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Why mothers of tweens – not babies – are the most depressed
'Little kids, little problems; big kids, big problems.'
If you had to guess, you might think that one of the most trying times for mothers is bringing home a new baby, given the sleep deprivation and the adjustment that comes with taking care of an infant. But some might be surprised to learn that our latest research shows the most challenging period of mothering comes during children's middle-school years.
We studied more than 2,200 mostly well-educated mothers with children ranging from infants to adults, and examined multiple aspects of mothers' personal wellbeing, parenting and perceptions of their children. Our findings show an inverted-V shape in feelings of stress and depression, with mothers of middle-school children ('tweens' aged 11 or 12) consistently faring the most poorly, and mothers of infants and adult children doing the best.
As it turns out, despite the exhaustion and feelings of overload during the infancy period, mothers experience a great deal of satisfaction and fulfilment in caring for their babies. But as puberty approaches, mothers find less and less positivity in interactions with their children, and the challenges of parenting become far more complex.
From the perspective of mothers, there's a great deal of truth to the saying: 'Little kids, little problems; big kids, big problems.' During the tween years, several factors come together in a perfect storm. One, the kids are dealing with puberty and all that this implies – hormones, acne and changing bodies on the one hand and, on the other, the draw toward experimenting with alcohol, drugs or sex. Children are also coping with the transition to a relatively impersonal school environment, with large buildings and different teachers for each class, as well as the increasing academic and extracurricular pressures – think standardised testing and college preparation (yes, it starts that early, now!). Finally, children this age are starting to figure out who they are, separating from their parents and looking toward their peer group for acceptance. This often comes with testing limits, as well as starting to take risks.
That is an enormous amount of change to deal with simultaneously. And as children struggle to negotiate all of these major challenges, so too must their mothers as primary caregivers.
Mothers are essentially the 'first responders' to children's distress, and now they must figure out how best to offer comfort and reassurance, as the old ways – hugs, loving words and bedtime stories – no longer work. They also have to walk a very fine line in setting limits. Decisions about what to allow and where to draw the line bring confusion and even fearfulness. We want our children to talk to us about everything and to be supportive, but worry about how to do that without seeming to condone bad or dangerous stuff. Even for confident mothers, it's a time of second-guessing ourselves, worrying about whether we made the right judgment calls, and feeling guilty about the firm stands that we do take.
And then, of course, mothers face the often-drastic change in the child's persona, as behaviours in everyday interactions can change rapidly from one day to the next. The adoring, happy first-grader is morphing into an unpredictably sullen adolescent: affectionate and thoughtful one day, and implacably closed-off the next.
That tweens roll their eyes at their parents is not news. What is new is evidence, in our study, that these behaviours can be deeply hurtful to mothers. Women who saw their children as rude and rejecting were among those who felt most distressed.
A central take-home message from our findings is that the big 'separation' from offspring, the one that really hurts, comes not when children leave the nest literally, but when they do this psychologically – in their complex strivings to become grown-ups, in their tweens.
On top of the emotional strain, the tween years also come with rising demands on time and energy, particularly for relatively well-educated mothers. In terms of sheer number of hours, college-educated mothers spent increasingly more time on their children's extracurricular activities compared with well-educated fathers, or less well-educated mothers. Besides the time, there is the huge psychological toll associated with planning, organising, attending and travelling to and from events, often with inflexible deadlines, and often for more than one child on a given day.
And all this comes at a time when many mothers first experience the signs of approaching middle age, with declines in physical and cognitive abilities, and increased awareness of mortality. It also is a period when, according to studies other than our own, marital satisfaction is the lowest and strife the highest.
It's no wonder that middle-school mothers are so stressed.
To cope with the coming onslaught, they must be prepared, and books and online resources can certainly help. But middle-school mothers must also refuel themselves through close, reliable, authentic friendships. In an earlier study, we showed the strong protective potential of these relationships in buffering women through the challenges of motherhood. So mothers should treat it as an imperative, and not an option, to connect with supportive friends, and stick with this resolve especially during the middle-school years. They should use each other as sounding boards. Reach out when feeling frail or exhausted, or just plain fed up. And have fun together.
