Parenting a child with ADHD isn’t always easy. Because every child with ADHD is unique and comes with a different set of challenges, there isn’t a roadmap to tell you what to do. Every day, it seems, you are faced with a new set of trials to overcome. When you finally think you have control of one issue, a different one pops up.
The following are six things parents of children with ADHD wish that someone had told them when their child was diagnosed.
YOU ARE THE EXPERT AND THE ADVOCATE
When your child is diagnosed with a medical condition, you might expect doctors to understand how the condition impacts everyday life. But not every doctor understands ADHD.
Some doctors might diagnose based on a few questions, and some might suggest medication without a thorough evaluation. Some might not understand that ADHD is more than just the major symptoms. While doctors today are more knowledgeable about ADHD than 10 or 20 years ago, you as the parent still need to be the expert.
Read everything you can about ADHD and how symptoms manifest in children. Read the pros and cons of medication and other treatment methods. If your doctor can’t provide answers, ask for a referral to a specialist. As the parent of a child with ADHD, it isn’t enough to rely on others for answers — you need to seek them out.
YOUR CHILD NEEDS AN ADVOCATE
Children with ADHD are often seen as lazy. They are frequently immature for their age, and they may need extra assistance or accommodations in school to help them succeed. Some children may need extra help navigating social situations.
When you have a child with ADHD, your job of parent extends to the role of advocate. You might need to regularly meet with teachers, attend IEP or Section 504 meetings, discuss treatments with doctors, explain your child’s behavior to classmates’ parents, and work to find social settings where your child feels comfortable. In each of these situations, you are the parent and the advocate. By acting as both, you can make sure your child has every chance of success.
Sometimes symptoms or challenges from these conditions overlap, and it is hard to know which condition is at the root of some behaviors. Your child has the best chance at success in life with an accurate diagnosis and treatment.
It’s worth your while to know the major symptoms of conditions that are associated with ADHD. That way, if you have a concern, you can immediately bring it to the attention of your child’s doctor or school and have it addressed.
SCHOOLS DON’T ALWAYS AGREE WITH YOUR ACCOMMODATION REQUESTS
To you, it might seem like common sense that your child needs extra time for tests, an aide to help him stay focused, that he not be denied recess to complete work, or any other accommodation you believe will help. But schools don’t always agree.
YOUR CHILD IS GOING TO BE FRUSTRATING, BUT HE IS STILL JUST A CHILD
There are going to be days when you are pretty sure your child is being purposely defiant. You might think, “she must have heard me and is clearly ignoring me,” or “he can’t possibly have forgotten to do that, he is being stubborn.” If your child has ADHD, he probably isn’t being defiant on purpose.
She probably isn’t “acting out to get your attention.” Your child isn’t trying to be ADHD. Your child has ADHD.
As a parent, it’s your job to love your child anyway. It’s your job to remember that as frustrating as it can get, your child is still just a child. He or she still wants your acceptance. In one way, it isn’t any different than any other child; love is what your child needs most.
YOU SHOULD TAKE TIME TO CELEBRATE YOUR CHILD
It’s easy to get caught up in the constant cycle of trying to improve your child’s behavior, improve grades, to get your child to listen when spoken to, and get along with siblings.
When you have a child with ADHD, there is always something that can be improved. But don’t forget to celebrate your child’s successes, no matter how small, and his or her unique way of looking at the world. Take the time to enjoy your child’s sense of humor, enthusiasm for life, endless curiosity, and boundless energy.
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.)
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.
Anxiety isthe 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.
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.”
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.”
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.”
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.”
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!”
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.
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.
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.”
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.
Take off your snarky hat. Adolescents get a bad rap, says Dr. Daniel Siegel, and he should know. He’s a clinical professor of psychiatry at the UCLA School of Medicine, founding co-director of the Mindful Awareness Research Center, Distinguished Fellow of the American Psychiatric Association, Executive Director of the American Psychiatric Association, and author of many books, videos, and articles on the mind. Despite his endless awards and titles, Siegel displays in lectures the warm avuncularity of James Taylor in an off-the-rack suit as he urges parents and educators to stop viewing adolescence as a grim and crazed space that kids need to cross through quickly. Why? Because teens will perceive these attitudes and act accordingly.
