Ep 207: Anxiety and the Communication Tools to Fix It

Episode Summary

Donna Jackson Nakazawa, author of Girls on the Brink joins us to talk about the drivers behind sky-high rates of anxiety and depression among young people—and how bio-synchronicity and emotional attunement might be the answer.

Show NotesInterview TranscriptGuest Bio

Full Show Notes

Nowadays, kids have 24 hour access to the internet—meaning they can scroll through pictures of perfect models on Instagram, check the ever-terrifying news or log on to a chatroom with random strangers at any time of the day! And while this allows them to connect with others and learn more about the world, it can also lead to an overwhelming level of exposure to everything from cyberbullying to predators. Without parents there to steer them clear of danger, are kids bound to get into trouble?

Not to mention that constant use of the internet–especially social media–can have seriously adverse effects on a kid’s mental health. The perpetual pressure to live up to the images of perfection they see online has been linked to sky-rocketing growth in depression and anxiety disorders among kids. And it’s young women in particular who face the most expectations online–the expectation to be sexual without being too sexual, the need to have the perfect body, and the constant fear that they aren’t going to fit in with all their other peers.

So how can we help girls who are struggling with the stressors of being online? We’re asking Donna Jackson Nakazawa, author of Girls on the Brink: Helping Our Daughters Thrive in an Era of Increased Anxiety, Depression, and Social Media. Donna is a science journalist who’s written for Wired, The Washington Post, The Boston Globe, and more! She’s also a mom, and was inspired to dive deeper into girls’ mental health when she saw how much her daughter was affected by the perils of the online world.

In our interview, we’re discussing how estrogen and the female immune system contribute to the development of mental health disorders among young girls, especially in our modern, media-driven world. Plus, how adverse childhood experiences affect kids into adulthood, and what we can say to help our teen girls feel supported during this stressful time.

The Estrogen Effect

The internet can add stress to anyone’s life…so why do we need to focus on young women? Research shows that women are developing mental health disorders at an alarming rate compared to their male counterparts, explains Donna, and this ties directly into how much these young women use social media. But why?

Donna explains that estrogen is the culprit. Since the dawn of the human race, women’s bodies have responded to stress with an intense surge of estrogen. This is because women typically have smaller bodies and even smaller organs than men, says Donna, and therefore need a stronger immune response to combat threats! This is why girls often have stronger responses to vaccines and have longer-lasting reactions to viruses like Covid-19. 

When their brains are still developing, girls are constantly looking to the world to sense if they’re safe or not….and with social media and the internet, girls often feel that they aren’t safe! This bumps their stress levels, leading their estrogen to provoke an immune response that floods their bodies and brains with inflammation. No wonder so many young girls are developing chronic physical and mental health conditions like autoimmune disorders and depression, she says.

But that’s not even the worst of it! Donna explains how adverse childhood experiences  can make this immune response even more harmful to young girls.

Long Term Effects of Childhood Experiences

Women have more robust immune responses to stressors because of their hormones, says Donna, but there are other factors that can cause people to have intense reactions to stress. One of these factors is adverse childhood experiences. When we think of childhood trauma, we often think of intense moments like divorce or physical abuse–but Donna explains that these traumas can be milder and more common than we might expect. Feeling bullied by siblings, having a parent with substance use issues or experiencing mild parental neglect can all be adverse childhood experiences, she explains.

With their brains still in development, young girls are perpetually trying to discern whether or not they are safe. Because these adverse experiences are often chronic and unpredictable, it can send a message to kids’ minds that they are frequently in danger. Donna explains that this is largely a product of evolution–social ostracization of any kind could be extremely dangerous if it meant they were cast from the group without food or protection from predators. And although kids are no longer typically in physical danger from emotional neglect or bullying, their immune system still behaves as though they are! 

The more adverse experiences girls experience in childhood, the more their brain becomes acclimated to responding to stress, and the more intense it’s immune response. This causes chronic mental and physical health disorders to develop among young women at an alarming rate–and social media is not helping, says Donna. That’s why she believes parents need to give their kids the least traumatic childhood possible, so they don’t develop serious conditions like anxiety or depression as teens or adults.

But how can we keep our homes as free from trauma as possible? And what can we say to teen girls who are really going through it? Donna helps us see how parents can step in to help girls when they’re at their lowest.

Helping Our Girls Heal

The first step to helping our girls is to heal ourselves, says Donna. When we’ve dealt with our own traumas and stopped our impulsive reactions, we can be there to calmly guide our kids without passing our trauma on.  The developing brains of our kids are constantly looking for reassurance from caregivers, so if we can make kids feel safe, they’ll live happier, healthier lives.

