Episode 56: Anxiety and Depression in Girls: The Neuroscience of Social Media with Donna Jackson Nakazawa

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Donna Jackson Nakazawa:

It is true that there are differences in the brain in the face of overwhelming adversity and chronic stress, which we know girls today are facing. And when we see that unrelenting stress, the amygdala in the female brain, some research has shown that left amygdala which we associate with rumination, and your aunt’s I, like your acronym is more perfused in the female brain. And this is a problem, because that left amygdala is associated not just with rumination, but currently I’m trying to find the amygdala in my brain while I’m talking. It’s when it is perfused. We also associated with less action, right? Less ability to break that ruminating state. And we don’t see that same perfusion in the male, adolescent brain in the same way, because we see in rumination, that boys for reasons having to do and there’s whole book to be written about boys on the brink, I promise you, we see boys are more likely to take an action right? We see that in in in boys in the world. And that can also be a negative or a positive. In the female brain when there is a lot of toxic stress. And that left amygdala becomes perfused and lights up and there’s no action. That is a recipe for depression.

Dr. Andrew Wong:

Our social media dominated world has created a unique challenge for both teen girls and their parents. How can we navigate a social media landscape that emphasizes comparison and breeds anxiety and depression. That is what we are discussing with today’s guest, Donna Jackson Nakazawa. Donna is an award winning journalist and internationally recognized speaker whose work explores the intersection of neuroscience, immunology and human emotion. Her latest book girls on the brink helping our daughters thrive in an era of increased anxiety, depression and social media, published this year in 2022, is available for order wherever books are sold. In this book, Donna explores today’s growing adolescent female mental health crisis. I am Dr. Andrew Huang, co founder of capital Integrative Health. This is a podcast dedicated to transforming the consciousness around what it means to be healthy, and understanding the root causes of both disease and wellness. Please enjoy this insightful conversation with Donna on the neuroscience of how social media impacts teenage girls and what parents can do to best support their daughters as they navigate this virtual landscape. Welcome to another podcast. Thank you so much for coming on today. It’s

Donna Jackson Nakazawa:

a pleasure to be here with you Dr. Wong.

Dr. Andrew Wong:

So you’ve written many books about, I believe the intersection of science and biology, and they’re different books that we can talk about. But their latest book is so interesting girls on the brink, and it’s subtitled helping our daughters thrive in an era of increased anxiety, depression and social media. We are taping this during the COVID pandemic, we’re in 2022 right now. But Donna, what was your inspiration for your book girls on the brink here?

Donna Jackson Nakazawa:

Oh, with every book, the personal always informs the professional but my actual beginning point is yours before you see a book in print, right. For all authors. This is the case. And for me, as I was wrapping my book tour in 2020, for the angel in the assassin, I was literally hearing from scientists, neurobiologists from Harvard to records what’s going on with our girls, we’re seeing this shift in the mental health of our girls. Have you dug into that, and indeed, I had started to keep a hot file, which is how every book begins. Looking at these shifting statistics for girls. Suddenly, we’re seeing an increased rate of girls reporting suicidal ideation. Compared to boys, we’re seeing that one in four girls present with depression compared to one in 10 Boys, we’re seeing that 1/3 of girls by age 17 report a major depressive episode, and yet simultaneously juxtaposed to that, I came to realize in my conversations with leading neuroscientists and neurobiologists that all of the research upon which I based all my books, childhood disrupted the angel and the assassin, all of that neurobiology, which is you know, as well as anybody starts with preclinical and translational research had been done in male research models. So I reached out to different experts. And indeed, they confirmed to me that researchers had wanted to keep those pesky female hormones out of it. Until very recently, and so I began to watch that space for this research coming out. And as it did, it kind of blew everybody’s minds, right, that what’s happening during puberty for girls, is very different than what’s happening for boys in terms of setting girls up for depression, anxiety, autoimmune disorders, and so much else. And I felt like, as the mother of a daughter and a son, I had also seen this difference, right. And I needed to just put my shoulder behind that wheel.

Dr. Andrew Wong:

Well, as you said, you know, personal does inform the professional, I think we all know, of girls growing up, whether in our own families, our loved ones, relatives, friends, and, you know, I do also see a difference. Sometimes, you know, as people grow up, and you know, I see patients to and they have kids, and they’ve there may be some differences in you know, mental health, you know, anecdotally, but it’s so interesting that you mentioned about the research coming out, that is more, you know, gender focused on on females, which it hadn’t has, it hasn’t history. That’s right, actually, I’ve done a whole podcast on gender bias as well. And how a lot of that research done in heart disease was done on on males, right. And stuff. So, you know, it’s interesting that you mentioned about depression and suicidal ideation. So why are health issues and outcomes so different? For for boys and girls? What is it? Was it about the biology? What is it about the socio cultural environment?

