CHAPTER 1 Sicker, Not Smarter
IN LATE 2010 I received an email from Saint Louis University School of Medicine professor and pediatrician Stuart Slavin, who was concerned about the health effects of excessive performance pressure on children. One passage in it sticks with me to this day:
My personal feeling is that we are conducting an enormous and unprecedented social experiment on an entire generation of American children, and the evidence of a negative impact on adolescent mental health is overwhelming. This is particularly disturbing given the fact that having mental health problems in the teen years predisposes to mental health problems in adulthood. It is even more profoundly disturbing when one considers that there is absolutely no evidence that this educational approach actually leads to better educational outcomes.
The science shows that Slavin is right: Our children are paying a high price for our cultural misdirection. Thousands of students are suffering from withering anxiety, depression, eating disorders, insecurity, dangerous sleep deprivation, and even thoughts of suicide. And it’s not just our children’s mental health that’s in jeopardy (which would be worrisome enough by itself); it’s their physical health, too. The result of the Race to Nowhere is a public health crisis on a scale that we have yet to fully recognize.
Before we turn to solutions, which are the heart of this book, it’s important to take a chapter to demonstrate that students’ stories are backed up by hard data—to take stock of the science of just what we’re fighting for. In fact, the price of the achieve-at-all-costs approach includes more than sickness. It produces a drill-like mode of education that deadens lessons and narrows students’ chances to explore broadly or think creatively. We see even young students disengaging from school experiences that feel impersonal and irrelevant, high school grads arriving at college in need of remediation, and rampant cheating among students of all ages. Ironically, the constant pressure also physiologically impairs children’s capacity for learning. In other words, it backfires, undermining the very achievement that it’s meant to promote.
All told, the outcome is a school environment that deprives children of both sound health and vibrant learning. These grave consequences are at the heart of what makes our work to transform childhood so urgent. What’s at stake is no less than raising healthy, thriving kids and—as they become adults—a healthy, thriving society.
Fremont, California: A Crisis Visible
Irvington High School is a sprawling, single-story beige building wrapped around a central courtyard with picnic tables and a few redwood trees. The city of Fremont spreads out around it, pancake flat and pasted with strip malls and small ranch houses, the bare brown hills of California rising in the background.
Over the past five years, Assistant Principal Jay Jackson has watched this school community transform. He taught world history and sports psychology here for eight years before becoming an administrator. With close-cropped hair and the compact build of a lightweight wrestler, Jackson is the kind of compassionate teacher whom students instinctively trust. He has an Elvis Presley shrine in his office—replete with Elvis figurines, Elvis clocks, Elvis PEZ dispensers, and even a life-size Elvis cardboard cutout—made up of gifts from past students, who kept giving him the knickknacks as a kind of joke, even though he insists he’s not that big of a fan. During his teaching years in the 2000s, Jackson recalls, the student population here was mixed:
about half of them were academically oriented and intent on college, the other half not. When, in 2010, the auto plant that had employed many of the students’ parents shut down, taking nearly five thousand mostly blue-collar jobs away with it, the demographics of the school district began to shift. Around the same time, the district redrew neighborhood boundaries, delivering to Irvington a flood of students from a more affluent part of town. Many of these new students’ parents were immigrants, drawn to the technology industry in nearby San Jose with high hopes for their children’s futures in this land of opportunity.
The school’s standardized test scores shot up—as did its rates of student anxiety, sleep deprivation, and stress-induced illnesses. When Jackson became assistant principal in 2012, the change was already under way.
“Two or three weeks into the school year, you start seeing students coming into the office with these issues, with stress, breaking down crying,” even cutting themselves, he remembers. The problem hadn’t been as obvious from the vantage point of his classroom, where students put their best face on and their late nights spent laboring over piles of do-or-die assignments weren’t so visible. But you go to work in the school office, the crossroads of students’ difficulties, and, he says, “You see enough.”
Enough, that is, to deeply alarm Jackson, who’s also a father of two boys in elementary school. It convinced him that Irvington has a serious health crisis on its hands. Jackson organized an online survey of students in fall 2013, to see if his instincts matched the teens’ own experiences. The measure wasn’t perfect—only about one in six students completed the survey. But this much was clear: if even a small percentage of Irvington students overall felt the same way as those who answered the questionnaire did, the situation was dire.
More than four in five of the teens who responded said they felt moderate or high stress about school. They reported doing hours of homework a night and sleeping too little. A majority were taking multiple AP and honors classes, and the most common reason they gave for enrolling in those classes (cited by 61 percent of students) was that it would help them get into a better college; trailing far behind, the next reason (cited by just 42 percent) was that they were actually interested in the subject matter. Nearly half of the teens admitted to cheating on tests or homework in the past year,
primarily because they didn’t have enough time to study or finish the assignment. Perhaps saddest of all, when asked, “What is your main purpose for being in high school?” more students checked “To get into a good college” than “To learn.”
Stress levels were high when I visited Irvington in the fall of 2014. Sitting with a classroom full of juniors, I casually asked, “How stressed are you, on a scale of one to ten?” The teens replied with a chorus of groans: “Ten!” One said eleven.
I went on: “Who gets seven hours of sleep a night? Raise your hand.” A couple of hands went up. “Six hours?” A few more. “Five?” And there the bulk of the class raised their hands. Growing ever more incredulous, I asked: “Four?” Up went the last couple of hands. Even as the discussion continued, many students were scribbling in their notebooks, not sparing a moment that could be spent on schoolwork. Finally, I put the critical question to them: “Is it worth it?” They mumbled yes. “Why?” One boy with a blondish mop of hair answered for his peers: “To better your future.”
Afterward, Jackson strode down the hall away from the classroom, his frustration showing in his gait. “It pains me to go into those classes because they’re really stressed, and my assumption is we’re doing this to them,” he said. “They’re all messed up.”