Finally, as mothers work through middle school, they can take heart: it does indeed get easier. Middle-schoolers become high-schoolers, and then adults, and our data clearly show that the happiest mothers are those whose children have grown into adulthood. The 'empty nest' is largely a myth. It also helps to remember this constantly (seriously, put a sticky on the refrigerator if you must): we're not just caregivers. We're people too.
Lucia Ciciolla & Suniya Luthar
This article was originally published at Aeon and has been republished under Creative Commons.
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The COVID-19 pandemic is making health disparities in the United States crystal clear. It is a clarion call for health care systems to double their efforts in vulnerable communities.
- The COVID-19 pandemic has exacerbated America's health disparities, widening the divide between the haves and have nots.
- Studies show disparities in wealth, race, and online access have disproportionately harmed underserved U.S. communities during the pandemic.
- To begin curing this social aliment, health systems like Northwell Health are establishing relationships of trust in these communities so that the post-COVID world looks different than the pre-COVID one.
COVID-19 deepens U.S. health disparities<p>Communities on the pernicious side of America's health disparities have their unique histories, environments, and social structures. They are spread across the United States, but they all have one thing in common.</p><p>"There is one common divide in American communities, and that is poverty," said <a href="https://www.northwell.edu/about/leadership/debbie-salas-lopez" target="_blank">Debbie Salas-Lopez, MD, MPH</a>, senior vice president of community and population health at Northwell Health. "That is the undercurrent that manifests poor health, poor health outcomes, or poor health prognoses for future wellbeing."</p><p>Social determinants have far-reaching effects on health, and poor communities have unfavorable social determinants. To pick one of many examples, <a href="https://www.npr.org/2020/09/27/913612554/a-crisis-within-a-crisis-food-insecurity-and-covid-19" target="_blank" rel="noopener noreferrer">food insecurity</a> reduces access to quality food, leading to poor health and communal endemics of chronic medical conditions. The U.S. Centers for Disease Control and Prevention has identified some of these conditions, such as obesity and Type 2 diabetes, as increasing the risk of developing a severe case of coronavirus.</p><p>The pandemic didn't create poverty or food insecurity, but it exacerbated both, and the results have been catastrophic. A study published this summer in the <em><a href="https://link.springer.com/article/10.1007/s11606-020-05971-3" target="_blank">Journal of General Internal Medicine</a></em> suggested that "social factors such as income inequality may explain why some parts of the USA are hit harder by the COVID-19 pandemic than others."</p><p>That's not to say better-off families in the U.S. weren't harmed. A <a href="https://voxeu.org/article/poverty-inequality-and-covid-19-us" target="_blank" rel="noopener noreferrer">paper from the Centre for Economic Policy Research</a> noted that families in counties with a higher median income experienced adjustment costs associated with the pandemic—for example, lowering income-earning interactions to align with social distancing policies. However, the paper found that the costs of social distancing were much greater for poorer families, who cannot easily alter their living circumstances, which often include more individuals living in one home and a reliance on mass transit to reach work and grocery stores. They are also disproportionately represented in essential jobs, such as retail, transportation, and health care, where maintaining physical distance can be all but impossible.</p><p>The paper also cited a positive correlation between higher income inequality and higher rates of coronavirus infection. "Our interpretation is that poorer people are less able to protect themselves, which leads them to different choices—they face a steeper trade-off between their health and their economic welfare in the context of the threats posed by COVID-19," the authors wrote.</p><p>"There are so many pandemics that this pandemic has exacerbated," Dr. Salas-Lopez noted.</p><p>One example is the health-wealth gap. The mental stressors of maintaining a low socioeconomic status, especially in the face of extreme affluence, can have a physically degrading impact on health. <a href="https://www.scientificamerican.com/index.cfm/_api/render/file/?method=inline&fileID=123ECD96-EF81-46F6-983D2AE9A45FA354" target="_blank" rel="noopener noreferrer">Writing on this gap</a>, Robert Sapolsky, professor of biology and neurology at Stanford University, notes that socioeconomic stressors can increase blood pressure, reduce insulin response, increase chronic inflammation, and impair the prefrontal cortex and other brain functions through anxiety, depression, and cognitive load. </p><p>"Thus, from the macro level of entire body systems to the micro level of individual chromosomes, poverty finds a way to produce wear and tear," Sapolsky writes. "It is outrageous that if children are born into the wrong family, they will be predisposed toward poor health by the time they start to learn the alphabet."</p>Research on the economic and mental health fallout of COVID-19 is showing two things: That unemployment is hitting <a href="https://www.pewsocialtrends.org/2020/09/24/economic-fallout-from-covid-19-continues-to-hit-lower-income-americans-the-hardest/" target="_blank" rel="noopener noreferrer">low-income and young Americans</a> most during the pandemic, potentially widening the health-wealth gap further; and that the pandemic not only exacerbates mental health stressors, but is doing so at clinically relevant levels. As <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7413844/" target="_blank" rel="noopener noreferrer">the authors of one review</a> wrote, the pandemic's effects on mental health is itself an international public health priority.