Donna Jackson Nakazawa:

Well, so we want to step back for a minute here. And remember that we have very good evidence that adversity and chronic stress, or chronic unpredictable stress in childhood really shifts the immune system’s response over time in ways that we can think of on a physical level, ramp up inflammation, right over time, we have a good understanding that chronic stress ramps up inflammation, and that this is particularly harmful when it happens during development, because it can also begin to turn on genes for disease. However, what we’ve also come to understand is true for all children and teens, is that when there is a chronic sense of unsafety in the environment, something begins to shift in the brain as well. This is has to do with another new understanding that the brain is really an not immune privileged, right. It’s an immune organ. And when the brain growing up, which serves as our detective monitor, ask the question, Am I safe or not safe? And the answer keeps coming back as I’m not safe. For reasons we’ll go into, then, things begin to shift in terms of the brain’s immune response, as well. And we can think little cells in the brain called microglia. For this, when they feel that their environment is not safe, it can be emotional stress, toxins, what have you, they begin to spit out neurotoxins in the brain, but they do something else, they also begin to actually prune necessary and needed neural synapses in the brain. Now we all know that childhood is a period of time where the brain is developing super quickly. And as that happens, there’s a lot of growth. And then during adolescence and puberty, there’s a pulling back, right? A lot of that neural structure gets pruned very quickly. So here’s what’s really interesting is that puberty is happening a lot earlier, especially for girls, on average two years earlier, when that sense of unsafety exists. Again, we’ll go into the reasons and puberty happens earlier, and estrogen comes on board. Estrogen is a master regulator. We think of it as being associated with that thrum of excitement and mood changes. But it’s also a master regulator in the brain, it’s helping to make sure those juicy growth factors are making those neural synapses plump and happy and in the right places. But estrogen as you know very well also comes with a new immune boost. It’s an immune amplifier. This is why we see such a strong association between being female chronic stress and autoimmune disease or, or exposure to toxins, or it’s why women have a more robust vaccine response than men and why women have long COVID more than men. It’s an advantage and we’ll break that down later. But it flips to a disadvantage in the face of too much toxicity, including social stress. Now, you Let’s put all that together because I threw a lot out there. Stress is increasing, of course, on social media, our world is heating up, also, politically, socially, emotionally, bring in puberty too early, bring in estrogen, which remaps the brain and amps up the brain’s immune response to stressors. And yet the parts of the brain that should govern how well a child can make sense of stressors, that prefrontal cortex, other key areas that put stressors in context is not wired up.

Dr. Andrew Wong:

And it’s just not wired up, because that’s just how we were made, right. I mean, that’s just the idea of this is a certain time at which the PFC starts to develop, or is there something that that would also, you know, make that an earlier developmental time there? Well,

Donna Jackson Nakazawa:

we used to have this period, we call middle childhood from seven to 13, which was kind of privileged for children in that they came of age without the excessive pressures that we see today, in terms of let’s just name a few girls as young as eight are off on on Instagram seeing over early sexualization of girls seeing what happens to girls in the world in terms of sexual harassment, being asked to take off more clothes in order to get more likes being critiqued for not being pretty enough or being too fat, but then being blamed, they are too pretty, it just goes on and on the gendered messaging that girls receive. And then we add in a pandemic, and school shootings, that sense of overwhelm. At an age which used to be a time in which psychologists call these the in between years because girls were exploring the world in safe friendships in the backyard, they weren’t running to clubs, sports and running to Instagram and worried about a shooting in their classroom. We can stack all those stressors up any way we want. But it’s not really looking good for our kids, in terms of when that brain asked the question, developmentally at seven, or eight or nine or 10am, I safe, it’s not looking good.

Dr. Andrew Wong:

And the PFC really cannot, you know, at that age differentiate between what’s real and what’s not. And that’s why it sounds like social media has an outsized impact on girls brains at that age.

Donna Jackson Nakazawa:

Yes. And we know that the more time children spend on social media, the more likely they are to develop depressive, anxious symptoms, and issues regarding body image and self Well, lots of other inward self hatred. And we see that this association is much stronger among girls than boys. Now part of that is because of the way girls are treated on social media. And part of that is that neurobiological shift that we’re talking about, with that ramped up, or stress machinery response.

Dr. Andrew Wong:

So there’s social media, and there’s, I think, more chaos in the world now, like you mentioned, more unrest in different different areas of the world. What do you think is happening to girls biology with all this overall as a population, I think?

Donna Jackson Nakazawa:

Well, I think what we when we put all these pieces together, you talk to leading neurobiologists, which is my job as a science Toronto and investigative reporter. And I will I will be a little flippant here and tell you that one leading neurobiologist at the Mayo Clinic, to Lisa fairweather, who is an expert on sex differences in immunology, that is her job in translational research, said to me, it’s like we need a new planet for girls. I know I’m being flippant, but it’s, it’s when we see that this gap between mental health in girls and boys, which is, which is we’ve known epidemiologically has existed for a while, right? We’ve known after puberty, there is this increase in anxiety and depression among girls that we don’t see in the same way in boys. Now we see other things in boys and I want to I want to reiterate, I’m the mother of a son and a daughter. Right? So this isn’t about leaving boys out. It’s that we’ve researched the brain on stress across development for decades. And we are just adding girls to the conversation. So I just want to be really clear. I really boys are suffering too. Of course they are with toxic masculinity and all kinds of other pressures in our environment that are the same as what girls face. But I think what we’re seeing now when we put all of this together is that we’ve got to get serious about dialing down girl’s body and brain stress machinery.

