DEEP DIVE: Donna Jackson Nakazawa on Helping Our Daughters Thrive

0:00Amy, let me tell you about a magical place that is so exactly designed to be enclosed space, year-round fun for the whole family, that I bet you already know what I'm going to say before I even say the name. Let's say it together on three. One, two, three. Great Wolf Lodge. You got it, Amy. My kids loved Great Wolf Lodge when we went. You probably already know that it has a huge indoor water park with a wave pool, Lazy River, a bunch of massive water slides. But then your pack can hit the other attractions because, wait, there's more. Great Wolf Lodge has adventure-packed attractions like MagiQuest, a live-action game kids can play throughout the lodge.

0:42Plus, the Northern Lights Arcade spent some quality time there. So your kid who loves the Lazy River and your kid who loves fantasy games will both have a great time. Great Wolf Lodge also offers great dining options and complimentary daily events like nightly dance parties. All under one roof. Unpack the car once and you're settled in to have fun. And with 22 lodges across the country, you're always a short drive away from adventure. We've both had such great times at Great Wolf Lodge. So bring your pack together at a lodge near you. Learn more at greatwolf.com and strengthen the pack. Hello, everyone, and welcome to Fresh Take from What Fresh Hell?

1:21Laughing in the Face of Motherhood. This is Margaret. And this is Amy. And today we're talking to Donna Jackson Nakazawa. She is the author of four books that explore the intersection of neuroscience, immunology, and emotion, including The Angel and the Assassin, named one of the best books of 2020 by Wired Magazine, and Childhood Disrupted, how your biography becomes your biology, and how you can heal. Jackson Nakazawa is also the creator and founder of Your Healing Narrative, Right to Heal with Neuro Renarrating. She lives with her family in Maryland, and her new book is Girls on the Brink, Helping Our Daughters Thrive in an Era of Increased Anxiety, Depression, and Social Media.

2:01Welcome, Donna. Thanks for having me, guys. Pleasure to be here. Oh, we both need this one. I have a 10-year-old girl and Amy has 14-year-old. And so we are on the brink of them being on the brink. Yeah, they're on the brink. You're on the brink. And I've been there. We're on the brink. Yes, we're all on the brink. And we have a banana peel. Yes. So let's start with the problem. We like to talk about what are we seeing when we look at the state of mental health in girls today? Well, we're seeing that rates of depression and anxiety, which have already been higher in girls traditionally than in boys once girls hit puberty, are skyrocketing.

2:40And that gap is continuing to widen between girls' mental health and boys' mental health. So if we just look at a few of the big take statistics, a third of girls now by age 17 report a major depressive period. I don't mean just, you know, a bad breakup or worrying about finals. I mean, a period of weeks where they didn't want to get out of bed or they lost interest in their activities. We know that one in four girls suffers from depression compared to one in 10 boys. And more recently, this past year, the CDC reported that the rate of girls with suicidal attempts or ideation rose 51 percent compared to 4 percent in boys.

3:28So, you know, as a science journalist and investigative reporter, you have to step back and say, what's going on here? And so I set out for two years to ask, I think, the greatest minds of our time and get a picture of why is this trend happening and why is it getting worse now? And it's not just the pandemic. This was in place in the decade before the pandemic. Long before the pandemic, a big report came out in a pediatric journal that said out of 32 hospitals, pediatric heads were really concerned because instead of their wards being full, pediatric wards being full of kids with stomach disorders or the normal appendicitis, they were full of girls who didn't want to live.

4:19What's going on? Your overall thesis, Donna, is that this is societal, but it's also biological and that teenage girls are uniquely susceptible to stressors at this time in their lives in a way that boys aren't. I thought this was fascinating. Can you walk us through the science of this? Because it's probably not familiar to almost anybody listening. Yeah. So it's a little deep in the weeds, but I want to first spit out a few caveats. Number one, this is only true when girls face unrelenting toxic stressors. Toxic is a big word, but in science, it basically means toxic stress means a stressor that is chronic and unpredictable.

5:02By that, it's ongoing. You don't have a lot of control over it, and you don't know when it's coming next. So everything that I'm about to say about girls versus boys is qualified by the fact that these vulnerabilities or concerns that we might associate with these rising rates of depression, anxiety and self -harming girls. These are only the case in the face of unrelenting stress and feeling unsafe. OK, but let's start it. There's two sort of times in life, right? I'm saying this having read the book as a non-science major in college. There are two times in life that our brains are sort of uniquely susceptible to the stresses of our environment.