In the episode, Donna explains how kids watch parents react to stressful situations and then learn to practice the same patterns themselves–a scientific concept known as bio-synchrony. If we yell, freak out or bully others when we’re in distress, our kids take notice–and will likely carry that pattern on into adulthood themselves. If we can learn to center ourselves and practice techniques that take us out of fight or flight mode and back into a level head, Donna explains that we’ll be able to teach our kids to do the same.

If your daughter is struggling, Donna recommends bringing some positivity back into her life. In our interview, we discuss the value of praising our kids in healthy ways. Donna encourages us to remind our kids that they are intrinsically valuable, and can accomplish anything they hope to do if they work hard. It’s never truly wise to measure their success against other kids’–even if you’re telling them how much better they are! This only leads to a life of comparing themselves to others, and despairing when they fall short.

This doesn’t mean we should overshelter our kids or make life too easy for them, says Donna. They still need to stumble and fail, learn how to figure out their own solutions to life’s problems. Plus, parents aren’t perfect, and we’re bound to mess up and cause our kids some inevitable emotional turmoil. But if we can make sure they feel a general sense of safety and trust in their own homes, we can help combat the rising tide of mental health disorders among young girls and give our kids the chance to prosper.

In the Episode….

If you’re raising a girl, you won’t want to miss this episode! On top of the topics discussed above, we also talk about:

  • How social media affects young men
  • Why parents shouldn’t exhibit emotional detachment
  • How parents can help when teens have friend drama
  • Why it’s important to acknowledge tension in your home

To find more of Donna’s work, head over to donnajacksonnakazawa.com or find her on Instagram at @donnajacksonnakazawa. Thanks for listening, and don’t forget to share and subscribe!


Complete Interview Transcript

Andy: Just finish reading through this book, Girls on the Brink. Tell me about the story behind how this evolved and what led you to write about this.

Donna: Well, I’m a mom of a girl and a boy. And I noticed when my daughter was entering the teen years, that a lot was happening for girls of her age and in a way that seemed bigger than what was happening for boys.

Donna: And I was also very aware that around that same time, NIH had put out a call to include the study of the female body and brain in research on how stress affects the body and the immune system and the brain.

Donna: Now I’m a science journalist, I’m a teacher, I lecture, and sometimes the professional and the personal kind of converge in a way that makes you know you must put your shoulder behind the wheel.

Andy: Yeah.

Donna: So I went around and I talked to 10 of the leading neuroscientists in the world and I started following three girls for two years from very different backgrounds. And the story that they told me simply had to be written.

Andy: One of the most interesting points from the book is on the differences in how experiences maybe affect boys and girls at different periods of life. And you have written that estrogen makes a huge difference. Why is that?

Donna: Well, estrogen is this super power hormone when you think about it across evolutionary time, way back. It was super important that the female immune system could really pack a potent response to any kind of interloping virus or infection because the female body has to do a lot with less.

Donna: In other words, the female body is smaller. Its organs are smaller, the womb is there. And so, females have to be able to respond to any kind of infiltrating toxic stressor or infection with a bigger bang than what testosterone is going to give you.

Donna: And guess what? The body and across evolutionary time, the goal of the brain is to say, “Hey, are we going to be prepared one day for procreation?” We’re organisms, we evolve so that our genes can be passed on.

Donna: And what happens when estrogen comes in is that it takes that very robust immune response that we all have in the face of stress, that everyone has, boys, girls, males, females, and it bumps it up really, really high.

Donna: This is why, with vaccines, girls often have a more robust response; why women have more long COVID than men. It’s a advantage across evolution for being able to keep another life in the womb safe, but it’s a disadvantage when stressors become toxic and ongoing.

Donna: And when kids’ bodies and brains are marinating in toxic stress over time, then it begins to flip on genes. That, without intervention, can lead to mental health disorders. So that has to do with another story about evolution in terms of how our brains and our immune systems evolve together. But I’ll let you get to that.

Andy: Okay. Okay. No, that’s really interesting. And it really made me think a lot about how different things affect different people in different ways. And I think so often we just kind of assume people are all the same or react to things so similarly.

Andy: And one thing that was interesting, social media. You write about how social media can often have different effects on boys and girls, and that some data shows actually that maybe there’s more deleterious effects happening for girls than for boys. It seems like.

Donna: Yes. Right. So in the book I have a couple of pages that I call girls growing up by the numbers. And we know that for girls, the more time they spend on social media, the more likely they are to develop depression or anxiety disorders compared to boys.