Dr. Andrew Wong:

So how do we do that? What neuroprotective strategies do you recommend to help our kids, especially girls, it sounds like all boys and girls, but you know, specifically girls here,

Donna Jackson Nakazawa:

well, I want to be clear all of these strategies that I have in the book or expert agreed upon. And there are 15 of them that we isolated as being sort of step by step neuro protective approaches and stances we can take as we raise our girls, and they really 90% of them apply to all children. And if we make the world better for girls, we’re making it better for boys to at because how boys grow up affects girls and the women they will become. So this is really geared to all children. But there are certain ways in which we have to pay attention to the messages that girls are getting. And when I think about these neuro protective strategies, what I think of are those nesting T dolls, those Russian, Mary Mary OSHC Goodall’s that, you know, we nest inside of each other. And of course, at the center, we have a girl, right, but we have these little nesting dolls that surround a girl as she grows up. One of the most important, of course, is that first nesting, and that is the family of origin, the caregivers in the home. And then we go to immediate community schools, the environment, the neighborhood, and then we go to that wider world, which we really want to be sure to set girls up to thrive autonomously within. So starting with that first nesting circle, we start with a lot of strategies in terms of really thinking about the safety, and the messages of safety in the home, which as we know, from all of our research into trauma and adversity, we know that that main goal there is that sense of safe and stable, nurturing connection with primary caregiver. And that that becomes a primary goal with parenting. And why is that it’s so hard to do in today’s world, because the world is really really, really fractious and really busy. Parents love and adore their children, but we’re moving really, really fast, things are stressful, there isn’t a lot of time. And when we’ve had our own trauma, growing up, which two thirds of us have, we may not have all the skills we need to self regulate, and provide those messages of wellbeing, connection and safety. So that’s where we begin. And I like to remind parents, because I talked to a lot of groups. Listen, none of us are doing this, right. And it’s okay to not know what you’re doing. And wish you’d said or done things differently. But when you put everything in the perspective of bringing down the brain’s stress machinery for your children, this is probably going to require you stepping in and doing a little bit of work on you. And I can’t start those 15 Antidote strategies without starting there. Because we know that that is really what is priming the brain is offering that cellular sense of safety within yourself. And we have a lot of ways to do that across development that are I off, I offer just dozens and dozens of scripts even for doing it in different situations. And why do I do that? I don’t write scripts. That’s not who I am as a science journal. I do it because of the science we know that when life is busy, when things are stressful, when we’re in those parenting moments, which we’ve all been in, if you haven’t been in them, maybe you’re raising your children at or something, but we’ve all been in them, the brain goes offline, regulate self regulation goes offline. And what we’re trying to do are develop those skills right off the bat. So we can not go into those old patterns, not go into reactivity, and be that regulate itself, who can really see the needs of the child in front of us. Listening without judging and being a regulatory valve for the world.

Dr. Andrew Wong:

It starts with ourselves as caregivers, like you said, I just think it came to mind when you were talking about you know, starting with ourselves and creating that safe and secure environment that you Now a lot of us are also, you know, on social media a lot and and then that probably affects our mental health as adults, right as parents to kids or as caregivers to kids. So that’s a whole nother conversation. But you know, we’ve definitely had, you know, guests on here talk about social media, and the destructive aspects of that, do you find that the increase in the rise in prevalence of social media, for adults has potentially impacted the presence of mind that the bandwidth that those adults have for their, for their kids or their, you know, people, they care, they’re caring for

Donna Jackson Nakazawa:

100% I mean, we all know that the dopamine rush of checking your text and your dings in your emails, and oh, I have 10,030 emails, but 10,031 Who’s it from, you know, the dopamine rush, we know that that’s real. And in the book, I interviewed pediatricians as well as lots of other folks. And I’ll never forget one pediatrician sent to me, not only our 90% of her patients, kids on social media by age 13, or even 11, or 10, or nine, especially with smartphone watches. Not only that, but parents largely never talk to their kids about social media use. It’s not even a conversation that happens in the home. And more she what she does is she reminds families, your kids shouldn’t be on social media, until they’re 13, or 14. And then there have to be all kinds of conversations, and I break all those down in the book, you know how to create this, this protective environment around social media. But she pointed out something else. And that is that kids spill in safety, over meals, breakfast, dinner, rising and bedtime. And what if we fill those times with, so where when can kids even spill? When it’s rushed in the car, we’ve got to get to, you know, club lacrosse, or, you know, get out the door or eat your breakfast to to, to em, we’re all checking our phones. Just having periods of time where we put our phones away as a family can become what I call in the book, a family routine or ritual. And we can make these family routines and rituals, really something to join in as a family and be proud of like, Hey, this is who we are as a family, like we play games at the dinner table. Or we do this when we get up together and make breakfast together, shifting the way in which smartphones have taken over our lives. And remember, girls on social media, by the age of eight on Instagram, even though the age of use is supposed to be 13. And up the world is crept in stress machinery is in gear way before it should be biologically. And it’s our job to do everything that we can to bring that stress machinery down.

