Under Pressure: Confronting the Epidemic of Stress and Anxiety in Girls

A clinical psychologist witnessed the rising tide of stress and anxiety. Here’s what she says about shielding daughters from toxic pressures.

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Karsen: From the Parents Club, I’m Karsen Kolnicki. This is your briefing.


Karsen: Today, we’re discussing Under Pressure: Confronting the Epidemic of Stress and Anxiety in Girls. Written by Dr. Lisa Damour.

In this New York Times bestseller, the author takes an urgently needed look at the alarming increase in anxiety and stress experienced by girls from elementary school through college.

Karsen: Vincent Phamvan on the key takeaways [pause] and what you need to know.


Karsen: Vincent, what does the author say is the difference between life for girls and boys?

Vincent: The author is a Clinical Psychologist specializing in children’s development, so Damour has a lot of experience in this area. She says that it’s not always easy being a girl, particularly because girls are subject to all kinds of pressures that their male counterparts aren’t. As a result, the rates of stress and anxiety among girls has risen sharply in recent years.

This has had an impact in how parents, teachers, and mentors try to address the mental health crisis occurring among young women.

Karsen: What are some of the common pressures that the author says girls face today?

Vincent: Well, she says that when you look at all the aspects of a girl’s world, whether that’s at school, societal expectations, friendships, or interactions with boys. These are the areas that often amount to pressures that girls face.

Karsen: So she says that being a girl can be tough because of pressures that boys aren’t subject to. What’s the best way to handle this stress?

Vincent: Psychological research has found that the stress of pushing ourselves outside our comfort zone is good for personal growth. For example, think about how stressful it can be to speak in front of a large group of people. Even though this could be a source of anxiety, it can also help build resilience so that you can better face future hardships.

Karsen: Is anxiety always a bad thing?

Vincent: The author says that experiencing some anxiety occassionally is not necessarily a bad thing. The reason is because anxiety let’s us know that something is wrong.

So sometimes, this is helpful in order to get an appropriate reaction. One example is a teen who feels anxiety over a test at school because they haven’t studied enough. There is a limit though where stress and anxiety can become unhealthy.

Karsen: So when does someone know if they’ve reached that tipping point?

Vincent: Well, when the anxiety starts impacting someone’s mental wellbeing, then you know you’re approaching or have already crossed this line into the unhealthy territory.

If someone doesn’t have the emotional, financial, or social resources to tackle the issue, then this could be harmful.

Karsen: So different people can have different reactions to the same source of stress.

Vincent: That’s right. Let’s say that a girl breaks her arm. This could be a healthy source of resilience if she has friends who can take notes for him in class. But if her  college acceptance is based on being able to get a scholarship, this could impact her mental health.

If your anxiety happens too frequently and you have a constant feeling of being panicked, then this could also be a signal that it’s unhealthy. When it interferes with your sleep, happiness, or concentration, then this is unhealthy.

Karsen: So how can girls address their anxiety?

Vincent: The author says that girls can lessen their anxiety by learning to approach their problems, instead of avoiding them.

Karsen: How can girls learn to approach their problems?

Vincent: Well, Damour gave an example of a teenage girl named Jamie who once came to her in tears. She was scared about failing an upcoming chemistry test, and she was trying to find ways to avoid taking the test.

Damour took the approach of empathizing with the girl’s stress, but not helping her get out of taking the test. She says that avoidance makes the anxiety worse because it might help in the shorterm, but the girl would have to take the test eventually, so the anxiety would just return in the future.

Karsen: I suppose if the girl avoided the test that day, she would have continued to feel scared of tests too.

Vincent: That’s a good point, and if you help teenage girls avoid something just because it gives them anxiety, then they may actually develop a long-term phobia.

For example, if a girl is kind of scared of dogs, and she crosses the street everytime she sees a dog, she might feel relieved. However, this doesn’t give her the opportunity to meet a friendly dog. So she’ll continue to be scared of dogs and will associate avoidance with relief of that fear.

Karsen: So what ended up happening with the girl with the test?

Vincent: So Damour helped her approach the fear instead of running away from it. She suggested that the girl ask her teacher for more help in the hour before the test while looking for online video tutorials on parts where she was unsure.

A few days later, the teenager said that the test still didn’t go well, but that she felt better after taking it.

Karsen: When it comes to social skills, what should parents know about their teenage girls?

Vincent: Damour is a psychologist who often sees parents who are concerned that their teenager is shy and cautious. However, she says that this doesn’t necessarily mean it’s an anxiety problem.

There was one 10-year-old girl named Alina who was mentioned in the book. She was socially anxious, had just a few friends, and was often wary of unfamiliar people. Damour though didn’t really see a problem that needed to be solved.

Some children are just naturally shy, and that’s okay.

Karsen: Are there different personality types for children?

Vincent: Absolutely, I think we all know people with very different personalities, but the same applies for children. For example, research shows that infants have three personality types: easy infants, who are easy going, accepting of change, and comfortable with strangers.

Then there are difficult infants, who are irritable and dislike change. And lastly, there’s slow-to-warm-up infants, who are cautious and slow to adapt to change.

The research shows that babies with any of these three personality traits can have the potential to grow into balanced, secure adults.

Karsen: It sounds like it’s possible that Alina was a slow to warm up personality type?

Vincent: That’s what Dr. Damour thought too. And she pointed out to her parents that this wasn’t a bad thing, and they shouldn’t compare her to her more social brother.

Karsen: So if you have a daughter who seems anxious about socializing, it can be helpful to remember that she can grow over time. What if you have a shy child who gets an invite to a birthday party and says they don’t want to go?

