When Does It End?


lonely sad girl sitting outside of school

In the area where I live, testing starts in preschool. Kids at the mere age of 3 undergo rigorous academic and social testing for acceptance into prestigious preschools. As a child psychiatrist, I don’t typically see these kids in my office because they tend to be happy and easy going.

At our public school, the second graders are tested to see if they “meet the criteria” for the local magnet school. These same kids go on to take achievement and intelligence tests to apply for the prestigious middle school. And again a few short years later for the prestigious high school.

I see these kids in droves. They come to my office anxious, depressed, suicidal, frustrated, lonely, and lacking confidence. Fearful of failure because they see what it does to their friends: Cutting. Drinking. Smoking. Jumping in front of trains.

These teens come to me and say, “My parents are never around and when we do talk, they only focus on my grades and screen time. No one really sees me, no one sees who I am and who I want to be. I feel lonely, disconnected, and lost.”

When does it end?

These same kids, after a lifetime of prestigious preschools, elementary, middle and high schools, are now accepted to their prestigious college of choice.

I see these kids in droves because the stress continues. Now in addition to the scars on their arms and antidepressants in their bloodstreams they have hallow bellies and gaunt faces because they don’t eat and they don’t sleep so they can stay up late to get the grades they need to guarantee a prestigious job.

They don’t have time for socializing and the few friends they do have are competitive and harsh and also starving and depressed. But they keep pressing on to get that summer internship and that job leading to that prestigious career.

These college students come to me sleep-deprived and tearful saying, I can’t keep up and surely I must have ADHD because I can’t focus and my grades aren’t the best in the class and I have to do better or else my life will be over.

When does it end?

These same kids grow up to be adults who have prestigious careers. I see these patients in droves because they are working 60-80 hours per week and not sleeping and eating too much and staring at screens all day and not spending enough time with their families. They finally have that high-status career that they always wanted and sacrificed their whole childhoods for. They are depressed and anxious and don’t have time to take care of themselves.

These adults come to me with doubt. This doesn’t feel right, they say, but I don’t know how to stop. This is what I thought I always wanted, what I was told would prove my worth. What would my life mean without this career? All my hard work would be for naught. And how would we afford this lifestyle we’ve created and our kids’ prestigious schools?

When does it end?

These same people approach the end of their careers. I see these patients in droves. People who have worked too hard and are divorced and don’t know their kids because they had that prestigious career and made all the money and got all the promotions and drove all the fancy cars and owned at least one multi-million-dollar home.

And they come to me saying, I regret it.

They mourn a normal childhood and a normal adolescence and a fun college experience. They would trade all the promotions and accolades for more time with their kids who are now grown up and disconnected and following their own prestigious careers because that’s the way they’ve been raised to recognize success. They realize they took the wrong path the minute they stopped listening to their own voice, and while it seemed to happen gradually over time with each small decision, they also wonder if they ever even had a choice.

When does it end?

But wait. I do also see these people from time to time. The ones who choose to step off the carousel of chaos. They re-evaluate, re-prioritize, and rejuvenate. They realize they can change paths and still feel valued, worthy, successful, and less stressed.

They are the ones who come to me smiling, confident, content, connected. They tell me it is possible and they do have a choice. The cycle can and will end, you just have to choose.   



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