Why Are More American Teenagers Than Ever Suffering From Severe Anxiety?

The disintegration of Jake’s life took him by surprise. It happened early in his junior year of high school, while he was taking three Advanced Placement classes, running on his school’s cross-country team and traveling to Model United Nations conferences. It was a lot to handle, but Jake — the likable, hard-working oldest sibling in a suburban North Carolina family — was the kind of teenager who handled things. Though he was not prone to boastfulness, the fact was he had never really failed at anything.

Not coincidentally, failure was one of Jake’s biggest fears. He worried about it privately; maybe he couldn’t keep up with his peers, maybe he wouldn’t succeed in life. The relentless drive to avoid such a fate seemed to come from deep inside him. He considered it a strength.

Jake’s parents knew he could be high-strung; in middle school, they sent him to a therapist when he was too scared to sleep in his own room. But nothing prepared them for the day two years ago when Jake, then 17, seemingly “ran 150 miles per hour into a brick wall,” his mother said. He refused to go to school and curled up in the fetal position on the floor. “I just can’t take it!” he screamed. “You just don’t understand!”

Jake was right — his parents didn’t understand. Jake didn’t really understand, either. But he also wasn’t good at verbalizing what he thought he knew: that going to school suddenly felt impossible, that people were undoubtedly judging him, that nothing he did felt good enough. “All of a sudden I couldn’t do anything,” he said. “I was so afraid.” His tall, lanky frame succumbed, too. His stomach hurt. He had migraines. “You know how a normal person might have their stomach lurch if they walk into a classroom and there’s a pop quiz?” he told me. “Well, I basically started having that feeling all the time.”

Alarmed, Jake’s parents sent him to his primary-care physician, who prescribed Prozac, an antidepressant often given to anxious teenagers. It was the first of many medications that Jake, who asked that his last name not be used, would try over the next year. But none seemed to work — and some made a bad situation worse. An increase in dosage made Jake “much more excited, acting strangely and almost manic,” his father wrote in a journal in the fall of 2015. A few weeks later, Jake locked himself in a bathroom at home and tried to drown himself in the bathtub.

He was hospitalized for four days, but soon after he returned home, he started hiding out in his room again. He cried, slept, argued with his parents about going to school and mindlessly surfed the internet on his phone. The more school he missed, the more anxious he felt about missing school. And the more anxious he felt, the more hopeless and depressed he became. He had long wanted to go to the University of North Carolina at Chapel Hill, but now that felt like wishful thinking.

Not every day was bad. During spring break in 2016, Jake’s father wrote: “Jake was relaxed and his old sarcastic, personable, witty self.” A week later, though, Jake couldn’t get through a school day without texting his mother to pick him up or hiding out in the nurse’s office. At home, Jake threatened suicide again. His younger siblings were terrified. “It was the depth of hell,” his mother told me.

That summer, after two more hospitalizations, Jake’s desperate parents sent him to Mountain Valley in New Hampshire, a residential treatment facility and one of a growing number of programs for acutely anxious teenagers. Over the last decade, anxiety has overtaken depression as the most common reason college students seek counseling services. In its annual survey of students, the American College Health Association found a significant increase — to 62 percent in 2016 from 50 percent in 2011 — of undergraduates reporting “overwhelming anxiety” in the previous year. Surveys that look at symptoms related to anxiety are also telling. In 1985, the Higher Education Research Institute at U.C.L.A. began asking incoming college freshmen if they “felt overwhelmed by all I had to do” during the previous year. In 1985, 18 percent said they did. By 2010, that number had increased to 29 percent. Last year, it surged to 41 percent.

Those numbers — combined with a doubling of hospital admissions for suicidal teenagers over the last 10 years, with the highest rates occurring soon after they return to school each fall — come as little surprise to high school administrators across the country, who increasingly report a glut of anxious, overwhelmed students. While it’s difficult to tease apart how much of the apparent spike in anxiety is related to an increase in awareness and diagnosis of the disorder, many of those who work with young people suspect that what they’re seeing can’t easily be explained away. “We’ve always had kids who didn’t want to come in the door or who were worried about things,” says Laurie Farkas, who was until recently director of student services for the Northampton public schools in Massachusetts. “But there’s just been a steady increase of severely anxious students.”

For the teenagers who arrive at Mountain Valley, a nonprofit program that costs $910 a day and offers some need-based assistance, the center is usually a last resort after conventional therapy and medications fail. The young people I met there suffered from a range of anxiety disorders, including social anxiety, separation anxiety, post-traumatic stress disorder and obsessive-compulsive disorder. (Though OCD and PTSD are considered anxiety disorders at Mountain Valley and other treatment centers, they were moved into separate categories in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders.)

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Sharon McCallie-Steller, a therapist, during a counseling session at the Mountain Valley residential program in New Hampshire.CreditSasha Rudensky for The New York Times

Mountain Valley teenagers spend a lot of time analyzing — and learning to talk back to — their anxious thoughts. During one group session in the summer of 2016 in a sunlit renovated barn with couches, a therapist named Sharon McCallie-Steller instructed everyone to write down three negative beliefs about themselves. That’s an easy exercise for anxious young people (“Only three?” one girl quipped), but McCallie-Steller complicated the assignment by requiring the teenagers to come up with a “strong and powerful response” to each negative thought.

She asked for volunteers. First, residents would share their negative beliefs and rebuttals with the group. Then others would act those out, culminating in a kind of public performance of private teenage insecurity.

Jake raised his hand. By then, he was in his third month at Mountain Valley, and he looked considerably less anxious than several of the newcomers, including one who sat slumped on a couch with his head in his hands. “I’m free to play the part of terrible, evil thoughts for anyone who needs them,” Jake said with a smile. He had already spent weeks challenging his own thinking, which often persuaded him that if he failed a single quiz at school, “then I’ll get a bad grade in the class, I won’t get into the college I want, I won’t get a good job and I’ll be a total failure.”

At Mountain Valley, Jake learned mindfulness techniques, took part in art therapy and equine therapy and, most important, engaged in exposure therapy, a treatment that incrementally exposes people to what they fear. The therapists had quickly figured out that Jake was afraid of failure above all else, so they devised a number of exercises to help him learn to tolerate distress and imperfection. On a group outing to nearby Dartmouth College, for example, Jake’s therapist suggested he strike up conversations with strangers and tell them he didn’t have the grades to get into the school. The college application process was a source of particular anxiety for Jake, and the hope was that he would learn that he could talk about college without shutting down — and that his value as a person didn’t depend on where he went to school.

Though two months in rural New Hampshire hadn’t cured Jake of anxiety, he had made significant progress, and the therapy team was optimistic about his return home for his senior year. Until then, Jake wanted to help other Mountain Valley teenagers face their fears.

Among them was Jillian, a 16-year-old who, when she wasn’t overwhelmed with anxiety, came across as remarkably poised and adultlike, the kind of teenager you find yourself talking to as if she were a graduate student in psychology. Jillian, who also asked that her last name not be used, came to Mountain Valley after two years of only intermittently going to school. She suffered from social anxiety (made worse by cyberbullying from classmates) and emetophobia, a fear of vomit that can be so debilitating that people will sometimes restrict what they eat and refuse to leave the house, lest they encounter someone with a stomach flu.

Jillian listened as Jake and other peers — who, in reality, liked her very much — voiced her insecurities: “I can’t believe how insignificant Jillian is.” “I mean, for the first three weeks, I thought her name was Susan.” “If she left tomorrow, maybe we wouldn’t even miss her.”

At the last one, Jillian’s shoulders caved, and her eyes watered. “I don’t want to do this,” she said, looking meekly at McCallie-Steller.

“If it’s too much, you can stop,” the therapist said, but Jillian considered the offer only long enough to reject it. She straightened her back. “No, I feel like I need to do this,” she announced. “I have a week and a half left. If I can’t get through something like this here …”

Her voice trailed off, but the implication was clear: The real world would be much more anxiety producing — and much less forgiving.

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Jillian in her room in Florida.CreditSasha Rudensky for The New York Times

Anxiety is the most common mental-health disorder in the United States, affecting nearly one-third of both adolescents and adults, according to the National Institute of Mental Health. But unlike depression, with which it routinely occurs, anxiety is often seen as a less serious problem.

