We need skills, not pills, to tackle teenage stress
Should the Nobel committee ever find itself stumped
for a recipient of its prestigious prize for medicine, it ought to look
no further than the hallowed offices of DC Thomson to Gordon Small, the
founder of Jackie magazine.
It is only now, a decade after the magazine folded,
that its contribution to the mental health of the nation has become
apparent. As subversive in its day as Eminem, Jackie magazine was the
antidote to double physics. It acknowledged a truism to which the
parents of teenage girls were clearly blind: that the only things in the
world which really mattered were boys, make-up and where you stood on
the David Cassidy v Donny Osmond debate.
In its heyday it sold one million copies a week. By
simply following Jackie’s advice on applying eye-liner or up-dating last
season’s denim skirt with jazzy coloured patches, a generation of girls
were able to navigate the hormone-ravaged torrents of adolescence and
land, relatively unscathed, on the distant shores of adulthood.
If your anxieties extended beyond a concern that
Woolworth’s would sell out of recordings of Puppy Love before you had
saved sufficient pocket money, there was always Cathy and Claire. This
was the problem page which knew the answer to the teenage equivalent of
Fermat’s last theorem: what to do if the boy you fancied was going out
with your best friend.
The fact that Cathy and Claire was actually a bearded,
six-foot Scotsman called Bill was immaterial. Bill, via his aliases,
instinctively understood that the problems of teenage girls needed to be
taken seriously, but not too seriously.
This approach to adolescent angst is worth bearing in
mind when considering the latest research from the Social and Public
Health Services Unit at Glasgow University. The study of 2,700 school
pupils in the west of Scotland discovered that the mental health of
teenagers has deteriorated significantly in the last decade and that
those suffering most are middle-class girls.
Two groups of 15-year-olds were interviewed in 1987
and 1999 using a standard questionnaire designed to measure levels of
psychological distress. The results, published in the Journal of Child
Psychology and Psychiatry, demonstrate that stress levels among
middle-class girls have almost doubled in the last 12 years.
According to Professor Patrick West, co-author of the
report, this is not a trivial matter. "We have identified a level of
mental health problems that could be considered clinical," he said. "If
the girls went to a GP with this level of problems, the GP would
intervene."
The study is as thorough and authoritative as its
findings are alarming. But the most striking thing that comes across is
the mundane nature of the teenagers’ worries. According to West, the
main source of angst is school work. Concerns about body image - looks,
weight and clothes - compound the problem. Today’s teenagers are not
grappling with difficulties unknown to their parents’ generation. They
are worried about the same things as the rest of us: how we perform and
how we look.
These are the perennial concerns of teenage girls. The
difference is that a decade ago they were aired on the problem pages of
teenage magazines. These days we instinctively look to medicine to
provide the answers. Quite how our hard-pressed GPs are expected to
intervene, however, is worth considering. The tools available to doctors
consist of either drugs or talking therapies. The idea that doctors
should dish out pills to 33 per cent of middle-class teenage school
girls in an effort to lower their levels of anxiety is a worry in
itself.
As for the benefits of counselling, they have recently
been called into question by the authoritative Oxford-based Cochrane
organisation, whose research demonstrated that people offered
counselling often end up believing they have a mental health problem
when they do not.
The irony, of course, is that our teenage years ought
to be our healthiest. Death and disease are mercifully rare. Major
psychiatric illnesses such as bi-polar disorder and schizophrenia are
unusual in this age group. As we have become more attuned to the risks,
both real and imagined, that our children face, we have laboured to
eradicate them. Middle-class girls in particular - the very children
whom West and Sweeting have identified as most at risk of psychiatric
illness - are among the most cosseted and cloistered. Could it be our
anxiety to protect them which is inadvertently exposing them to danger?
While we have been busily dismantling every perceived threat to their
wellbeing, however far-fetched - refusing to let them out on their own,
monitoring their e-mails, issuing them with rape alarms and mobile
phones - we may unwittingly have been robbing them of their resilience
and their ability to cope. If West and Sweeting are to be believed,
teenage girls are now at grave risk from routine aspects of their lives.
The authors have been careful not to over-interpret
their findings. Not all will be so scrupulous. There will be those who
will use this research as a cudgel with which to beat the education
system. Others will use it to wage war on the middle classes,
interpreting it as yet another example of pushy parent syndrome. But
middle-class parents are not monsters who are prepared to drive their
daughters to the verge of nervous breakdown in the pursuit of five
Highers and a prefect’s badge. Like the vast majority of parents, they
care deeply about their children’s happiness and well being.
The problem lies not in the parenting skills but with
a society which is intent of medicalising the human condition from birth
to ageing. Once upon a time, a miserable teenager would have been
prescribed JD Salinger’s Catcher in the Rye or Françoise Sagan’s Bonjour
Tristesse by a concerned parent or teacher. Now they are offered
telephone helplines and Prozac.
Doctors’ waiting rooms are filled with the worried
well, convinced that happiness should be available on the NHS. Stress, a
normal part of everyday life, is now equated with mental illness. The
explosion in the prescription of anti-depressants is a global
phenomenon. They are now demanded by people who are not so much
clinically depressed as "a bit pissed off".
Behaviour which does not immediately equate to our
ideal of normal is labelled and treated. Children who would once have
been described fondly by their teachers as "little originals" are now
perceived as problems. Of course, there are children who suffer mental
health problems and for whom medical intervention is essential. But when
the dividing line between behavioural differences and behavioural
disorders becomes blurred, nobody benefits.
West and Sweeting’s research has alerted us to a real
concern. To tackle it we need skills, not pills. Instead of dismantling
the exam system and removing the sources of stress, we should be giving
our children strategies for coping with them. Learning to deal with such
pressures is a vital aspect of growing up. Normal anxiety is not an
illness.
Children and adolescents are remarkably resilient. The
current generation of British pensioners endured bombing, rationing,
separation from their parents and the prospect of imminent death in
their youth without access to drugs or counselling and with no obvious
ill effects to their long-term mental health.
Of course teenagers’ worries should be treated
sympathetically, but they should also be put in perspective. A poor exam
result or a pound of extra puppy fat must not become the basis for an
appointment with a psychiatrist.
By Gillian Bowditch
26 March 2003
http://news.scotsman.com/columnists.cfm?id=357062003
home
|