Under Pressure

Confronting the Epidemic of Stress and Anxiety in Girls

Lisa Damour

• Publisher: Atlantic Books
• Year: 2019
• Print ISBN:
  9781786493972
• eBook ISBN:
  9781786493989
• Topic: Psychology
• Subtopic: Developmental Psychology
• Index: Psychology

Though anxiety has risen among young people overall, recent research studies confirm that it has skyrocketed in girls since the turn of the century. So what's to blame? And how can we help these girls? In the engaging, anecdotal style and reassuring tone that won over thousands of readers of her bestseller Untangled, clinical psychologist Lisa Damour examining the science of stress and anxiety and the many facets of girls' lives where stress hits them hard: - The parental expectations they face at home
- Pressures at school
- Social anxiety among their peers
- Social pressures on social media Exploring the multiple layers of girls' lives, Damour shows us the critical steps we can take to shield them from the toxic stress to which both our culture and also we, as their caregivers, subject them. Readers familiar with Damour's bestseller Untangled or from her New York Times journalism will need to read this important new contribution to understanding and supporting today's girls - and tomorrow's young women.

CHAPTER ONE

Coming to Terms with Stress and Anxiety

I HAVE GOOD NEWS. ACTUALLY, I HAVE TWO PIECES OF REALLY GREAT news. First, stress and anxiety aren’t all bad. In fact, you can’t thrive without them. Understanding the difference between their healthy and unhealthy forms will change, for the better, how you help your daughter manage the tension she feels. Second, the field of psychology has a lot to say about how to alleviate stress and anxiety if they do reach toxic levels. Indeed, if I were to take an informal survey of my colleagues, the vast majority would agree that we have come to understand the root causes and inner workings of pathological stress and anxiety as well as we understand anything in our field. As a result, we have many ways to help people rein in psychological strain when it gets out of control.

Taken together, these two happy facts mean that you can already start to worry less about how stressed or anxious your daughter feels because, to a degree, these mental states are essential catalysts for human growth and development. And if you suspect that your daughter’s unease far exceeds the healthy mark, then I’m here to reassure you that you and your daughter do not need to feel helpless. We’re going to tackle unhealthy stress and anxiety, too.

Healthy Stress

Stress gets a bad rap. Though people don’t always enjoy being stretched to new limits, both common sense and scientific research tell us that the stress of operating beyond our comfort zones helps us grow. Healthy stress happens when we take on new challenges, such as giving a speech to a large audience, or doing things that feel psychologically threatening, such as finally confronting a hostile peer. Pushing ourselves past familiar limits builds our capacities in the same way that runners prepare for marathons by gradually extending the distances at which they train.

Learning to brave stressful situations is also a skill that develops with practice. Researchers actually use the apt term stress inoculation to describe the well-documented finding that people who are able to weather difficult life experiences, such as riding out a serious illness, often go on to demonstrate higher-than-average resilience when faced with new hardships. I can speak for myself in saying that being middle-aged doesn’t seem to come with a lot of advantages, but it definitely has one particular benefit: problems don’t bother me as much as they used to. Like most of my agemates, I’ve got enough life experience under my belt that I now take in stride events—such as having a plane flight cancelled—that would have put me on the ceiling when I was younger. While the saying “What doesn’t kill you makes you stronger” almost certainly overstates the point, it’s not all wrong.

As parents, we should think of stress the way Goldilocks thought about making herself comfortable while trespassing. We don’t want our daughter’s stress level to be consistently too low or too high. But we can embrace reasonable levels of stress as a nutrient for our daughter’s healthy development that will help her to grow into the strong and durable young woman we want her to be.

Much of what our girls learn about how to manage stress comes from observing how we manage it as parents. Our daughters watch us for cues about how alarmed they should be by life’s difficulties. When we let our own inner Chicken Little take over and panic in the face of manageable challenges, we set a bad example. When we accept that stress often leads to growth—and help our girls do the same—we create a self-fulfilling prophecy for ourselves and for our daughters.

Obstacles, however, only make us stronger when we can surmount them. Accordingly, Under Pressure will address in its coming chapters how you can help your daughter master the challenges she will face as she moves from childhood to adulthood. With your help and over time, your daughter can come to appreciate that stress is a positive and growth-giving part of life.

Except for when it’s not.

