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Donna Bozzo
Grace, Donna, Ava Francesca, Matt and Juliana Bozzo, on a skiing trip. The Bozzos have always made sure to teach their daughters to have confidence and know that they can communicate with their parents about any anxiety or problems they may have.
Parents need to use these moments for keeping the dialogue open — if the child is moody or irritable, acknowledge the mood ... let the child know it's okay to show frustrations to them, the parent. —Dr. Kimberly Williams

Hampton, N.H. — The alarm blares at exactly 6:30 a.m. Krissy rolls out of bed after deciding against the snooze button and gets ready for yet another packed day.

Backpack, check. Guitar, check. Day organizer, double check. She wants to doze a bit as she drives to school at Philips Exeter Academy in Exeter, N.H., where she is involved with student government, woman's choir, varsity softball, music lessons and numerous clubs and classes.

Krissy Truesdale is a sophomore and has been an honor student since the third grade, which got her into the academy in the first place. She's also on an environmental action committee, participates in community service and has a boyfriend at a different school whom she sees every weekend.

"I know my parents are telling me to stop studying for a minute and catch my breath, but I feel like I can do better," Truesdale said.

The extracurricular activities available to kids and teens in today's world, on top of school, exceed those available at any time in the past. Additionally, the pressure teens feel, specifically girls, to take on all that they can and excel in every respect continues to mount. The average time spent on structured activities for kids, outside of school, is five hours a week, according to a report from the Society for Research in Child Development in Montreal. Though five hours weekly may not seem like much, 3 to 6 percent of children spend more than 20 hours a week in structured activities outside of school.

The pressure to be so heavily involved in activities and to be top performers comes from parents, peers, media, society and most importantly, the girls themselves. Many girls are expected to participate in multiple activities outside of school — sports, dance, clubs, music lessons — while performing well academically. There also are expectations for them to look a certain way — what society deems attractive — while doing it all.

Pressure is inevitable.

"There are so many aspects that people are looking at us from and it's hard to balance that all," Truesdale, said. "With the added pressures, we have to kind of do it and can't be frustrated about it, and we have to maintain good appearances with all of the pressures and stress."

Anorexia of the soul

Dr. Leonard Sax, a psychologist and physician based in Chester County Pennsylvania, has done extensive work with both young boys and girls to look at longitudinal differences between the two throughout the years. In his own medical practice, he has worked with families often more worried about their intelligent sons who slack in school than their daughters who are achieving perfect grades. However, the girls often are struggling more internally, and in many cases, more severely than their brothers.

"The younger girl is doing great, has straight A's, good friends, does lots of things. But — has trouble falling asleep, worries about if her parents can afford tuition at a private college," Sax told the Deseret News. "Both (boy and girl) have problems that are getting more serious, and not that boys shouldn't get attention, but we need to recognize that just because a girl is getting good grades and has friends, that she is doing well — she is still vulnerable."

Sax, author of "Girls on the Edge: The Four Factors Driving the New Crisis for Girls," sees four specific parts of girls' worlds today that are contributing to serious issues, anxiety and oftentimes breakdowns for them — sexual identity, the cyberbubble, obsessions and endocrine disruptors, which are absorbed chemicals that block hormones.

These girls will, after becoming overwhelmed with the need to be perfect in all aspects of their life, often become obsessed with finding a way to feel as if they are handling the anxiety and stress stemming from their lifestyle, according to Sax, and end up "missing the point to build a robust sense of self," he said.

The end result of many of these things is the same, something Sax refers to as anorexia of the soul, a term first used in a 2007 New York Times article about the pressure on girls. The meaning behind the metaphor is that there is more of a drive to be perfect on the outside, but without the priorities to be well-rounded and emotionally healthy, on top of everything else.

"All of these girls feel like they have to be effortlessly perfect in academics and athletics and personal appearance," Sax said. "These girls who have anorexia of the soul may have anorexia of the body, they may cut, they may have an obsession with fitness; it's a very important role of the parents to figure that out."

Racing through

Anxiety is becoming a prominent, everyday part of girls' lives, making it just another thing for them to juggle and keep under control as they fight to be balanced and stay in control of everything else.

"We're taught and have learned that we can do anything and be anything — we can do sports and be highly academic," said Dr. Kimberly Williams, a clinical psychologist who works specifically with teen girls.

"Because it's so competitive, if you're frustrated and stressed out and if you voice it, it looks like you're weak ... if you feel overwhelmed, it means you can't hack it. Nobody wants to be the one who can't hack it; it's important to look like you are just racing through."

Internalizing much of the pressure felt by teen girls happens because expressing anxiety or stress only seems to make one incompetent, which is the result desired least for these girls in the first place.

Research done by Fredricks looked at the number of hours spent on extracurriculars for children, and the end result of their academic performance.

Positive effects, specifically with test taking, were visible for those who were involved in one to 13 hours of structured activities outside of school. However, those who participated in more than 17 hours of supplemental activities saw a decline in achievement and grades.

Anxiety is heightened with the more stress put on children, and unlike Truesdale's personal desire to excel and be involved with so much, the parents are often the main source of pressure to "be the best," according to Sax.

Parents and pressure

In Williams' work with teen girls, the majority of pressure comes from parents wanting their children to go to the best school, become involved with everything and ultimately be successful enough to attend an influential, and often big-name, college.

"I have girls I work with who are in an academically rigorous school, and ... they are struggling academically, but because it is the première school for them to be in, their parents want them in there and they inundate them," Williams said. "(The girls) are falling apart; it enhances anxiety when parents are not worried they are not performing well — it enhances any difficulty they are having."

Recognizing the signs of stress with a child is the foremost step to take as parents when aiding in decreasing pressure and anxiety for young girls, Williams said. Every person shows signs of stress differently, whether it's by being irritable, grumpy or moody. Parents may just assume their child is being like any other moody teenage girl, when they are actually internalizing their stress.

"Parents need to use these moments for keeping the dialogue open — if the child is moody or irritable, acknowledge the mood ... let the child know it's okay to show frustrations to them, the parent," Williams said.

Developing self-esteem, mutual understanding and communication among family members are also ways to keep dialogue open when children need to let frustrations and worries out, all things Donna Bozzo, a mommy blogger in the Chicago area, has tried with her three teen and pre-teen daughters.

The most important part of her day is taking 10 minutes to walk her youngest daughter to school each morning, and being able to talk about anything with mom helps to alleviate pressure her daughter may be feeling, she said.

"I just think when you're able to spend time as a family, that is a cure-all for everything," said Bozzo. " ... When you spend time with your kids it really makes them feel better about themselves."

Mandy Morgan is an enterprise intern for the Deseret News, reporting on values in the media. She is a true-blue Aggie, studying Journalism and Political Science at Utah State University, and hails from Highland, Utah.