A student had died by suicide the previous spring. And just the day before my visit, Jackson said, he’d checked a student into the home-and-hospital program. That’s an alternative education program for students who are too sick to come to school. What was this girl’s ailment? The doctor couldn’t diagnose the precise cause of her bodily pains and ulcers, but mysteriously, they went away during the summer and returned two weeks before the start of school. “It’s driving me crazy,” said Jackson, “because what’s going on is flawed, but we’re not brave enough to change it.”
The fact is that he and his colleagues at Irvington actually are taking courageous steps to change the school’s high-stakes culture and rebuild student health—most notably by restraining students from overloading on AP classes and working with Dr. Slavin to research what kind of support they most need, as we’ll learn more about later. The progress is just slower than Jackson would like.
The questions I didn’t ask in that classroom at Irvington were these: What
makes you so sure it’s worth it? Is this sprint to achieve a certain version of “success” (reaching the top of the class, the top college, the top job, and the top life) really helping? Or is it actually making you sicker, not smarter—the kind of sick that will likely last through your adulthood—and causing you to miss opportunities to build the real-life skills that really matter?
Let’s examine the facts about what is happening to children’s health. The implications are long-lasting, as there is an avalanche of evidence that an unhealthy youth sets the stage for an unhealthy life. I’ll begin with the effects that we can see right now: the current frayed state of our children’s and teens’ health.
Unhealthy Hearts and Minds
Students these days are incredibly stressed.
On the American Psychological Association’s Stress in America survey, teens rate their stress levels during the school year higher than adults rate their own. Nearly one in three teens says the stress drives them to sadness or depression. And what are the top sources of their stress? Eighty-three percent of the thousand teens surveyed named school, and 69 percent named getting into a good college or deciding what to do after high school.
Meanwhile, 30 percent of high schoolers said on a government survey that they had felt sad or hopeless almost every day for two weeks or more within the past year.
Young Americans’ mental health has deteriorated dramatically since the postwar days of the 1950s. Jean Twenge, a psychology professor at San Diego State University and author of the book Generation Me, has scoured and crunched decades’ worth of data to illuminate these trends.
By her calculations, five to eight times more college students today report serious mental health problems than did students at midcentury.
This doesn’t bode well for their future health, as depression raises a person’s risk of heart disease, diabetes, and other illnesses, and having depression early in life significantly increases the risk of having it again as an adult.
Federal data also show that suicide rates more than doubled among youth age fifteen to twenty-four between 1950 and 2010 and more than tripled
(though the rate is still much lower) among younger children.
What’s less well known but equally worrisome is how many kids consider taking their own lives. In a Centers for Disease Control and Prevention (CDC) survey of high school students—children as young as fourteen—nearly one in six said they had seriously thought about suicide. Half that many had made an attempt within the past year.
It makes me wonder: How much torment happens below the surface, beneath the game faces that adults can see? And how much is hidden behind the airbrushed lives today’s teens present on Twitter and Instagram, where one kid’s seemingly effortless achievements only make the next kid feel she must do more?
Behind these numbers are stories like that of an alarmed mother in Orange County, California, whose seventeen-year-old son had once ranked first in his high school out of a class of 764, taking six AP classes (out of seven total) in his junior year and sleeping only five hours a night. His worried mother wrote:
I discouraged him from taking on this load, but he insisted and continued this into his senior year by taking the International Baccalaureate, and now the chronic stress and lack of sleep has taken its toll. . . .
Prior to high school my son was a secure, outgoing well-liked person with many friends. He likes to surf and would design and paint patterns on his boards. He organized camping trips, booking at state parks and organizing his friends without any help from me. He would not be able to do this today. . . . He is now in his senior year and was diagnosed last month with major depression. He has a terror of going to school and has only attended school for about six days in the past two months. . . . We are working with a doctor, a counselor (who brought your film to our community) and the school to try and salvage what we can for him to graduate in June.
What happened to this young man is sadly not uncommon. And unfortunately, our kids’ poor health outcomes are anything but temporary. The unhealthy, unhappy patterns laid down in the grade school years stay
with teens as they enter the nation’s universities, where officials are battling binge-drinking episodes and reporting a rising mental health crisis, as well.
“They work their tails off to get here, and then reach the finish line and are accepted and get here, and then realize that there is no finish line,” says Kevin Wehmhoefer, a Harvard University clinician and coordinator of outreach, counseling, and mental health services. “I got here and I was blown away by the level of acuity that kids were presenting with.”
Wehmhoefer observed extreme anxiety or depression in many students who came to his clinic—and counselors from the University of California to Appalachian State University in North Carolina report the same trend. Surprisingly, though, after final exams ended, Wehmhoefer saw the symptoms for some students resolve within days. That’s not typical of clinical depression. The problem, he says, reflects “kids who have been measuring themselves by a lone metric for a long time,” who have no tolerance for failure. And who, crucially, have never learned the emotional skills to manage the acute stress that results.
The scale of the problem is huge.
In the latest National Survey of College Counseling Centers, 94 percent of counseling directors said they were seeing rising numbers of students with severe psychological problems.
Indeed, more than half of college students in a recent survey reported that they’d felt overwhelmed by anxiety within the past year.
One in three said they’d felt so depressed it was hard to function.
Tulane University, particularly hard hit in fall 2014, lost three students to suicide by Thanksgiving.
“The increased need for mental health services on our campuses is outstripping our ability to provide those services,” John Stobo, an executive vice president for the University of California system, told the California Report radio program that same fall. The number of students seeking help at UC counseling centers had jumped by more than a third in the previous six years. Reduced stigma around seeking mental health counseling could account for some of that rise. But the increased incidence of emotional distress among college students is dramatic nonetheless: UCLA has surveyed entering freshmen at four-year colleges and universities around the country about their own mental health since 1985.
In 2014, these students’ ratings hit a record low.
