Girls on the Brink: Helping Our Daughters Thrive in an Era of Increased Anxiety

good litmus test for the health of any society is how well it treats its girls and how well its girls are faring. When we look at the mental health of American girls today, one thing becomes clear: We as a society are failing pretty miserably. Depression has long been more prevalent in girls than in boys, but rates of depression in girls have now reached epidemic proportions. One out of four adolescent girls reports suffering from symptoms of major depression compared with fewer than one in ten boys. Girls and young women are twice as likely as boys and young men to suffer from anxiety. In 2021, the Centers for Disease Control and Prevention reported that suicide attempts had recently increased 51 percent among girls compared with 4 percent among boys. These statistics cannot be explained by higher rates of awareness or diagnosis. They are real, and they are scary to every parent of every daughter and to anyone who cares about young women.

Even as rates of depression and anxiety in girls rise, the reasons behind this downturn in adolescent female health have been difficult to comprehend. Why does this disparity between girls’ and boys’ mental health emerge as girls enter puberty? And why is this trend worsening now? In the pages to come, I follow the discoveries of leading researchers who, in the face of today’s crisis among girls, have pivoted to answering these two questions. Not only do their findings tell us that we are raising girls in an era whose problems are different from those of previous generations, but they also offer us a new scientific understanding of how mounting adversities affect girls’ bodies and brains in surprising and unique ways. In the face of today’s ongoing toxic stressors, these negative effects can begin to manifest at a biological level in distinctly different ways as boys and girls enter puberty and come of age. This, coupled with the stress that accompanies simply growing up female in our society, is a more important driver of today’s depression and anxiety epidemic among girls than anyone previously realized.

When I first began to report on these scientific findings, I wondered if it was wise to try to view what lay behind today’s teen girl mental health crisis through a biological lens. Even as it became clear that something was happening to girls due to the environment in which they lived and that it affected them during puberty in ways distinct from boys, the question of whether sex differences played a role was not a room I was eager to enter. I feared even opening the door to the discussion, lest it be misused or misinterpreted in ways that harmed girls—wrongly implying that female biology was somehow weak, or that girls themselves were somehow to blame.

Nothing could be further from the truth. Let me say it clearly: The female body and brain are more susceptible to being adversely affected by chronic stress only when the source of that stress remains unaddressed and unmitigated. Indeed, in a healthy environment, one that fosters girls’ well-being, girls can possess distinct advantages in navigating adversity. Such an environment would include a healthy, strong relationship with parents and other adults; the experience of a deep psychological sense of safety in the world; and feeling seen and valued in society.

Adolescence is a time unlike any other, full of unimaginable promise—a golden period marked by learning and possibility and growth. As hormones rush in and begin to create visible physical changes, the brains of teens become especially ripe, agile, and flexible, open to new opportunities and experiences and to learning new approaches to self-awareness, coping, and connection that can prepare teens to navigate even highly complex challenges. And yet adolescence is also a precipice. Each young person stands at its brink, poised either to falter or to stride forward and thrive as they cross into young adulthood. So much depends on the emotional, social, and environmental terrain in which they come of age.

This may be truer for girls. As you will see in the pages that follow, the aspects of the female stress-threat response that make the female body susceptible to the biophysical ill effects of adversity and toxic environments as a girl comes into puberty are also what make the female adolescent brain remarkably flexible and responsive to positive shifts in a girl’s lived experience. But a supportive environment that provides strong scaffolding for a girl’s healthy development is not created merely through the absence of trial and adversity or by buffering children and teens from every form of toxic stress (even if such a thing were wise, or possible). A neuroprotective environment is one in which the conditions that foster a sense of being safely seen, deeply connected, and valued have been set in place by parents and other family members, mentors, and community. Each of these neuroprotective spheres of influence lies nestled inside the next, larger sphere, as with a series of Matryoshka dolls, each painted wooden doll held inside the next. If we are to grow strong girls, each neuroprotective sphere must pass the litmus test of whether girls feel secure and connected within it. Ultimately, this is what ensures that each girl, represented by the smallest figure at the center, feels safe within herself.