Working to close the health gap<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDc5MDk1MS9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYxNTYyMzQzMn0.KSFpXH7yHYrfVPtfgcxZqAHHYzCnC2bFxwSrJqBbH4I/img.jpg?width=980" id="b40e2" class="rm-shortcode" data-rm-shortcode-id="1b9035370ab7b02a0dc00758e494412b" data-rm-shortcode-name="rebelmouse-image" />
Northwell Health coronavirus testing center at Greater Springfield Community Church.
Credit: Northwell Health<p>Novel coronavirus may spread and infect indiscriminately, but pre-existing conditions, environmental stressors, and a lack of access to care and resources increase the risk of infection. These social determinants make the pandemic more dangerous, and erode communities' and families' abilities to heal from health crises that pre-date the pandemic.</p><p>How do we eliminate these divides? Dr. Salas-Lopez says the first step is recognition. "We have to open our eyes to see the suffering around us," she said. "Northwell has not shied away from that."</p><p>"We are steadfast in improving health outcomes for our vulnerable and underrepresented communities that have suffered because of the prevalence of chronic disease, a problem that led to the disproportionately higher death rate among African-Americans and Latinos during the COVID-19 pandemic," said Michael Dowling, Northwell's president and CEO. "We are committed to using every tool at our disposal—as a provider of health care, employer, purchaser and investor—to combat disparities and ensure the <a href="https://www.northwell.edu/education-and-resources/community-engagement/center-for-equity-of-care" target="_blank" rel="noopener noreferrer">equity of care</a> that everyone deserves." </p><p>With the need recognized, Dr. Salas-Lopez calls for health care systems to travel upstream and be proactive in those hard-hit communities. This requires health care systems to play a strong role, but not a unilateral one. They must build <a href="https://www.northwell.edu/news/insights/faith-based-leaders-are-the-key-to-improving-community-health" target="_blank" rel="noopener noreferrer">partnerships with leaders in those communities</a> and utilize those to ensure relationships last beyond the current crisis. </p><p>"We must meet with community leaders and talk to them to get their perspective on what they believe the community needs are and should be for the future. Together, we can co-create a plan to measurably improve [community] health and also to be ready for whatever comes next," she said.</p><p>Northwell has built relationships with local faith-based and community organizations in underserved communities of color. Those partnerships enabled Northwell to test more than 65,000 people across the metro New York region. The health system also offered education on coronavirus and precautions to curb its spread.</p><p>These initiatives began the process of building trust—trust that Northwell has counted on to return to these communities to administer flu vaccines to prepare for what experts fear may be a difficult flu season.</p><p>While Northwell has begun building bridges across the divides of the New York area, much will still need to be done to cure U.S. health care overall. There is hope that the COVID pandemic will awaken us to the deep disparities in the US.</p><p>"COVID has changed our world. We have to seize this opportunity, this pandemic, this crisis to do better," Dr. Salas-Lopez said. "Provide better care. Provide better health. Be better partners. Be better community citizens. And treat each other with respect and dignity.</p><p>"We need to find ways to unify this country because we're all human beings. We're all created equal, and we believe that health is one of those important rights."</p>
With just a few strategical tweaks, the Nazis could have won one of World War II's most decisive battles.