Beyond the kinds of mental and emotional pains the college psychologists describe, the health consequences of the childhood rat race are also frequently physical. Many of the pediatricians I’ve met around the country have told me, with grave concern, that they’re seeing physiological impacts of this stress among their patients. And not just among high schoolers: many report symptoms in children as early as elementary school, just like I saw in Zak in third grade.
Lawrence Rosen, a pediatrician in northern New Jersey, told me that over the past fifteen years he’s seen more and more children diagnosed with depression, anxiety, and physical symptoms of stress such as motor tics and panic attacks. “Kids are coming here with migraine headaches, ulcers. I’m talking about five-, six-, seven-year-olds who are coming in with these conditions. We never used to see that,” Rosen said. “I do a lot of work nationally with other pediatric groups and pediatricians and I’m hearing this from my colleagues everywhere.”
From Highland Park, Illinois, pediatrician Susan Sirota emailed me the following: “Every day I see children with some condition that is a direct result of the stress they experience related to school. Interestingly, when I started practice we used to figure this out by asking about what happened to the pain on the weekend—it would go away; now there is no difference since so many children are continuing to ‘do extra school’ or just not able to relax on the weekends.”
This is how extreme the physical symptoms of childhood stress can get. Edin Randall is a psychologist at a pediatric pain rehabilitation center at Boston Children’s Hospital. Her clinic specializes in a poorly understood and severe illness called complex regional pain syndrome—which she describes as commonly associated with high-pressure educational and extracurricular settings.
This rare disease was described as early as the American Civil War and affects youth and adults in various countries, but its rates are rising, probably due to increased awareness and diagnosis. Randall says a typical case starts with an injury, such as an ankle sprain in a dance recital. The acute pain persists beyond the normal tissue healing process and
then becomes chronic. Then, for reasons doctors don’t yet understand, the child’s nerves become irritated such that “a light touch will feel like stabbing pain,” Randall explains. Normal treatments don’t work for some patients. The pain is so severe that the child stops using that limb, which becomes waxy and stiff from disuse. Many sufferers stop going to school or participating in other activities.
There’s been no research done yet to identify a causal link between high-stakes education and such pain disorders, but Randall sees a connection. Many of the children she treats tell her they come from stereotypically high-achieving communities with intense competition and pressure to perform. “It’s a common denominator for a lot of our patients,” she told me. Randall is careful to point out that, though stress seems to make the syndrome worse, it’s not the cause. Rather, the physical and emotional distress work in tandem: the pain heightens a patient’s anxiety, and the anxiety, in turn, makes it harder to cope with the pain. “Pain turns out to be a good communicator,” Randall explains. Many of her patients put great effort into appearing fine even when they’re incredibly stressed. So, Randall says, “Oftentimes pain is an indicator that there’s something else going on.” That something else may include the extreme expectations of an achievement culture gone crazy.
The Young and the Sleepless
At every screening I’ve attended, without fail, a bewildered, exasperated parent takes the mic and says his teen is staying up until the wee hours, night after night, then pounding coffee or going through her days in a sleepy haze, and no matter how this parent tries, he just can’t convince his kid to close the books and go to bed. I couldn’t sympathize more. When my girls were in middle and high school, I lost count of the number of times I’d tell them to go to bed, only to find them hours later awake at their desks, afraid to show up at school with work incomplete. Finally, I started insisting: interceding when they reached for lattes to power through piles of homework and emphasizing that life would go on if they didn’t get an A.
Studies demonstrate that chronic lack of sleep is practically an epidemic
among American teens. This is one of the causes of greatest concern for parents and pediatricians alike. Not only can sleep loss make our children surly at the breakfast table, it also can spell serious consequences for their health—and for their learning itself.
Researchers from the CDC have reported that the vast majority of American teens get at least two hours less sleep each night than what’s recommended for their age. In a national survey published in 2010, the researchers found that fully one-third of high school students sleep only five or six hours on an average school night. Contrast that with the National Sleep Foundation’s determination that, for teens, nine hours is optimal, eight is borderline, and anything less is insufficient. And it gets worse in eleventh and twelfth grades, as college application pressures mount.
The rise of sleeplessness has even spawned a whole new category of pricey specialists that some parents hire: sleep coaches, who provide individualized step-by-step plans for sufficient slumber.
As Cornell University sleep expert James Maas has put it, “Every single high school student I have ever measured in terms of their alertness is a walking zombie.”
Skeptics will be quick to blame video games, text messaging, and the like for the teen sleep crisis, and there’s no doubt technology is among the many culprits. But don’t mistake it for the main one.
In a National Sleep Foundation poll, more than one in three parents said that scheduled activities make it harder for their child to get a good night’s sleep. More than one in four said homework had been a sleep thief within just the past week. And among the surveyed students at Irvington High School, far and away the most common reason for getting fewer than seven hours’ sleep (cited by 77 percent) was homework and studying. Social networking was cited by just 28 percent.
A 2014 report on teen sleep by the American Academy of Pediatrics named all of these factors—homework, extracurriculars, and social networking—as significant contributors to the crisis.
Homework’s impact on sleep is sadly ironic, given the clear evidence that sleep deprivation harms the very process schoolwork is supposed to foster.
Sleep plays a key role in attention and consolidation of new information in the brain, reports Harvard Medical School, and thus “the quantity and quality of sleep have a profound effect on learning and memory.”
Just how foggy does a lack of sleep make children? As reported in New York
magazine, Tel Aviv University’s Avi Sadeh tested this by instructing fourth and sixth graders to go to bed earlier or stay up later for three nights. The later-to-bed group ended up getting about an hour less sleep per night, compared to the others. When, after the third night, a researcher went to school to test the children’s neurobiological functioning, the difference was stark. “The performance gap caused by an hour’s difference in sleep was bigger than the normal gap between a fourth-grader and a sixth-grader,” the magazine recounted. “Which is another way of saying that a slightly sleepy sixth-grader will perform in class like a mere fourth-grader.”
Clearly, chronic late-night study sessions are not a pathway to mental growth; on the contrary, they are a symptom of a system that broadly encourages children to complete tasks and fulfill expectations without considering the consequences.