Vincent: The author suggests just calmly acknowledging his or her reaction without showing any judgement. And then just suggesting that they see how they feel in a few days. Often children who are slow to warm up will have a different second reaction once they’ve had time to think about it.

Karsen: That seems like good advice. In school, it’s not a secret that girls outperform boys in all subjects because they are quicker to mature. However, girls report that school stresses them out more than with boys. What does Dr. Damour suggest on helping your daughter with this?

Vincent: She says that girls definitely worry more about their academic achievement than boys do. And the research shows that girls place more emphasis on feedback from teachers than boys do.

And as a result, girls tend to see grades as more important in terms of being a reflection of their abilities.

Karsen: And I know firsthand that this can leave them feeling pretty hopefully when they get a bad grade.

Vincent: Yea, Damour indicates that this is because they’re interpreting it as a sign of their academic abilities. The major difference in the research is that it found that boys were more confident in their attitudes with school work, so even when they got bad feedback or grades, they attributed it to their lack of effort.

Karsen: Instead of their ability?

Vincent: Right.

Karsen: So what can be done about this? How would you help a girl overcome her thoughts that poor grades are indicative of her natural ability?

Vincent: The author suggests that you should try to persuade her that she has the power to improve her performance next time. So for instance, you could explain that a test only tests how well she understands the materials at a point in time. However, by working hard and improving her understanding of the materials, she can improve her performance in the future.

Research found that students who believe their skills can be developed through hard work end up worrying less than students who think their grades reflect their fixed abilities.

Karsen: Another area that raising girls differs from raising boys is with sexual harassment, especially with the #metoo movement. What does the research say about this?

Vincent: There was a study by the American Association of University Women that found that half of all American girls in middle school or high school have experienced unwanted touching or groping at school.

The girls reported that boys they knew grabbed their butts, pulled their bra-straps, and called them names like hoe and slut.

Karsen: Uhg, that’s horrible.

Vincent: I know, and even more unfortunate is that many of the girls didn’t know whether or not the sexual harassment was their fault or not.

So the author told a story about a time when she met with a group of 15- and 16-year olds, and one girl said that she and her friends wore leggings and that it may have encouraged boys to degrade them. And the result of this is that the girls are less likely to tell anyone about the harassment because they felt like they may have done something or worn something that caused it.

Karsen: And that's obviously not the case. How can a parent help dispel this sense of self-blaming?

Vincent: Parents of girls can help reassure their daughters that they are never responsible for someone harassing them. If you have a teenage girl, you can consider starting a conversation about sexual harassment.

This could include asking about how boys treat her and ask whether she’s being treated with respect. If she shares any degrading stories, you can let her know that you’re glad she feels like she’s able to tell you, and that you’re ready to help her with that problem.

Karsen: And if she shuts and doesn’t want to share?

Vincent: Then, Damour suggests letting her know that harassment, unfortunately, is widespread. And that it’s only shameful for the harasser, not the victim. And lastly, let her know that you will never make her regret asking for your help with issues like this… whether that’s now or in the future.

Karsen: Are there other differences between boys and girls when they are teenagers?

Vincent: We’ve talked about a few ways already that our culture holds girls to a different standard than boys, but one in particular that Damour talks about was that as a society, we teach girls to be more obedient and agreeable than boys. So often times, girls will be expected to do what we tell them to do.

When girls or women disagree with a requests, they’re often referred to as inconsiderate or called the b-word. But the author points out that when boys are disobedient, they’re given the scapegoat that “boys will be boys.”

Karsen: So this puts different expectations on girls who will find themselves in a difficult situation?

Vincent: Yes, and so sometimes girls are stuck between a rock and hard place because of the pressure to agree or say yes to everything that people ask of them. And this pressure can really add up when you have the dread or fear of saying no to people.

So girls are often anxious about turning people down.

Karsen: Like if a girl gets invited to a party that doesn’t want to go to.

Vincent: Exactly, she may be concerned about what other people will think of her if she doesn’t go. And the author suggests that to help with this, you can teach her how to protect her time and minimize the stress and anxiety by teaching her that it’s okay to say no. And in fact, it’s healthy to set boundaries.

Karsen: It sounds like the key takeaway from this book is that girls will face challenges because of societal pressures that may have an impact on their stress and anxiety levels. With support from adults in their lives, they can manage this pressure and build healthy habits, behaviors,  and thoughts.


Karsen: That’s it for your briefing. I’m Karsen Kolnicki. See you next time.


Though anxiety has risen among young people overall, studies confirm that it has skyrocketed in girls. Research finds that the number of girls who said that they often felt nervous, worried, or fearful jumped 55 percent from 2009 to 2014, while the comparable number for adolescent boys has remained unchanged. As a clinical psychologist who specializes in working with girls, Lisa Damour, Ph.D., has witnessed this rising tide of stress and anxiety in her own research, in private practice, and in the all-girls’ school where she consults. She knew this had to be the topic of her new book.

In the engaging, anecdotal style and reassuring tone that won over thousands of readers of her first book, Untangled, Damour starts by addressing the facts about psychological pressure. She explains the surprising and underappreciated value of stress and anxiety: that stress can helpfully stretch us beyond our comfort zones, and anxiety can play a key role in keeping girls safe. When we emphasize the benefits of stress and anxiety, we can help our daughters take them in stride.

But no parents want their daughter to suffer from emotional overload, so Damour then turns to the many facets of girls’ lives where tension takes hold: their interactions at home, pressures at school, social anxiety among other girls and among boys, and their lives online. As readers move through the layers of girls’ lives, they’ll learn about the critical steps that adults can take to shield their daughters from the toxic pressures to which our culture—including we, as parents—subjects girls.

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