- The Battle of Britain is widely recognized as one of the most significant battles that occurred during World War II. It marked the first major victory of the Allied forces and shifted the tide of the war.
- Historians, however, have long debated the deciding factor in the British victory and German defeat.
- A new mathematical model took into account numerous alternative tactics that the German's could have made and found that just two tweaks stood between them and victory over Britain.
Two strategic blunders<p>Now, historians and mathematicians from York St. John University have collaborated to produce <a href="http://www-users.york.ac.uk/~nm15/bootstrapBoB%20AAMS.docx" target="_blank">a statistical model (docx download)</a> capable of calculating what the likely outcomes of the Battle of Britain would have been had the circumstances been different. </p><p>Would the German war effort have fared better had they not bombed Britain at all? What if Hitler had begun his bombing campaign earlier, even by just a few weeks? What if they had focused their targets on RAF airfields for the entire course of the battle? Using a statistical technique called weighted bootstrapping, the researchers studied these and other alternatives.</p><p>"The weighted bootstrap technique allowed us to model alternative campaigns in which the Luftwaffe prolongs or contracts the different phases of the battle and varies its targets," said co-author Dr. Jaime Wood in a <a href="https://www.york.ac.uk/news-and-events/news/2020/research/mathematicians-battle-britain-what-if-scenarios/" target="_blank">statement</a>. Based on the different strategic decisions that the German forces could have made, the researchers' model enabled them to predict the likelihood that the events of a given day of fighting would or would not occur.</p><p>"The Luftwaffe would only have been able to make the necessary bases in France available to launch an air attack on Britain in June at the earliest, so our alternative campaign brings forward the air campaign by three weeks," continued Wood. "We tested the impact of this and the other counterfactuals by varying the probabilities with which we choose individual days."</p><p>Ultimately, two strategic tweaks shifted the odds significantly towards the Germans' favor. Had the German forces started their campaign earlier in the year and had they consistently targeted RAF airfields, an Allied victory would have been extremely unlikely.</p><p>Say the odds of a British victory in the real-world Battle of Britain stood at 50-50 (there's no real way of knowing what the actual odds are, so we'll just have to select an arbitrary figure). If this were the case, changing the start date of the campaign and focusing only on airfields would have reduced British chances at victory to just 10 percent. Even if a British victory stood at 98 percent, these changes would have cut them down to just 34 percent.</p>
A tool for understanding history<p>This technique, said co-author Niall Mackay, "demonstrates just how finely-balanced the outcomes of some of the biggest moments of history were. Even when we use the actual days' events of the battle, make a small change of timing or emphasis to the arrangement of those days and things might have turned out very differently."</p><p>The researchers also claimed that their technique could be applied to other uncertain historical events. "Weighted bootstrapping can provide a natural and intuitive tool for historians to investigate unrealized possibilities, informing historical controversies and debates," said Mackay.</p><p>Using this technique, researchers can evaluate other what-ifs and gain insight into how differently influential events could have turned out if only the slightest things had changed. For now, at least, we can all be thankful that Hitler underestimated Britain's grit.</p>
The next era in American history can look entirely different. It's up to us to choose.
- The timeline of America post-WWII can be divided into two eras, according to author and law professor Ganesh Sitaraman: the liberal era which ran through the 1970s, and the current neoliberal era which began in the early 1980s. The latter promised a "more free society," but what we got instead was more inequality, less opportunity, and greater market consolidation.
- "We've lived through a neoliberal era for the last 40 years, and that era is coming to an end," Sitaraman says, adding that the ideas and policies that defined the period are being challenged on various levels.
- What comes next depends on if we take a proactive and democratic approach to shaping the economy, or if we simply react to and "deal with" market outcomes.
A new MIT report proposes how humans should prepare for the age of automation and artificial intelligence.
- A new report by MIT experts proposes what humans should do to prepare for the age of automation.
- The rise of intelligent machines is coming but it's important to resolve human issues first.
- Improving economic inequality, skills training, and investment in innovation are necessary steps.