Insufficient sleep is known to lead to ill health effects such as depressed mood, headaches, and drowsy driving. And it nearly killed Hayley Eaton, now a graduate student at the University of Oklahoma, who shared her story of how dangerously far sleep deprivation can go:
My world finally came to a screeching halt when I fell asleep at the wheel of my vehicle and crashed into a tree in the fall of my senior year of high school. Until that October day, I had assumed that I could keep pushing myself without consequence. I was taking all the available AP and Honors courses at my school, leading various school clubs, participating in an internship, volunteering, earning awards, and really anything that would make a nice addition to my college applications. I was allowing myself an average of 5-6 hours of shut-eye a night before waking up and repeating the cycle of school, then after-school activities, then oodles of homework. Spending quality time with family was a rare occurrence and hanging out with friends even more rare. Time to exercise or even just relax was simply unheard of. . . . I joked that I would “sleep when I’m dead” without realizing just how close I would come to fulfilling that prophecy at an incredibly young age.
The day of my crash was like any other: school, club meetings after school, run an errand or two, head home. I was driving carefully,
under the speed limit, wearing my seat belt. Like any other day, I was exhausted—this was simply a part of my reality. . . . Five and a half hours of sleep the night before—and the previous night, and the night before that—just wasn’t sustaining me, like the ice on a frozen lake that finally starts to crack under pressure.
People say that their eyelids feel heavy when they are tired, but I was way past that: my entire body felt heavy, as if gravity was working extra hard on me, willing me to lie down and rest. I turned up the volume on my CD player a bit more, in the hope that it could keep me awake for about twenty more minutes of driving. . . . I was getting further and further away from the present moment until I finally fell asleep only a few miles from my house. I have a very brief memory of the ground under my vehicle changing from smooth pavement to shaky gravel and grass. I opened my eyes slightly and saw for a split second the tree in front of me, but my mind didn’t even have time to register what I was seeing before the collision. I didn’t have time to brake or scream out or shield my face or react whatsoever before the truck went from forty miles an hour directly to zero, and everything went black.
Hayley walked away, miraculously, with minor cuts and bruises and the determination to change her life. “Today I pay much more attention to my health and get plenty of sleep,” she wrote. “The demanding course load and high academic expectations for myself are a significant part of my life, but nothing will come before my personal needs: healthy foods; sleep; exercise; and time to reflect, to relax, and to spend with family and friends are all vital to my well-being. Too few students have this perspective, however, and it is easy to see why.”
Self-Medicated for “Success”
It’s also easy to see why more and more young students these days are turning to prescription drugs for energy and focus. With the expectations that have been placed on them far exceeding what their minds and bodies can
naturally sustain, they’re using unnatural means to keep up. New York Times reporter Alan Schwarz has researched the problem extensively.
For his 2012 story “Risky Rise of the Good-Grade Pill,” Schwarz interviewed students and doctors in more than fifteen academically intense high school communities across the country and concluded that pressure for top grades and college admissions is encouraging students to abuse prescription stimulants such as Adderall. Schwarz wrote:
Pills that have been a staple in some college and graduate school circles are going from rare to routine in many academically competitive high schools, where teenagers say they get them from friends, buy them from student dealers or fake symptoms to their parents and doctors to get prescriptions.
The availability of prescription ADHD medications is skyrocketing, with the number of stimulants such as Ritalin and Adderall dispensed having shot up more than eightfold since the early 1990s.
Prescription rates for teens alone more than doubled in just over a decade. The medications do help bring calm and ease symptoms for people who have a genuine disorder, Schwarz points out—yet for those who don’t, a pill can provide laser-like focus and the energy to jam through late-night study sessions and final exams. In many communities, the drugs are practically de rigueur for students taking the SAT and ACT—perceived to be as essential a supply as a No. 2 pencil.
A young woman named Taylor, by then a student at Northern Arizona University, confessed to me that she first took Adderall as a high school junior. “I knew a lot of people who took it and I would ask them for it every once in a while,” she said. “It’s hard to be the vice president of your class, play on the soccer team, and do homework. It made me feel focused and almost better because, ‘Look, I can keep up with everyone now. I come to school and my homework’s done.’ ” Her story underscores the irony that kids are taking the drugs to compete with other kids, who are in turn taking the drugs to compete with them. Taylor started using the pills more frequently her senior year, until they backfired, ultimately sending her to the
emergency room. “All of a sudden, I couldn’t breathe as well,” she recalled. “It was scary. I’d be sitting there trying to catch my breath. I couldn’t fall asleep at night.”
There aren’t solid numbers on just how many teens such as Taylor are taking stimulants as a study aid, not out of medical need. As one might guess, studies that rely on teens’ self-reporting don’t provide a full picture of the problem.
In the national 2013 Monitoring the Future survey, 15 percent of high school seniors said they’d taken a prescription drug for nonmedical reasons in the past year, and about half of those named Adderall. Yet the teens and doctors Schwarz interviewed would call those rates low: they estimated the real number as anywhere from 15 to 40 percent.
The short-term boost young students are after comes at a cost. What kids may think of as a harmless “study drug” is actually a DEA Schedule II controlled substance, so designated because of its potential for abuse. The misuse of stimulants can result in loss of appetite, insomnia, anxiety, heightened blood pressure, and, at high doses, an irregular heartbeat. If a child or young adult becomes addicted, the problems can get still worse. Most students who misuse the drugs don’t suffer serious harm—Schwarz’s research indicates that about 10 percent of those who use these stimulants will develop an addiction—but it’s hardly a risk we want our children to take for the sake of their studies. The mere fact that our kids feel they need to self-medicate just to meet expectations, like pro athletes propped up by steroids, is a sign that something’s wrong.