Siegel’s recent and sobering book, Brainstorm: The Power and Purpose of the Teenage Brain, relies on recent neurobiology research to explain how the mind works during adolescence, the ages between 12 and 24. It’s not just adding five years onto a ten-year-old’s brain, he says. Teenagers get a whole new brain. More to the point, his book sensibly frames how adolescents’ brain developments and concomitant personality traits serve a grand purpose — preparation to leave the nest.
According to Siegel, there are several unique features of the adolescent mind that deserve the awareness of teachers who “alloparent” (perform parenting duties without technically being a guardian).
Wait 90 Seconds
The brain’s emotional system is more active during adolescence than at any other stage of life. So what? Shown a photo of a neutral face, an adult’s reasoning prefrontal cortex is activated, whereas the same photo lights up the emotional amygdala of the teen brain. Consequently adolescents may feel complete conviction that a neutral face is hostile or that an innocent remark is aggressive. It’s the lower limbic system getting braced to face the outside world.
When a teen over-reacts and blows attitude your way, try not to take it personally. Matching a student’s fire with our own — “Jeremy! Take that attitude outside!” — can escalate the threat level, thereby triggering the adolescent’s “fight, flee, freeze, or faint” response. Instead, wait 90 seconds — the amount of time it takes for spiky emotions to subside. Then say, “I felt some heat back there. Can you name what you were feeling?” Brain studies show that naming emotions activates the prefrontal cortex and calms emotions. So name it to tame it.
I’m So Bored . . . That’s Fantastic!
Dopamine is a neurotransmitter that helps to control the brain’s reward and pleasure centers. Baseline levels of dopamine are lowest during adolescence, but its ecstasy-triggering release in response to “sex, drugs, and rock and roll” and novelty, giggling, texting, chocolate cake, rugby, and risk, is higher than at any other stage of human development. If adolescents didn’t experience such grinding boredom living in mom’s Tribeca brownstone, they’d never leave to major in ecogastronomy, be all they can be, climb Mt. Rainier, and ride a bus for two days to see Deadmau5.
Unfortunately, increased reward drive can lead to what is often incorrectly categorized as impulsivity. A better term would be “hyperrationality,” or examining the facts of a situation and placing more “weight on the calculated benefits of an action than on the potential risks of that action.”
This played out for me in the 1980s when my parents took a trip, leaving me home for the summer. My teen brain decided that eating nothing more than three cups of Rice Krispies with skim milk each day would be a good way to lose weight. I realized this was not a healthy choice, but the benefits and originality of my solution for quickly shedding pounds overrode the headaches, mouth lesions, and two contiguous bouts of strep throat that followed. When my parents returned home, they found me woozy with hunger, and ordered me to eat a PB&J sandwich. I protested for an hour because, duh, my plan was working — and then finally relented.
Saying “no” does not counter hyperrationality. Scare tactics, admonishments, and medical information didn’t curb teen smoking, says Siegel. “The strategy that worked was to inform them about how the adults who owned the cigarette companies were brainwashing them so they could get their money.” Instead of negatively directing adolescents to abandon their risky plans, Siegel says, respect their goals, and then suggest alternative boundary-pushing actions. Example: “Todd, wanting to modify your appearance is natural, but how about swimming for an hour every day this summer? Most of your friends would find it too challenging, but they’d be impressed by how you accomplished your goal and grew muscle.”
Siegel also recommends having adolescents put their hands on their chest and their stomach to become aware of the neural networks surrounding intestines (“gut feeling”) and the heart (“heartfelt feelings”), and counter hyperrationality with intuition. Ask, “What does your heart and gut tell you about that plan?”
The Holy Grail of Brain Development
Neural integration, linking areas of the brain so that more sophisticated functions emerge, writes Siegel, is the most important concept in brain development. But 98 percent of schools don’t use one of the most effective strategies for achieving this integration, as well as recalibrating adolescents’ emotional reactivity and countering hyperrationality. Through mental trainingfor 12 minutes a day, adolescents can stimulate the growth of myelin sheaths that make their neural networks more efficient. Mental training can also lead to feeling more engaged, receptive, resourceful, and adaptive — ideal traits for learning how to develop resilience and efficacy.