How Stress Becomes Unhealthy

Stress becomes unhealthy when it exceeds what a person can absorb or benefit from. There is no single yardstick for what constitutes unhealthy stress, because the volume of manageable hardship differs from person to person and can even differ for a single individual from day to day. Whether stress becomes unhealthy depends on two variables: the nature of the problem and the person upon whom the problem lands.

Psychologists consider stress to be unhealthy when it interferes with well-being in the short or long term. Whether or not a stressor harms well-being has surprisingly little to do with the source of the stress and much more to do with whether adequate resources—personal, emotional, social, or financial—are available to address the problem. For example, a broken arm could be a resilience-building hassle for a girl who writes with her other hand and has lots of friends to help carry her books. Or it could be a full-blown crisis for one who might lose a shot at a desperately needed athletics scholarship due to the injury. In the same way, if the primary breadwinner is laid off, that feels much worse for a family without a financial cushion than it does for one with a healthy savings account.

Knowing that stress becomes unhealthy only when its demands exceed our resources helps us to better support our girls. We can’t always prevent calamities, but we can often summon reserves to help our daughter manage the challenges life puts in her path.

A terrific example comes from my work as a consulting psychologist to Laurel School, a local all-girls’ school that runs from nursery through Year 13. I’ve spent part of each week there for the past fifteen years, and in that time I’ve watched several secondary school girls and their families contend with glandular fever, a particularly tenacious stressor. The course of the virus doesn’t differ much from girl to girl, as sufferers usually miss classes for a few weeks and also need to suspend their extracurricular activities. But the illness turns out to be much more stressful for some students than for others.

Under ideal conditions, a girl’s parents can surround their daughter with loving support to make the best of a bad situation. Her folks ensure that she gets lots of rest, they coordinate effectively with the Laurel staff to keep their daughter reasonably up to date on her assignments, and they find ways for her friends to stop by for visits. One family of a dedicated football player happily drove their daughter to games so she could cheer on her beloved teammates from the bench. When parents have the wherewithal to marshal resources on their daughter’s behalf, I’ve seen a bout of glandular fever amount to nothing more than a bothersome blip in a girl’s secondary school career.

Other families, especially those who may already be at the limit of the stressors they can manage, can provide only minimal support. A girl who spends long hours alone at home can be inclined to choose social media over sleep, thus causing the virus to drag on longer than it should. She might fall far behind on her schoolwork or be dragged down by sadness about missing her friends or the fun parts of school. When students in this situation eventually get better, I’ve heard them ruefully remark, “Thanks to glandular fever, my entire term was messed up.”

The Three Types of Stress

Of course, there are girls and families who do everything in their power to address the social and academic impact of glandular fever yet still find themselves struggling to get back on track. We can better understand their challenges when we recognize that just as stress is not all bad, it is not all the same. When psychologists study stress and its impact on health, we sort it into three distinct domains, namely life events, daily hassles, and chronic stress.

Any life event that requires adaptation, such as a teenager catching glandular fever, is inherently stressful. Even happy occasions, such as becoming a parent or starting a new job, come with the strain of adapting to abrupt change. There aren’t many cardinal rules in psychology, but here’s one: change equals stress. The more change a life event requires, the more taxing it will be.

Moreover, life events, both good and bad, often trigger daily hassles as well. For instance, parents who rearrange their schedules to care for an unhealthy teenager may have trouble getting around to their routine errands. Or they may not be able to clean up the sink full of dinner dishes that are usually loaded into the dishwasher by the teenager felled by glandular fever. While daily hassles seem like they shouldn’t be a big deal, they do add up. Quite remarkably, one research study found that it was the number of daily hassles triggered by a major stressor, such as the death of a loved one, that actually determined how much emotional difficulty people faced down the line. In short, the pain of losing one’s wife is amplified by the stress of trying to figure out her system for paying the household bills.

Our instinctual understanding of the burden of daily hassles explains our impulse to cook for friends with new babies. We stock the fridges of those facing major life events to spare them the added nuisance of shopping and making meals. Appreciating that our own daily hassles really do compound stress can spur us to take steps to minimize them. Eating off paper plates for a few weeks won’t cure a teenager’s glandular fever, but it can help to reduce the level of stress overall.

