Girls on the Brink

Helping Our Daughters Thrive in an Era of Increased Anxiety, Depression, and Social Media

About the Book

15 “simple but powerful” (The New York Times Book Review) strategies for raising emotionally healthy girls, based on cutting-edge science that explains the modern pressures that make it so difficult for adolescent girls to thrive

“This is a brave and important book; the challenging stories—both personal and scientific—will make you think, and, hopefully, act.”—Bruce D. Perry, MD, PhD, New York Times bestselling co-author of What Happened to You?

ONE OF THE BEST BOOKS OF THE YEAR: The Washington Post, Mashable

Anyone caring for girls today knows that our daughters, students, and girls next door are more anxious and more prone to depression and self-harming than ever before. The question that no one has yet been able to credibly answer is Why?

Now we have answers. As award-winning writer Donna Jackson Nakazawa deftly explains in Girls on the Brink, new findings reveal that the crisis facing today’s girls is a biologically rooted phenomenon: the earlier onset of puberty mixes badly with the unchecked bloom of social media and cultural misogyny. When this toxic clash occurs during the critical neurodevelopmental window of adolescence, it can alter the female stress-immune response in ways that derail healthy emotional development.

But our new understanding of the biology of modern girlhood yields good news, too. Though puberty is a particularly critical and vulnerable period, it is also a time during which the female adolescent brain is highly flexible and responsive to certain kinds of support and scaffolding. Indeed, we know now that a girl’s innate sensitivity to her environment can, with the right conditions, become her superpower. Jackson Nakazawa details the common denominators of such support, shedding new light on the keys to preventing mental health concerns in girls as well as helping those who are already struggling. Drawing on insights from both the latest science and interviews with girls about their adolescent experiences, the author carefully guides adults through fifteen “antidote” strategies to help any teenage girl thrive in the face of stress, including how to nurture the parent-child connection through the rollercoaster of adolescence, core ingredients to building a sense of safety and security for your teenage girl at home, and how to foster the foundations of long-term resilience in our girls so they’re ready to face the world.

Neuroprotective and healing, the strategies in Girls on the Brink amount to a new playbook for how we—parents, families, and the human tribe—can secure a healthy emotional inner life for all of our girls.
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Praise for Girls on the Brink

“Some books translate science into understandable language; some offer advice in the form of actionable steps; and some weave stories that grab you by the heart. This one—miraculously—does all three.”—Cara Natterson, MD, bestselling author of The Care and Keeping of You 2 and Decoding Boys

“After describing the environmental and physiological ‘toxic stressors’ on girls, Nakazawa offers simple but powerful ways to combat them. And she doesn’t only explain why it’s beneficial to keep your children from certain online influences as long as you can—she actually has a step-by-step program for how to do it.”—Judith Newman, The New York Times Book Review

“A perceptive, informative examination of the problems young American girls face and how to change them . . . All of the author’s advice is sound, and her insights into how to start the process of change make this an important book for parents of girls.”Kirkus Reviews (starred review)

“The smart analysis and wealth of neuroscientific and psychological research adds nuance to public discourse around girls’ mental health. . . . Timely and incisive, this issues an acute warning that the kids are not alright.”Publishers Weekly
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Girls on the Brink


Our Girls Are Not Okay

Why Are So Many of Our Daughters Struggling?

Anna Moralis keeps a portrait of her maternal grandmother on her desk in her small Chicago student apartment. Her resemblance to her grandmother is striking—they share large dark eyes, chestnut hair, and a narrow chin. “Just seeing my grandmother smiling at me helps bring down my anxiety levels,” Anna tells me when we meet for the first time. As we talk, Anna leans over a sketchbook and doodles with colored pencils. I wonder if drawing also helps her manage her anxiety.

Anna, who has just turned twenty-one and has a clear sense of herself gained through time and talk therapy, plans to go to law school and focus on social justice. But even when she was young—indeed, by the time she was twelve—she was politically engaged and reflective about the world. “I begged my parents to take me to human rights marches,” she tells me. “Everywhere I looked, there was so much social and environmental injustice. Racism, voting rights, terrorism, global warming, climate change, spates of school shootings. On the one hand, I found a lot of confidence by being so engaged; I wrote op-eds for my middle school newspaper and sold candy bars to raise money for kids caught in the Middle East conflict.” But immersing herself in larger social issues also made her feel as if “the little things I was going through in my own teenage life couldn’t be valid. I had this sense that it was silly for me to be upset about anything happening in my personal life.”

Toward the end of middle school, “I became popular for the first time,” Anna recalls. “Then social media took over. Social media was terrible for me. I already had a lot of discomfort with my body image. So much of social media is imbued with this constant, pervasive sexism.” That year in middle school, “a lot of girls would get together to watch TV shows like Pretty Little Liars, in which perfect-looking twentysome-things played perfect-looking sixteen-year-olds. They had Victoria’s Secret Fashion Show–viewing parties and posted pictures of themselves on Snapchat trying to look sexually mature and model perfect. That wasn’t good for me or for my self-image.”

