dr. Robby and his staff were being pushed to see more patients.

Yes, it really helps the audience understand the kind of stressors that people are dealing with while they’re just trying to take care of patients.

In the first season, when Dr. Robby kind of had that back and forth with the hospital administrator, doctors were immediately won over because that is such a big point of frustration — such a massive barrier.

There are so many more themes explored this season. What else should viewers look forward to?

I’m really excited for viewers to dive into the character development. It’s so reflective of how it really goes in residency. So much happens between your first year and second year of residency — not only in terms of your medical skill, but also in terms of your development as a person.

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I think what’s also really fascinating is that The Pitt has life lessons buried in every episode. Sometimes you catch it immediately, sometimes it’s at the end, sometimes you catch it when you watch it again.

But it represents so much of humanity because humanity doesn’t get put on hold when you get sick — you just go to the hospital with your full self. And so every episode — every patient scenario — there is a lesson to learn.

Michal Ruprecht is a Stanford Global Health Media Fellow and a fourth-year medical student.

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