Margaret Qualley says she’s been in therapy since 16 and that The Substance helped her process family trauma

Margaret Qualley has disclosed that she has been in therapy since she was 16, and she says the process has helped her navigate both personal struggles and generational wounds within her family. In a Cosmopolitan interview and accompanying photos, the American actress, now 30, described how her mental health journey intersected with her breakout work and recent roles. She recalled suffering from severe insomnia in her early 20s, a period that affected daily functioning and even caused her to miss a major industry moment.

Qualley said she began therapy as a tool for self-understanding and revealed that insomnia in her early 20s kept her awake until late in the morning, sometimes seeing sleep elude her for four days at a stretch. She said the difficulty led her to skip events she would have otherwise attended, including a Cannes premiere for one of her early films because she feared she wouldn’t be able to cope with the pressure after nights without rest. Now, she meditates twice daily and maintains a focus on mental health as part of her routine.

The Substance, Qualley’s 2024 horror-tinged drama, has become a focal point in her discussion of healing. In the Cosmopolitan piece, she described the film’s lead role as a vehicle for confronting generations of trauma within her family, including the experiences of her mother, Andie MacDowell, who has spoken publicly about a difficult upbringing marked by alcoholism and bipolar disorder. Qualley portrayed a character whose journey forced her to confront not only her own wounds but the patterns passed down through her mother’s past.

The actress characterized The Substance as a cinematic storm, saying it felt like entering the eye of the storm and dealing with “all of my sh**, my mum's sh**, generations of trauma.” She emphasized that the role pushed back against simplistic ideas of femininity, describing the process of inhabiting an “idyllic, youthful fembot” as a nightmare and noting that the film is not a reliable template for what femininity should be; in many ways, she said, the film carries masculine undertones.

Qualley has frequently connected her work to her mother’s experiences. Andie MacDowell, 67, has described a traumatic upbringing defined by her mother’s alcoholism and bipolar disorder, which contributed to anxiety and post-traumatic stress disorder that she continues to manage. The elder MacDowell has said she drew on those memories while filming Maid, the 2021 Netflix series in which she starred alongside her daughter, often using self-soothing techniques to cope with on-set anxiety. The family’s shared history thus informs Qualley’s conscientious approach to roles that touch on women’s vulnerabilities and resilience.

Beyond the screen, Qualley has offered glimpses into the personal project of uniting her family. While promoting The Substance, she referenced an ongoing effort to set up her mother with other people, discussing the idea playfully on late-night TV. On The Tonight Show Starring Jimmy Fallon, she recalled attempting to arrange a match between Andie MacDowell and Bill Murray, a notion that connected to a bit of pop-culture history they share from Groundhog Day. Fallon noted Murray’s Charleston residence, and Qualley described her mother’s move to the South Carolina city after becoming an empty nester, underscoring how intertwined personal life and professional relationships have become for the family.

Qualley’s reflections extend to her sense of womanhood. She described The Substance as a crucible for understanding what it means to be a woman in contemporary culture, emphasizing that the film’s presentation of femininity is far from definitive. The discussion also spotlighted how therapy, sleep health, and intergenerational trauma intersect in the lives of artists who carry the weight of public visibility and personal history. In addition to her film work, Qualley has spoken about her ongoing work with mental health support and her belief in the therapeutic process as a lifelong practice rather than a finite solution. The Cosmopolitan feature contributes to a broader narrative about how actors navigate the pressures of fame while pursuing healing and authentic self-understanding.