There are myriad ways we can harness the tremendous power of this science to promote new layers of resilience in girls. If we can identify the toxic chronic stressors a girl faces, reduce what stress we can, and provide adequate support in the face of adversity, we can create a different coming-of-age environment for girls, one that will yield a very different outcome. Indeed, we now understand the core factors that, when bundled together, are neurobiologically protective both in preventing mental health concerns in girls and in helping those girls who are already struggling.

Just as today’s change in girls’ health is not due to any single variation in their environment, protecting girls against negative shifts in the female brain and immune health likewise has many moving parts. The right interactions and interventions that help girls feel safe can promote a cascade of powerful changes at the biophysical level—acting as a cellular antidote to our culturally complicated, toxic era and setting the stage for new possibilities for flourishing. Over time, bundling together small micro changes can alter a girl’s life and emotional trajectory.

In many ways, I wrote this book because I felt a moral imperative to close the gap between what experts have learned about growing strong girls in an increasingly threat-laden era and what parents need to know.

In addition to talking to research and medical experts, I also follow the stories of three girls whose journeys illustrate why adolescent females do not feel safe in the world we’ve created for them and how modern stressors are more powerful than we previously thought in shaping every girl’s story of who she is and who she can become. I’ve changed some girls’ names and characteristics to disguise their identities, but their experiences are real. Their stories, coupled with the latest insights from science, offer what I hope will be seen as a new and powerful blueprint for how we can raise, and protect the emotional lives of, girls.

The girls I interviewed were very thoughtful about and aware of why they did not feel safe, seen, or valued in the world. Each had endured a very challenging passage into and throughout puberty. Through no fault of their own, these girls learned the hard way. And yet, despite navigating difficult journeys, they each found—with the help of caring others and by bravely searching out answers for themselves—powerful ways to heal. Indeed, the strategies they clung to for learning to thrive are included in part 3 of this book, “The Antidotes.”

As you’ll read in that section, there are ways to help downshift a girl’s stress-threat response, build up her ability to adapt and self-manage in positive ways, and prevent a chronic state of fight, flight, or freeze, even in the face of stressors. This, in turn, can help usher in a girl’s interior sense of safety and bolster her mental well-being. The fifteen antidotes I lay out in part 3 invite the reader to embrace a new way of thinking about how, when, and where to better promote deep psychological safety and connection for girls across four domains of life experience in which stress can arise—household, environmental, community, and social—while also increasing girls’ autonomy and resilience. My hope is that these antidotes will enable parents to help their daughters avoid having to muddle through or struggle quite so much—and, indeed, enable them to flourish. I hope, too, that these antidotes will help teachers, counselors, therapists, mentors, and other adults better support the girls whose lives they touch. The goal is for each of us—in whatever role we play in girls’ lives—to help make this difficult and at times precarious passage into adulthood smoother, easier, and therefore more joyful.

Perhaps today’s growing trend of despondency among girls hits home for you because you’re worried about a girl you know who is struggling. Or perhaps you’ve already been on a journey to help a girl you love flourish and thrive but have found yourself unable to uncover the best ways to do so. If that’s true for you, you’re not alone.

The deeper I delved into this research, the more my own maternal heart propelled me onward. It seems fitting to acknowledge that my foray into investigating the forces confronting today’s girls was driven by a love for all girls as well as for my own. For me, the personal has always informed the professional, compelling me to translate emerging science into clear, plain language as best I can. This book is no different. It was written with a journalist’s mind and infused with the love of a mother’s heart.

I am the mother of a beautiful and, dare I say, remarkable daughter who, like so many girls, struggled throughout adolescence and into her early twenties with mental health concerns—a story that is hers to tell, not mine. Yet, as I write these pages, I cannot stop wondering: If I had known when my daughter was younger, and still free from suffering, what I’ve now learned, could I have helped her more? Sooner? I cannot know. And yet, understanding this science has helped me know how to help my daughter now. Because, for parents, families, and society, it is never too late to better the lives of our daughters and other girls we care about.

The new neuroscience on the biology of female teen flourishing offers all of us who care about the health of girls a new blueprint containing a message of hope, responsibility, and possibility to enhance the lived experiences of girls. It is in that spirit that I offer what I’ve learned from some of the best minds of our time, and from girls themselves.