“Anxiety is easy to dismiss or overlook, partially because everyone has it to some degree,” explained Philip Kendall, director of the Child and Adolescent Anxiety Disorders Clinic at Temple University in Philadelphia. It has an evolutionary purpose, after all; it helps us detect and avoid potentially dangerous situations. Highly anxious people, though, have an overactive fight-or-flight response that perceives threats where there often are none.

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But sometimes there are good reasons to feel anxious. For many young people, particularly those raised in abusive families or who live in neighborhoods besieged by poverty or violence, anxiety is a rational reaction to unstable, dangerous circumstances. At the Youth Anxiety Center’s clinic in the Washington Heights neighborhood of Manhattan, which serves mostly poor and working-class Hispanic youth, teenagers would object to the definition of anxiety I heard often at Mountain Valley: “The overestimation of danger and the underestimation of our ability to cope.”

“The fears can be very real for our kids,” explained Carolina Zerrate, the clinic’s medical director. “Oftentimes their neighborhoods are not safe, their streets are not safe and their families can feel unsafe if there’s a history of trauma and abuse.” The contemporary political climate can also feel “incredibly unsafe for the community of kids we serve,” Zerrate adds, explaining that many have undocumented family members.

And yet addressing anxiety is low on the priority list in many economically disadvantaged communities. Kids who “act out” are often labeled defiant or aggressive, while those who keep to themselves — anxiety specialists call them “silent sufferers” — are overlooked or mistaken for being shy. “If you go to a public school in a struggling urban area, teachers will talk about drugs, crime, teen pregnancy, violence,” Kendall says. “When you start to talk about anxiety, they’re like, ‘Oh, those are the kids we like!’ ”

Teenagers raised in more affluent communities might seemingly have less to feel anxious about. But Suniya Luthar, a professor of psychology at Arizona State University who has studied distress and resilience in both well-off and disadvantaged teenagers, has found that privileged youths are among the most emotionally distressed young people in America. “These kids are incredibly anxious and perfectionistic,” she says, but there’s “contempt and scorn for the idea that kids who have it all might be hurting.”

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A resident taking part in equine therapy at Mountain Valley.CreditSasha Rudensky for The New York Times

For many of these young people, the biggest single stressor is that they “never get to the point where they can say, ‘I’ve done enough, and now I can stop,’ ” Luthar says. “There’s always one more activity, one more A.P. class, one more thing to do in order to get into a top college. Kids have a sense that they’re not measuring up. The pressure is relentless and getting worse.”

It’s tempting to blame helicopter parents with their own anxiety issues for that pressure (and therapists who work with teenagers sometimes do), but several anxiety experts pointed to an important shift in the last few years. “Teenagers used to tell me, ‘I just need to get my parents off my back,’ ” recalls Madeline Levine, a founder of Challenge Success, a Stanford University-affiliated nonprofit that works on school reform and student well-being. “Now so many students have internalized the anxiety. The kids at this point are driving themselves crazy.”

Though there are cultural differences in how this kind of anguish manifests, there’s considerable overlap among teenagers from different backgrounds. Many are anxious about school and how friends or teachers perceive them. Some obsess about family conflicts. Teenagers with OCD tend to worry excessively about what foods they should eat, diseases they might contract or whatever happens to be in the news that week. Stephanie Eken, a psychiatrist and the regional medical director for Rogers Behavioral Health, which runs several teenage-anxiety outpatient programs across the country and an inpatient program in Wisconsin, told me that in the last few years she has heard more kids than ever worry about terrorism. “They wonder about whether it’s safe to go to a movie theater,” she said.

When I asked Eken about other common sources of worry among highly anxious kids, she didn’t hesitate: social media. Anxious teenagers from all backgrounds are relentlessly comparing themselves with their peers, she said, and the results are almost uniformly distressing.

Anxious kids certainly existed before Instagram, but many of the parents I spoke to worried that their kids’ digital habits — round-the-clock responding to texts, posting to social media, obsessively following the filtered exploits of peers — were partly to blame for their children’s struggles. To my surprise, anxious teenagers tended to agree. At Mountain Valley, I listened as a college student went on a philosophical rant about his generation’s relationship to social media. “I don’t think we realize how much it’s affecting our moods and personalities,” he said. “Social media is a tool, but it’s become this thing that we can’t live without but that’s making us crazy.”

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A resident meditating during a yoga session at Mountain Valley.CreditSasha Rudensky for The New York Times

In his case, he had little doubt that social media made him more self-conscious. “In high school, I’d constantly be judging my self-worth online,” he told me, recalling his tortured relationship with Facebook. “I would think, Oh, people don’t want to see me on their timeline.”

While smartphones can provoke anxiety, they can also serve as a handy avoidance strategy. At the height of his struggles, Jake spent hours at a time on his phone at home or at school. “It was a way for me not to think about classes and college, not to have to talk to people,” he said. Jake’s parents became so alarmed that they spoke to his psychiatrist about it and took his phone away a few hours each night.

At a workshop for parents last fall at the NW Anxiety Institute in Portland, Ore., Kevin Ashworth, the clinical director, warned them of the “illusion of control and certainty” that smartphones offer anxious young people desperate to manage their environments. “Teens will go places if they feel like they know everything that will happen, if they know everyone who will be there, if they can see who’s checked in online,” Ashworth told the parents. “But life doesn’t always come with that kind of certainty, and they’re never practicing the skill of rolling with the punches, of walking into an unknown or awkward social situation and learning that they can survive it.”

Jean Twenge, a professor of psychology at San Diego State University who researches adolescent mental health and psychological differences among generations, used to be skeptical of those who sounded an alarm about teenage internet use. “It seemed like too easy an explanation for negative mental-health outcomes in teens, and there wasn’t much evidence for it,” she told me. She searched for other possible explanations, including economic ones. But the timing of the spike in anxious and depressed teenagers since 2011, which she called one of the sharpest and most significant she has seen, is “all wrong,” she said. “The economy was improving by the time the increase started.”

The more she looked for explanations, the more she kept returning to two seemingly unrelated trend lines — depression in teenagers and smartphone adoption. (There is significantly more data about depression than anxiety.) Since 2011, the trend lines increased at essentially the same rate. In her recent book “iGen,” and in an article in The Atlantic, Twenge highlights a number of studies exploring the connection between social media and unhappiness. “The use of social media and smartphones look culpable for the increase in teen mental-health issues,” she told me. “It’s enough for an arrest — and as we get more data, it might be enough for a conviction.”

Last fall, at a high school near the New Hampshire-Vermont border, I watched Lynn Lyons, a psychotherapist and author, deliver bad news to a packed auditorium of teachers and counselors. “We’re not getting the job done,” she said, pacing the stage at Fall Mountain Regional High School, where she had been asked to lead a professional-development training session about anxiety.

More than a decade ago, the school would have been unlikely to invite her to speak. Anxiety was barely on the radar of most educators back then, according to Denise Pope, another founder of Challenge Success, the Stanford-affiliated nonprofit. Pope remembers facing skepticism when she sounded the alarm about growing anxiety among teenagers. “We don’t have to convince them anymore,” she told me. “Schools are coming to us, eager for help.”

A gregarious speaker, Lyons kept her audience entertained by calling anxiety “the cult leader” — for its ability to convince people of falsehoods about themselves — and telling funny stories about overinvolved parents. But her main point was clear: In a seemingly well-meaning effort to help kids avoid what makes them anxious, administrators actually make anxiety worse. “Anxiety is all about the avoidance of uncertainty and discomfort,” Lyons explained. “When we play along, we don’t help kids learn to cope or problem-solve in the face of unexpected events.”

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Kids hanging out in the lounge after lunch at Mountain Valley.CreditSasha Rudensky for The New York Times

She pointed to the increasing use of “504 plans,” a popular educational tool that allows for academic accommodations for students with physical or mental disabilities. Though 504 plans for anxiety vary by student, a typical one might allow a teenager to take more time on homework and tests, enter the school through a back door — to avoid the chaos of the main entrance — and leave a classroom when feeling anxious.

Lyons believes in the necessity of 504 plans, and she is in agreement with many of the recommendations of Challenge Success, including later school start times, less homework and more project-based learning. But Lyons worries that too many 504 plans are “avoidance-based and teach zero skills.” She gave the example of a plan that allows a student to leave a classroom anytime he feels overwhelmed. Often, a teenager “can go wherever he wants and stay there for as long as he thinks he needs,” she said. Instead, she argued, a school should have a policy in place for the student to seek out a guidance counselor or nurse and do some role-playing that helps the student “externalize his worry,” similar to how Mountain Valley teenagers are taught to observe their thinking and talk back to it. Then the student should return to his regular classroom as soon as possible, Lyons said.

