Adolescent girls’ explanations of their high rates of low mood and anxiety
As a pediatrician, I often hear kids and teens say things like:
“Everyone has thoughts like this sometimes, but it doesn’t mean anything,” when I ask about suicidal thoughts or self-harm after a positive screening.
“I don’t need to talk to anyone. I can handle it myself,” when I suggest getting support.
“It’s normal,” even when anxious thoughts are keeping them up at night. But poor sleep isn’t just frustrating — it can increase the risk of accidents, weaken the immune system, cause mental fatigue, lead to falling grades, and make it harder to manage emotions.
These statements come from both males and females, but in general adolescent girls have higher rates of anxiety and depression compared to boys.
Teens often prefer talking to friends over adults. While peer support can be comforting, it can also lead to normalizing negative feelings without finding real solutions, since friends may not have the tools to help. Sometimes, one teen’s anxiety or sadness can unintentionally bring others down as they share their struggles. I regularly encourage teens to reach out to trusted adults, but this advice is often ignored. Understanding why teens feel this way may help us find better ways to support them.
A recent study published in BMC Women's Health explores why adolescent girls experience higher rates of low mood and anxiety compared to boys. Researchers studied focus groups in 2022 with 32 adolescent girls aged 16 to 18 years in England.
The timing of this is important, because it was still in the early pandemic times, significantly impacting everyone’s lives. Teens of this age had spent earlier teen years in lockdown and potentially watching endless newsreels of a deadly virus sweeping their world. The AI capabilities have increased significantly since that time too, which might impact some of the social media concerns noted. There has been at least one teen that died by suicide after encouragement from an AI “friend” recently.
Identifying as LGBTQIA+ has historically been linked to higher rates of depression and suicide, largely due to societal stigma and discrimination. While progress has been made in recent years through inclusive policies, public education, and increased support, these gains are now at risk of being reversed. Recent political movements in the U.S. aim to roll back diversity, equity, and inclusion protections, with some government agencies being pressured to remove terms like “gender” from research studies and public health initiatives. These efforts not only undermine the advances made in supporting the LGBTQIA+ community but also contribute to a climate of fear, marginalization, and rejection. Such regressive policies can intensify feelings of isolation, anxiety, and hopelessness among LGBTQIA+ youth, further increasing the risk of mental health struggles and suicide within this vulnerable population, while also negatively impacting their families and communities.
6 key themes that contribute to this disparity
Theme 1: Rising rates of low mood and anxiety are unsurprising
The first theme supports what I’ve noticed in clinic and mentioned above.
No one is shocked that evidence of low mood and anxiety are rising — both in girls and boys.
Several study subjects noted that in some ways it is popular to have mental health struggles and that it has been romanticized.
Theme 2: Strict and narrow expectations of how girls and women should look and behave
Participants in the study described how sexist stereotypes and societal expectations are imposed on adolescent girls, shaping their behavior, appearance, and self-worth. These expectations stem from longstanding views that restrict women to specific roles, promoting the idea that men are more capable while girls should be quiet, polite, and conform to narrow beauty standards. For instance, makeup and shaving are so normalized that they no longer feel like personal choices but obligations.
These gender norms are introduced early through toys and media, with girls often receiving quiet, domestic toys like kitchen sets, while boys are given loud, active toys like Nerf guns. Media portrayals also focus heavily on women’s appearances and personalities, often judging them more harshly than men.
Girls face constant judgment from both peers and adults for failing to conform to these expectations. Whether labeled as "too girly" or a "tomboy," girls are criticized no matter how they express themselves, creating an impossible standard. This environment normalizes issues like sexual harassment in schools and limits opportunities in fields like sports and STEM. Girls are also often blamed for inappropriate behavior directed at them, such as being told that harassment is just flirting.
These pervasive gendered messages deeply affect adolescent girls' mental health, leading to feelings of insecurity, low self-worth, and internalized beliefs of inferiority. Participants emphasized that these insecurities go beyond superficial concerns, becoming ingrained in girls' identities and shaping how they view themselves and their place in society.
