How Dr. K used Twitch and YouTube to bring mental health education to the masses

About 43 minutes into a livestream, Dr. Alok Kanojia, known more familiarly online as Dr. K, asks streamer and voice actor LilyPichu if she’d rather talk about a recent breakup or where she got the idea she’s not good enough.

Even for those well-versed in the more parasocial nature of livestreaming, it’s a surprisingly vulnerable scene. But for Dr. K and his guest, it’s expected, with this therapy-esque interview being one of the several formats he’s brought to Twitch and YouTube.

The Harvard-educated psychiatrist got his start on his Twitch channel HealthyGamer_GG in 2019. These days, that channel has 667,000 followers, while his YouTube channel has 2.94 million subscribers. On it, you’ll find videos on all things mental health, with titles including “Why You’re Struggling With Discipline,” “Stop Letting Social Anxiety Control You,” and “Getting a Girlfriend is NOT an Achievable Goal.”

In addition to the content he creates, Dr. K is also the co-founder and president of the company Healthy Gamer, where folks can find mental health guides, coaching, and community. In addition to the Healthy Gamer comment sections, there’s a Healthy Gamer Discord and an active subreddit with 143,000 members. He also wrote the book How to Raise a Healthy Gamer.

Below, we caught up with Dr. K to hear more about the experience of building this community up — and the lessons he’s learned along the way.

Why did you start making videos?

 What I found in my office with my patients was that everyone was facing the same problems. And most of what I was doing was not therapy with my patients. It was educating them. So I started to realize that what people are missing is an understanding of how they work: How does the mind work? Where does depression come from? How do we get depressed? Where does anxiety come from? I was like, OK, I’m having the same conversation like 15 times in a week. So I started to develop talking points. And then I was like, “OK, can I just share this with everybody, and would it be helpful?” And that’s what I started doing, and it turned out that it is helpful.

When you considered how to share that information, was making YouTube videos the first thing that came to mind?

 No. I started streaming on Twitch. I’m a gamer, and I really love teaching, so that’s where we started out. And then I think what we realized on Twitch is that things only live there for 30 days. And a lot of the questions, like, if someone asks about how do I cut back on pornography use, that stays an important question for years. So we really started focusing on YouTube to create a storehouse of resources for people.

When you started out, was it just you running the show?

Yeah.

What was that like?

 I had an intern help me set up my camera. Then, quickly within the first two months, I looked at the metrics. My goal was to have 100 concurrent viewers by one year in. So I was like, “OK, if I can have like five new viewers by the end of the month, like that’ll be a win.” And then it started going really fast. Within the first 45 days of my first stream, I had two or three people starting to help me out, because they started building emoji and helping me with managing chat, moderating things, and moderating a subreddit. Those are people who are actually here with me today; they were some of our first five employees.

Within those first 45 days, how many people were coming to the stream?

My first stream had 20 to 30 concurrent viewers, which is very unusual, I think. I also did a collab super early on, and people showed up and were like, “This is pretty cool.” So it started spreading and then we grew very rapidly. We started with 30, and I think within six, eight months, maybe within a year, we were up to 40,000 concurrents. That was crazy.

After that first year, how did you navigate that growth?

Our numbers kind of dropped, but we also did this on purpose. I started to realize that a lot of people were coming to us for the wrong reasons. They were coming to us for voyeurism instead of to learn, because sometimes people would get emotional on stream and things like that.

I started streaming to try to help people and that’s the north star. I would rather help one person a lot than entertain 10 people.

As we shifted towards being more value-oriented as opposed to entertainment-oriented, our numbers dropped. I still think that if we had gone like the entertainment route, [the numbers] would be better, but I don’t think we’d be having the impact. I started streaming to try to help people, and that’s the north star. I would rather help one person a lot than entertain 10 people. There are plenty of people out there to entertain; the field is plenty saturated.

What was the selection process for who you interviewed?

 For people who are community members, it’s just: Are you struggling with something that a lot of people are struggling with? Let’s talk about it. With creators, it’s kind of all over the place. We don’t honestly care about the size of the creator — we’ll do things with gigantic creators, and we’ll do things with like tiny creators. It’s really about the problems that they want to talk about.

The other thing that’s really important is what our community tells us. If they say, “Hey, you should do a collaboration with this person,” or you should do something, then we are likely to do it because our community knows us and what we bring to the table, and so we’re driven by them more than anyone else.

More generally, how do you decide on your content topics?

There are a number of things. When I was in residency, you’re working like 80 to 100 hours a week, every week, for like four years. And so there’s this idea that when you’re done with residency, it gets easier. The crazy thing is that I learn way more than I have in the history of my career. I’ll read between 100 and 400 pages of scientific literature a week.

In residency, I would do that in a month because I had to. So I read a ton because there’s so much research out there, and that’s a chunk of my inspiration. I also read a lot of spiritual texts and have a lot of spiritual practice; that’s a bunch of my inspiration.

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And then there’s like, things happen on the internet, which is another source of inspiration. So we just had this video about why women prefer beta males. So someone on our team sent me this tweet that was this Twitter argument between men and women about whether women are more attracted to super cut dudes.

I feel like I saw this one.

Yeah, so someone on my team said, “Hey, have you seen this? What do you think about this?” And I was like, “Let’s find out.” I did a literature search and found something really fascinating. Then we made a video about it, and it went great.

