What parents need to know about girls’ stress and anxiety

By Lisa Drayer, CNN

(CNN)As a mother of two young girls, one of the things I care about most is staying in tune with my daughters’ day-to-day social interactions, worries and concerns. My daughters attend a school in New York City where social and emotional health is a top priority, and I’ve learned a lot about how feeling confident and secure on the inside is a prerequisite not only for happiness but for academic success.

Through their school, I’ve had the opportunity to hear firsthand from experts such as Lisa Damour, who explained that stress and anxiety have skyrocketed in girls.

In addition to consulting at my daughters’ school and others, Damour is a clinical psychologist who counsels girls in private practice. Her previous New York Times best-seller, “Untangled: Guiding Teenage Girls Through the Seven Transitions into Adulthood,” revealed the normal developmental transitions that turn girls into grownups.

When I heard about Damour’s new book, “Under Pressure: Confronting the Epidemic of Stress and Anxiety in Girls,” I was eager to talk with her about the ways parents can help their daughters manage stress and anxiety in their lives.

In an edited version of our conversation, here’s what she had to say.

CNN: What inspired you to write this book now about stress and anxiety among girls?

Damour: There were two reasons. One is that about 10 years ago, the word anxiety came up out of nowhere. In every conversation that came up, I had more and more girls showing up in my office saying “I struggle with anxiety.” And the same with stress — girls talking about stress and explaining how overwhelmed they feel.

The other reason is, it became very clear to me that what psychologists know about stress and anxiety — which is largely that these are normal, healthy functions that we don’t find particularly concerning, and we’re really good at treating when they are concerning — that understanding was not translating to the broader culture.

So my wish is to communicate that stress and anxiety are not inherently problematic. In fact, there’s a lot of good in them … and my hope is that we can do something where we end up with fewer young people that are stressed about being stressed, and anxious about being anxious.

CNN: Why are girls suffering so much more from higher levels of stress and anxiety than boys?

Damour: There are a few forces at play here. One is that girls tend to collapse in on themselves and become depressed and anxious; boys are more likely to act out.

There are other forces, though, that are very unique to girls. One is, we have put so much on girls’ plates and taken nothing off. Girls are now unbelievably good students; they are yards ahead of boys; they are incredibly successful, they are 70% of the valedictorians — and yet we also fully expect that they will be agreeable and helpful to the people around them, and they will also be adorable, if not kind of “hot” in their way. And that they’ll be friendly and maintain good ties within the family. Even when boys are really bringing it academically, I know they do not operate with the same sense of they’ve gotta be gorgeous, and they’ve gotta be really kind and giving to people around them.

CNN: It’s amazing. I wonder where those gender differences originated. But you implied that there is an upside to being stressed and anxious, whether we’re talking about girls or boys. Really?!

Damour: Both stress and anxiety have positive elements. Stress is what happens when we operate at the edge of our abilities, and stress almost always expands our capacities.

We experience stress any time we do something new or difficult — and what’s really amazing is that humans quickly adapt to new and difficult things. For anyone with more than one child, the first time you brought a baby into your home, it’s this overwhelmingly stressful thing where you felt like, “we’re never going to make it.” And then the second time you bring a baby home, it’s not nearly such a big deal. You’ve done it all before. That’s a gorgeous example of what stress has done for you.

Stress is happening because you are growing and changing, and once you’ve adapted, you get to keep the new capacities, and it makes new things in that vein less difficult.

If we think about girls and school, we have a very reassuring message: School is supposed to be stressful. You’re there to grow and change, and it’s working as it should if you feel pushed.

So if a girl says, “I’m really anxious about this test I have tomorrow” and the parent says, “well, where are you in your studying?” and she says, “I haven’t started” — [the parents] should say, “well, that’s good that you’re anxious. You should be very anxious!” That’s anxiety helping to prevent a problem.

I do worry, for our most ambitious students, that school becomes a place where the demands are so extensive that there is not the possibility of recovering … when you’re taking three APs and doing a lot of extracurriculars and volunteering on the weekends. Doing difficult things, however stressful it may be, makes us tougher and more able — but only if there is an opportunity to stop, rest, repair and then go back in.

CNN: In dealing with girls, whether about their interactions at home, pressures at school or social anxiety, what is it that you want parents to know most?