Alas, this sign of distress, too, continues into college, where substances can serve not only as study aids but also as a form of stress release. Jarreau, who runs alcohol education programs at Stanford, sums up the general mental health status of students at the university in a word: “Anxious.” (He emphasizes that he speaks mainly from his own experience as a Stanford undergrad, not as a university representative.) He observes that many of them have spent their young lives so focused on academics that they haven’t fully developed their social skills. They turn to hard alcohol as a social lubricant and a stress reliever, but they don’t have the experience to handle it. The results—getting sick, getting injured, damaging property, injuring others—are dangerous. It’s not that students today actually drink more than students past, he says; they just drink differently. “It’s about something different.
I don’t think it was as much about the social anxiety and about using alcohol as a coping mechanism in the past.”
In the radio report on the surging demand for mental health services on UC campuses, Elizabeth Gong-Guy, director of Counseling and Psychological Services at UCLA, described the situation thus: “Increasingly, we find that many of the students who make their way to our counseling centers are seasoned perfectionists who’ve driven themselves to unsustainable positions in which their lives lack any semblance of balance or self-compassion. These are students with eating disorders, crippling obsessive-compulsive disorders, cutting histories, addictions, and illicit stimulant abuse.”
That is not how I, or any parent I know, would define success for my child.
The Tidal Wave of Illness to Come
These are the immediate health effects of the chronic, extreme expectations we have placed on our students. And if these were the only consequences of our pressure-cooker educational culture, that alone would be enough for us to act. But it’s likely there are consequences we can’t yet see—domino effects that could undermine our children’s physical and mental health well into the future.
The science on this is just emerging, and there is little awareness of it outside the scientific community. Research over the past decade or so has clearly shown that childhood trauma affects a person’s health throughout adulthood.
This work, originating with the landmark Adverse Childhood Experiences Study in San Diego in the late 1990s, demonstrates unequivocally that unchecked stress in the early years is linked not only with adult mental health troubles but also with disruptions of brain development, higher rates of illness, and even altered gene expression. The more trauma a person experiences in childhood, the more likely he or she is to suffer later from depression and alcohol abuse. More surprisingly, survivors of early trauma are also more likely to suffer physical ailments including heart, lung, liver, and autoimmune diseases.
To be clear, most studies have focused on childhood problems that go far beyond academic anxiety, such as parental drug addiction, abuse, and neglect. It should go without saying that one cannot compare such a trauma
with excessive academic pressure. What’s new, though, and what researchers are just starting to flesh out, is the realization that the constant presence of less severe stressors could take a similar toll. No study I know of—yet—has directly examined whether the excessive pressure to perform in and out of school could be the kind of chronic stress that becomes toxic. But every scientist I’ve spoken to expects that that is what we’ll find as research continues. That’s because stress exerts the same effects on the body no matter what the cause. In children, any kind of stress “can really impact how the structure and architecture of the brain forms,” says Andrew Garner, a pediatrician at University Hospitals Medical Practices in Ohio and associate professor at Case Western Reserve University. Garner cowrote the American Academy of Pediatrics’ 2012 paper on the lifelong effects of childhood adversity, and he adds, “It doesn’t really matter what the stressor is, whether it’s poverty or chronic abuse or the bully on the bus.”
Stress begins its spread throughout the body in a part of the brain called the amygdala, which triggers a cascading release of hormones that reach our every cell. This hormonal jolt is calibrated to help us spring into action to avoid an immediate threat such as a forest fire (or, in modern student life, to avoid flubbing the SAT). But it is ill suited to see us through chronic, long-term worries. In fact, when the stress response does drag on, unrelenting, it creates a physiological strain that scientists call allostatic load. That burden feeds inflammation in the body, suppresses the immune system, and even enlarges the amygdala itself, making it more volatile and reactive to future stress. In other words, by subjecting young students to excessive and constant stress in their formative years, we may be making them more vulnerable to stress for the rest of their lives. “The brain is like a muscle,” Garner says. “The parts you use get stronger.”
It’s critical to understand the difference between good stress and bad, lest we mistakenly try to protect our kids from every little thing. A little bit of the right kind of stress can actually be essential. Donna Jackson Nakazawa, journalist and author of the book Childhood Disrupted: How Your Biography Becomes Your Biology, and How You Can Heal, explains it like this: “Of course we don’t want a childhood in which nothing bad happens, because we have to learn adversity and learn grit and resilience and determination, and those things take a little bit of failure and hard knocks.” The critical difference, she
says, is between the bumps in the road that we might expect in life—you miss the bus, you’re unprepared for an exam, or your grandmother dies—and “chronic stress that keeps coming, doesn’t let up, is unpredictable, and a child isn’t getting the support they need from adults.” These two kinds of stress hit our brains and affect our immune systems very differently, Nakazawa says, “and we sometimes confuse the two.”
With temporary, predictable stress, we have a chance to recuperate and grow new neural connections in response to the problems we’ve encountered, learning to arrive at the bus stop early, study better, and cope with normal loss. It’s chronic, unpredictable stress from sources beyond our control that gets toxic. And that is a pretty good description of what today’s most pressured, overscheduled, underslept kids go through in the name of education. There’s a perception that constant high demands will make kids stronger, says Nakazawa, “but biologically that is not the case; it’s actually breaking down the brain rather than creating resilience.”
In fact, a survey of the existing science in the 2013 Annual Review of Public Health concluded that “repeated exposure to less severe, but often chronic stressors is likely to play as large, if not larger, of a role in forecasting children’s future mental and physical health,” compared to extreme adversity.
What this means, in sum, is that we as a nation are not only making our kids miserable in the moment; we may actually be building a ticking time bomb of illness that will someday turn this generation of overstressed children into a generation of unhealthy adults. Research is under way that may show that bringing them up on a diet of unchecked stress is setting them up not for a happy, flourishing adulthood but for later waves of depression, anxiety, and even heart disease and cancer. And UC Berkeley health economist Richard Scheffler expects this ill health will come with both a human and a financial cost to society. “Many of the health effects are apparent now but many more will echo through the lives of our children,” Scheffler says. “We will all pay the cost of treating them and suffer the loss of their productive contributions. Seeing these hidden costs now gives us a chance to avoid them.”