“If anxiety could talk, it would say, ‘You know, let’s just get out of here. We don’t have to do this!’ ” Lyons said from the stage. “But in order to retrain the brain, in order to create that message that says that even though I’m uncomfortable I can do this, we need to stop treating these anxious kids like they’re so frail, like they can’t handle things.”

Lyons sees a connection between how some schools deal with anxious students and what she worries is a generation of young people increasingly insistent on safe spaces — and who believe their feelings should be protected at all costs. “Kids are being given some really dangerous messages these days about the fact that they can’t handle being triggered, that they shouldn’t have to bear witness to anything that makes them uncomfortable and that their external environments should bend to and accommodate their needs,” she told me.

Among many teachers and administrators I spoke to, one word — “resiliency” — kept coming up. More and more students struggle to recover from minor setbacks and aren’t “equipped to problem-solve or advocate for themselves effectively,” a school counselor in suburban Oregon told me. In the last few years, the counselor said, she has watched in astonishment as more students struggle with anxiety — and as more of those “stop coming to school, because they just can’t.”

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A Mountain Valley resident doing art therapy.CreditSasha Rudensky for The New York Times

Some schools have taken drastic measures to accommodate what one administrator called “our more fragile students.” At Roxbury High School in Roxbury Township, N.J., there are two dedicated classrooms for anxious teenagers, including one next to a mural of Edvard Munch’s painting “The Scream.” These students typically avoid the mammoth school cafeteria in favor of eating lunch in one of the classrooms, as they did on the day of my visit last May. They had just finished gym class, an anxiety-producing event for some even as the school did all it could to reimagine the concept. Music blasted throughout the gym as the teenagers halfheartedly played something vaguely approximating a game of volleyball. The ball was allowed to bounce once before being struck — not that anyone was keeping score.

I couldn’t help wondering what Lyons, and other therapists I spoke to who worry that schools inadvertently worsen anxiety, would think of this approach. Some of the programs’ teenagers hoped to go to college, where no special classrooms would await them. How was this preparing them for that?

“Some will say that this feeds the monster,” concedes Patricia Hovey, director of special services at Roxbury High. “But you’ve got to start where the kids are, not where you are or where you want them to be. We’ve got to get them in the building. Many of our students simply don’t come to school if they have to spend all day in” general-education classes. Once the students are in school, Hovey explained, staff members can help them build the confidence and skills to eventually transition to Roxbury’s regular classes — and stand a chance at navigating college or a job once they graduate.

Even with the promise of a special classroom, getting anxious kids to Roxbury High each morning demands a herculean effort from the program’s teachers and therapists. During my visit, I watched them text and call several no-show students in an effort to coax them out of bed. They also regularly communicate with parents, talking them through what to say to a teenager who refuses to leave his room. Paul Critelli, one of the program’s teachers, told me that many parents feel overwhelmed trying to get two or three kids ready for school each morning, and that their instinct is often to “sacrifice the anxious kid” in order to avoid morning hysterics and keep the family train running on time.

Mostly, though, Critelli wants to talk to the anxious students. “What’s the issue today?” I heard him ask during a phone call with a sophomore boy, who had missed his scheduled bus and was presumably speaking to Critelli from underneath his sheets. The call was a “Hail Mary,” as Critelli put it, because while he suspects that the boy sleeps with the phone “right next to his face,” he rarely responds when he’s feeling anxious. “I appreciate you picking up — you don’t normally do that,” Critelli told him, mixing in positive affirmation with a call to action. The school would be sending another bus, and Critelli expected him to be on it.

Critelli looked for any opportunity to push students out of their comfort zones. During an informal study period after lunch, I watched him confiscate cellphones he said the teenagers were using to “hide from, control and avoid” their feelings; scoff at a student who claimed to be too anxious to return a book to the school library; and challenge a particularly reserved boy who said he had nothing to work on.

Critelli looked at him incredulously. “Dude, you’re failing physics,” Critelli said. “What do you mean you don’t have anything to do?”

“There’s nothing I can do — I’m going to fail,” the student mumbled.

“So you’re just accepting that you’re going to fail?” The boy looked at his hands. “Here’s an idea,” Critelli continued. “You can email your teacher and say, ‘What can I do to improve my grade? What extra work can I do?’ ”

Critelli surveyed his classroom of anxious teenagers. “I’d love to see you advocate for yourselves!”

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A Mountain Valley teenager during equine therapy.CreditSasha Rudensky for The New York Times

Jake is a remarkably minimalist emailer and texter, eschewing exclamation points and emojis in favor of an almost old-fashioned formality. It can be challenging to gauge his moods that way, so I checked in with him regularly by phone in the months after he left Mountain Valley. He usually sounded content when we spoke, an impression confirmed by his parents, who were relieved by the changes they saw in him. In the fall of his senior year, Jake was regularly attending school — on some days he “even enjoyed it,” he told me with a laugh.

While he was careful not to overschedule himself, anxiety still sometimes overtook him. One weekend, he had to leave a Model United Nations conference after he became anxious and his stomach started cramping. “That was really disheartening, but when I struggle now it doesn’t last long, and I can usually get myself out of it pretty quickly,” he said, by talking back to his negative thoughts.

Jake also confessed to some worry about his application to attend U.N.C. He had decided to be transparent with the school about his anxiety disorder, partly because it helped explain his junior-year absences and grades and partly because the months he had spent challenging his beliefs and ideas at Mountain Valley perfectly fit the application essay prompt: Reflect on a time when you challenged a belief or idea.

In 650 thoughtful and sometimes uncharacteristically dramatic words, Jake explained that in middle school he had “aced the tests and seemed to many as the bright future of the American ideal.” But then came high school and fear of failure, the debilitating worry that he might not be good enough. He explained that going to treatment helped him change his perspective on learning and life. “Just being able to type this very essay would have been impossible months ago due to my fear of judgment,” he wrote. “College is the next step in my journey to find a true sense of self, both academically and personally. The future has reopened its doors.”

The doors had not reopened quite as wide for Jillian, whom I visited on an oppressively humid spring afternoon in Florida. It was a school day, but Jillian wasn’t at school. Instead, she was on the screened-in back patio of the townhouse where she lives with her mother, Allison. A talented artist, Jillian loves theater and special-effects makeup design, and she was hard at work on an outfit for a “Walking Dead” costume contest at a local car dealership.

While she painted her costume to make it appear blood-soaked, we half-watched an episode of the Netflix series “13 Reasons Why” on her laptop. Jillian told me she could relate to many of the series’s themes, including cyberbullying. In middle school, she made a profile page on ASKfm, a social-networking site favored at the time by mean girls and their unsuspecting prey. Jillian was quickly targeted. “I’d get 30 mean questions or messages a day,” she said. “Most of them were like, ‘Just kill yourself.’ ”

Nothing like that happened at the small private high school Jillian attended after leaving Mountain Valley. Though the school is known for its flexibility and willingness to work with nontraditional students, Jillian still struggled to feel comfortable there. She didn’t want to open up and be known as “the anxious girl.” There were other students at school who had severe anxiety and depression — “It’s like the flu broke out here with anxious kids this year,” the headmaster told me — but Jillian didn’t feel comfortable hanging out with them, either. Several had yet to go to treatment, and “I don’t want to go backward,” she told me. But the end result, unsurprisingly, was that most students never got to know Jillian.

Her longtime pattern of missing school began again. She had the tools to challenge her anxious thoughts, but using them every day proved exhausting. “There’s feeling a weight on your chest, and there’s the feeling of 16 people sitting on top of each other on your chest,” she said. “As soon as I’d wake up, it was absolute dread.”

Needing to get to her job 40 minutes away each morning, Allison, who had sold her previous house in order to afford Mountain Valley, had little time to coax Jillian out of bed. They argued constantly. Jillian thought her mother — who was severely depressed during a year when Jillian was younger and especially needed support — could be insensitive. Allison struggled with when (and how hard) to push her daughter. She knew Jillian had a serious disorder, but she also knew it wouldn’t get better by letting her hide out in her room. Allison also couldn’t be sure when Jillian was genuinely paralyzed by anxiety and when she was “manipulating me to get out of doing whatever she didn’t feel like doing,” she said.