5:43And one is prenatal and infancy and one is puberty. And they affect boys and girls differently. This fascinated me. So can you walk us through that? Yes. So early in life, girls in the womb have an advantage. This comes down to the fact that girls have XX chromosomes. Again, this is kind of nerdy, but XX chromosomes turn out to be more protective to outside bumps in the road, outside influences, outside environmental hits. And that's why we see that at birth, girls tend to be a little bit healthier than boys. I know this to be true because my son, when he was born, was in pediatric intensive care at Johns Hopkins for a while.

6:27And it was more full of little baby boys than girls. Boys with the X, Y, they tend to have less of a buffer against the stressors that are happening in a mother's outside world. This has to do with estrogen. It's going to be really important in our conversation. estrogen is this really cool, protective bump up for the human stress response and for the immune system. It's the reason why if a woman goes and gets a vaccine and a man goes and gets a vaccine, if you look at the biomarkers afterwards, a woman's immune response is going to be a lot higher. This is an evolutionary advantage. However, we all know, right, that when there is a lot of stress, our immune system lumps up, it gets going, we get some fight, flight, freeze going, none of which is good for us.

7:24That's linked to long-term inflammation. It's linked to long-term anxiety and depression. It causes dramatic changes in the brain. So when puberty comes in, and it's coming in earlier than ever, in girls, two years earlier than it used to, and the brain is not yet ready for the major stressors that we are throwing at our children today. And we can lump a lot of them together, right? Climate change, school shootings, cultural misogyny, shifts into a woman's right to choose, and the constant liking, disliking, critiquing, commenting about girls' bodies, about their faces, about their hair on social media.

8:10When all that comes in, Girls come closer to puberty. Estrogen rushes in. It's a master regulator in the brain. We think of it. We think of estrogen as, oh, that's going to come in and you're going to have like these groovy feelings and this thrum of excitement and like ups and downs. But estrogen is also making sure that neural synapses connect, that wiring fires up in the right way in the brain. And when puberty comes in early, estrogen rushes in to whomp up your response to stressors and to feeling unsafe. But the important decision-making areas of the brain, the prefrontal cortex and other areas of the brain, that allow you to make sense of these stressors in real time with a more mature outlook, coping skills, and mindset, including knowing when to ask for help when you feel overwhelmed.

9:10When those areas of the brain haven't wired up, we've increased the stress. We've changed the timing at which the brain gets remodeled before it's ready to discern whether or not you're safe or unsafe in the world or how to be safe, we start to see changes in the brain that on brain scans, we know are anxiety and depression. And in picking up the book, I was very much expecting like, the problem is Instagram and everybody in their outfits, you know, and we've certainly had that conversation, and it is a problem. But this book takes it to a very different level while getting into the biology and neuroscience.

9:56And so this may be a kind of a big question. But in thinking for myself reading the book, why does it help us to know that rather than just saying, OK, Instagram stinks and everybody's in little outfits and people are sending each other mean texts and that stinks for teenage girls? Like, what does it give us to understand the biology, even though we kind of already see the problems? Great question, because as a science journalist, you really can't take on a big gnarly societal worrisome trend and run around and ask people, am I right if I say or would that connect to that? Unless you feel like there's something we can do about it.

10:38Now, of course, I'm biased. You're asking the choir this question. I think that when we have some baseline of understanding, it takes away some of our confusion. I think it takes away some of our fear. I too am the mother of a daughter. And I have been there. I have been there, folks. My daughter really, really struggled. And we're very, very close. And we went through a lot. And it's difficult to talk about. It's not my story to tell. It's her story to tell. But I can say I have been there. And when we don't understand what's going on, at least for me, for my brain, the not knowing, the wondering, the maternal ruminating, what am I doing?

11:19What should I do? this shouldn't be happening. I should fix this. This is on me. I should have, could have, would have. I'm going to make it better. I'm going to do it all by myself tomorrow. I'll say the right thing. We get caught up in that maternal ruminating, which mothers are much more prone to than fathers, by the way, as well as self-blame. And if we don't have a broad picture, wow, this isn't just me. Wow. I get what's happening in her brain right now. I get what's happening in our society right now. And I can have a framework for understanding that takes us out of the realm of what's happening in the kitchen and into the realm of, okay, let's step back and let's think here, what will bring down her body and brain stress machinery?

12:10Like what are all the ways that we can do that? And I think we become much more effective. We think outside our old maternal box, which is often very limited and may even be based on what we experience growing, right? So we break wide open into a world of possibilities that change us and give our kids a very different way of looking at their connection to us, their safety with us, and the different supports that are available through family, through community, through extended family, through school, through therapy. And it just goes on from there. It depersonalizes it. I just want to add one thing, a personal thing that bothers me when I talk about this.