Donna: And we also know that girls spend more time on social media. Girls also are the recipients on social media of a lot more early sexualization, right. So, they’re encouraged to sexualize themselves on Instagram and TikTok, and that correlates directly to their popularity at school, online, on TikTok.

Donna: And girls are also more likely to get this double whammy of likes and dislikes and critiques over their body, their faces. So all of this really matters during these developmental years where the most important thing that’s going on in the brain is, “Am I safe or not safe?”

Donna: That is the number one question the developing brain is asking of the environment in which our teens come of age, “Am I safe or not safe?” And girls, by virtue of being female in our environment, obviously have a lot more messaging that they’re not safe, but this also plays out for them on social media.

Donna: The standards for girls on social media are often impossible to meet in terms of what we call scroll and despair, right. There’s just the idea that girls have to live up to this very ironic standard in being female.

Donna: On the one hand, you have to be sexual early like nine, 10 to be liked, to be popular, to even be part of the in-crowd. But at the same time, when you’re too sexual, you are the H-word, for younger listeners. Or you also could be criticized for being raped or harassed or later in life, sexually harassed in your jobs.

Donna: Girls are very, very bright and they see, all they have to do is look on Twitter or the headlines and see, wow, gymnasts were abused by their coach. Name any powerful man and super powerful. I’m talking the Matt Lauers, and the Bill Cosbys, and the Harvey Weinsteins and the Epsteins. When they get that much power, it tends to come down on underage girls.

Donna: So how can you be popular and be part of today’s overtly sexualized culture in which girls are sexualized as women and women are expected to be pubescent like girls, and also be safe? It’s a conundrum. And we, as the adults have not done a very good job of ironing this out for our young people. I do want to say boys are suffering too. Let me be clear.

Andy: Okay.

Donna: Okay. Boys are struggling in droves, but if you look at those three pages of statistics in the book, growing up female by the numbers, you’ll see that this precipitous rise in girls’ mental health disorders over the past two decades is much higher and continuing to rise much higher in girls.

Donna: And it’s only since 2016 that we even began to look at differences between development when estrogen and testosterone come in, and researchers have begun to see that chronic toxic stress in the environment begins to shift genes in the developing female brain as estrogen comes in, in a global kind of way, opening up this greater likelihood for anxiety and depression.

Donna: And one other caveat, guess what? This does not happen at all except in the face of toxic, ongoing stress. Without toxic ongoing stress causing the body to rev up this potent immune response, the female brain is so groovy and flexible and can do a lot of things that it can be harder for the testosterone brain to do. So, I just want to point that out.

Andy: Okay. Yeah. That’s good to know.

Donna: I don’t want to any listeners to come at me and say, “What about boys? I’m the mother of a son.”

Donna: I care so deeply about boys and girls, but when the science is there, when we didn’t look at it, when we should look at it, when we’re facing this crisis epidemic of depression and anxiety and self-harm in girls and it’s growing every year and the gap is widening between what’s happening to boys and girls, we really have to take notice.

Donna: And I would argue that if we make the world better for girls, we’re making it better for all of our children.

Andy: Now, you’re also talking about rumination in the book. And you talked about the importance of having a trusted adult to turn to, someone who can help them bounce back, who can make you feel safe, seen, valued, and known.

Donna: Absolutely.

Andy: Okay. And it actually… it goes as far as saying that being able to feel safe with and connected to caregivers and adults is the single most important ingredient in a child’s physical and mental health. And in the health of the adult, she or he will. That’s pretty strong.

Donna: Yes. Well, let’s think about this. If the brain’s job during development and across our lifespan, but with greater consequences during development, it’s to determine if we’re safe or not safe, then it would make sense that from very early on the messages that a child is getting, that they’re safe in their environment are going to come primarily through a primary caregiver. Right?

Andy: Yeah.

Donna: We’re like… Children are born. They come out of the womb in the womb, the placenta serves as the screen for toxicity. But out of the womb, really a parent’s mental and emotional state provides that same service.

Donna: So we see that when parents are well regulated and have resolved their own trauma, when they’re able to provide that safe and even presence, children learn how to regulate their own nervous system even when hard things happen by patterning on the adults around them.

Donna: And bio psychologists now have come up with a pretty cool term for this called bio synchrony or parent-child attunement. And what it really means is that… To a thought experiment, look back to when you were a kid and something went down that was really terrible for you, really hard.

Donna: And you think about maybe being with your mother or father during that event and the question is, what was that emotional climate for you? Did you feel really safe and seen and heard and known, or was there a circumstance of having to what we call parentification, take care of the adult in the room so that they didn’t get more upset or was there blame or shame or humiliation, or just, “Stop that we don’t want to hear about that, you’re fine”?

