Alice begins her diary because she has no one else to talk to, and she spends her energy searching not for drugs, but for someone who understands her. The drugs only create the temporary illusion that she is in touch with nature and people. Fortunately, Alice is a gifted writer, lacing her unhappy vision of the world with poetic, sensitive language. Her diary becomes the personified "Diary," and Alice feels only Diary knows who she is underneath her social posture. Her string of friendships—Greta, Beth, Chris—are ongoing attempts to find a best friend, each time believing this person is the one who will truly know Alice (ultimately, Joel fulfills this role). Her inability to share herself completely with them, let alone her family, is the greatest factor in Alice's descent into drugs. Even throughout her various recoveries, Alice cannot open up fully to her parents. Her discussions with teen runaways and experiences in group therapy at the mental hospital help Alice learn about the difficulty of communication, and galvanizes her dreams of becoming a social worker. As the therapy leaders put it, when thoughts are kept inside they are "magnified" and "distorted." Alice has reservations about prying into the teens' lives, but her discomfort is a sign that she understands how difficult, and precious, open communication can be. Through small steps—opening up to Joel about her past, for example—Alice gains the trust in others that she formerly put in her diary and is able to discard her literary life for an interpersonal one.
Alice's problems are as relevant today as in the 1960s. She begins as an insecure girl who worries about sex and popularity, and, to an extent, these anxieties persist throughout her diary; sex continually plays on her mind, whether through her fear of pregnancy or dependency on men, and she remains concerned with what others think of her, especially when she goes "straight." Her sexual maturation is too quick: her schoolgirl crush on Roger turns quickly into a drug-dealing affair with Richie and later devolves into prostitution for drugs. Only with Joel does she develop a mature, fulfilling relationship.
The deeper problem for Alice, though, is the adolescent cliché of not knowing who she is. She observes the social stratification at school (divisions between drug users and others) and feels that she does not belong in any group. She is lonely no matter where she is, with reprieves from drugs coming less frequently the more she sinks into addiction. She reads an article about the problems that develop when children make too many or too few decisions while growing up. She thinks she doesn't fall under either category, but throughout her diary she balances precariously between adulthood and childhood, feeling at times independent and at other times homesick. Her strengthened relationship with her family affords Alice the opportunity to grow into a new person with a commitment to a responsible, mature life—as an older sister to her siblings, a peer to her father and mother, and a future social worker to others who have suffered the same pains she has.
The hippie counterculture of drugs, casual sex, and other anti-establishment mores readily seduces Alice, whose discontentment with her middle-class upbringing is strong in the first few sections of the diary and whenever she reverts to drugs. Regular society is competitive, cruel, and hypocritical (note the difficulty of attaining liquor versus the ease of acquiring drugs); the counterculture gives Alice what she wants: excitement, experience, ecstasy. Her experiments with drugs are initially strolls into newfound lands, but they soon become her entire world, and she reflects the counterculture in her appearance, language, and ambitions. No longer does she want to go to college, marry, and have a stable career, but she simply wants to get stoned and have casual sex. For Alice, drugs are a way to connect, however briefly, with others. Moreover, they offer a powerful escape, blurring the line between fantasy and reality as books once did for her. However, the counterculture soon becomes empty and cold to Alice, and her repeated returns home—and ensuing happiness in the family fold—indicate her true desire for the stability that middle-class life offers, despite its downfalls.
Alice documents several cases of sexual assault, either on her or on others. She and Chris are molested by Sheila and her boyfriend; Alice performs oral sex for drugs; a boy from school threatens to rape her; and both Doris and Babbie have long histories of abuse. The numerous cases provide evidence of the utter cruelty of society; not only do others try to lure Alice back into drugs or remain unsympathetic to her, they actively victimize her and other girls who are in need of help. Alice develops a jaded attitude toward sex, and only through Joel's gentleness does she regain her belief in romantic love.
As a purported piece of non-fiction, Go Ask Alice does not have any explicit symbols, but Alice's nightmares and hallucinations of maggots and worms eating away at corpses or her own body can be viewed as a dual symbol. At first, Alice's fears of the maggots center on the loneliness of the individual mind. No one knows what happens to a body underground, hidden from sight. Alice's loneliness and her feeling that only "Diary" understands her connects this anxiety: she fears no one knows what is happening in her mind. In the hospital, she fears that even she does not know what is happening in her mind, and her memory of her unintentional overdose deliver the maggots a second meaning. She remembers the "dead things and people" that were "pushing" her into a casket, intermingling and becoming one entity that sought Alice's harm. We can interpret the maggots and worms as all the destructive impulses of society that Alice has internalized into low self-esteem; society is "pushing" her inside the coffin, as it has pushed her into drugs, away from her family, and into a lonely corner at school. She remarks that both her first and last drug uses were without her knowledge, but, in a sense, all times were without her full consent: the drugs were pushed on her by a society that was harmful and could not understand her mind.