Damour: What I really want adults to know is, how we respond to a girl’s stress or anxiety is a very powerful thing, and it can make things much better for her or much worse.

he moment when parents get this right is when they are raising a toddler and the toddler scrapes her knee. First, [toddlers] look at their knee, and then they look at the parent’s face. If the parent is panicking, the child will fall apart. And even if the parent on the inside is panicking, they say, “you’re OK. We’ll get you cleaned up. You’re all right,” the child’s like, “OK.”

So what we can do to help keep these fires contained is that when one of them starts — she’s panicked about a fight with a friend or about a test that’s coming up — if we say “you know, I think you’ve got this” or “I can see it’s very uncomfortable, but I think you can handle this” or we ride out her having a big emotional upset and be patient, knowing it will resolve itself if we stay calm — those are supportive responses that won’t make it worse. Sometimes in our own anxiety we say, “I’m going to call the other kid’s mom” or “I’m going to get you a tutor.” We jump in fast, which is the equivalent of the panicked face with the scraped knee.

CNN: It’s so counterintuitive, because you want to reach in and save your child.

Damour: If the parent did nothing, that wound would heal. Emotions are more like waves in the ocean. They rise, they crest, and then they ebb. You get upset, you have a really good cry, and then there is a relief that comes, and it’s so important for our kids to understand that they actually contain automatic self-regulating systems, and they don’t have to be scared of becoming very upset.

The rescuing interrupts that lesson to the child, that “oh, I see you’re very upset, and if we just wait this out, you’ll feel much better” — which is such a powerful thing for a child to learn about how they operate.

CNN: Can you give some examples of things that girls struggle with but can handle?

Damour: Being in a group project with a kid they can’t stand. No one would sign up for that; it’s absolutely in the category of what kids can reasonably be expected to handle. Having teachers they find quite annoying. I hope it happens to every kid in the course of school! No, they do not enjoy it, [but] it’s completely in the realm.

CNN: You say that the happiest girls are those with one or two solid friendships. I thought it’s better to have lots of friends. Can you explain?
Damour: The research tells us that when we look at friendship groups, small comes with much less stress. It’s stressful for parents because they’re worried if their daughter hits a rough patch with that one friend, she’s going to be out in the cold.

But once you get to four, five kids in a group, numbers bring drama. Often within that group, there are a couple of girls who are like oil and water with each other, and the remaining group members are left to mediate things or get stuck picking sides, which is a terrible way to be in a friendship group.

Another thing is that often within the group of five, there’s maybe two or three girls who are closer and want to get together and not invite everybody else, and then of course they still can’t help themselves and put up on Instagram a photo of what they all did. Then drama ensues.
And you get this misperception that “oh, it’s good to have lots of friends,” — and I’m not saying don’t do that, I’m just saying plan on drama. It’s not that these are mean girls. It’s that no adults could have a group of five where they like one another equally.

CNN: On the flipside, what’s the advantage of having one or two close friends?

Damour: Having one or two friends actually contributes to a sustainable, predictable routine. You know who you are hanging out with on the weekend. If you are upset, you know who you’d call.

When girls are in groups that are larger, that destabilizes it a bit, like, “I want to hang out with Jenny, but I hung out with her last weekend, and if I don’t call Molly, she’s going to be upset because she’s going to say I always hang out with Jenny.” It interferes with the sustainable routine of just falling into a friendship that’s predictable, and it’s predictable because it’s your only option, but there’s a lot to be said for having fewer options sometimes.

CNN: If you could be an adolescent girl again, what is the one thing you would tell your younger self?

Damour: I wish I had known how much time I had to develop skills and to figure out the kind of person I wanted to be.

When I graduated high school, I was a very poor writer. I arrived at college to discover that I didn’t know anything about writing. I became a psychologist, and it was through opportunities to do co-authorships with very good writers that I started to develop my writing skills. But I didn’t start writing in any way that a broad public would have access to until I was in my late 30s, and if you told me at 17 that I would be someone who people would recognize as a writer, I would have thought that was a totally ridiculous thing to say.

I tell that story every time I can because right now, with the amped-up college process, we are saying to 17- and 18-year-olds, “tell us what you’re good at; tells us what you’re all about,” and they don’t have the perspective to know that this is a silly request — they may know what they want to be or who they are — but I sort of hope they don’t.

I hope that they still see themselves as very much in process, because they are. And so I say, “look, to get good at something takes a really, really long time; you have a long time.” That’s the perspective I’m always trying to share with young people.

Lisa Drayer is an author and a CNN health and nutrition contributor.