Donna: Whatever all that is, it’s usually about the parents’ stuff. And we all have stuff let’s be clear.

Donna: So if you want to pull this all the way back to the very first step in the safety for children, it’s basically, figure out your own stuff, do what you have to do to work through any history of adversity or trauma or dysregulation.

Donna: And of course, in the book, I have a thousand ways to do this and a thousand things to say and do and not say and do, because heck, when the brain’s on overdrive, when hard things happen, or when we’re just perplexed as a parent, like, “What do I do now?” And your heart is racing and you are afraid you’re going to say and do the wrong thing, there are ways to bring it back so that we can offer that state of bio synchrony. And that’s the work that we have to do.

Andy: Sounds like a lot of work.

Donna: Yeah. I think it’s not as hard as we think it is when we think about the fact that we’re making our life better, we’re protecting our own health and we’re creating a relationship for the future with our child that will be lifelong, which is good for them. And really ultimately, I think, what every parent wants.

Andy: Talk to me about ACEs. You talk about ACEs or Adverse Childhood Experiences in your book. What do you say about that?

Donna: ACEs are types of adversity that happen in two thirds of kids’ lives. We’ve tended to think historically about adversity as being something very overt like a car accident or being physically beaten. But there are many, many types of adversity that researchers have been looking at for 25 years now.

Donna: And in… they’ve shown a direct correlation between these events happening in childhood or the teen years, before age 18, and later developing mental health or physical health disorders. That correlation is pretty tight, extremely well established at this point.

Donna: And what might surprise people is that some of these are things that we might think of as kind of ubiquitous in growing up in some homes, like being made fun of, or put down, or humiliated, or not feeling like your parents or family has your back, or feeling emotionally neglected, no one to turn to when hard things happen, no one to lean on. Or physical neglect: you were sick and people didn’t care to take you to the doctor.

Donna: So also growing up with parent with depression or untreated mental health disorders. Let me be clear, untreated depression, anxiety, mood disorders, and growing up with a parent with a substance use disorder.

Donna: What do all these things have in common? They’re chronic, they’re unpredictable; therefore, we call them toxic stress. And back to the beginning, they create a chronic returning sense of unsafety because a kid never knows how is my parent going to react when I need them. “Am I going to get what I need? Or is it going to be scary?”

Donna: And that tells the brain, “We’re not safe and we’re not going to be safe for a while,” which chins up a lot more of this stress immune response that we are trying to move away from.

Andy: So there’s some comparisons in the book that I thought were really helpful to understanding all this stuff and how this works. And one of them was you say, it is like girls who face chronic childhood stressors have a lower set point at which the stress response gets flipped on. I thought that was good.

Donna: We have very good evidence and replicated studies which show that when estrogen comes in and we suddenly see girls developing mental health disorders at higher rates than boys, that girls who have a history of early adversity, these ACEs that we’re talking about are more likely than boys who have the same number of categories of adversity or ACEs, if you will.

Donna: Even when all things look equal, girls have a greater likelihood of developing depression, anxiety, and autoimmune disorders, which is interesting because autoimmune disorders are immune mediated. And that tells you that the immune system is going more on over drive in girls as estrogen comes in.

Donna: So, I guess I should lay out why does the immune system talks to the brain in a way that prompts mental health disorders. What’s going on there?

Andy: Yeah.

Donna: So, that’s the two-part answer. The first part is that, going way back in time again, across evolutionary history, our brains and our immune systems evolved together in very intricate ways so that at the first sign of social, emotional stress, the immune system would ramp up to protect you.

Donna: Well, this is true of males and females. So, why would that happen? Well, early in our human history, if you were slighted, or dissed, or left out, or made fun of, or even if you just thought those things were happening, the immune system would rev up with all kinds of protective factors because, back across evolutionary time, back in the day, it was physically dangerous to be dissed or dismissed.

Donna: You might be set at the edge of the tribe where you wouldn’t get good food, and guess what? What did we talk about earlier? As humans also, we are organisms and our bodies evolve to care about carrying on our gene pool, right?

Andy: Yeah, right.

Donna: So if you know that you could be at the edge of the tribe where you would be more open to other marauding, invaders, or tribes, you wouldn’t get good food, nor would your children, you might not have access to the shaman or what have you.

Andy: Yeah.

Donna: And if you continue to be dismissed or dissed or slighted, and it grew, you would be ostracized. And that would mean starvation, exposure to predators, the elements.