Distribution of Health
By now you may be thinking, and not without good reason, that the pressure-fueled health problems described here only afflict children in upper-middle-class communities. Let me address that common perception head-on. Communities like mine, filled as they are with highly educated, financially comfortable parents who expect their children will attain the same, are undoubtedly hubs of the educational stress epidemic. And no one has made the case that children in upwardly mobile communities are suffering more vividly than has Suniya Luthar.
A psychology professor at Arizona State University and a native of India, Luthar has demonstrated over and over, in urban and rural communities and public and private schools from coast to coast, that the children of white-collar, well-educated parents in upper-middle-class communities are more likely than the average American youth to show “serious disturbance,” manifested in mental health and behavior problems and substance abuse. These kids have higher rates of anxiety and depressive symptoms—sometimes at twice the national rate. Luthar’s studies show that they are also significantly more likely to use cigarettes, alcohol, marijuana, and other drugs than are those from low-income settings (especially, it turns out, the girls). These youth don’t appear particularly troubled as young children, Luthar reports, but—in a disturbing echo of what I saw in my own home—problems begin to emerge around seventh grade.
“Our sons and daughters are sort of living with this runaway train of who they’re supposed to be,” Luthar explains. Their aspirations for themselves mirror the status and accomplishments they see around them, in parents and community members and especially their peers, and thus they feel compelled to do everything at a peak level of performance. “The adage by which these children live is ‘I can, therefore I must,’ ” she says. “You’ve got this mad rush to achieve, and that’s sort of interspersed with this mad rush to relax, with whatever substances, and back to a mad rush to achieve.” When a child defines herself and her self-worth by her accomplishments, Luthar adds, “That’s a very tenuous way to live.”
It’s possible to take a cursory look at Luthar’s work and the realities of inequity in America and dismiss academic stress as a rich kid’s problem, an
issue confined to kids with ample resources and one therefore not worthy of our alarm—or at least less worrisome than other social ills. Yet the causes for concern are manyfold. As Luthar herself notes, any population of children who are at risk, whether or not they fit our common perceptions of need, deserve to be protected. The pain these young people are experiencing is too excruciating—and the implications for our society’s future are too real—to be ignored.
Besides, the knee-jerk assumption that academic stress is confined to privileged kids itself isn’t true. The pressure to perform, while it pools within privileged neighborhoods, doesn’t stay contained there. The troubling trends we’ve seen in depression and anxiety affect children from all kinds of schools and communities: affluent, middle class, impoverished, urban, suburban.
School counselors widely report that the emotional distress they see in young people crosses socioeconomic lines and impacts children across the spectrum of academic ability. And they say it’s worsening at a pace with which national surveys of adolescent mental health can’t keep up.
Roy Wade Jr., a pediatrician at the Children’s Hospital of Philadelphia, has seen the evidence. In interviews with Philadelphia youth from diverse socioeconomic strata, he has found that, though their external circumstances differ, they all describe feeling unsupported—an experience which is itself a stressor. In one study, Wade assessed stress levels in clients of five youth organizations, ranging from a homeless shelter to a running club that serves many kids from the affluent suburbs. “What we found is that if you took away the names of the organizations from the top of the report, you couldn’t tell whose kids were whose,” he said. “They all endorsed the same levels of stress.”
No matter where we grow up, we are all inundated from birth with media messages about what makes success. Hint: it’s not a modest job with a small house and a happy life; it’s something at once much glossier and more limited. Perhaps it’s the spacious suburban home with a smiling child eating Cheerios at the granite kitchen counter and a power-suited dad pulling his Lexus into the driveway. Or perhaps it’s the übermodern city condo outfitted with slick Apple products and designer lighting. Our culture no longer celebrates the everyday travails of the blue-collar men who inhabited the bar on Cheers. Instead we idolize the urbanites of Mad Men and Scandal,
their personal dysfunctions as grand as their lifestyles. Everywhere we look, someone is telling us to go bigger, to strive for more. Even a recently introduced line of Dreyer’s frozen fruit bars (they’re just Popsicles!) is named with a command: “Outshine!”
All together, the glittering images that surround us fuel a status anxiety that’s hard to shake.
Plus, the fierce competition for college admission among upper-middle-class students only raises the bar to entry for all students who hope to get in. For example, Mayra Valle, the daughter of Mexican immigrants in Houston, missed her last chance to see her dying grandmother because of school obligations. Her devotion to school came from years of watching her parents push their bodies to the limit. She’d seen her dad come home with white sweat stains on his green shirt from twelve hours working in the sun, and noticed her mom’s calloused hands and chronic headaches from full days of childcare and cleaning. Mayra admired their strength but worried about their health, and wanted a solid education and career so she could relieve them from that labor. So, while not surrounded day to day by the trappings and expectations of affluence, she was nonetheless racing to compete academically. Mayra, vivacious and diligent, ultimately ended up at bucolic Connecticut College, in classes among peers who, by and large, faced far fewer challenges in getting there.
McKenzie Charlene Morrow, a student from a small town in western North Carolina, offers another example. As a high school junior, McKenzie wrote:
I have lived my whole life stressing, worrying, focused on school. . . . I come from a family where neither my father nor mother graduated from high school. My parents always told me I needed to graduate and I needed to make something of myself. . . .
In eighth grade, McKenzie was thrilled to be accepted at a local early college high school, where students could take college and high school classes and graduate with both a high school diploma and an associate’s degree. She felt as if all her hard work in middle school was finally paying off. Because her parents couldn’t afford to pay for college, she felt excelling in school was
her only path to a scholarship to a good college. McKenzie was determined not to squander the opportunity:
My freshman year I focused solely on school, no other activities, I spent 4 to 5 hours after school on homework. . . . If I made a 95 on a test, it wasn’t good enough for me. . . . I would study all night, and run on 3 or 4 hours of sleep daily.