What unique features of teenage brain activity have you experienced at your school?
Debunking the most common media myths and truths with real research and practical advice.By Sierra Filucci3/28/2017
Parents have a lot of responsibility. Mainly, keep the kid alive. Next, try to raise a decent human being. And the messages about media and tech start almost from the moment they’re born: TV will rot your kid’s brain! Video games are evil! Kids don’t know how to have conversations anymore! It all boils down to the idea that too much media and tech will ruin your kid — or make them fat, dumb, and mean. But obviously that’s an oversimplification. The truth is more complicated — and a lot less scary.
Here we break down the scariest media and tech rumors and give you some solid research and simple, no-stress advice.
Rumor: TV rots kids’ brains.
Research says: No credible research exists that says screens cause any sort of damage to the brain. It’s pretty clear, though, that having a TV on in the background isn’t good for little kids. It’s been shown to reduce the amount of time kids play and the quality of that play. It also seems to be related to less parent-child talk and interaction, which can have a negative impact on kids’ language development. Television in the bedroom is also a no-no; research shows it affects the quality and amount of sleep kids get, which can affect learning, among other things.
Advice: Turn off the TV unless you’re actively watching it. And keep it out of sleeping areas. Play music — perhaps wordless — if you want some background noise. And set aside time each day, if possible, to actively play with little kids.
Rumor: Watching TV or playing video games makes kids fat.
Research says: Some research suggests a connection between watching TV and an increased body mass index. But the numbers seem to point to this being a result of kids being exposed to food advertising, not necessarily being couch potatoes.
Advice: Avoid commercials by using a DVR or choosing videos without ads. Also, teach kids to recognize advertisers’ tricks and marketing techniques, so when they see ads, they can evaluate them critically. Make sure kids get exercise every day, either at school or home. If kids can’t spend time outdoors, find ways to be physically active indoors (create obstacle courses; do kid “boot camps”) and choose active video games or find fun exercise apps or TV shows to enjoy together or for kids to enjoy on their own.
Rumor: Cell phone radiation causes cancer.
Research says: Lots of studies have been done, and the results are inconclusive. The research community is still investigating, but there is still no indication that cell phones cause cancer in humans.
Advice: Kids don’t talk on their phones very much — they’re more likely to text or use apps — so even if there were a credible connection between the radio waves emitted from phones and damage to the brain, most kids would be at little risk. If you want to be extra cautious, make sure they aren’t sleeping with their phones under their pillows (not a good idea anyway!).
Rumor: Kids use the internet/their phones too much — they’re addicted!
Research says: While plenty of research has been done to try to figure this out, the results are still pretty inconclusive, especially for kids. Certainly, studies show that kids feel addicted, but whether many are experiencing the symptoms of true addiction — interference with daily life, needing more to achieve the same feeling — is still up for debate. Also, no one has defined what “too much” time is.
Advice: Build as much balance into kids’ days and weeks as possible. That means aiming for a mix of screen and non-screen time that includes time with family and friends, reading, exercising, chores, outdoor play, and creative time. If kids seem to be suffering in some area — at school, with friends, with behavior at home — take a look at her daily and weekly activities and adjust accordingly.
Advice: Avoid games that are age-inappropriate, especially ones that combine violence with sex. Make media choices that reflect your family’s values; that can mean choosing nonviolent games, limiting the amount of time kids can play certain games, or playing along with kids to help guide them through iffy stuff. Also, as much as possible, limit other risk factors of aggression in kids’ lives.
Rumor: Kids don’t know how to have face-to-face conversations anymore.
Research says: Studies on this topic haven’t focused on kids yet, but that data is surely on the horizon. What we know says that many older adults think devices harm conversations, but younger adults aren’t as bothered. A couple studies have also found that the absence of devices (at summer camps or during one-on-one conversations) can inspire emotional awareness. What that means about the ability to have a conversation is unclear.