Donna: So, our immune systems are so smart. Unfortunately, they take a long time to evolve and that’s problem today, when you’re having this mismatch between deep evolutionary wiring and modern life, which we can get into, especially for girls, it’s an evolutionary mismatch. It’s a problem. It means that in today’s world, kids are responding to the universe around them, which is pretty overwhelming.

Donna: I mean, we can cite our hundred reasons for that at the moment as if they’re going to be set outside our tribe, as if they’re in physical danger. And we have good research to show that emotional and social stress activates the same biological pathways as are activated when an individual is in physical danger. The body and brain don’t really distinguish. So, that is just a little primer on that.

Donna: The second part of the question is that about 10 years ago, neurobiologists started to look closer at the brain. And they noticed that when the immune system ramps up in the body, it’s also causing a bunch of little cells in the brain called glial cells, which I wrote a whole book about in 2020 called The Angel and the Assassin.

Donna: These little glial cells are actually immune cells. They separate out from our white blood cells on the eighth day of gestation in the womb. They rise up to the brain and they’re hanging around there. And their job is to help discern based on signals from your immune system, which remember, gets perked up by social and emotional stress in addition to any kind of pathogen or infection.

Donna: And when there is a lot of incoming onboarding stress, these little cells get a little hyperactive, just like immune cells in the body can lead to inflammation if you whack your thumb or in your joints, if you have rheumatoid arthritis.

Donna: Immune cells in the brain get really active, it doesn’t look like inflammation in the body. Guess what they do? They spit out these toxins that begin to harm our synaptic connections and they start to actually literally gobble up our brain’s synapses.

Donna: So think about it, in the body, right; when you’re dealing with inflammation in the body, you want to bring down that immune response because you’re, “Oh my God…” There’s swelling or joint inflammation.

Donna: Well, in the brain inflammation, isn’t red, hot, painful, and swollen. It’s a loss of synaptic connectivity, which we can see on brain scans is what we see in individuals with mental health concerns.

Donna: So, lot of new science here. I’m sorry, I know I’m talking fast for your listeners, but I am a science journalist and-

Andy: Yeah, a lot of information.

Donna: … and a lecture.

Andy: Okay. This is great. No, yeah, this is awesome. This is really, I think so interesting. A lot of the neuroscience that you talked about in the book, and it’s kind of scary to think about how to fix some of these effects.

Donna: I think it’s scarier not to know. I think it’s scarier not to know because once we know it, it changes how you see everything in terms of the signals that you’re getting in the world around, what you’re allowing into your life and who you’re being as a parent because I think your listeners are parents.

Donna: I would argue there is just nothing across our lifetime that we care about more than the wellbeing of our kids and the teen years turn out to be a fulcrum point for that and getting in on that to help create the kind of family that we all want to have and frankly deserve to have, right.

Donna: We’re doing our best. It’s tough. It’s tough. There’s a pandemic. Now, there’s Monkeypox. There’s social media with platforms that just don’t seem to care about how they’re affecting our kids.

Donna: The world is flooding and burning our poor kids. A majority of kids now sight that they’re afraid their school will be in the next school shooting. I don’t know.

Donna: You’re a lot younger than I am, Andy, but this is not how it was when I was growing up. Things were tough, they were rough, but there wasn’t so much coming at the developing brain with so little guardrails.


About Donna Jackson Nakazawa

Donna Jackson Nakazawa is the author of Girls on the Brink: Helping Our Daughters Thrive in an Era of Increased Anxiety, Depression, and Social Media.

Donna is also the author of six previous books. Her book The Angel and The Assassin: The Tiny Brain Cell That Changed the Course of Medicine  was named one of the best books of 2020 by WIRED magazine. Childhood Disrupted: How Your Biography Becomes Your Biology, and How You Can Heal was a finalist for the 2015 Books for a Better Life Award.

As a science journalist, her writing has been published in The Boston Globe, AARP Magazine, Glamour, and more. For her reporting on health-science, Donna received the AESKU lifetime achievement award and the National Health Information Award. She has appeared on The Today Show, National Public Radio, NBC News, and ABC News.

Donna has been a speaker at numerous universities, conferences and medical centers, including the Harvard Division of Science Library Series, Rutgers University Behavioral Health, the Peace & Justice Institute, and many more. She has been the recipient of writing-in-residence fellowships at the Corporation of Yaddo, the MacDowell Colony, and the Virginia Center for the Creative Arts. 

Donna is also the creator and founder of the narrative writing-to-heal program, Your Healing Narrative, which uses the process of Neural Re-Narrating™. She’s brought this course to thousands of individuals, parents, health care workers, physicians, and educators. 

She lives with her family in Maryland.

Want More Girls on the Brink ?

Find him on her Instagram, Twitter, and Facebook.