When Anna turned fourteen and entered high school, the social scene grew far more challenging. “The friends I’d had in middle school dropped me. They said I was ‘too nice’ and my concern for social justice was ‘fake’; that I was trying to get attention. I couldn’t make new friends because my magnet school was so tiny.” Anna’s precocious self-awareness became a double-edged sword. As her peers made fun of her, she began to turn her capacity for observation and reflection against herself. “I had this sense that if I were skinnier or prettier or happier or less serious, I’d be included in the things everyone posted about on Snapchat and Finsta,” she says, referring to the private accounts teens use to share inside jokes and gossip with a restricted group of peers. “Maybe I’d even have a boyfriend. I assumed there was something missing in me and that was the reason I was missing out.”

Using the language for self-reflection that comes with therapy, Anna sees, looking back, how “the role models imposed by the world around me for how to be female were bombarding me from screens, phones, computers, TV, which everyone my age was on six or seven hours a day. The screen version of the feminine ideal overshadowed real life. I never got to choose how I wanted to be as a female teen.”

Anna’s mother, a physician with the U.S. Army Medical Corps, was stationed overseas. “I felt very alone. I told myself, Oh, so what if I don’t have friends? It’s not that bad; it could be worse. I wasn’t suffering from atrocities—there was no war or school shooting or flood or fire on my own doorstep—so how could my own sadness be valid? But inside, my depression snowballed. I didn’t understand what I was so sad and fearful about. We didn’t even have the pandemic! It was more like a pandemic of a growing feeling of unsafety about everything, everywhere I turned.”

Anna began restricting her meals to tiny portions. These periods were followed by binge eating. “When I was fourteen, I gained fifteen pounds. My mom came home on leave, and one day while my parents and I were driving, I was sitting in the back seat and they said, ‘Anna, you’ve gained weight. We’re worried about it. We wanted to talk to you about eating less and signing up for an exercise class.’ They didn’t seem to notice that I was also no longer my bubbly self. . . . On the one hand, my parents supported who I was on the inside—they told me I was a really good writer and would be an amazing novelist one day—but I was also living in this larger, toxic soup of damaging, gendered messages about being female, and that led me to process everything I heard them say in a toxic way, especially when it came to messages about my body: You are less than if you are fat. If you are fat, even the people who love you aren’t going to accept you for who you are.” This added to Anna’s “pervasive sense of invalidation, of not feeling seen for who I was and what I was going through.” And that contributed to a “vicious cycle of eating and purging.”

Academic stress, meanwhile, snowballed. “I was in a competitive magnet school. I’d be at school seven hours a day, totally stressed because I knew I had to do well to get the accolades of top grades and college acceptances, and totally bored by the endless work teachers assigned. When I was fifteen, sixteen, and seventeen, I spent every free minute doing activities or homework until midnight. I’d spend all weekend doing more homework. Even though my school talked about valuing ‘learning’ over awards, that was just not true. It was all about getting the accolades.”
Anna’s mother took a second tour overseas. Anna was at home with her dad and her elder sister and brother. Her sister, several years her senior, went off to college. “Suddenly, I was the only girl in my house. I often felt that when there were family arguments, I was somehow the one who’d said or done something wrong. My dad could be very patronizing. And that would lead to explosive clashes between us. He’d say something condescending, and I’d slam my door and stay in my room. It was always made out to be my fault; I was always the one who got the blame for all this ridiculous, constant anger simmering in our household, and [I] had to apologize. My brother clammed up. My dad got so fed up with single parenting, he completely disengaged. I started going out and drinking a lot with this one friend I had. I started eating a ton. When I think back to that time, I can see I felt this overwhelming sense of female powerlessness, coupled with a sense of just being abandoned. I had no female mentors, and my family felt ruptured. We’d always had this very loving family when I was a kid—but suddenly, that was gone. My mom and I would talk on Skype a lot, but there was no one I could turn to to help me process life as a teenage girl in a pretty f***ed-up world.”

Throughout the rest of high school, Anna put forth the appearance that all was okay—that she was okay. She was eighteen when she left for college, carefully concealing her mounting sense of melancholy and unease. It was then that things fell apart. It was as if she had buried all her fears and sorrow and sense of dejection in some bottomless black hole inside her, and now the hole had become so large that it had swallowed her, too, until she could no longer find herself within it.

About the Author

Donna Jackson Nakazawa
Donna Jackson Nakazawa 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, which was a finalist for the Books for a Better Life Award. Her work has appeared in Wired, Stat, The Boston Globe, The Washington Post, Health Affairs, Parenting, AARP Magazine, and Glamour, and has been featured on the cover of Parade and in Time; she has appeared on Today, NPR, NBC News, and ABC News. Jackson Nakazawa is also the creator and founder of the narrative writing-to-heal program Your Healing Narrative: Write-to-Heal with Neural Re-Narrating.™ She is a regular speaker at universities, including the Harvard Division of Science Library Series, Johns Hopkins University, and the University of Arizona. She lives with her family in Maryland. More by Donna Jackson Nakazawa
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