“The million-dollar question of raising an anxious child is: When is pushing her going to help because she has to face her fears, and when is it going to make the situation worse and she’s going to have a panic attack?” Allison told me. “I feel like I made the wrong decision many times, and it destroyed my confidence as a mother.”

Allison sometimes wondered how her own anxiety issues might have genetically predisposed her daughter to anxiety. Allison had done enough Google searches to know that anxious teenagers tend to come from anxious parents. Research points to hereditary genes that predispose children to an anxiety disorder, and studies have found that an overbearing or anxious parenting style can induce anxiety and risk-aversion in kids. In the parents’ workshop I attended in Oregon, Ashworth, the therapist, spent a lot of time urging family members to work on their own anxiety issues.

He also cautioned parents not to accommodate their children’s avoidance strategies. Families of children with OCD will routinely open doors for them, cook only the two or three specific foods they’ve agreed to eat and avoid saying certain words or sounds. Families of socially anxious kids will let them stay in the car while they go shopping, order for them at restaurants and communicate with a teacher because they’re afraid to. “So many teens have lost the ability to tolerate distress and uncertainty, and a big reason for that is the way we parent them,” Ashworth said.

While Ashworth can be blunt, he is also disarming and funny, with a self-deprecating sense of humor that appeals to both parents and their cynical children. Like many therapists who work with anxious teenagers, he tries to model a “let’s not take life — and ourselves — too seriously” approach. He also has an almost endless empathy for the challenges that these teenagers and their families face. He knows, for example, that raising a severely anxious child can feel counterintuitive. How, for example, do you set and enforce limits with an anxious teenager? If you send him to his room, “you’ve just made his day,” Ashworth told the parents in his workshop, who nodded knowingly.

Though Jillian had returned from Mountain Valley a more confident person with a nuanced understanding of her issues (and with her emetophobia largely under control), treatment didn’t solve her school struggles. As she fell further behind, her morning battles with her mother became increasingly untenable. In consultation with the school, Allison agreed to let Jillian drop out and study for the G.E.D. But Allison wasn’t happy about it; she considered it a momentary concession. “We basically said, ‘O.K., anxiety, you win.’ ”

Jillian was relieved never to have to set foot in another high school. “I’m just a lot more relaxed now,” she told me in her messy bedroom, where the walls were adorned with “Star Wars” posters and the bookshelf overflowed with young-adult fiction and sci-fi, as well as a worn copy of “Chicken Soup for the Teenage Soul.” Near her bed were two prescription bottles — one for Prozac and another for Klonopin, a benzodiazepine tranquilizer. Jillian had been prescribed a number of drug combinations over the years, and while none were panaceas, she believed she would be “a lot worse if I wasn’t taking them.”

Though she spoke to a therapist once or twice a week online, Jillian otherwise ignored the structured daily schedule — including yoga, studying and cleaning her room — that she had agreed to with her mother. Jillian told me she often felt lonely at home, and she spent much of her days texting friends from around the country, some of whom she met at “Star Wars” conventions or on social media.

At the same time, Jillian was trying to make new friends. I watched her joke with fellow contestants at the costume contest (where she walked away with a $250 prize), and she was practically a social butterfly at a film event she attended with her mother. Bored with our company after the screening, Jillian spotted two teenagers talking to each other in a corner.

“O.K., I’m going to go mingle,” she announced.

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A Mountain Valley teenager talking to a passer-by during exposure therapy.CreditSasha Rudensky for The New York Times

On a busy weekday morning last May, a new crop of Mountain Valley residents were discovering that a key component of their treatment would involve repeatedly making fools of themselves. On the Dartmouth College campus, eight teenagers wore hand-painted white T-shirts that read “Ask Me About My Anxiety” and “I Have OCD.” They were encouraged by the therapy team to come up with scenarios that would make them uncomfortable. One teenager considered approaching random guys on campus and saying, “You must be a Dartmouth football player.” Later that afternoon, a second group of teenagers arrived. One feigned a panic attack at Starbucks. Another ordered nonsensically at a restaurant.

“What do we need to do to make your anxiety higher?” McCallie-Steller, the therapist, asked several teenagers as they prepared for their morning of exposure therapy. First developed in the 1950s, the technique is an essential component of cognitive-behavioral therapy (CBT) for anxiety, which a vast majority of researchers and clinicians believe is the most effective treatment for a range of anxiety disorders. In a large 2008 study of anxious youth published in The New England Journal of Medicine, more improved using CBT (60 percent) than the antidepressant Zoloft (55 percent), though the most effective therapy (81 percent) was a combination of the two.

But while exposure therapy has been proved highly effective, few teenagers receive it. “We’re much more likely to medicate kids than to give them therapy,” says Stephen Whiteside, director of the Child and Adolescent Anxiety Disorders Program at the Mayo Clinic. “And when we do give them therapy, it’s unlikely to be exposure. With a few exceptions, we’re not treating people with what actually works best.”

Part of the reason is that exposure work is hard. Anxious people aren’t typically eager to feel more anxious. “It’s also uncomfortable for many therapists,” Whiteside told me. “Most people go into therapy or psychology to help people, but with exposure therapy you’re actually helping them feel uncomfortable. It’s not much fun for anybody. It’s much easier to sit in a therapist’s office and talk about feelings.”

Researchers are trying to better understand how exposure works in the brain and to fine-tune its application for anxiety treatment. At U.C.L.A., scientists at the school’s Anxiety and Depression Research Center discovered that the more anxious a person feels going into an exposure exercise, and the more surprised he or she is by the result, the more effective it is at competing with an original negative association or traumatic memory. (That’s why McCallie-Steller did her best to ramp up the teenagers’ anxiety before they began their exposure work.) Other researchers are focused on virtual-reality-aided exposure therapy, which allows people to encounter the sources of their anxiety in a therapist’s office.

For two Mountain Valley 14-year-olds on the main quad at Dartmouth, the sources of their distress were numerous. One, a brown-haired boy who embarrassed easily, suffered from a dispiriting combination of social anxiety, OCD, binge-eating and depression. It was a lot to work on in three months, and he was often overwhelmed by the magnitude of the project. On this day, he had agreed to tackle his social anxiety by sitting next to a stranger on a park bench and striking up a conversation.

Earlier, another Mountain Valley teenager took part in a similar exercise, during which the stranger opened up about his own struggles with anxiety. The teenagers were sometimes surprised that others could relate to their issues. As one girl handed out fliers about anxiety on campus, she sometimes asked people, “Can I tell you about anxiety?” More than a few students — including one who looked as if he might actually be a Dartmouth football player — responded with some version of “Trust me, I know all about it.”

The brown-haired boy was highly anxious about his exposure. He bombarded the therapist, Bryan Randolph, with questions in a seeming attempt to run out the clock until they had to return to Mountain Valley. “Can I just sit on the bench for a minute?” he asked Randolph. “And can I sit down and then start talking? I mean, do I need to ask, ‘Do you mind if I sit there?’ It’s weird to just sit there, have a conversation, then get up and come running back to a group of people.”

“Even better — let’s make it weird,” Randolph told him.

The boy shook his head. “Maybe the guy’s on break and doesn’t want to be bothered.”

“Maybe,” Randolph said. “He might hate you. He might get real mad at you.”

“That’s terrifying,” the teenager confessed. “And what if we’re so close on the bench that we’re touching?”

“That would be awkward,” Randolph said with a half-smile.

The boy craned his neck to get a better look at the man. “Is he sitting in the middle of the bench?”

“I don’t know — he might be,” Randolph told him. “But are you going to ‘what if’ this to death, or are you going to do it?”

He eventually shuffled off toward the stranger, allowing Randolph to turn his attention to the other 14-year-old, Thomas, who stood sheepishly on a nearby corner holding his sign: “I’ve Been Bullied. Ask Me.” The “Ask Me” was hard to make out, because Thomas had also included many of the insults peers have hurled at him over the years, including “B*tch,” “F*ggot,” “Ur Fat” and “Kill Yourself.” Holding the sign on a busy corner had been Thomas’s idea; he thought it might ratchet up his anxiety and force him to interact with strangers, while having the potential added benefit of educating people about bullying.

