They were just 150 girls out of 10 million, but their deaths were still shocking to federal health officials. That’s because the girls, all between ages 10 and 14, killed themselves in 2014, tripling the suicide rate in their age group.
It was the largest percentage increase of any age group in the Centers for Disease Control and Prevention’s latest report on suicide in the U.S. And while the reasons for each individual girl’s death are not known, they occur at a time of increasing concern about teen girls’ mental health; in particular, their escalating levels of anxiety.
“In any given year, 12 to 22 percent of teenagers are suffering with an anxiety disorder. They need help,” said Anne Marie Albano, director of the Columbia University Clinic for Anxiety and Related Disorders.
Until about age 13, girls and boys suffer from anxiety at roughly the same rates, but after puberty, anxiety in girls skyrockets. Studies have shown they are twice as likely to be diagnosed with depression and anxiety than boys, a gap that has widened in recent years.
“There’s been an explosion in anxiety among American girls in the past 20 years,” Dr. Leonard Sax, a family physician and psychologist in Exton, Pennsylvania, told radio host Matt Townsend recently on BYU Radio. “There is something going on in American culture that is causing kids, and especially girls, to become more anxious, and you cannot blame this on their parents’ genetics.”
Although persistent anxiety can lead to physical illness, self-harm, academic problems and depression, about 80 percent of girls who suffer from it don’t get help, experts say.
A generation of worried girls
Although there are many types of diagnosable anxiety disorders, three are most prevalent in adolescent girls, Albano said.
Social phobia is an exaggerated fear of being rejected, humiliated or embarrassed, to the point that the sufferer shrinks from people.
Generalized anxiety disorder is marked by excessive worry that things will go wrong; it can lead to physical problems like insomnia, fatigue, stomach issues and irritability.
And specific phobias cause paralyzing fear of ordinary things, and can lead to girls refusing to participate in age-appropriate activities like sleepovers or class trips and later, dependency upon parents in adulthood, or “failure to launch.”
About 22 percent of adolescent girls have a specific phobia (11 percent are social) but only 1.4 percent obtain treatment, Albano said. About 3 percent have generalized anxiety, and only 1.3 percent are treated.
“Part of this we can own up to the sexual revolution,” Albano said. “There is so much more of an emphasis on girls to achieve and succeed. In general, all teenagers are getting more pressure, but we are expecting more out of girls than we ever were before.”
But the expectations and demands of parents are dwarfed by the pressure put on girls by society, and it’s exacerbated by social media, Sax says. Research has shown that girls and boys use social media differently, he told Townsend. On sites like Instagram and Snapchat, boys show photos of things they’re doing, while girls post pictures of themselves, making them more personally invested in social media and the response they get there — and more likely to be wounded by negative reaction.
This behavior is consistent with studies that show today’s teens suffer more self-focused fears than previous generations, even as they are more likely to believe they’re above average.
In her study on depressive symptoms among young people in the U.S. between 1982 and 2013, Jean Twenge, a psychology professor at San Diego State University and author of “Generation Me,” said research shows mental-health problems escalate “when people become more focused on extrinsic values such as money, fame and image.”
Other studies have noted that anxiety and depression, which are closely related, may have physical components, such as social isolation, lack of exercise and sunlight, and poor diets, also commonplace in contemporary society.
In an interview, Twenge said that a decline in religious practice among young people may also be a factor in their increasing anxiety.
In a study published last year, she analyzed religious orientation between 1966 and 2014 in the U.S., and found that although the majority of adolescents and “emerging adults” are still involved with a religion, twice as many seniors and college students, and 20 to 40 percent of eighth- and 10th-graders, never attend religious services now, compared to their counterparts in previous decades.
The decline was larger among females than males.
Twenge said it’s a “plausible theory” that a decline in religious faith figures into the increase in girls’ anxiety, in part because research has shown than religious belief and practice correlates with happiness, but also because faith groups provide social structure.
“Highly related to anxiety and depression is the breakdown in relationships: the lack of social support and solid relationships with others,” Twenge said. “People are not spending as much time interacting in person, and our relationships are not as stable as they were in the past.”
The problem, however, points to one solution: Strengthen those relationships.
Helping the anxious child
Columbia University’s Albano said the first thing parents should do if they suspect their daughter is suffering from anxiety is to listen.
“When kids are struggling in any way, parents tend to jump in and tell kids what to do; they start directing them.
"But first of all, you listen, say, ‘Tell me what’s going on.’ And just sit and give the kids a chance to open up to you. By being nonjudgmental and saying ‘I want to know more, I’m here to help’, it may get them started talking.”
If anxiety has progressed to where children are not socializing with friends, are frequently irritable or crying, and if they often say they don’t want to go to school, Albano recommends finding help through the Association for Behavioral and Cognitive Therapies or the Anxiety and Depression Association of America. The website effectivechildtherapy.org has videos that discuss anxiety and advise parents on what to look for in a provider, she added.
Sax recommends that parents restrict their children’s social-media exposure, using apps such as My Mobile Watchdog or Net Nanny Mobile. “It’s the parents’ job to govern what kids are doing, and to give kids an excuse to do the right thing,” he said on BYU Radio.
While anxiety is inheritable, it can be worsened by social pressures, and that’s something that parents can help to alleviate by nurturing strong family ties. Among other things, that means no cellphones in bedrooms, earbuds at the table or in the car, and no friends on family vacations, Sax says.
There’s some evidence that supplementing with Omega 3 fish oils may provide some relief for anxiety, Twenge said.
One study has shown that even drinking more water may help.
But, Twenge said, “There is no magic bullet; some people have a genetic predisposition, but to my mind, that’s all the more reason to be aware of what the causes may be and try to live your life in a way that protects you.”