Advice: Make sure kids get experience having face-to-face conversations with family members, friends, and others, such as teachers, coaches, or clergy. Teach kids proper etiquette, including not staring at a phone while someone else is talking. Model the behavior you want to see. But also accept that digital communication is here to stay. Embrace it and use it with your kid. And don’t criticize kids for using it appropriately, even if it’s not your preferred method of communication.
Sierra has been writing and editing professionally for more than a decade, with a special interest in women’s and family subjects. She has a master’s degree in journalism from the University of California at Berkeley…. Read mor
Crying jags over B’s and test scores are common at Lexington High School. To lift spirits, students decorated rocks that they gave to friends.CreditGretchen Ertl for The New York Times
Small rocks from the beaches of eastern Massachusetts began appearing at Lexington High School last fall. They were painted in pastels and inscribed with pithy advice: Be happy.… Mistakes are O.K.… Don’t worry, it will be over soon. They had appeared almost by magic, boosting spirits and spreading calm at a public high school known for its sleep-deprived student body.
Crying jags over test scores are common here. Students say getting B’s can be deeply dispiriting, dashing college dreams and profoundly disappointing parents.
The rocks, it turns out, were the work of a small group of students worried about rising anxiety and depression among their peers. They had transformed a storage area into a relaxation center with comfy chairs, an orange/peach lava lamp and a coffee table brimming with donated art supplies and lots and lots of rocks — to be painted and given to favorite teachers and friends. They called it the Rock Room.
“At first it was just us,” said Gili Grunfeld, a senior who helped with the effort. “Then everyone was coming in.”
So many rocks were piling up, they had to be stored in a display case near one of the cafeterias. The maxims seemed to call out to students as they headed to their classes in conceptual physics, computer programming, astronomy and Advanced Placement Music Theory.
And they became a visual reminder of a larger, communitywide initiative: to tackle the joy-killing, suicide-inducing performance anxiety so prevalent in turbocharged suburbs like Lexington. In recent years, the problem has spiked to tragic proportions in Colorado Springs, Palo Alto, Calif., and nearby Newton, Mass., where stress has been blamed for the loss of multiple young lives. In January, a senior at Lexington High School, who had just transferred from a local private school, took her own life.
Residents in this tight-knit hamlet, with its high level of civic engagement, are hoping to stem the tide. Mary Czajkowski, the district superintendent, was hired in 2015 with the mandate of “tackling the issue head on.”
Elementary school students now learn breathing exercises and study how the brain works and how tension affects it. New rules in the high school limit homework. To decrease competition, there are no class rankings and no valedictorians and salutatorians. In town, there are regular workshops on teen anxiety and college forums designed to convince parents that their children can succeed without the Ivy Leagues. Last October, more than 300 people crammed into the town hall for a screening of “Beyond Measure,” a sequel to Vicki Abeles’s documentary on youth angst, “Race to Nowhere.”
“We want to be a model,” said Jessie Steigerwald, a longtime school board member.
But it has not been easy.
Claire Sheth, a mother of four who had invited Ms. Abeles to town, describes Lexington students as “tired to the core.” Students say depression is so prevalent that it affects friendships, turning teenagers into crisis counselors. “A lot of kids are trying to manage adult anxiety,” said the principal, Laura Lasa.
The problem is not anecdotal. In a 2015 national health survey, 95 percent of Lexington High School students reported being heavily stressed over their classes and 15 percent said they had considered killing themselves in the last year. Thinking about it most often were Asian and Asian-American students — 17 percent of them, as is the case nationally.
The town’s growing Asian community has not been timid acknowledging the problem. Through college forums and chat rooms, a group of parents and leaders of the local Chinese-American and Indian-American associations have been working to lower the competitive bar and realign parental thinking. Others are pushing back. They don’t want the workload reduced — they moved here for the high-rigor schools. At association meetings, where the tension is most pronounced, discussions about academic competition in the district have brought some to tears.
Indeed, reversing the culture is complicated in a town that prides itself on sending dozens of students to the Ivy Leagues: 10 went to Harvard last year and seven to the Massachusetts Institute of Technology. Young people are lauded at school board meetings and online for having published academic papers or performed at Lincoln Center. Last year, the varsity team placed second in the 2016 History Bowl nationals and fourth in the National Science Bowl. The robotics team has qualified for the FIRST Championship, an international technology and engineering competition, for five of the last six years.