12:57And that is that I wish we didn't need the science. I wish we could just say, oh, girls are really suffering. This is, you know, X percent don't want to get out of bed for several weeks a year or X percent look at Facebook or Instagram and feel worse about themselves, 40 percent. You know, I wish we could just take the stats and run from there and that even more so we didn't even need them in the first place. We could just go, they're suffering. Let's change this. Let's change it. Shouldn't that be enough? Let's fix it. Yeah, let's work on it. We're talking to Donna Jackson Nakazawa and we will be right back.

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16:51Get 10 % off your first order site-wide with code fresh at oseamalibu.com. That's 10 % off your first order with code fresh at oseamalibu.com. Before the break we were talking about, And I think it's something that I'm reflecting on talking to you that we talk so much on the podcast. And it's something that always gives me a lot of comfort. And we've been doing the podcast for many years. I had little kids when we started. The idea of like this is developmentally appropriate. And so when your two-year-old is biting or hitting and that someone is able to say to you, this is developmentally appropriate.

17:29This is what they're struggling with. it's a much easier starting point than like my kid is broken and my kid is bad and my kid is completely out of control. And I think we stop having the developmentally appropriate, you know, it's like for a two-year-old, this is about three, four, and we kind of stop having that conversation around teenagers and they just all fall into this cloud of like, teenagers are a nightmare and they kind of stink. And this allows us to, I think there is a huge value in going underneath that and saying like, there's actually something that's causing this and making it happen.

18:04And it is developmentally appropriate, which doesn't mean it's good. It doesn't mean your two-year-old gets to keep biting you. It just means to say, this is what you need to understand because hopefully it can help you get behind it a little bit and start to find solutions. I totally agree. Isn't it the, in this case, it's the mismatch between what's developmentally appropriate for these girls and what's being expected of them, right? I think in your example of the two-year-old that's biting, the mom needs to understand two-year-olds are going to bite. So you redirect, you don't, you know, shame and punish.

18:35The world is sometimes telling the 14-year-old, the 11-year-old, the nine-year-old that she needs to be showing her body, you know, for likes and comments. And you call it the in-between years, Donna, that they've been stolen. So can we talk about that? How the in-between years are something that our girls are losing? Yeah, absolutely. So the years of seven to 13 used to be this time called middle childhood or the in-between years. In between kind of being a very little child of whom very little was expected in terms of, you know, doing big things in the world. You're seven. And being During 13 and entering at that time, what we would think of as adolescents, although pediatricians are thinking of moving the age up earlier since it's happening earlier.

19:24But 13 and on where you start to do more on your own. You need outside validation more than your parents. You begin to turn more to peers. All of a sudden you start to think, oh, I have got book reports to write. You know, I've got things that I want to be passionate about in the world. I want to take on, I want to learn more about climate change. All of that's moved up earlier, including, you know, testing kids in schools, starting to talk about college, not just after school sports, but club sports, travel sports. If you haven't driven your kid to a club sport event somewhere other than in your home state, you're probably not with the 21st century.

20:09And yet, how did that happen? And what kind of message is that coupled with lots of other things? Let's tick them off. School nurses tell me that Apple watches, which are just as full of Instagram and images as a smartphone, are in the worm now at seven or eight. If you're worried about your eight-year-old daughter seeing TikTok or photos on Instagram of girls revealing in order to get likes, it's all right there. Or how about, you know, who's the best in the class or who's getting the award on the sports field? All of it has come in a lot earlier. And what do all those things have in common? Extrinsic value.

20:56Other people ascribing giving value to what kind of student you are, how good you are at a particular sport, what your face or body looks like for other people's consumption instead of intrinsic value. And this used to be a time where girls were free to make friendships and figure out what they really liked. And, you know, do I want to get into photography? Yeah, I think so. Or do I want to build sand castles in the backyard. And we've taken that away and we've replaced that kind of intrinsic, internal exploration to find oneself still in the safety of community with a time in which what you do then is a measuring stick for who you will be in high school and where you will go to college and whether or not you will get a job.

21:49And parents know how our world works. It's really out of love that we try to help our kids get a leg so they can get on this track. But the track is starting sooner and sooner, and it's more evaluative, and it's more punitive if you aren't evaluated in extrinsic ways that our society has decided matter. And not just society, not just colleges and employers and coaches, but your peers. You make a good point in the book about how a girl these days is likely to construct her identity using her phone. She starts with that and then I think you sort of try to backfill your real life to match the gay and carefree girl flipping her hair that you tried to be on Instagram.