Randolph and I watched dozens of students walk by, some giving Thomas’s sign a glance but most never slowing their stride. He had been bullied for years, and now he was being ignored. I felt anxious just looking at him.

Eventually, an attractive couple in their mid-20s stopped to read the sign. They smiled, Thomas beamed and after a minute or two of conversation they all hugged. “Oh, my God, that was the greatest,” Thomas announced upon his return.

I asked him what they’d talked about. “The muscular dude said he’s been bullied, too, in middle school, and that bullies get nowhere in life,” Thomas told us. “Then the girl said, ‘You’re really brave. Can I give you a hug?’ ”

“That’s not what you were expecting, huh?” Randolph said. “Instead of being mean to you, people actually treated you with compassion.”

“Yeah, it was awesome,” he said. “I feel so good!”

The brown-haired boy, meanwhile, returned from his brief visit to the bench: “It was sooooo awkward,” he reported. “The guy just kept texting. He was probably like, Why is this kid asking me questions?”

“And what if he was?” Randolph asked him. “You’re not responsible for what he’s thinking.”

The boy appeared to consider Randolph’s point as they made their way back to the van that would return them to Mountain Valley. Sometimes, Randolph told the boys, “exactly what you think will happen happens. Other times, the exact opposite of what you think will happen happens. Either way, it’s all manageable.”

The subject line of Jake’s email to me last winter read simply, “College Results.” I opened it: “Hey Benoit, I just wanted to tell you that I was accepted to U.N.C. Chapel Hill. Jake.” I emailed back to say that he could stand to sound a little bit more excited, to which he replied, “Trust me, I’m pretty excited!”

Last month, I visited him during his fourth week of college classes. It was a Sunday, and Jake met me outside his dorm wearing khaki shorts and a Carolina Panthers jersey. He looked happier than I’d ever seen him. “Let’s walk,” he said, leading me on a tour of campus and nearby Chapel Hill, where he went record shopping (he left with a Parquet Courts album) and played touch football with a few of his friends.

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Teenagers at the chicken coop at Mountain Valley.CreditSasha Rudensky for The New York Times

Since leaving Mountain Valley, Jake had prioritized his social life. “The health of my relationships with people is just as important as academics,” he told me on a bench overlooking the main quad. He had said something similar at Mountain Valley, but back then it sounded theoretical, aspirational. It felt true now. He had made new friends on campus and was keeping up with old ones from home — and some of his peers from Mountain Valley — via text and Snapchat, the only social-media platform he regularly uses these days. “My junior year, when things got really bad, I told myself that I didn’t need to hang out with my friends a lot, that all that really mattered was how well I did at school,” he said. “I don’t think like that anymore.”

That’s not to say that Jake doesn’t study. He does — usually days before he needs to. “Procrastination isn’t a good idea for me,” he said. But he was actually enjoying several of his college classes, especially Intro to Ethics, for which he was reading Plato’s “Republic.”

Jake had experienced only one intense bout of anxiety at U.N.C. For his info sciences course, he turned in an assignment online but realized days later that there had been a technical glitch and it hadn’t gone through. He said he felt “a sudden burst of anxiety” — his chest tightened, and adrenaline coursed through his body. What had he done? He sent a panicked email to his professor and told a friend who also has anxiety issues that he was “freaking out.” Then he took a nap, which had long been one of his coping strategies. When he awoke, the professor had emailed saying it wasn’t a big deal. “That ended that crisis,” Jake told me.

For the most part, Jake felt he was managing his anxiety. Over the summer, he met twice with Jonathan Abramowitz, a psychology professor who leads the university’s anxiety and stress lab, but Jake had put off finding a regular therapist for the school year. His parents kept bugging him about it. “I just haven’t felt like I need it here,” Jake told me. But then, a few beats later, he added: “I know I need to stop making excuses and just do it.”

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Carrying apples to the pasture to feed the cows on Mountain Valley’s campus.CreditSasha Rudensky for The New York Times

I was curious how much of Jake’s newfound contentment had to do with being at U.N.C., with getting into his dream school. After all, a major component of his treatment at Mountain Valley was learning to accept that his value didn’t depend solely on academic achievement. How would he have reacted if his application was one of the 74 percent that U.N.C. rejected last year?

It was clear that Jake had thought about the question. “I would have been disappointed, but I really think I would have been O.K.,” he told me. “There are other schools in the world where I would have been happy. I definitely wouldn’t have believed that a couple years ago, but a lot’s changed.”

Before walking back to his dorm, where Jake’s friends were waiting for him, we stopped at the Old Well, a campus landmark where legend has it that students who drink from it on the first day of classes will get straight A’s that semester. The old Jake might have been first in line. But the new Jake? He hadn’t bothered to show up.

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How to Be Mindful While Reading

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CreditSam Kalda

“Reading is so much a part of our everyday lives that we take it for granted – text messages, the banners that run across our televisions, the ads that pop up. And yet, reading can be a crucial opportunity for mindfulness — the ability to be in the present moment, aware while withholding judgment, both inside and outside of yourself. This summer, take a break from passive reading, skimming, reading-as-multitasking, and try mindful reading.” — Marcella Frydman Manoharan, co-founder of Cambridge Coaching, which specializes in academic coaching and mentoring.

Find a window of time when you can focus on your reading, rather than trying to squeeze it into a busy day or get a few pages in before bedtime.

Pick reading that will engage but not deplete you, something that requires a bit of mental energy, but doesn’t end up as another item on your growing to-do list. There’s a whole world of text out there to discover: novels, biographies, histories, but also collections of essays, science writing, poems and long-form journalism.

Consider reading in print. If much of your reading is on a screen – your phone, computer or tablet — then mindful reading from a tangible book could be a nice break from the pinging.

As you turn the pages, notice the quality of light, the color and even the smell of the ink on the page, the way that the spine of your book feels against the palms of your hands. You may find yourself more easily bored or sleepy. Take note: This is you slowing down – the point of this exercise to begin with.

Pay attention to language. Look at an individual word; look up unfamiliar words. Maybe you use a pencil to underline language that you notice, or maybe you just make a mental note. Either way, get into the details — the rhythm of a sentence, a detail that conjures a person or place. Notice as reading causes your thoughts to meander. Reading does not have to be a comprehensive or linear exercise. Your mind is not a vacuum sweeping up each word mechanically. You will invariably drift off, think of something else, imagine what you’re getting for lunch, or what you should have said to your date last night — all of this is expected.

When your mind wanders, gently usher yourself back to the text and keep going. If you’ve forgotten the last passage you read, you can always go back and read it again. Or don’t. There’s value in a bit of uncertainty, in finding peace within ambiguity.

Finally, don’t over-prepare for your reading. You don’t really need the perfect lounge chair, with light at just the right slant and a cup of tea precisely brewed. Mindful reading can provide an oasis even in more turbulent settings.

When Mindfulness Feels Like a Necessity

Edutopia

It’s quick and easy to implement, and has proven benefits including boosted working memory and reduced stress.

Mindfulness is something I incorporate into each of my classes once a week, and it only takes four to seven minutes. After reviewing the benefits of mindfulness practices—like reduced stress, boosted working memory, and lowered emotional reactivity—it was no longer a nice-to-have, but rather a necessity.

Opening a Mindfulness Activity

At the beginning of each weekly session, I welcome everyone into a circle. We leave an empty chair for those who are unable to join us that day. We put our feet flat on the ground, close our eyes, and start with three deep breaths in and out. I guide students to follow where the air from their breath goes. While students are focusing on their breath, I invite them to reflect. Sometimes we reflect on the theme we’re going to discuss in class, but not always. I always spend a minute having everyone, including myself, focus on how we’re showing up to the space. Someone could show up happy from a great start to their day, angry because of an argument they just had, or stressed from an upcoming exam. We always make sure to validate how we are showing up without judgment toward ourselves.