Theme 3: Educational pressures feel intense and gendered
Participants described their educational experiences as rigid and high-pressure, often neglecting developmental, emotional, and individual needs. They highlighted intense pressure from teachers, parents, and the education system itself, emphasizing academic performance and behavior with little tolerance for mistakes. This stress peaks during secondary school (in the US this would be 7th grade) and further education, especially around exams, grades, and life decisions, leading to persistent feelings of anxiety and sadness.
Girls, in particular, were seen to experience these pressures more acutely. Participants felt that high achievement is more expected from girls, and failure carries a heavier emotional burden compared to boys. Gendered expectations also influenced classroom behavior and participation, with girls feeling undervalued or judged. In male-dominated fields like STEM, girls faced additional stress, feeling responsible not just for their own success but for representing other women.
Theme 4: Challenges in peer relationships can add pressure
Participants highlighted that peer relationships play a significant role in contributing to low mood and anxiety among adolescent girls. A culture of constant comparison focused on appearance, academic performance, future plans, and self-expression was frequently discussed. This competitive atmosphere fosters judgment and insecurity, as illustrated by one participant who described how girls at lunch competed to eat the least, with anyone deviating from this norm feeling judged.
These dynamics were linked to broader societal expectations and gendered insecurities, creating stress and undermining self-esteem. Many girls felt pressured to engage in competition as a way to validate themselves. Beyond comparison, participants described conflicts with peers, including arguments, fallouts, bullying, and romantic breakups, all of which could cause significant distress both online and offline.
Some participants suggested that anxiety and low mood might spread within friend groups, creating a cycle of shared emotional struggles. Supporting friends with mental health issues was also seen as challenging. Despite these difficulties, friendships were recognized as important sources of support, with many girls finding comfort and strength in close connections.
Theme 5: Social media can be a space of comparison and insecurity
Participants discussed social media as a space where existing challenges like gendered expectations and peer issues are amplified. They described how comparison and insecurity are normalized on platforms like Instagram and TikTok, where visual content reinforces unrealistic standards for appearance and lifestyle. This constant exposure leads girls to compare themselves to peers and influencers, fostering feelings of inadequacy.
Unrealistic portrayals of “perfect” lives and appearances were highlighted, with younger adolescents struggling to distinguish between real and curated content. Filters, photoshop, and algorithms that promote certain body images further distort reality, encouraging harmful comparisons.
Participants linked these dynamics to increased low mood and anxiety in adolescent girls, noting how comparisons happen unconsciously. However, they also cautioned against blaming social media entirely for mental health issues, recognizing that it offers positive aspects like body positivity movements, mental health discussions, and supportive communities. They emphasized the complex role of social media, acknowledging both its benefits and harms.
Theme 6: There is no easy answer to explain or resolve issues
Participants highlighted the complexity of factors contributing to low mood and anxiety among adolescent girls, emphasizing that no single cause explains recent increases. They noted that while some issues, like body image concerns, are often associated with adolescent girls, they also affect boys and people at other life stages.
Individual differences were stressed, with participants acknowledging varied experiences based on factors like exposure to social pressures and intersectional identities, including ethnicity and LGBTQIA+ status.
The systemic nature of these issues, such as misogyny and social media norms, was seen as a barrier to change, requiring action from those in power. Participants called for leaders to listen to those directly affected. Despite the challenges, they emphasized the importance of incremental progress.
Putting it All Together
Understanding these themes is essential for parents, educators, and policymakers to develop effective interventions that support the mental health of adolescents.
The study emphasizes the importance of understanding these contributing factors to develop effective interventions. It suggests that parents, educators, and policymakers should work together to create supportive environments that address these issues, aiming to improve the mental well-being of adolescent girls.
While this small study was done in England, those of us in the US can benefit from it and use it to better understand what impacts mental health in our youth. By using information in this and similar studies we should work towards supporting our youth.
Parents: don’t normalize depression or anxiety in your kids. If you’re not sure if their behavior is normal or not, bring them to their pediatrician to talk about concerns. If they are struggling, help them get help. No one should go through this alone!
My practice website has resources for anxiety and depression that anyone is welcome to use. The following numbers are great resources to keep in your phone and share with your teens!
The Trevor Project - Suicide Prevention for LGBTQ+ Young People
Call 211 for Essential Community Services
Mental Health | Johnson County Kansas (search online for your county if needed)
Thank you for this insightful piece on such an important topic.