Apart from life events and daily hassles, there’s also chronic stress. This is the kind that results when basic life circumstances are persistently difficult. Enduring chronic stress—such as living in a dangerous neighbourhood or caring for a relative with dementia—has been found to take a grinding toll on both physical and emotional health. Yet even in the worst circumstances, relief can sometimes be found. Studies of how young people cope with two grave and persistent sources of stress—ongoing cancer treatment or being raised by a severely depressed parent—have yielded valuable lessons that apply to a wide range of chronically stressful situations.

I found myself relying heavily on what we know about helping children and adolescents manage stress, even in the context of unrelentingly difficult conditions, when working with Courtney, a bright seventeen-year-old whose parents were in a drawn out and contentious separation. Courtney and I started meeting weekly in the autumn of her GCSE year after she announced to her folks that she could not bear another day of their fighting. Though they disagreed about many things, Courtney’s parents both wanted to provide their daughter with some much-needed support.

Once we got to know each other, Courtney and I set our minds to figuring out how she could manage the problems at home. Our first step was to determine what she could and couldn’t change.

“Honestly,” she said, “I don’t think that they’ll ever get along.” With an air of exasperation she added, “They say that they won’t fight in front of me, but they can’t seem to help themselves.”

“I’m really sorry to hear that . . . and can only imagine how painful it must be to hear them go after each other.”

Courtney looked at her hands and then back at me before replying wearily, “Yeah, it sucks.”

I reflected a moment before saying, “With regard to the fighting, I think you’re stuck. Your folks are the only ones who can make it stop, and it doesn’t sound like they’re ready to do so.”

Courtney ruefully nodded her agreement.

“So, as much as I hate to say this, I think that you have to find a way to accept that reality for now.”

Indeed, for difficulties that cannot be changed, research shows that practising acceptance is the critical first step. If your nose wrinkles at the new-age aroma wafting from the suggestion to “practise acceptance” (true confession: that was my own first reaction), consider it pragmatically. Why expend energy fighting an immutable reality? Once we find a way to digest a hard truth, we can get on with adapting to it.

Courtney, however, was having none of it.

Simultaneously incredulous and annoyed, she replied, “How can I possibly accept their fighting? It’s awful!”

“I hear you,” I responded as nondefensively as I could. “And if I thought you had the power to help your parents come to a truce, I’d be encouraging you all the way. I do, however, think that there are things you can control that will help your situation. Are you open to some ideas?”

Courtney reluctantly indicated her willingness to hear me out, so I proceeded with more of what we know from the research on chronic stress. Namely, that it’s helpful for young people to seek out happy distractions and enjoyable activities in order to take cover, even briefly, from their monsoon of stress.

“Are there things you enjoy that their fighting can’t disrupt?”

Courtney’s face relaxed as she thought about my question. “You know,” she ventured, “there is something I really like to do . . .”

I raised my eyebrows to let her know that I was eager for her to continue.

“I have a car . . . we say it’s my grandma’s, but it’s basically mine . . . and I love to drive it out on Chagrin River Road.” I smiled to indicate my familiarity with the wooded, hilly route that picks up about twenty minutes east of my office in the suburbs of Cleveland. “I roll down the windows, even when it’s cold outside, and play my music loud. Even after one song, I feel better.”

“Can you take that drive whenever you want?”

“Basically. Unless I have homework or something like that—but it doesn’t take me long to get there from my house.”

“Then I think that should be part of our plan. You can’t stop your parents’ fighting, but it sounds like you have a reliable way to take a break from the stress of it.”

Courtney bit her lip, letting me know that she remained unconvinced.

“It’s definitely an imperfect solution,” I said gently, “but think of it this way: the arguments make you feel bad, and driving makes you feel better. Until your parents sort things out, taking a drive when you need to gives you some control of your mood.”

“That’s true,” she said slowly. She paused, then added, “I’ll try it and let you know.”

We can bring these lessons about coping with chronic stress home to our own girls by guiding them to think about what they can change and what they can’t when they are st...

Table of contents

• Cover
• Title
• Copyright
• Introduction
• Chapter One: Coming to Terms with Stress and Anxiety
• Chapter Two: Girls at Home
• Chapter Three: Girls Among Girls
• Chapter Four: Girls Among Boys
• Chapter Five: Girls at School
• Chapter Six: Girls in the Culture
• Conclusion
• Acknowledgments
• Notes
• Recommended Resources
• Index
• About the Author