After school recently at the public library, which was packed with students poring over textbooks, calculus work sheets, lab reports and term papers, a sophomore looked up from her world history textbook and said, “You see all these people? They want the same thing — that’s really overwhelming.” What they want: Entry into a top colleges when acceptance rates are at an all-time low.
Lexington looks and feels like a lot of other affluent suburbs: serene, stately, with a whiff of muted money. Minivans and aging Volvos are packed with violins and well-worn soccer gear. There are meticulously restored Colonials and Tudor revivals. Walk along the red brick sidewalks of Massachusetts Avenue, which cuts through the center of town, and Lexington’s Brahmin past is evident: a statue on the Battle Green of a musket-toting Captain John Parker, who led the fight against the British in 1775.
In evidence as well are signs of the burgeoning biotech industry, and the changing face of America’s elite.
Since 2000, the Asian population has ballooned from 11 percent to an estimated 22 percent of Lexington’s 32,000 or so residents, surpassing Newton (at about 13 percent) and Cambridge (15 percent). Today, more than a third of Lexington’s students are Asian or Asian-American. The demographic mirrors the migration of Asian families to suburbs across the country.
In the Crafty Yankee or the Asian bakery across the street, you are likely to bump into electrical engineers from Seoul, physicists from Beijing and biochemists from Boston. They teach at Harvard (10 miles away) and run labs at M.I.T. (11 miles). They hold top positions in the pharmaceutical companies that dot the Boston-area tech corridor. More than half of the adults in Lexington have graduate degrees. And many want their children to achieve the same.
In many ways, students in Lexington are the byproduct of the self-segregation that Enrico Moretti writes about in his book “The New Geography of Jobs,” which addresses the way well-educated, tech-minded adults cluster in brain hubs. For their children, that means ending up in schools in which everyone is super bright and hypercompetitive. It’s hard to feel special.
Best-selling authors and child psychologists have long urged parents to divest themselves from their child’s every accomplishment, thereby sending the message that mental health matters more than awards. In Lexington, the attack is more comprehensive, involving schools, neighborhoods, churches and synagogues. It is riffing off research that shows that resilience and happiness, reinforced by the entire community, can be just as contagious as stress and depression.
“You need to bring along everybody,” said Ms. Abeles, whose campaign has taken her to towns with similar communitywide efforts, including Elkins Park, Penn., San Ramon and Burbank, Calif., and New Rochelle, N.Y.
Peter Levine, associate dean for research at the Jonathan M. Tisch College of Civic Life at Tufts, says that communities that bond to promote pro-social behavior can be powerful inoculators for young people.
“Family problems are often community problems,” he said. “They need community solutions.”
No one is more aware of this than Ms. Lasa, who grew up here, earned degrees from nearby Springfield College and Lesley University, and then returned to the district — watching all the while as the population morphed from relatively laid back to Type A. She often wakes to emotional emails from parents delivered to her inbox after midnight. Most, she says, are about their children’s academic standing, and the tone is often disappointment.
Last fall, as 557 bright-eyed freshmen gathered in cushioned folding chairs in the auditorium for orientation, she gave a speech that over the last few years has come to focus more and more on stress reduction. She begged the students to make mistakes. “Do not believe that you must acquire straight A’s to be a successful student,” she said. “If you and/or your parents are caught up in society’s picture of success, let us help you change the focus.”
Students are now required to meet with counselors when choosing courses to talk about their academic loads. The practice is largely seen as a way of keeping students from overscheduling to beef up their college transcripts.
“We are trying to change a culture that is deeply rooted here,” Ms. Lasa told me in a sunny Boston accent as she barreled through the school. She was showing off the 45-minute free period she instituted this year, allowing — or in some cases, forcing — students to take time to unwind. Some were playing basketball in the gym. Others were talking with teachers. A few hung out in classrooms, chatting with friends. An awful lot, though, were getting a head start on homework.
