Too-Busy Teens Feel Health Toll

Jessica Huey, here with her mother, Janice, rarely has time to rest during the school year.
Jessica Huey, here with her mother, Janice, rarely has time to rest during the school year. (By Sarah L. Voisin -- The Washington Post)
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By Sandra G. Boodman
Special to The Washington Post
Tuesday, July 15, 2008

For Jessica Huey, the circumstances preceding the episodes she calls her "nervous breakdowns" were always the same: She was exhausted, it was 1 a.m. and she still faced a mountain of homework due when school started at 7:20 the next morning.

"I would look around and think, 'I can't possibly get this all done,' and then burst into tears," said Huey, 17, who is scheduled to start her senior year at Walt Whitman High School next month. Even while she was weeping, Huey recalled, she felt she was wasting valuable time.

Her freakouts, Huey said, were a consequence of a frenetic schedule, which last year included three Advanced Placement classes, a part in the school musical that required frequent rehearsals sometimes stretching until 10 p.m., a regular babysitting job, participation in both a school and church chorus, membership in a club for students interested in business, a volunteer weekend gig as a candy striper, SAT prep classes, driver training and homework that averaged three hours a night.

"I'm always in a state of anxiety, but it only piles up every few months," she said, adding, "All my friends do this. We're all over-scheduled. We live in Bethesda: It's a way of life."

And not just in Bethesda. Anisha Abraham, who works at Georgetown University Hospital as chief of adolescent medicine and in a school-based clinic at the District's Woodson High School, said she routinely encounters students who go from a full day of classes to a job in a fast-food restaurant that ends at 11 p.m.

"These kids have no time for themselves," Abraham said. A growing number of the teenagers she sees complain of similar symptoms: exhaustion, headaches, stomach problems, depression and irritability, a consequence of so little free time. "Our teenagers are becoming more over-scheduled and over-stressed."

Despite warnings by experts, including the American Academy of Pediatrics, which in 2006 issued a report about the perils of "pressure-filled intense preparation for a high-achieving adulthood," and a recent spate of popular books including "The Overachievers" (which focused on Whitman), there are few indications that high school students will face an altered landscape anytime soon.

Adolescent medicine specialists say that a primary cause of the apparent pervasiveness of this relentless activity is demographic: The number of applications to the nation's colleges is expected to peak with the class of 2009 and won't begin to decline for several more years. Although there is no precise definition of over-scheduling and little empirical research documenting its impact, pediatricians, psychologists and child psychiatrists say the problem is real.

They contend that some BlackBerry-tethered parents, who equate being constantly busy with being successful in their own lives, compete to see whose kids can cram in the most activities: pre-dawn swim practice, weekend travel soccer tournaments, elite ballet classes, Mandarin lessons, SAT tutoring sessions. Unstructured time, which experts say is essential to figuring out who one is and what one wants, tends to be regarded as laziness or being unproductive.

"Our definition of what makes a kid successful has become unbearably narrow," said California psychologist Madeline Levine, author of "The Price of Privilege," a 2006 book that documented the psychological fallout of unrealistic expectations and packed schedules on affluent teenagers.

The toxic combination of perfectionism and over-scheduling can lead to excesses such as those seen by University of Pennsylvania adolescent medicine specialist Kenneth Ginsburg, author of the AAP recommendations. Ginsburg said his patients have included a teenager who had started studying for the SATs at age 11 and high school students whose parents told them they "didn't need to bother to go to college" if they didn't get into either Harvard or Yale, schools that last year reported record-low acceptance rates hovering around 8 percent.

Sometimes, he noted, teenagers who say they can't imagine life without a packed schedule and profess to "love" hours of extracurricular activities are really afraid of disappointing their parents by opting out or scaling back.

Janice Huey, Jessica's mother, said she and her husband have stepped in to curtail their older daughter's schedule, but they want to give her the freedom to make her own decisions and her own mistakes. (Case in point: three simultaneous AP classes, which her mother advised against.)

Last spring, at Jessica's request, her parents blocked her access to Facebook and instant messaging to prevent her from spending too much time on both. They also told her she could not try out for the spring play because her schedule was too full.

"It just kind of gets out of control sometimes," Janice Huey said of Jessica's schedule. "I am an extremely bad role model," she added. "I completely over-volunteer."

Mother and daughter say they hope that Jessica's activities and grades will land her a spot in a competitive college and possibly scholarship money.

Summer Résumé-Building

Child psychiatrist Michael Brody said that in the past 15 years, summer has become more an extension of the academic year than a respite from it.

"Camp seems to end earlier now" for many kids, Brody said. For many high school students, the progression used to be camper, then CIT (counselor in training) and then a job as a full-fledged counselor.

"A lot of kids don't do that now," said Brody, who has practiced in the Washington area for more than three decades. Rather than working at a camp, "they've got to go discover the cure for cancer by working at NIH for the summer. And you can't just play a sport; you have to play several, and be in leagues during the summer and get coaching. It's all done for résumé-building."

Not everyone regards the proliferation of organized activities as a problem.

In 2006, around the time that the pediatrics group issued its warning, psychologist Joseph L. Mahoney, then an associate professor at Yale, and two colleagues published a study debunking what they called "the over-scheduling myth."

Based on an analysis of previous research, Mahoney's team concluded that fewer than one in 10 youths could be described as over-scheduled and that 40 percent did not participate in any organized activities. Teenagers who did participate averaged fewer than 10 hours per week, Mahoney reported, while fewer than 6 percent devoted 20 hours or more to extracurricular activities. The researchers also challenged the notions that parental pressure was to blame for over-scheduling and that a lack of free time caused undue stress.

Mahoney, now at the University of California at Irvine, declined to discuss his research, which appeared in Social Policy Report.

Some experts say that Mahoney's critique may be aimed at shoring up funding of after-school programs, which could be an easy target for politicians.

"He's kind of looking at different things," adolescent medicine specialist Ginsburg said of Mahoney's conclusions. "Some kids need more enrichment activities, and other kids are over-enriched."

"This is a very nuanced phenomenon," Ginsburg added. One teenager may deftly juggle a schedule that another would find overwhelming.

"Parents should look at their child and see whether what they're doing is giving them joy" or whether they seem anxious or stressed, Ginsburg said. "All kids need some downtime and the flexibility to change their focus when they want."

Enforcing Lunch

Later this month, said California psychologist Levine, Stanford University's School of Education is scheduled to unveil a program called Challenge Success, a nationwide effort designed to help high schools, parents and students redefine the notion of success.

Among the goals, said Levine, who is affiliated with the program, is to persuade high schools to agree to make simple changes designed to reduce over-scheduling.

They include "enforcing lunch," not allowing students to skip lunch to take a class or do extra work; allotting 20 minutes in the middle of the day to permit students to "just hang out"; and limiting the number of AP classes a student can take at one time.

"This is about reframing your message of what the purpose of school is, which is that it's not the best thing to be busy every minute of your life," Levine said.

About 60 high schools in the United States and Canada have signed on, she said, but none so far in the Washington area.

Jessica Huey has been relishing a summer largely devoid of scheduled activities other than her job herding 5-year-olds as a day camp counselor. The weeks when she got a total of eight hours of sleep are a fading memory, she added. "It's been fabulous," she said.

But Jessica and her mother are braced for the demands of senior year and the unforgiving calendar of the college application process.

"I'm hoping next year will be easier," Janice Huey said.

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