Dr. Andrew Wong:

Once Once the stress machinery kicks in and changes the brain, you know, cognitively biologically, is it possible to cultivate resilience to change that brain back to a more balanced state?

Donna Jackson Nakazawa:

Well, that’s overtime. That’s the greevey thing about the brain, right is that it’s so neuroplastic. And we can create change in ourselves across our lifespan. Again, we’re going to go back to that. That small picture I painted of the immune system in the brain with those little micro glial cells and other glial cells running around their job is to kind of determine the safety of your Your Life, Your World, Your immediate environment, and to act accordingly. And we know that over time, we can begin to see big ships and think of a ballet dancer who, what how does she spin on her toe like that so fast, right? That was not something she was born with. But that practicing over time created neural circuitry, which allowed her to spin without falling over in a dizzy spell. That can happen that really narrow that really neural programming can happen across the lifespan for all of us. I have a feeling that you would not be doing what you’re doing with patience if you didn’t believe that to true.

Dr. Andrew Wong:

Absolutely. I feel like do you feel like it’s like quorum sensing for the microbiome? You know how the gut is kind of doing this all the time like how As the environment is safe or not, and the bacteria are changing response to you know how we do go about our lives and wonder if it’s similar to the brain as well?

Donna Jackson Nakazawa:

Well, we go. And we also know that glia in the brain talk directly to immune cells in the gut. So it’s one system, this entire system between the immune system and the cut body, the brain, it’s just one bi directional system. And if we think about that, from a safety point of view, as well, because we’ve been talking about environmental safety, there’s, we might ask, Well, what is this system chatting about this, this brain gut body system, this immune conversation, this brain immune conversation? Well, they’re chatting all day long about how safe is this world. And there’s just so much that we can do to create a not an overly protective environment for young people, we don’t want to do that either. The brain needs a little wobble, we don’t want to be driving our kids, you know, left papers left on the counter over to school in the middle of the day or running after them with their lunchbox that that doesn’t allow the brain to to develop a lot of crucial wiring in that prefrontal cortex. And it doesn’t give kids the message, hey, I can deal with this on my own. But when will you remember that the brain is opening up to being rewired? Too early. In a world that’s largely too hot on every level, then we want to be thinking, what are those ways in which we can switch out all the different things that we’re thinking about during this developmental period? And it requires some deep thinking about how you know the messages we send our kids? Oh, you were the best, you know, you ran faster than anybody else. Or, well, you you are loving yesterday, and you look 16 Today, oh my god, she’s turned to, you know, just all of it. We’re, we’re caught up in this faster, earlier environment for kids on every level. And we need to back away from that.

Dr. Andrew Wong:

It sounds like the planet physically is too hot. The information overload is coming in too hot, right? Everything’s kind of too high on overload. It’s too hot. Yeah, exactly. What are some other highlights not to go through all 15 but have neuroprotective strategies that you want to highlight from your book here, which I have right here. Okay, there it is.

Donna Jackson Nakazawa:

Well, I think some of the ones that really stand out as I’m talking to parents and, and researchers and public health experts, that that without going into all 15 really shine a light. Starting at that beginning of the process. One of the things that really struck me is that one of the most important signs of adolescent female thriving, is when parents can answer yes to this single question. Does this child can this child come and talk to you about anything, no matter how hard no matter how difficult, and the work it will take you as a parent to be that person is your work. And when you set that work in place, when you create that foundation, it is highly neuro protective. Of course, that’s not enough. You can be doing all the right things, it’s apparent. We don’t want to put everything on a parent parent, you know, we ruminate all the time about our kids, that’s not good for us either. And we try and we do our very best. And the world still creeps in right kids run to school and they look at other kids smartwatches or smartphones. The world creeps in. I hear these stories from parents all the time I did this I I heard all the right things. And yet, so it’s not all on us. But we can move on to really important things that we can do bringing in the wider community, you know, bringing in avatars for our kids, right? We broken down community in a lot of ways. When I say avatars, I mean I’m using the word and a really old sense from the Hindu like a being that comes into an individual’s life to help guide and nurture, a nonparent being and we can find those in the world around us and we can help set our kids up to have those avatars and we can bring in community in a lot of different ways we can teach girls how to speak back Get in an autonomous way when it’s safe to sexism in their environments. You know, let your daughter like, blow off steam to her dad. Sorry, sorry.

Dr. Andrew Wong:

But in the kitchen, it’s great, great for great for great. Yeah,

Donna Jackson Nakazawa:

just, you know, kids blow up at their moms a lot, especially girls, let let your daughter like be in the kitchen and say, your dad, I think you’re really wrong about this, and I totally disagree and blah, blah, blah. We also know that social emotional safety is the ability to voice your ideas and opinions at any age without fear of judgment, ridicule, humiliation, or being dismissed. And that creates a sense of mattering. So I’m being a little more philosophical here, then breaking down the 15 antidotes, which again, you know, are all in the book and come replete with scripts you can use in your own kitchen, because trust me, I learned the hard way.

Dr. Andrew Wong:

Yeah, it sounds like that’s the foundation is creating that sense of trust and openness. And like you said, it’s not just about sharing, but how that information is received, so that the next time that they want to share with their caregiver, whoever that is, or are, it becomes a, you know, positive reinforcing cycle. That’s right.