Ms. Lasa says she is trying to “balance all the messages” they are getting about success and happiness. The one she wants to most impart is: “Slow down.”
The paradox of Lexington High School is that while indicators of anxiety abound, so too does an obsession with happiness. A large banner from the town’s newly formed suicide prevention group, a chapter of the national organization Sources of Strength, greets students as they enter the sprawling red brick building, proclaiming: “Be a Part of Happiness.” There are close to 50 students in the group. Below the banner are remnants of their project to spread positivity. Students were asked to write down their sources of strength, which were then posted beneath the banner and on Facebook. Some named their pets or friends. One wrote: “My mom.” Another: “Trip to Israel!” A girl with green hair: “Chicken curry.”
One morning in February, students in “Positive Psychology: The Pursuit of Happiness,” a popular elective, were following up on a discussion about the psychologist Barbara Fredrickson’s “broaden and build” theory, which posits that negative emotions like anxiety and fear prompt survival-oriented behaviors, while positive emotions expand awareness, spurring new ideas, creativity and eventually building skills.
“Today, we are going to look at pretty simple ways to make it more likely that you experience positive emotions on a day-to-day basis,” Matthew Gardner told his “Happiness” students as they pulled out notebooks and pencil cases. The class discussed the benefits of exercise and eating foods that release feel-good hormones. The students also learned that smiling and being smiled at releases dopamine, which has an uplifting impact.
Mr. Gardner offered an alternative to smiling: “Our brains are not so perfect that, sometimes, if you hold a pen or pencil like this” — he held a pencil between his teeth — “you activate some of the same face muscles. You might get a little bit of a dopamine effect, too.”
Several students held pencils between their teeth to test the theory.
At one point, the class practiced laughter yoga, raising their arms slowly as they breathed in, then lowering them as they breathed out, and bursting into peels of laughter. Afterward, the students recorded changes in their pulse rate to demonstrate research from the HeartMath Institute that shows heart rates slow down and smooth out after bouts of good feeling.
“It’s not just that your heart rate goes down and you become very calm,” Mr. Gardner explained. “It’s that the shape of your heart rate is smooth and more controlled. Frustration is more jagged.”
Their homework assignment: Do laughter yoga or “smile at five people you wouldn’t normally smile at.”
The effects of smiling are also taught in the A.P. Psychology class that Gili Grunfeld is taking, and it has informed her thoughts on stress. On a winter afternoon, she and several classmates were uncoiling in the Rock Room, making friendship bracelets and sketching in fat coloring books. A Post-it that read “Unplug” was taped to the wall clock. The students were bemoaning how so many of their peers develop “tunnel vision,” in Gili’s words, about schoolwork and extracurricular activities, sacrificing sleep and time with friends.
“They isolate for academics,” she said glumly.
Soon the students had changed topics, and were discussing the ice that had caked the school parking lot that morning and how to balance on it. The subtext, once again, was well-being: How much can friends support each other if both feel overwhelmed?
“Are we more likely to fall or are we more steady if we hold onto each other?” asked Jocelyn Geller, a junior.
“I feel like if you have a friend with you, you feel safer,” said Millie Landis, a sophomore, pulling Jocelyn up and wobbling on the floor with her to demonstrate. “But you could pull each other down.”
The district has increased the number of counselors and social workers, including those working in the district’s elementary schools, and expanded the training they receive in identifying and supporting at-risk students.
Cynthia Tang, whose parents emigrated from Taiwan, has been a counselor at Lexington High for 12 years. Warm and well-liked, she organizes workshops addressing the pressure on Asian students to succeed, borrowing insights from the childhood discord she experienced with her own parents as well as research on biculturalism. Studies show that the less assimilated parents are to American culture, the more stressed the children.
Adding to the pressure, she says, are cultural differences in how parents, raised abroad, and their offspring, raised in the United States, are expected to process setbacks and strife: American educators routinely encourage students to share their feelings; not so in Asia.
“I really see a lot of this being bicultural conflict,” Ms. Tang said. “When you have one side of the family holding one set of values and the other embracing a new set of values, that inherently creates a lot of misunderstanding and a lot of tension.”