There’s a lot of stuff that people are debating about, worrying about, and struggling with, and so we think about how we can offer an evidence-based perspective to help people navigate what the hell is going on.

The way to offer that perspective could be research-oriented, like a video or an interview. So, do we just want to talk to someone about what it’s like to date nowadays or the existential threat of AI? Oftentimes, there’s a lot of stuff that if there isn’t [data about it], if there aren’t studies to explain it, then we’ll just talk to a human.

When did you start to scale up the Healthy Gamer team? How did you decide it was time?

I was CEO for six months. I suck at being CEO and [my wife’s] fucking amazing. So she took over as CEO, and it was really challenging in a lot of ways, but it was also great in a lot of ways.

That’s when we really started to scale. I had a group of people who were helping me out, and we weren’t paying them, so those became our first five employees.

[My wife also] started thinking about monetization, started thinking about like how to get people salaries, how to get people competitive salaries. We hired our first employee in April of 2020. We’re now up to a team of like 30 employees. Then we’ve got 150 coaches. And then we’ve got other contractors, so we’re up to like 200. And it all started with one [employee] five years ago. So that’s really when we started to kick ass and take names.

Did you go through learning curves after bringing on a team and adjusting your workflow to working with a group?

 Yeah, absolutely. I’m lucky because in medicine you learn how to work with teams, right? One of the most important things I learned in medicine is listening to nurses.  As a doctor, I know way more medicine than a nurse does, but the nurse knows the patient way more than I do.  So even if you’re the boss, you listen to the people who are, quote unquote, under you because they know things you don’t know.

 The biggest thing that I’ve learned as a content creator is that the more we’ve grown, the farther down the reporting structure I go. So with the content director, I am their boss on paper, but in practice, I’m their employee. When my content director is like, “Hey, I want you to make a video about this,” I say, “Yes, sir.” That was kind of strange, but recognizing that I’m a resource and all of these people have jobs, and in order for them to do their jobs, they need me to do certain things.

And I think that’s hard for a lot of people from an ego perspective, but if you have your domain, I’m a resource, and if you need me to do something, I will do it.

You’re a mental health professional and a mental health creator who has communities of people online who seek your help. Do you get burned out or deal with any empathy burnout?

What do you mean by empathy burnout?

Basically, a lot of people come to you with mental health problems — do you ever find yourself taking that stress on?

That doesn’t really happen to me. I’ve been working for five years, and I had my first vacation of about two weeks; it was amazing. After five years, I worked six to seven days a week. I’m not saying this because I’m like, “Oh, I’m great.”

The main thing is that we just don’t understand how our empathy battery works. Empathy burnout can be fixed if you figure out how to fill up your gas tank. What is the gas station of your life? So, I think there are a couple of helpful things that we learn as psychiatrists. The first is to understand that there’s only so much that you can do.

This lesson is something that a lot of creators do not understand. You are limited in your capacity for what you can do…there’s nothing you can do that will make a video go viral.

A lot of creators do not understand this lesson: you are limited in your capacity for what you can do. You can put forth most of your effort. Absolutely. Work hard, work six days a week. But there’s nothing you can do that will make a video go viral. Can you try to make it go viral? Absolutely. That attitude is how you work five years without a day off. It’s really focusing on the things that you can do.

The other big thing that I do is take care of myself every day. If I drive a hundred miles, I go to the gas station every day. I don’t wait until I’m at E because there are going to be times when things pile up.

I imagine some creators struggle to identify when their meter is down and getting close to E. How did you even learn to read that?

I know it’s weird, but it’s the wrong question.  The question is, how do you fill up your tank, and are you doing it every day?  The problem is that everyone waits until the gas tank is empty to fill it up, and then, of course, you’re going to get in trouble. It’s not about focusing on empty; it’s about focusing on staying full.

 If anyone who looks at what you’ve done with Healthy Gamer wants to make content that helps people and create a community in the way you have, do you have any advice?

Do it.  There is no shortage of people who need your help, and each human being has a unique set of genetics, a unique set of circumstances, a unique set of experiences. So you can help other people in a way that no one else can.

The second thing is that it’s going to be hard. It’s going to suck and you’re going to fail a lot, and that’s OK. As you fail the first time, the second time, the third time, then you’ll figure out how much your heart is really in this. And it’s OK to try something and recognize even though [you] want to help people, if it’s not working for you, that’s OK too. It doesn’t make you a bad person to not want to help people. You’ll help people later in life — that karma will come to fruition — it may just not be your time. So I’d say give it a shot.

The other thing is to try to really do your best. Focus on iteration, focus on improvement. It’s about, “What did I do today? How can I be better tomorrow?” I think people are way too goal-oriented. The goal is over there, right? And I’m over here. So focus on the next step you’re going to take and the next step you’re gonna take and the next step that you’re gonna take. In my practice with my patients and in my private coaching clients, I have a ton of creators who are 10, a hundred times bigger than I am. And I think that we see something that’s really interesting, which is that basically all the super successful creators focus on what’s next, not what’s at the end.

So what’s next for Healthy Gamer?

 I have a panel in two hours, a couple of podcasts, some thoughts that I want to write down, and I’m going to try to swim today.