Donna Jackson Nakazawa:

So one of our one of my antidotes is, you know, when your daughter comes to you with hard things, once you’ve set that foundation, make it a really good experience for her. Right? It isn’t going to happen again, if it isn’t a good experience for her. And how do we do that? It’s complicated. But there are ways to do it. There are very, you know, pretty easy ways. Actually, when we have kind of practiced our frame, I have one parent who said to me that she’s put the script, she was an early reader of the book through advanced Random House something, and she put the scripts on posterboard on the inside of her kitchen cabinets, so that she could just kind of when her brain goes offline, she could take some of those and respond in the way that she wants to. And when we do that, over time, we know that that changes our brain as a parent. I also want to just reiterate, again, we’re not in this alone, it isn’t just about what happens in the kitchen, we have to create social media plans as a family, we have to make sure that we treat our kids mental health, the same way we would if they tripped and sprained their anchor ankle. While in a track meet, we would go to the coach and we would say, Hey, can you let me know how he’s doing here? When will we know that? That he’s ready to practice again, or she’s ready to get back into field hockey or whatever. So bringing in schools and outside therapists, I’ll share something else with you, the majority of parents 90% say they would know when their adolescent is thriving is not thriving, they would know when there’s a problem. And yet the same parents, the majority also say they really have no idea how to discern normal teen moodiness, from there being an actual problem. And half of parents miss it when their kids are having suicidal ideation. We are not soothsayers, as parents, we cannot do this alone. We can do everything that we can to do the work in our own minds and hearts and in our own homes. But we cannot do it alone.

Dr. Andrew Wong:

So speaking of that, Donna when tough things happen with kids, whether that be anxiety, depression, even suicidal ideation, things like that, what do you recommend that we use to help our kids overcome, overcome those type of challenges, but even even things that they may feel or are challenging? They’re, they’re coming to you for? Hey, you know, what do I do in this situation at school or at some other situation?

Donna Jackson Nakazawa:

So the most important thing is to not do everything you want to do. What do I mean by that? We, as parents have taught our children that we’re the fixers doers, we’re going to jump in. And there’s good reason for that, right? Because before you hit these years in which kids are developing their own autonomy and their own sense of self, that’s who you have to be let it You fell down and skinned your knee. Let me kiss it and make it better. This is this is good parenting. This is what we do. It’s our hearts and minds come together to care for these little people who are the most important things to us in the entire world. And all of that comes out of a wonderful place, but it requires judging, fixing, jumping in between the two protective. Well, where did you fall? Well, how did it happen? Well do I need to take him to the doctor take her to the doctor, lots going on in the brain when we have young children and across development. But as kids start to come through these middle childhood years and into puberty and adolescence, they’re starting to care a lot more about what the world thinks as well. They’re having a lot more voices from coaches, teachers, peers, Instagram, and we don’t really know how that’s getting processed. Unless we don’t do everything we want to do. And what I mean by that. Don’t jump in. Don’t be the judge. Don’t be the detective. Don’t be the fixer. Sit back and ask open ended questions. Wow, that sounds really hard. Can you tell me more about that? Or maybe you have a child who’s so closed up by the stress going on in her life and in her environment? She doesn’t even know where to begin. And you can’t even ask a question. Maybe you need to sit there and say, Wow, that sounds really hard. Anyone in your shoes would find that really, really hard. I would find that really, really hard. I’m just here to listen. I have funny things in the book, like giving your kids coupons at that age where it’s no questions asked Convo, right. So your kid can come to you and talk to you and say, Hey, you, you promise me that I could come to you, and you wouldn’t ask a single question. Or if your child is is coming at you and saying, Can you fix this, which is another sort of parent child dynamic? And you go, yeah, that’s me, I’m gonna do it. You can just say, Hey, I’m gonna, I’m gonna tell you what I think. But right now, I want to hear what you think is what you think is so much more important than what I think. So there are hundreds of things we can offer children in these moments that build that sense of safety and connection. So that we can then understand the framework for what they’re thinking and feeling. And then we can get to the action later.

Dr. Andrew Wong:

I want to focus on one of the anecdotes you have in the book about how to break the cycle of negative self talk with I think, writing things down. Thank you. Yeah, well, well, you know, there’s this kind of thing we have here words, this ants, you know, automatic negative thoughts syndrome. And so do girls, do teens or two girls and girls more specifically, have more ants? Do they have more automatic negative thoughts? Is that rooted in biology? Is that rooted in puberty and things like that? Or is it social media?