Ms. Tang says that the disconnect is compounded by a lack of knowledge about the various routes to success available in the United States. Last year, she was brought in by the vice president of the local Chinese-American Association, Hua Wang, to help plan the college forum, a three-hour event on Father’s Day. Dr. Wang, an engineering professor at Boston University, wanted to shift the focus away from a guide on applying to top colleges.
Despite resistance from the organizers, he and Ms. Tang prevailed. At the forum, she presented a slide show celebrating the academic trajectories of respected Chinese-Americans: the fashion designer Vera Wang went to Sarah Lawrence College; Andrew Cherng, the founder of the fast-food chain Panda Express, went to Baker University in Kansas; the best-selling author Amy Tan, San José State University. Parents were surprised. But, Ms. Tang said, “I think a lot of parents felt like: ‘What do I do with that information?’”
This year, organizers will delve deeper into the differences between the Chinese and American systems, and are planning to add another new element: a panel discussion on combating stress. Dr. Wang said they want to showcase families who have adopted a more “holistic view” of education. Selected parents of graduating seniors will be asked to talk about how they encouraged their children to get enough sleep, comforted them when they came home with B’s and discouraged them from skipping ahead in math to be eligible for higher level classes earlier.
This would not be the only time that Dr. Wang has engaged in this kind of dialogue. Using the Mandarin words “danding,” which means to keep calm and steady, and “ruizhi,” which means wise and farsighted, he has initiated conversations on WeChat, an online chat room popular among Chinese parents. Recently, he told them: “Calmness and wisdom from the parents are the Asian child’s greatest blessings.”
But the message was not well received by everyone. Among the posted responses: “If your child gets a C, how do you get to a point of calm? You think we should be satisfied because at least he didn’t get a D?” And: “But my heart still whispers: Am I not just letting my child lose at the starting line?”
One parent, Melanie Lin, found herself, too, in a heated conversation on WeChat after early-admissions decisions arrived last school year. She urged the other parents to stop bragging on the site about acceptance letters to top-tier schools: “If it’s only those students who are attending the big-name schools that are being congratulated, then the idea being passed on is that only those students are successful, and attending a big-name school is the only way to become the pride of your parents.”
Dr. Lin, who works at a pharmaceutical company, emigrated in the 1990s from Beijing to get a Ph.D. in biochemistry from Arizona State University. She says her rebuttal annoyed even close friends, whose online responses accused her of trying to deny parents and their children their moments in the spotlight.
Recounting the conversation with me brought Dr. Lin to tears. “There is just so much pressure,” she said. For her, the struggles are not theoretical. On the home front, she too can be just as obsessed as her peers, she says.
Her daughter, Emily, would agree. During junior year, she dreaded car rides and family dinners — any time, really, that she was alone with her parents — because conversations routinely veered back to college. Now a senior, Emily has eight A.P. and 13 honors classes under her belt. She is also a violinist, choral singer, competitive swimmer and class vice president.
For a chunk of her high school career, Emily was one of those who “isolated for academics,” working into the early morning hours on homework and waking up, sometimes before dawn, after only five or so hours of sleep. She skipped birthday parties and lunch to squeeze in more studying. “I was never doing anything for pure fun,” she said. “I put my head down and I was always running somewhere with some purpose.”
But as a member of a youth board for a teen counseling center in town, she realized that her study habits were unhealthy. To get support for herself and others, she helped launch the town’s Sources of Strength chapter. She has assisted in planning student outreach events and spoke up at a town meeting about “the dog-eat-dog” competition that still persists at the high school.
Homework remains heavy, students say, particularly in high-level classes. Class rankings may be gone but students have a pretty good sense of where they stand. And while there has been talk of a later start time to the day so students can get more sleep, the idea is on hold.
In December, when early decisions came in, Emily found out she was deferred to the regular admissions pool by Yale, her top choice. Parents on WeChat were more sensitive this time around, but accepted seniors still bragged on Facebook.
Since then, Emily has been admitted to nine universities; rejected by three, including Yale; and waitllisted by Harvard and the University of Chicago. She is deciding between Columbia and Duke.
Through it all, she has wondered if it’s worth it.