Facilitating Mindfulness for the First Time

I have found the following steps useful in introducing and facilitating a mindfulness practice:

  1. Let the research and purpose speak for themselves. I often lead with: “It is not strictly meditation, but rather a practice in supporting your mind to take care of yourself.” I then list the benefits.
  2. Offer an out and get visible buy-in. Students will often be hesitant. “It’s weird!” they may say. And that’s OK. When I first introduced this to students, I told them that if they could find a research-based practice that achieved the same goals, I would be happy to help them create a proposal for the group. I then asked the group to give a thumbs up if they could at least try it.
  3. Share how developing a mindfulness practice has personally benefited you. After I get my students’ buy-in, I tell them how mindfulness has helped me, and I give one or two anecdotes. For example, the last time I had to have a very difficult conversation with a personal friend, I felt my mind racing. I got to the coffee shop a few minutes early, put my phone away, and got into position—feet flat and hands flat on my knees. I took a few deep breaths, calmed myself, and made myself aware of how I was showing up. I was able to recognize why I was showing up that way, and I asked myself how I wanted to show up. I tried to keep my focus on only that and my breathing. I then visualized how I wanted to show up, took a few breaths in, and returned to the present moment. The conversation with my friend was incredible and uplifting. None of my dialogue was colored by the anxiety, stress, or self-consciousness that cluttered my mind leading up to that conversation.
  4. Give a reason for every direction the first few times you go through the practice. For example, I’ll begin by saying, “We’re all going to close our eyes. I’ll keep mine open to make sure that no one is being watched because that could be awkward and feel unsafe, and my job is to ensure your physical and emotional safety.”
  5. Balance giving directions with silent time to practice the task. I will often say, “Together, we take a deep breath in [followed by a collective breath], and a deep breath out.” I then give us 40 seconds or so of just focusing. For that 40 seconds, I am silent. Before starting, I say, “Now we are going to hold that focus for a little while. We just focus on where our air is entering and exiting our body.” Then every time I have a new direction or narration, I include myself again. It must be a balance between targeted narration and silent time to practice the task.
  6. Only directly address behaviors that are unsafe. Otherwise, like when a student laughs or tries to make silly sounds, I will often gently reinforce the mindfulness practice by saying, “And we’re taking a deep, calm breath in.” I do this in a very direct but soft tone that sounds like a parent calming a child down rather than reprimanding them.
  7. Allow for reflection and feedback. The first few times, I had my students turn to a partner and discuss how it was for them, offered space to give me critical feedback, and also offered them space to make meaning of their experience. Often, it sounds like, “OK, now turn around to your partner, give them a high five or ask if they want a hug, and discuss how that exercise was for you. Was it annoying? Fun? Interesting? Did you find yourself thinking about things you wished you hadn’t? Whatever it is, be ready to share something that came in your conversation with the whole class at the end of 90 seconds!”

Ultimately, it takes a strong trust with your students and a set routine. At the end of the day, teaching is not about guaranteeing that students will use what we teach them. It’s about ensuring that they know how to use it, and giving them the space to practice it. Like one of my students told me, mindfulness “doesn’t help me know what to do, but it helps me recognize that I need something.”

Breathe. Exhale. Repeat: The Benefits of Controlled Breathing

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CreditAndrew Rae

Take a deep breath, expanding your belly. Pause. Exhale slowly to the count of five. Repeat four times.

Congratulations. You’ve just calmed your nervous system.

Controlled breathing, like what you just practiced, has been shown to reduce stress, increase alertness and boost your immune system. For centuries yogis have used breath control, or pranayama, to promote concentration and improve vitality. Buddha advocated breath-meditation as a way to reach enlightenment.

Science is just beginning to provide evidence that the benefits of this ancient practice are real. Studies have found, for example, that breathing practices can help reduce symptoms associated with anxiety, insomnia, post-traumatic stress disorder, depression and attention deficit disorder.

“Breathing is massively practical,” says Belisa Vranich, a psychologist and author of the book “Breathe,” to be published in December. “It’s meditation for people who can’t meditate.”

How controlled breathing may promote healing remains a source of scientific study. One theory is that controlled breathing can change the response of the body’s autonomic nervous system, which controls unconscious processes such as heart rate and digestion as well as the body’s stress response, says Dr. Richard Brown, an associate clinical professor of psychiatry at Columbia University and co-author of “The Healing Power of the Breath.”

Consciously changing the way you breathe appears to send a signal to the brain to adjust the parasympathetic branch of the nervous system, which can slow heart rate and digestion and promote feelings of calm as well as the sympathetic system, which controls the release of stress hormones like cortisol.

Many maladies, such as anxiety and depression, are aggravated or triggered by stress. “I have seen patients transformed by adopting regular breathing practices,” says Dr. Brown, who has a private practice in Manhattan and teaches breathing workshops around the world.

When you take slow, steady breaths, your brain gets the message that all is well and activates the parasympathetic response, said Dr. Brown. When you take shallow rapid breaths or hold your breath, the sympathetic response is activated. “If you breathe correctly, your mind will calm down,” said Dr. Patricia Gerbarg, assistant clinical professor of psychiatry at New York Medical College and Dr. Brown’s co-author

Dr. Chris Streeter, an associate professor of psychiatry and neurology at Boston University, recently completed a small study in which she measured the effect of daily yoga and breathing on people with diagnoses of major depressive disorder.

After 12 weeks of daily yoga and coherent breathing, the subjects’ depressive symptoms significantly decreased and their levels of gamma-aminobutyric acid, a brain chemical that has calming and anti-anxiety effects, had increased. The research was presented in May at the International Congress on Integrative Medicine and Health in Las Vegas. While the study was small and lacked a control group, Dr. Streeter and her colleagues are planning a randomized controlled trial to further test the intervention.

“The findings were exciting,” she said. “They show that a behavioral intervention can have effects of similar magnitude as an antidepressant.”

Controlled breathing may also affect the immune system. Researchers at the Medical University of South Carolina divided a group of 20 healthy adults into two groups. One group was instructed to do two sets of 10-minute breathing exercises, while the other group was told to read a text of their choice for 20 minutes. The subjects’ saliva was tested at various intervals during the exercise. The researchers found that the breathing exercise group’s saliva had significantly lower levels of three cytokines that are associated with inflammation and stress. The findings were published in the journal BMC Complementary and Alternative Medicine in August.

Here are three basic breathing exercises to try on your own.

Coherent Breathing

If you have the time to learn only one technique, this is the one to try. In coherent breathing, the goal is to breathe at a rate of five breaths per minute, which generally translates into inhaling and exhaling to the count of six. If you have never practiced breathing exercises before, you may have to work up to this practice slowly, starting with inhaling and exhaling to the count of three and working your way up to six.

Photo

CreditAndrew Rae

1. Sitting upright or lying down, place your hands on your belly.

2. Slowly breathe in, expanding your belly, to the count of five.

3. Pause.

4. Slowly breathe out to the count of six.

5. Work your way up to practicing this pattern for 10 to 20 minutes a day.

Stress Relief

When your mind is racing or you feel keyed up, try Rock and Roll breathing, which has the added benefit of strengthening your core.

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CreditAndrew Rae

1. Sit up straight on the floor or the edge of a chair.

2. Place your hands on your belly.

3. As you inhale, lean forward and expand your belly.

4. As you exhale, squeeze the breath out and curl forward while leaning backward; exhale until you’re completely empty of breath.

5. Repeat 20 times.

Energizing HA Breath

When the midafternoon slump hits, stand up and do some quick breathwork to wake up your mind and body.

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CreditAndrew Rae

1. Stand up tall, elbows bent, palms facing up.

2. As you inhale, draw your elbows back behind you, palms continuing to face up.

3. Then exhale quickly, thrusting your palms forward and turning them downward, while saying “Ha” out loud.

4. Repeat quickly 10 to 15 times.

Try Monotasking

Stop what you’re doing.

Well, keep reading. Just stop everything else that you’re doing.

Mute your music. Turn off your television. Put down your sandwich and ignore that text message. While you’re at it, put your phone away entirely. (Unless you’re reading this on your phone. In which case, don’t. But the other rules still apply.)

Just read.

You are now monotasking.

Maybe this doesn’t feel like a big deal. Doing one thing at a time isn’t a new idea.

Indeed, multitasking, that bulwark of anemic résumés everywhere, has come under fire in recent years. A 2014 study in the Journal of Experimental Psychology found that interruptions as brief as two to three seconds — which is to say, less than the amount of time it would take you to toggle from this article to your email and back again — were enough to double the number of errors participants made in an assigned task.

Earlier research out of Stanford revealed that self-identified “high media multitaskers” are actually more easily distracted than those who limit their time toggling.

So, in layman’s terms, by doing more you’re getting less done.

But monotasking, also referred to as single-tasking or unitasking, isn’t just about getting things done.