22:39Yeah, that you think you're supposed to be. And I would add to that that I have a 10-year-old who doesn't have a phone, but all the girls she knows have phones. She doesn't have social media, but it sneaks in by osmosis through the crowd. It's not just like, okay, get rid of the smart watch. It's a very deep societal thing. It's not just like, do you or do you not have a phone? I think that's right. Because all the kids are doing that. All the kids are doing that. And my daughter was the last one to get a smartphone. In fact, when she got her smartphone. Her best friend was so excited. She wanted to go with me to the store to get it to surprise my daughter.

23:21That's how big it was. Finally. Finally, she's going to have one. But it does all creep in there. However, I would say by not having a smartphone or a wristwatch, a smart watch or whatever we want to call it before 13 or 14, you are helping in a lot of ways she might not realize, for instance, it's slipping in. But your daughter is not up late at night when she should be sleeping. Scrolling through. Yeah. Scrolling, staring, despairing, comparing. She isn't doing that. And she isn't sitting at the dinner table with her phone in front of you, in front of her. So there are a lot of things. She isn't getting up in the morning and checking her phone over breakfast.

24:08And pediatricians I talked to for the book said, you know, there are these sacrosanct times, these free times that have always been connecting times in family life around food, around rising and sleeping. And what is with 99 % of girls over 12 now during those hours and not to let us off the hook as parents with us. Being on phones. So you are doing a lot by holding off on that smartphone start date more than you think. But you're right. Over time, all the messages you're sending your daughter, all of the different ways in which you're shoring her up and helping her have voice and autonomy and faith in herself for the world that's coming.

24:55All of those may not be enough if the voice that the world is sending through social media, through cultural misogyny, through legislation, whatever we want to add in there is sending her the message that she doesn't have that autonomy, that she isn't enough just as she is. So then it becomes our job to create a neuroprotective environment, to use your own term, Donna. And we love solutions. And this book is full of them. So fear not. We're going to take a break. When we come back, Donna Jackson Nakazawa, author of Girls on the Brink, is going to tell us some antidotes.

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26:15It's serum infused with a hyaluronic acid and oil blend for eight hour plumping moisture in tone enhancing shades. It's more than the shade. It's who's wearing it. You. New Maybelline serum lipstick. Maybe it's Maybelline. Okay, Donna. So this book has 15 antidotes, strategies that we can use to raise emotionally healthy girls and help them thrive in the face of this difficult world they're being raised in. So let's touch on a few of your favorites. So I really think that when I thought about these 15 and I talked to a lot of people in public health who have been thinking about this all their lives, their jobs, and kind of putting it together with our new information about what's happening in girls' brains that's new and different now.

27:04And it really has to begin with what we've touched on already, which is that essential sense of family safety and connection. So one of the things that really stood out to me in reporting the book was work out of the School of Public Health at Johns Hopkins by a researcher, Christina Bethel. And she found digging deep into family thriving that the one denominator that stood out the most for child mental health and adolescent female mental health was that a girl was able to go and talk to a parent about anything, anything. And so if we take that as a little flag, as a little, you know, green, that's a green flag.

27:52If we have that in place, that's good. How do we do that? And I think that when we talked about how things have become so ramped up in childhood and in those in-between years, we as parents, again, by trying to do the right and loving thing, have sometimes like whomped up our, oh, well, you were the best at that, or you're developing so quickly. Oh, my God. Or, wow, you look 16. Or, gee, I can't believe you thought about that for your essay. That's like a high school essay. We even in our own language, our own body language, our gestures, we're sort of revving them up to be grown up overnight.

28:33And we're doing it. Why? Because we believe in them. We think that's good. Maybe we didn't get it when we were growing up, and we want to be like the positive cheerleader. And we also rush in to want to fix things, judge things. And that makes sense with going back to a two-year-old, right? Okay, you fall, you skin your knee, let me fix it. Or you break it, your tooth comes out. It's okay, you know, the tooth fairy's coming, whatever. We always have an answer. That's what makes us really great moms. But sometimes as we're coming into this period where the brain is getting flooded with chronic stressors and feels unsafe, what girls really need most is for us not to judge, not to fix, not to step in and establish a safe connection where they can come to us with anything.

29:27And we can listen no matter how hard it is to hear. That is what the brain needs most during these years. Do you think there's a role? This is maybe slightly random, but I find for myself personally, as my daughter moves out of childhood and into this kind of next phase, that I'm having to let go a little bit of being like her pal, her other person. And I think I hear from my friends, it's harder, I think, for our generation than for my mom's generation who saw themselves very much as like, okay, we're the parent, they're the kids, and kind of finding a new line where I'm kind of back in the like, you know, Oracle sitting on the mountain roll and not so much like, hey, let's be friends on Facebook, you and me like we're, I have to kind of almost take a step back to find that role.