Pressure to be a supergirl is causing teen mental health crisis

At the same time that opportunities abound for teenage girls to compete in both traditional male and female bastions, conflicting messages to be ambitious, caring and effortlessly thin and glamorous have led to a surge in adolescent depression, eating disorders, self-mutilation, suicide, and aggression, according to "The Triple Bind: Saving our Teenage Girls from Today's Pressures" (Ballantine Books, 2009).

In the book, Hinshaw and coauthor Rachel Kranz make a compelling case that, compared to previous generations of young women who juggled fewer roles, today's teenage girls are literally collapsing under the weight of adult expectations, consumerism and a highly sexualized pop/cyberculture that celebrates physical perfection and stratospheric success.

"Given the unprecedented advances for women, it is the best of times to be a teenage girl. But it is also the worst of times, because many in this generation are experiencing depression earlier and are more vulnerable to serious mental health problems," said Hinshaw, chair of the UC Berkeley psychology department and an expert on child and adolescent psychopathology.

The phrase "triple bind' in the book's title is a play on "double bind," a term coined by 1950s social scientists who studied the effects of the conflicting messages conveyed to children by grownups. What's different about the "triple bind," said Hinshaw, is that teenage girls are receiving even more contradictory messages about what they should aspire to, and are often devastated if they don't meet these impossible standards. This largely explains why one in four teenage girls will experience major depression, self-mutilation, binge eating, a serious suicide attempt or notable aggression before age 20, he said.

"The Triple Bind is why girls who might have accepted or even celebrated their size 10 bodies a generation or two ago now feel disgustingly fat if they're not a size 2 or 4," he writes in the book. "It's why girls who might not have been all that interested in boys at ages fourteen and fifteen now insist on having steady boyfriends by ages eleven and twelve."

"It's why girls who once had a bit of breathing room to figure out their futures now feel under the gun before they finish sixth grade, already anxious about getting perfect SATs and a roster of impressive extracurriculars," the book goes on to say. "And it's why girls who once might have identified with alternative female figures - a rock star, an athlete, a female author - now have trouble finding any role models other than those who are beautiful, hot, thin, and thoroughly focused on conventional notions of success."

Hinshaw came up with the idea for "The Triple Bind" book while studying girls with Attention Deficit Hyperactivity Disorder (ADHD) at the all-female summer programs that he has been leading since 1997. Tracking these socio-economically and ethnically diverse girls from childhood through their late teens, he said he noticed that they had the same adolescent problems as boys with ADHD "plus a whole lot more." He sought to understand the reasons why.

In his research for the book, Hinshaw learned that the average age of onset for depression in women has fallen from their 30s to their 20s, with an ever-growing number of girls starting in their teens. Also, rates of "cutting," which involves nicking or slicing one's skin with knives or razors to relieve emotional pressure, appear to be skyrocketing, while obsessive dieting and binge eating are alarmingly prevalent, he said. Following puberty, girls are much more likely than boys to become depressed and anxious. But in the last decade, not only have such trends accelerated, but girls are becoming more aggressive. At the same time, aggression in boys has declined, Hinshaw said.

"Certainly, genes and other biological factors 'up the ante' for all such conditions," Hinshaw said. "Yet, the recent changes in girls' mental health problems cannot be explained by changes in genes, which would take generations to appear. Issues in the culture at large are the key focus of the book." However, a parental tendency to overvalue a child's achievements also plays a major role in the triple bind, said Hinshaw. He asks parents to be careful "not to succumb to the overwhelming social messages of insisting on top grades, top teams, top everything all the time."

"The Triple Bind" weaves together anecdotes and personal observations with a review of current research and sobering statistics. Topics include the culture of "busy-ness" that surrounds teens; the stress of homework and sleep deprivation; the ever-increasing sexual objectification of young females; today's relentless cyberculture; and how genes and environmental pressures are combining forces to compound a teen mental health crisis.

To resist the triple bind, Hinshaw advises girls to focus less on themselves by finding a wider sense of purpose, such as volunteering at environmental and civil rights organizations, or at an animal rescue shelter or program for at-risk youths. Volunteer work can provide a much-needed perspective for teens who obsess about their failures and imperfections, he said. He also urges parents and schools to promote self-discovery over rote achievement, and to stop putting pressure on kids to pad their resumés with ever more extracurricular activities.

Provided by UC Berkeley