Not the same as mindfulness, which focuses on emotional awareness, monotasking is a 21st-century term for what your high school English teacher probably just called “paying attention.”

“It’s a digital literacy skill,” said Manoush Zomorodi, the host and managing editor of WNYC Studios’ “Note to Self” podcast, which recently offered a weeklong interactive series called Infomagical, addressing the effects of information overload. “Our gadgets and all the things we look at on them are designed to not let us single-task. We weren’t talking about this before because we simply weren’t as distracted.”

Ms. Zomorodi prefers the term “single-tasking”: “ ‘Monotasking’ seemed boring to me. It sounds like ‘monotonous.’ ”

Kelly McGonigal, a psychologist, lecturer at Stanford and the author of “The Willpower Instinct,” believes that monotasking is “something that needs to be practiced.” She said: “It’s an important ability and a form of self-awareness as opposed to a cognitive limitation.”

This is great news for the self-identified monotaskers out there.

Jon Pack, a 42-year-old photographer in Brooklyn, was happy to hear that his single-minded manner might be undergoing a rebrand. “When I was looking for jobs and interviewing, they’d always want me to say, ‘I’m a great multitasker,’ ” he said. “And I wouldn’t. My inability to multitask was seen as a negative. Now I can just say, ‘I am a monotasker. I am someone who works best when I focus on one thing at a time.’ ”

And the way we work can have effects that kick in long after we clock out.

As much as people would like to believe otherwise, humans have finite neural resources that are depleted every time we switch between tasks, which, especially for those who work online, Ms. Zomorodi said, can happen upward of 400 times a day, according to a 2016 University of California, Irvine study. “That’s why you feel tired at the end of the day,” she said. “You’ve used them all up.”

The term “brain dead” suddenly takes on a whole new meaning.

A good sign you’ve task-switched yourself into a stupor: mindlessly scrolling Facebook at the end of the night or, as in Ms. Zomorodi’s case, looking at couches on Pinterest. “I just stuff my brain full of them because I can’t manage to do anything else,” she said. “The sad thing is that I don’t get any closer to deciding which one I like.”

But monotasking can also make work itself more enjoyable.

“I can multitask — and do, of course; it’s kind of essential — but I prefer to do one thing at a time,” Hayley Phelan, a 28-year-old writer, wrote in an email. “If I keep looking at my phone or my inbox or various websites, working feels a lot more tortuous. When I’m focused and making progress, work is actually pleasurable.”

Ms. Phelan isn’t imagining things. “Almost any experience is improved by paying full attention to it,” Ms. McGonigal said. “Attention is one way your brain decides, ‘Is this interesting? Is this worthwhile? Is this fun?’ ”

It’s the reason television shows we tweet through feel tiresome and books we pick up and put down and pick up again never seem to end. The more we allow ourselves to be distracted from a particular activity, the more we feel the need to be distracted. Paying attention pays dividends.

This is why, according to Ms. McGonigal, the ability to monotask might be most valuable in social situations. “Research shows that just having a phone on the table is sufficiently distracting to reduce empathy and rapport between two people who are in conversation,” she said.

Twenty-five thousand people participated in Ms. Zomorodi’s Infomagical project, which started the week with a single-tasking challenge. Upon completion, respondents agreed overwhelmingly that single-tasking was the No. 1 thing they wanted to carry into their post-Infomagical lives. “But they also said it was really, really hard,” Ms. Zomorodi said.

Parents of young children found it difficult for obvious reasons, as did people with jobs that permit them less control over their time. In those cases, try monotasking in areas where you can: conversations with your children, reading a book in bed before they go to sleep, dinner or drinks with friends. After all, monotasking is a good skill to incorporate into all aspects of your life, not just work.

Even those with more flexibility can find themselves going to great lengths for a little bit of focus. Nick Pandolfi, who works in partnerships at Google, once traveled to northern Sweden in what he described as an “extreme” effort to monotask.

“I had to write my business school application essays, and I was having no luck spending an hour here and there after work and on the weekends,” Mr. Pandolfi said. “I just wasn’t inspired. After spending a few days hiking in the Arctic by myself, I was able to get all of them done in just a few days.”

Transcontinental trips aside, Ms. Zomorodi stressed that it was important to find ways to practice. “Start by giving yourself just one morning a week to check in, and remind yourself what it feels like to do one thing at a time,” she said.

Mr. Pandolfi and Ms. Phelan use exercise to aid them, albeit in different ways. “If I need to get through a big project and don’t want to get distracted by my inbox and the minutiae of the web, I hop on the treadmill desk,” Mr. Pandolfi said. Ms. Phelan makes a point of running outside, weekly, “without listening to music or anything else.”

Monotasking can also be as simple as having a conversation.

“Practice how you listen to people,” Ms. McGonigal said. “Put down anything that’s in your hands and turn all of your attentional channels to the person who is talking. You should be looking at them, listening to them, and your body should be turned to them. If you want to see a benefit from monotasking, if you want to have any kind of social rapport or influence on someone, that’s the place to start. That’s where you’ll see the biggest payoff.”

So is monotasking a movement? “It’s not there yet,” Ms. Zomorodi said. “But I think it will be.”

If enough people pay attention to it, that is.

Technology and Teen Sleep Deprivation

Independent School Management

Vol. 16 No. 2 1/24/17

PSN eletter vol15 no2 slee

For the past few years, there has been notable research on how technology (e.g., digital devices, laptops, television) disrupts student sleep patterns—and student success (or not) in school. A recent meta-analysis of 20 studies, Association Between Portable Screen-Based Media Device Access or Use and Sleep Outcomes, published by JAMA Pediatrics, sheds more light on this “major public-health concern” for students. Attention-stealing devices like televisions, computers, MP3 players, and cell phones are largely to blame.

The study, covering more than 125,000 children, determined there was a “strong and consistent association between bedtime media-device use and inadequate sleep quantity, poor sleep quality, and excessive daytime sleepiness.” Almost 90% of teens have at least one device in their bedrooms, and most use those devices in the hour before going to bed. Such children are twice as likely to not sleep enough and 40% report poor sleep quality, compared to children who have no access to those devices at bedtime. Students who had access or used media devices before bedtime were also more than twice as likely to experience excessive sleepiness in school.

According to another study from the National Sleep Foundation (NSF), 95% of those surveyed reported using electronic devices just before sleep. People under the age of 30 are the worst offenders—especially teenagers aged 13 to 18. Texting an hour before sleeping is prevalent, for example. While Baby Boomers on average read, send, or receive five texts in the hour before sleep, Gen-Zers typically text 56 times in that hour. Many students feel a sense of attachment to their phones and other digital devices, and view technology as a lifeline that they can’t live without. Unfortunately, when using such devices disrupts their sleep, this leads to anxiety, depression, and other maladies.

Another problem reported by researches is that exposure late at night to the “blue light” created by computer and other screens causes sleep-phase delay. The lit screens impact (via the retina) the portion of the brain that controls the body’s circadian cycle, sending the message that it’s not time for sleep yet. A study in the Journal of Applied Physiology suggested that performing “exciting” computer activities, like a playing a video game, may suppress melatonin production, the so-called “sleep hormone.”

The NSF recommends that teens get 8.5 to 9.25 hours of sleep every night of the week. However, the average teen gets about 7.5 hours of sleep each night; 62% of 9th–12th graders report inadequate amounts of sleep.

Sleep deprivation is of particular concern to schools. As mentioned above, research shows that a lack of sleep leads to:

  • poorer school performance (lower grades),
  • inattention,
  • negative moods,
  • health risk behaviors (e.g., substance abuse, thoughts of suicide), and
  • increased incidents of adolescent-related car accidents.

Academic leaders must be aware of these problems and educate parents about the impact of sleep deprivation on their children.

The NSF and other sleep experts make the following recommendations for parents.

  • Take technology out of the bedroom. For example, mandate that all cell phones in the house are recharged at night in a room other than the bedroom. Don’t allow a TV, laptop, or other device in a teenager’s bedroom after a certain hour.
  • Reserve the last hour before bed for nighttime rituals like brushing teeth, showering, etc. Pleasure reading is also a wonderful way to unwind as well.
  • Make your child understand that the lack of sleep can cause them to be less creative, forgetful, do poorly on assignments, and fall asleep in the classroom. Sleep deprivation has also shown to cause acne, weight gain, and other health problems.
  • Establish a consistent sleep schedule, every day of the week. Don’t let teenagers stay up late nights or “sleep in” on the weekends.
  • Make sure your child gets enough exercise. An hour of playing tennis, for example, is far better than an hour in bed playing video games.
  • Monitor your child’s schedule. Is he or she overwhelmed with school responsibilities, sports, clubs, perhaps a part-time job at the expense of sleep? Perhaps lessening the number of these activities can rectify the situation.