“I lost out on a lot of high school,” she had told me as she waited for college decisions. What she hopes is that students who come after her find some balance before their time at Lexington is up.
Last week I received a letter from my son’s high school that started like this:
PowerSchool, our student information system, allows you to create your own account and use a single password to access information for all of your children who attend school in our district. This account allows you to keep up to date with your students’ academic progress, attendance, historical grades, etc.
I believe the letter goes on to detail procedures for setting up an account that would allow me to track nearly every aspect of my son’s academic life. I say, “I believe,” because I have not read the rest of the letter. Our family had known the letter was coming, and we’d already discussed how we were going to handle it.
My husband and I handed the letter over to my 14-year-old son with the promise that we will not be using the system to check on his grades or attendance (or anything else). In return, he promised to use the system himself and keep us apprised of anything we need to know.
We’re not the only family that’s had to decide what to do with “student information systems.” According to Bryan Macdonald, senior vice president of PowerSchool, 70 to 80 percent of the schools that use PowerSchool choose to implement the parent portal, which represents about 9 to 10 million students. “Our best data suggests that over 80 percent of parents and students who have access – meaning their school has enabled remote access – use the system at least once a week…and many users check multiple times a day.”
When I posted a challenge on Facebook encouraging friends to join us in eschewing PowerSchool, I received many comments and emails, none of them neutral. Either PowerSchool and its ilk are best thing that’s ever happened to parenting or the worst invention for helicopter parents since the toddler leash.
Several parents reject the technology on the grounds that they want to talk to their kids face-to-face about school:
I am fairly certain that the fear of facing me with bad academic news was the only thing that kept my kids in line. Take away that moment when they have to look us in the eye, admit to not having studied and the ensuing results….not on your life! -Lisa Endlich Heffernan, mother of three and parenting blogger at Grown & Flown
We don’t use the info, either. We just talk to our kids. -Elena Marshall, mother of eight
Teachers and administrators have mixed feelings:
I like that parents can check grades and I encouraged them to do so. I feel that open communication between home and school is essential in educating children, and only sending midterm and final grades home makes grades seem like a big secret. With parent access on PowerSchool, there are no secrets. I am bothered, however, by parents who CONSTANTLY check…sometimes 5 or 6 times a day. These parents tend to be the ones who push their children the hardest and are the first to complain when grades aren’t entered on the DAY an assignment is due. As a language arts teacher with 60 papers to grade, I just can’t do that! I’m not sure parents realize the school can see how many times they access the portal. –Mindi Rench, mother of two and junior high literacy coach and education blogger
Teacher Gina Parnaby tweeted that PowerSchool is a “Bane. Stresses my students out to no end. Freaks parents out b/c they see grades not as a communication but as judgment.” Teacher Dana Salvador wrote in an email that i-Parent, the parent portal her school has implemented is a moot issue for her. This is not because the parents have not chosen to use the software, but the parents of her low-income, ESL students don’t speak English and there is no Spanish version of the software.
For a sampling of what students think about PowerSchool, one need look no far than Twitter.
Ultimately, for many, including mother and teacher Christiana Whittington, the choice to use the unfettered access depends on the child.
I think this may be best viewed as a case-by-case scenario. Our son sailed through school effortlessly with excellent grades but hit one very hard. He procrastinated telling us about his issues. By the time we found out that he was struggling, it was really too late to save him. If we had had the opportunity to check on his grades through the portal, we could have easily prevented this. Our other daughter, being dyslexic, has always struggled in school. She had not yet come to grips with the fact that she is a bright person in spite of her disability and was embarrassed about lower grades especially in the highly competitive environment. For her, we would definitely have chosen to access the portal. I think overall this is a good thing but it can also completely undermine trust between parent and child. You really need to know your child.
For the time being, I choose to trust in the power of open communication and my son’s emerging sense of responsibility and character. When I handed him the envelope, and asked him to keep me in the loop, he thanked me and returned to his room to do his homework. He has four years of high school ahead of him, and only time will tell if my faith in him is warranted. Until then, I plan to keep my hands out of what should be his business, his responsibility, and his life.
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),
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.