Donna Jackson Nakazawa:

Well, I think that we have to remember that girls grow up being much more likely to be victims of sexual harassment and sexual comments, put downs, rape, other types of abuse, we know that girls in general have higher levels of adverse childhood experiences than boys. And it makes sense in way because girls are developmentally seen as more vulnerable in in those early years. So like, we don’t want to put it in the context of it being driven by sex differences. And, and in that pain, I would also say that, it’s really important to remember that every neurobiologist with whom I spent time reminded me that these changes in the female brain during puberty only occur in the face of unrelenting, toxic stress. So we talked about the brain being very plastic. The brain, the female developing brain is like this beautiful powerhouse. It’s like just this glorious thing that corpus callosum is really rich, and so much is happening. And that ability to have like a spidey sense about what’s going on in the world around us. There are a lot of evolutionary biology biologists who see those as an advantage across evolutionary time. And we didn’t get into that. But there’s a whole chapter on that in the book. And so however, when there is to answer your question, and we’ll get to the writing part, because you know, that’s something I really care about. So when we get to the biology part, it is true that there are differences in the brain in the face of overwhelming adversity and chronic stress, which we know girls today are facing. And when we see that unrelenting stress, the amygdala in the female brain, some researchers shown that left amygdala, which we associate with rumination, and your aunt’s I, like your acronym is more perfused in the female brain. And this is a problem, because that left amygdala is associated not just with rumination, but currently I’m trying to find the amygdala in my brain while I’m talking it, when it is perfused, we also associated with less action, right, less ability to break that ruminating state. And we don’t see that same perfusion in the male, adolescent brain in the same way, because we see in rumination, that boys for reasons having to do and there’s whole book to be written about boys on the brink, I promise you, we see boys are more likely to take an action, right? We see that in in employees in the world. And that can also be a negative or a positive. In the female brain, when there is a lot of toxic stress. And that left amygdala becomes perfused. And lights up and there’s no action, that is a recipe for depression. High and says You call it low action. So bringing in writing to heal, you know, I teach courses to teach it, they enter while you know, School of Medicine and many other universities and records and lots of places. And a lot of the groups I work with are physicians. You guys have a lot of stress and a lot, a lot of you have early trauma. And I work with a lot of therapists groups and parent groups. But the reason I teach writing to heal, what I call your healing narrative is because it is this really rare opportunity, we have to get in on the present moment. Because you’re doing something in the present, you’re riding bias Strider here, you’re getting in on the past, because in narrative writing and creating your healing narrative, you’re also bringing up things which are past oriented, but they’re affecting the present. And you’re creating a document that can go away into the future. I think that’s pretty cool. You can revisit it, I’ve seen time and time again, how that has changed people’s lives. For girls, what I suggest because we are not trying to do with adolescent girls from you know, and or girls in pre puberty through young adulthood from eight to 28. We are not trying to do this deep trauma die with young girls, older girls, sure, but not young girls. So what we can do is use a piece of writing to heal and that is ask your daughter to take a piece of paper and write down all of her thoughts and feelings, not lift her pencil from the paper for 10 minutes, she can write everything negative she wants, it doesn’t matter, it can be as negative as she she wants to get into. And do that without writing anything negative about herself. After those 10 minutes, set a timer. Tell her to rip it up in the tiniest little pieces, she can throw it away. This is not for you as a parent, you don’t need to know this is breaking that amygdala, high alert that left amygdala rumination and then afterwards if she wants to, it’s up to her not you have her write for 10 minutes ask her if she wants to write for 10 minutes about ways she has coped with these situations in the past or way she can make meaning about this in the future, or things she’s able to say to herself, which helped her put all of this in context and perspective. And we are creating new neural wiring as we do this.

Dr. Andrew Wong:

I love that. I was an English major myself in college. So I never thought about writing. Exactly. Writing to, you know, to you know, basically cultivate neuroplasticity, I think that’s so interesting. So, so great. It’s a great idea. So So Donna, you really wrote this amazing book about girls on the brink again, just want to highlight that and we know that there’s a lot of, you know, different mental health challenges. Now, did you find in this, I guess this was written obviously very recently, but you’re writing this during the pandemic? Yes. Did you find any research and it’s pretty, you know, in a couple of years now, but it hasn’t been researched on the increase that you found in mental health challenges for for girls. In the pandemic or

Donna Jackson Nakazawa:

so both girls and boys their rates of mental health disorders increased between 2019 and 2020 exponentially by At around 30% for girls and boys, it was interest. Interesting, also increased, but not as much. So again, we’re seeing that compilation of factors. This isn’t one factor. It’s kind of like, I’m a writer, English major in public policy major. So, you know, it’s, it’s I like analogies, it’s kind of like a wildfire, right? You can have a wildfire that burns itself out or isn’t really bad. But you accelerants like wind direction, and other you know, try conditions, and suddenly you have something that is much, much worse. So it’s all those factors together, coming together. And the pandemic is one of them. We saw these trends very well to find, even in 2019, a lot of the research that I quoted you was the poor, the odd. But we also know that his poured gasoline on an already existing fire and how could it not really, it’s been hard for all of us. And you and I are our brains aren’t still in development.

Dr. Andrew Wong:

And the virtual learning, I think, has played a big role in that, that this isolation from that? What is it like to cultivate just in general of family resilience? If you if you have a girl and a caregiver and and you know what’s it’s almost like preventative medicine. You know, a lot of times in functional medicine, of course, we talk about how to prevent how to build the terrain. So how do we build the terrain of healthy families and cultivate resilience?