The dynamics around sleep, student performance, student well-being, and the student’s evening time are complex. Talk with parents to ensure that your students receive an adequate amount of quality sleep—and a better experience at your school.

The Mindful Classroom

Time Magazine

Fifth-graders flow through yoga-inspired poses in a mindfulness class at a public school in Louisville, Ky.
Luke Sharrett for TIMEFifth-graders flow through yoga-inspired poses in a mindfulness class at a public school in Louisville, Ky.

Some experts think mindfulness is the antidote to distraction, misbehaving–even poor math scores. Are they on to something?

Christina Johnson’s classroom must be the most peaceful place at Cane Run Elementary School in Louisville, Ky. Instead of desks, six rows of black yoga mats line the floor. All the lights are off except for one gently glowing lamp. Underwater sounds gurgle from a pair of speakers.

Today nearly two dozen fifth-graders are sitting on the mats with their shoes off and eyes closed, following Johnson as she guides them through a relaxation exercise. “Take a nice, nice deep breath in, and keep your hands on your anchors, please,” Johnson says. The kids place one hand on their chest, the other on their belly. Johnson taps a chime and the kids know what to do: listen intently, and when the long reverberation stops, their hands shoot up. “Good job,” Johnson says. “We’re ready.”

For the next 45 minutes, Johnson leads the class through exercises that are designed to increase mindfulness–a catchall term for practices that help you focus on the present moment. They learn how to savor the taste of a mint until it dissolves on their tongue; they move their little bodies into poses lifted straight from a yoga studio.

Cane Run, which requires that students attend the class twice weekly from kindergarten on up, is at the frontier of a growing movement. Mindfulness has come to the classroom. At Cane Run, it’s still an experiment: researchers want to know if a program like this can improve students’ focus, behavior, academic performance–even their empathy. A seven-year study, called the Compassionate Schools Project, is under way in 26 Louisville schools. If all goes as well as researchers expect–and if officials can secure the funding–mandatory mindfulness classes will wind up at every public school in the city.

That mindfulness is taking its place alongside math in elementary school says something about the stressed-out state of kids’ brains these days. Educators increasingly believe that mindfulness can be an antidote to three of the biggest mental-health challenges that kids face: anxiety, trouble paying attention and bullying.

It makes sense. In adults, the benefits of activities such as yoga, meditation and deep-breathing exercises are well established. A robust body of research shows that these exercises lower stress, ease anxiety, improve sleep, ward off sickness, reduce depression and even blunt pain. If mindfulness can work even some of the same wonders in children, the implications would be huge. Up to 20% of kids in the U.S. have anxiety–and anxiety is the No. 1 predictor of depression in adolescence. Diagnoses for attention-deficit/hyperactivity disorder (ADHD) in kids show no signs of slowing, creeping up from 7% in 2003 to 11% in 2011.

Classes in mindfulness, its advocates hope, can make a dent in those worrying numbers, while also teaching kids softer skills, like how to communicate feelings, how to get along with classmates and how to modulate reactions–all skills that researchers believe the practice helps develop. If kids start early, the skills may prove useful down the road at countering the stresses and distractions of adult life. “These are not niceties. These are critical capabilities,” says Patrick Tolan, a professor at the University of Virginia Curry School of Education who is leading the analysis. “If children today don’t learn how to take care of themselves, it’s going to have enormous impact on our health care costs and on the health of our nation.”

Although research on mindfulness in children is still preliminary, studies show that it can help kids who have anxiety and trouble paying attention with their schoolwork, behavior and stress regulation. First-through third-graders who were taught mindfulness and breathing techniques had fewer ADHD symptoms and less test anxiety, one study found. Even for kids without these issues, mindfulness has been shown to increase kindness, sleep quality and even math scores.

This training appears to work in kids as young as 4. Preschoolers who received 12 weeks of a kindness and mindfulness class earned better grades and were more likely to share than counterparts in a control group, according to research by Lisa Flook, a scientist at the University of Wisconsin who is studying a mindfulness program in several schools in Madison. “A body of work shows there are these innate prosocial and altruistic qualities present from a very early age in children,” Flook says. “This is a way of nurturing the seeds of kindness in children.”

In another ongoing study, researchers from the University of North Carolina Wilmington teach preschoolers yoga poses and relaxation exercises. After just two weeks, these kids exhibit better attention, awareness, gratitude and happiness compared with kids who did not have the classes. “What’s amazing is that this brief exposure appears to be so powerful,” says lead researcher Simone Nguyen, a developmental-psychology professor at the university. “A few minutes of breathing, a few minutes of paying attention to the moment are appearing to make a difference.”

A movement is also under way to train teachers in mindfulness. “Our theory is that if we actually produce educators that are more aware and empathic and attuned to children, that in its own right is going to have an effect on kids’ nervous systems,” says Chris McKenna, program director of Mindful Schools, a group in Emeryville, Calif., that trains teachers in mindfulness.

“There’s an almost immediate calming effect of mindfulness practice,” says Randye Semple, an anxiety-disorder expert and assistant professor at the University of Southern California’s Keck School of Medicine. Calm breathing triggers the parasympathetic nervous system–the opposite of the fight-or-flight response–which slows heart rate and makes blood pressure go down, she says. Mindfulness training also encourages kids to focus attention on whatever is happening in the moment. “Essentially, mindfulness is attention training,” she says. “We’re showing them that attention can be increased, that it can be ramped up and it can be trained.”

Another study this summer found that students had higher levels of the stress hormone cortisol if their teachers reported being burned out. But if stress is contagious, so is its opposite. In a study of hundreds of teachers across 36 public elementary schools in New York City, half of the teachers received mindfulness and stress-reduction training while the other half did not. Those who were trained in mindfulness became better at handling their own stress–and as it turns out, the benefits appeared to spread to the kids too. According to Tish Jennings, associate professor of education at the Curry School of Education at the University of Virginia, the teachers who got the training were more sensitive to their students’ needs and better at fostering a productive environment for learning.

Encouraged by results such as these, a growing group of researchers, advocates and parents are pushing for mindfulness to be taught in all public schools. In some places, like Louisville, it could replace an enrichment or health course, while other districts will pick and choose parts of the practice to incorporate into existing classes. Other schools may try to create a more mindful culture by training teachers instead of adding a dedicated class. Private and charter schools across the country have been on to this for some time. “Self-regulation and attention can benefit kids on both ends and throughout the [socioeconomic] spectrum,” says Flook.

Not everyone thinks mindfulness belongs in schools. Classroom time is more prized than ever–and resources are scant. “If you can’t get art and music in a curriculum, you’re not going to be able to get this,” says McKenna. Nor do all parents find the material acceptable. One school district in Ohio piloted a mindfulness program in 2011 and found the results so impressive that it soon expanded to other schools. But parents complained that they felt the practice was teaching religion–Buddhism–and had no place in the classroom. In 2013, the district, in Canton, shuttered the program.

It’s a criticism researchers have heard before. “I don’t think any of us deny that most of these general practices and concepts come from Buddhism,” says Semple. “But we’re not teaching Buddhism. We’re teaching kids how to pay attention.”

Jennings too is careful to identify her program as “100% secular.” “We don’t teach anything related to other parts of yoga that might be considered spiritual or religious.” That’s part of the reason researchers are studying it closely. If the results show what they expect–a nearly universal benefit for kids–researchers hope it will lead to even broader adoption nationwide.

In Louisville, Christina Johnson knows it’s already working on her fifth-graders. She talks them through their final movements–raising both arms to the sky in a pose she calls “sunrise,” then releasing “all that negative stuff” as they flop over their toes–and then tells them to close their eyes and check in with their feelings. Moments later, a boy’s soft sniffle breaks the stillness. Johnson hugs and holds him as he whispers to her about problems at home. No one snickers. No one even opens their eyes.

“When the brain gets still and everything gets calm, the feelings come out,” Johnson says later. “That’s why this needs to be in schools.”