She spent the summer after her freshman year reviewing SAT test prep instead of hanging out with her friends. Eventually, all that stress caught up to her.
My sophomore year was when it all changed. I pushed myself so much, I was at the breaking point. I wasn’t getting enough sleep, I was worrying too much, I was stressing over school so much that it affected me physically. I became sick more easily, my hands would break out in eczema flares. It got so bad my doctor was going to put me on medication. He thought maybe I was OCD. That was when my dad told me to just stop stressing. It was going to be okay, I needed to just relax.
So when spring break arrived, I spent it with some old friends from middle school. They were all so happy and so carefree. I wanted that. I made up my mind I wanted to transfer to the regular high school. . . . I wanted to go to pep rallies, to prom, to be able to relax and enjoy things. . . . I am now enjoying every day, and yes I still stress a little about my classes even though there is no need. . . . I have enjoyed knowing I can achieve, but now I am learning something I never knew how to do before and that is just to relax and let go!
McKenzie ultimately graduated from the local high school with honors. Now she’s studying at community college while working full time as a daycare teacher—a job she calls “the best thing ever”—and aiming to become an early childhood education director.
Edin Randall also sees evidence of suffering across the socioeconomic
spectrum at the Boston Children’s Hospital pain clinic, where many of the patients are affluent but a handful are also from lower-income families. “Interestingly, a lot of them are in the same situation,” she says. “This is the good child. This is the child who’s going to break out because they’re such a good student.”
That’s just what I’ve heard from teachers, students, and researchers nationwide: kids in upper-middle-class communities may get a particular, potent dose of performance pressure, but children from many settings feel it. It’s the precise genesis of kids’ stress—whether from needing to keep up with inflated expectations or needing to escape poverty—that varies with a child’s individual situation.
The excessive stress isn’t doing much for children’s intellectual strength, either. There’s plenty of evidence that stress hurts cognition. As Garner points out, “That just makes sense intuitively. When you’re panicked, you’re not taking in a lot of information. You’re certainly not making good decisions.”
Research has linked chronic stress with the loss of neurons and neural connections in the hippocampus, a brain area that’s crucial to memory.
Loss also occurs in parts of the prefrontal cortex, which is essentially the brain’s conductor, a key player in so-called executive functions such as planning, problem solving, and self-control. The prefrontal cortex is still growing in adolescence, which means it’s still being intricately shaped by the effects of experience (and which also explains a lot about teens).
In fact, the brain is particularly plastic in the teen years. We think of the years from zero to three as the critical period for brain development, but Temple University neuroscientist Laurence Steinberg underscores that adolescence is another one.
“[T]he brain’s malleability makes adolescence a period of tremendous opportunity—and great risk,” writes Steinberg. “If we expose our young people to positive, supportive environments, they will flourish. But if the environments are toxic, they will suffer in powerful and enduring ways.”
These sensitivities could have a serious impact on our children in school. Steinberg—who says schools chronically miss the sweet spot by overloading
kids with assignments—explains that the key to learning is new experiences. These help to generate new synapses, or connections between neurons, which in turn create new links between different parts of the brain. A little bit of repetition can help strengthen those connections, but beyond that, repeated drilling produces no growth. “Novelty,” he says, “is required to stimulate the growth of new synapses.” So, by emphasizing quantity over quality, and content over mastery of complex skills, our traditional educational model is missing crucial opportunities to enhance brain maturation at a critical time. Plus, heightened levels of the stress hormone cortisol can injure the myelin, the protective white matter that surrounds brain circuits and allows them to function efficiently, Steinberg points out. So, school communities that place intense performance pressure on students, to the point of causing chronic stress, may actually be jeopardizing healthy brain function.
The misalignment of education with kids’ real needs may explain why many check out and exacerbates the problems that cause some to leave school altogether.
America’s high school and college completion rates, once the world’s highest, now lag far behind those of other developed nations.
And while the high school graduation rate is rising, one in three students entering college requires remediation. These students made it through the exhaustive high school checklist, but the learning didn’t stick.
This is one of the reasons why 41 percent of students who start at a four-year college do not finish within six years. Such sobering statistics remind us of the big picture: that despite the trials we put high school students through in the name of academic preparation, our education system is still operating at a major loss. The hoops our children are expected to jump through on the way to higher education are, for too many, not hoops at all, but barricades.
“There are some kids that do need . . . to be taught how to organize, structure, manage their time,” says Garner. “But we also know there are kids at the other end of the curve, crashing and burning.” He argues that we must do better at helping kids stay more in the middle, where they’re engaging but not burning out. Through our educational efforts to push every child to the max, he says, “We’ve gone off the deep end, and now we’re doing more harm than good.”
Less Prepared for Success
A youth spent in the pressure cooker also fails our children in one final way: by eroding the nonacademic skills that they also need to succeed in life. You’d think that a straight-A student who can manage four AP classes, run varsity track, and dominate the debate team with seeming ease would be perfectly poised to surmount challenges. In fact, we’re seeing the opposite.
College professors increasingly report that freshmen arrive on their campuses with the creativity strained out of them. Trained to color inside the lines, these students are afraid to take intellectual risks; they just want to know what it takes to make the grade. Then, as this stressed generation leaves college and enters the workforce, their employers report similarly troubling trends. Give them a discrete task, and yes, they can execute it like nobody’s business.
But more and more, surveys show, managers find young workers lacking in leadership, self-direction, critical thought, and collaboration skills—those essential, if immeasurable, qualities that truly determine success in today’s world.
“Businesses often lament the lack of work readiness by recent college graduates” yet don’t do enough to encourage change, says Bil Corry, a senior solutions engineer in information security at PayPal. “How can one expect innovative, creative thinkers that work well with others if the system they exclusively hire from does not value nor endorse those traits?”