Donna Jackson Nakazawa:

Well, resilience really is that ability to work together during really hard things and recover from really hard things together, it isn’t preventing hard things. So I want to be really clear about that. Hard Things happen in every family, certainly, to be personal for a moment. You know, this about me, I mean, I was I was paralyzed twice for long periods of time, when my kids were really little, that was a real adversity, it was really terrifying for them, I would go to the doctor, and my neurologist would say, you’re staying, you know, for a month, six weeks, and for little kids who are two or four or six, or it’s it’s a terrifying thing. And we can’t keep hard things from happening as a family, we can’t single handedly go out and stop all the things we talked about in our hot world. Right? Right. But what we can do is make sure that as a family, we can come together to talk about her things. Lots of strategies in the book for this one of them that I really love is Wonder together, it sounds really simple and slap silly. But wonder together. So often we’re responding to the world and reacting to it as a family. Well, gosh, you know, did you see that, and that’s so horrible. And we’re walking around on our phones, oh, my God, you know, politically or this guy. And remember, all of our news is there to get us to respond emotionally. Whether it’s coming from any news source you want to name or any, especially on social media algorithms are rigged to pump you up, because that’s what keeps you coming back. And they don’t even necessarily want you on a feed for 20 minutes, they want you putting it down and coming back and what makes you do that emotion. So we’re all responding in this hot way to a hot world. And some of that is appropriate. But we can break the way we’re responding to the world as a family. And we can wander together, Hey, I wonder what it’s going to be like, when you go back to school and a 10 person. And this does something else that we talked about. It allows your kids to have their own ideas, thoughts, express emotion, without being judged or fixed. We can start when kids are really literal, like it’s raining here today, you know, like, wondering what that bird feels like in the rain, what birds feel like in the rain. So there are hundreds of ways that we break down that are science based and really based on neural structure, that we can create a different sense of safety within the family that then extends out into the world and creates that resilience together.

Dr. Andrew Wong:

That’s really great advice. I also feel like there’s a juxtaposition, which you know, both are needed, but between screen time and green time and it seems like you know, looking up at the stars and the moon and the trees, right that that does cultivate that sense of wonder that you’re talking about that cultivates reason, and we have good

Donna Jackson Nakazawa:

studies on that during the pandemic kids who are outside more did better and that is one of the antidotes in the book is having kids in a space Find a place where they can have that sense of connection to something bigger. And really nothing does it faster than nature. And the girls I followed for two years, many of them came to me with that, with that as a thing that saved them that time often as a family in nature together.

Dr. Andrew Wong:

Right. And obviously, you know, you know, there’s, um, with each thing, there’s both light and shadow, you know, with any issues. So girls mental health and the side of you know, there are really difficult things in the world, and there’s more mental health issues than with boys, it sounds like, but then also in the book, you do mention the hopeful aspects of how, you know, girls seem to be at least, if the stress is not sort of, uh, like, randomly chronic all the time that they’re actually more resilient, or they can be more. You know, like you said spidey sense aware of the world. I believe there’s actually some research, you can correct me if I’m wrong on this, because you’ve done a lot of research on this, but that relative to boys, there is actually a sense, at least in females that there’s more biologically, relatively speaking more of a massive corpus callosum that separates the left and right brain. Yeah. Okay. Which, which I think is again, that’s an advantage. Yeah,

Donna Jackson Nakazawa:

yeah. Yeah, we mentioned that earlier. And so, gosh, I don’t want to get too nerdy here. But I think we’re both nerds I’ll risk. Yes, yes,

Dr. Andrew Wong:

let’s definitely,

Donna Jackson Nakazawa:

let’s go. Okay, let’s go there. So um, so I want to introduce to you something that I’ve had a really fun time reporting on, called social safety theory, we can thank George slave at shot at UCLA, he’s headed to UCLA stress lab. And, you know, he’s doing all these cool things out in California with the state of California, introducing stress as a factor we really have to look at and child development. And George and other he’s really the scientific father of this theory and others have joined him. And it is based on our evolutionary advantages and disadvantages over time. So here’s the nerdy part. way we’re back, we’re gonna go way, way, way, way back. Across evolutionary time, we developed with our immune systems to be very, very attuned to our social safety, this is gonna get to spidey sense. So I often give these long answers. But in any event, I try to wrap them up at the end. So, so across evolutionary time, being socially safe, mattered, even more than it does today. Right? Because you were in a tribe. If anyone was dissing you dismissing you making fun of you looking at your cross-eyed. This was something the brain really had to take note of why? Because you and your offspring may be set at the edge of the tribe. Well, what does that mean? Less tubers and nuts, not the good need on the spit, you’re at the edge, you’re going to be the ones most in line for other marauding tribes, or outside predators who pick somebody off the tribe. So social safety was physical, immune safety, because if you were at the edge of the tribe, or ostracize, guess what happened to you, your immune system had to kick into overdrive, really quick, starvation, predators, wounding without social safety, you are a physically immune compromised human. So it across time, our brains develop that at the very first sign of social safety, social unsafety, or isolation, right, which we’ve just seen with the past, with a pandemic, the immune system revs up like that, to respond, that is part of the stress machinery that we’re talking about. Now, these this same theory holds that across evolutionary time, the mother is particularly important those first few years, and what is our biology care about it cares about our gene pool, honestly doesn’t really care that much about the rest of mankind. We’re not programmed that way. In those early developmental zygote moments, you know, it’s really about passing on your personal gene pool. Well, you can’t do that if you’re socially unsafe, and a mother provides the greatest social safety. She provides breastfeeding and warmth and protection and feeding. And for that reason, it’s theorized that across evolutionary time, you went to that corpus callosum, which allows that left and right hemisphere to join together and get his sense of the world on this kind of Spidey level, and that girls had to develop across puberty to have a deeper spider’s spidey sense for your gene. Pool. That’s the theory. I think it’s interesting. We can’t go back and run epidemiology on that, or neurobiology on that. But it makes a lot of sense. And many writers have written about the importance of social safety and girls cross puberty, like Deborah Tannen, you know, being more important feedback from others on a social set on that social plane, being more important to girls sense of safety.