We have, without really meaning to, transmitted to young people the idea that academic achievement is the most important way to measure their value as people, and that success in school exclusively assures success in life. Yet the Nobel Prize–winning economist James Heckman has decisively put that notion to rest.
Analyzing thirty-five years of data that chronicled children’s lives from preschool into adulthood, Heckman and colleagues demonstrated that character makes more difference than IQ for economic and social success. Improved character even boosted kids’ standardized test scores, if that’s what you care to measure.
The achievement-driven life appears even to be subverting our children’s values.
A 2011 analysis at the University of Michigan, which combined the results of dozens of personality studies of American college students over the course of thirty years, found that today’s college kids rated about 40 percent
lower on empathy than students in the late 1970s. Current students were comparatively less likely to agree with statements such as “I sometimes try to understand my friends better by imagining how things look from their perspective.” Why? Researcher Edward O’Brien named “the hypercompetitive atmosphere and inflated expectations of success,” and surmised that it all adds up to “a social environment that works against slowing down and listening to someone who needs a bit of sympathy.”
A Harvard Graduate School of Education survey of ten thousand middle and high school students from diverse communities around the country found a similar distortion. When the researchers asked students to rank what was most important to them—achieving at a high level, happiness (feeling good most of the time), or caring for others—almost 50 percent picked high achievement as their top choice. Thirty percent chose happiness, and about 20 percent chose caring for others. When lead researcher Richard Weissbourd and colleagues compared the rankings head-to-head, they found that 60 percent of youth put achievement above caring. These values aren’t mutually exclusive, Weissbourd explains. “We think you can be very happy and very caring and achieve at high levels. The concern we were raising is how out of balance they appear to be.”
Evidence from the Josephson Institute of Ethics also reveals a disconnect. As you’d hope, 95 percent of the high school students the institute surveyed nationwide said trust and honesty are essential in the workplace. Yet, revealingly, more than half agreed with this statement: “In the real world, successful people do what they have to do to win, even if others consider it cheating.” Similar to the students in Jay Jackson’s survey at Irvington High School, more than 50 percent said they’d cheated during a test in school.
Even the so-called winners in the race may not ultimately gain.
Daniel Kahneman and his colleagues have demonstrated that rich people don’t actually feel any happier day to day than those with lower incomes. To be sure, it helps to have enough money to escape the pain of deprivation. But above an annual income of about $75,000, Kahneman and colleagues report, the link between wealth and happiness disappears.
“The irony here is all this focus on kids achieving may result in them achieving less, not more, because they’re not developing certain skills that are going to be essential for their success” once they get out of the academic
environment, says Weissbourd. Not to mention the skills essential for being good friends, romantic partners, and mentors, he adds, “and those relationships are probably the most important and durable sources of happiness that we have.”
Cause for Action
Call upon all of this evidence when skeptics suggest that a healthy, sane education that’s mostly free of anxiety is a soft one. I’ve encountered such resistance countless times. I’ve even encountered outright denial.
One screening of Race to Nowhere that I attended in Millburn, New Jersey, is seared into my mind. This came soon after the film’s release, before it had been widely viewed and frank discussions about students’ stress disrupted our national complacence. The moderator made audience members write their questions on notecards rather than speak them out loud, thereby silencing parents and students who had so much to say. Meanwhile, the evening’s panelists (teachers and counselors from the local middle and high schools) said essentially that the schools weren’t demanding too much of students, and that if there were problems with stress it was because of parental pressure and student procrastination. Afterward, in the lobby of the school auditorium, parents and students mobbed me to tell me just how acutely they disagreed with the panel. As one boy named Max put it to me, “I really feel that this movie is my life, and that the system truly needs change.”
Change is hard. Even those who face the problem honestly still struggle to act—as I have myself, at times. Suggest to a coach that she take Wednesday nights off, and she’ll say she can’t because then her team will be less competitive. Ask a teacher to assign less homework, and he’ll say his class might not then complete all the required content. Tell a student to ease up on her honors classes, and she’ll say she might not get into Princeton. Everyone is afraid to be the first—or the only one—to change.
But those fears are unfounded. Change is already happening. And as the facts make plain, we must build on it; our children’s health and preparation for the future are on the line. Even the gatekeepers at Harvard University say so.
The dean and director of admissions coauthored an open letter imploring incoming freshmen to slow down their “fast-lane childhoods” and
take a gap year before arriving, burned out and sapped of their souls, upon the vaunted campus. “The fact remains that there is something very different about growing up today,” they wrote. “Some students and families are suffering from the frenetic pace, while others are coping but enjoying their lives less than they would like. Even those who are doing extraordinarily well, the ‘happy warriors’ of today’s ultra-competitive landscape, are in danger of emerging a bit less human as they try to keep up with what may be increasingly unrealistic expectations.” In other words, the price of maintaining the status quo is simply too high.
So “to better your future,” to borrow the Irvington High School student’s phrase, is actually to stop the automatic, unquestioned race we’re all running and to redefine goals all our own. This is what the families and schools in this book have begun to do. They are not blaming each other, because they understand that the race is not the exclusive fault of any single group. It is the culture. Which is to say: it is everyone. We collectively create the culture, and it’s up to us to change it.
That’s what is so inspiring about the attitude of Irvington’s Jay Jackson. He knows that change begins on the ground, in each community, with teams of people who believe in it. He knows this work will be hard, yet he insists upon pursuing it anyway, unflinching. “Let’s try some things out,” Jackson said the day of my visit after sitting with the roomful of exhausted teens. He knew his initiatives to ease students’ stress and limit their overscheduling wouldn’t work overnight, he said, ready for the challenges that inevitably come with change, “but let’s see if we can tweak them and make them work.”
When we look into our children’s eyes and ask ourselves whether their “better future” should be the unhealthy one they’re now marching toward, every parent and educator will offer the same answer: no. Instead we wish for them health, happiness, and the contentment that comes from being a good citizen of the world. We need to act now to preserve that better future for our children, and to protect them from the false ideals that threaten to take it away.