Dr. Andrew Wong:

I like your spidey sense, analogies. They’re really, really big Canada, there’s movies, too, but um, what what was what what is one thing, Donna, that that you wish everyone knew about raising our daughters in the era of social media, if there’s like one, like, take home point here today, for our listeners,

Donna Jackson Nakazawa:

I think that my one take home is that you really doing okay, as the parent, you really doing okay? These are small fixes. These aren’t about everything being broken, they aren’t about you messing up, or wanting to listen to this, get off this podcasts and think about everything you are doing right. Now, this is about building on everything you are doing right, we’re working really hard. And building it out from there, because I promise you you already have, you already are doing 90% of everything, right. And when you add in this other 10%, it’s going to naturally evolve into pulling back on social media for your kids, because it’s going to be part and parcel of your deeper understanding of rewriting how we raise our kids today. Because these times are not the times you grew up in, you’re doing great, but you’re raising your child in a radically different era. And that is requiring you to go back to the beginning and rethink a lot of our traditional parenting reflexes, if you will.

Dr. Andrew Wong:

So this this, I love that message of hope. And like you said, you know, we can become the authors of our own lives and you know, help our children too, and they can write their own books sounds like, yes, they can be authors like you, you know,

Donna Jackson Nakazawa:

yes, we all have a story to tell. And that story really begins with understanding to me a lot of the need for this shift in our outlook. And I would close well, if we’re closing, I would say, you know, I wish a book like this does didn’t have to be written, right, it should be enough to know that our kids are suffering, really, really suffering, right? That should be enough for us to go, let’s just change everything that we do. But a quarter of my book is devoted to the science, probably half to the strategies and antidotes. But a quarter of it is Growing Up Female today, because it’s different. And the science behind why that is different, and how it’s affecting girls. And I wish we didn’t need all that. I wish we could go, hey, they’re suffering, let’s change how we do this. But I think the science allows us to really dig in on a different level. And go Okay, now that I know that, yeah, that’s a little scary to consider. But it really helps me to figure out with less confusion, less fear, how to move forward.

Dr. Andrew Wong:

So we are doing well. But it sounds like by knowing better, we can also also do better. And this book is definitely essential for our times, I’ll just hold it up again, for if you’re watching on video here. But this is a really great book, I really recommend it. For all those who have have kids have daughters, even as sons, I mean, this kind of because really you break like you said, you know, boys mental health will affect girls and vice versa. But you know, helping our daughters thrive in the era of again, increased anxiety, depression, social media. But I think just this is a way to really kind of rewrite that narrative. So thank you so much, Donna for coming on today sharing your wisdom and expertise with us. I surely appreciate it. Sure.

Donna Jackson Nakazawa:

And you can find out more about the book. Random House has set a lot of really cool things up on my website at Donna Jackson Nakazawa:.com. And you can find me well, you know, everywhere.

Dr. Andrew Wong:

Yes, and Donna Jackson Nakazawa: is spelled ma ke Zaw a lot of AI there. And any other places that listeners can work with you or learn more about Well,

Donna Jackson Nakazawa:

I am responsibly on Instagram and on Twitter and trying to use it as a tool for good. So you can find me there too.

Dr. Andrew Wong:

Yes, and as you were saying I think before It’s offline that that some hospitals are picking up the book as well. Yeah. So across the country. Yeah.

Donna Jackson Nakazawa:

So Children’s Hospitals Association nationwide, which is 220 hospitals, one of which both my kids have been in Johns Hopkins Children’s, you know, all of the children’s hospitals across the nation children’s hospitals is incorporating girls in the brink, girls on the brink into their national campaign. And we’re joining together to help create, I hope, change and awareness for this growing mental health crisis among children and teens, and help engender real change. So I’m really excited about that. And credible, very delighted because it takes us all working together.

Dr. Andrew Wong:

It does take a village, thank you so much, Don, again for coming on. And we’ll talk soon.

Donna Jackson Nakazawa:

Hi, Tara. Thanks for having me.

Dr. Andrew Wong:

Thank you for taking the time to listen to us today. If you enjoyed this conversation, please take a moment to leave us a review. It helps our podcasts to reach more listeners. Don’t forget to subscribe so you don’t miss our next episodes and conversations. And thank you so much again for being with us.