Psychological Effects of Perfection: The Barriers, Beliefs, and Benefits of Mental Health Assistance in Adolescent Girls Peri Kahraman,

2014

Introduction In our society, perfection is beautiful. Women dream of perfect bodies and perfect friends to go with their perfect lives. Young girls are told to fight their way to the top of the social ladder by pursuing perfection and suppressing their struggles. They are told constantly to smile and gage themselves against their beautiful friends. By the time they are grown, many of these young girls are immersed into a harmful routine of faking happiness. The reality is that perfection is unattainable. Many young women continuously struggle to fit in a convoluted mold of what perfection is supposed to be, pushing them toward over instability. What are the factors causing young women to need mental health assistance? What are the stigmas associated with mental health, which complicate the process? What can be gained from getting help? Much like the three-panel art component, this paper aims at examining some of the stressors and stigmas associated with seeking therapy in teenage girls and what can be gained from the process. This paper focuses on the specific issue of how getting assistance is complicated by the environment most teenage girls are in; however, a comprehensive and complete account of every reason why teenage girls seek mental health assistance is beyond the scope. Panel One below describes factors leading to conditions for young girls to need therapy, Panel Two discusses perceived barriers and stigma associated with getting mental help, while Panel Three emphasizes long-term benefits of receiving therapy in a young age. Panel One Factors leading to unhealthy conditions necessitating therapy are numerous. In a research study entitled Adolescent Girls and Boys Perceptions of Mental Health, a sixteen year old girl provides the testimonial: If you feel badly, things are heavy. Heavy at school, at home or in your leisure time or something. (Johansson et al., 2007). This heaviness felt by this young girl
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is caused by multiple stressors, and to some extent, this can be normal. Adolescence is often a difficult time that is full of natural and timely stress factors. But when stress intensifies, the ability to deal with it becomes harder to tackle alone, prompting therapy. Isolation is particularly damaging in a female adolescence, when the desire to form meaningful relationships is especially important. Isolation often occurs when a girl is subject of indirect aggression. Indirect aggression, which includes spreading false stories and exclusion from the group, is the most common form of aggression among girls ages 14-18 (Brannon, 2008). Initially met with confusion, if aggression continues, many girls feel a sense of utter helplessness leading to anxiety, loss of self-esteem and depression. The media both pokes fun of and draws attention to this climate in movies like Mean Girls, but the view that this is merely girls being girls is over simplified (Catanzaro 2011). Due to the social hierarchy of high school, many girls fail to interfere when they observe this type of isolation. Many girls of all social groups realize that bullying is a way to get ahead, in the process further isolating bullied girls. As stated by Catanzaro (2011), They know how to use power to emotionally distress another girls relationships and get friends to turn against a girl It also teaches girls about the hidden values of competition, unequal self-worth and psychological warfare. This aggression plays into a need for young girls to be perfect. Putting down their peers instills a sense of power and control. Complications with mental health extend beyond body image issues, popularity and friendships. Girls with a familial predisposition for depression, a low socioeconomic status and those who struggle to navigate sexuality in a heteronormative society are all at a greater risk for mental illness (Marshal et al, 2013; Link et al, 2004; Ansseau et al, 2008). Teenagers with families which have a history of mental illness are more likely to suffer from one themselves, this being especially true in cases of depression. Depression is more prevalent in teenage girls than boys and this continues into adulthood as more women suffer from depression than men. While the treatment can sometimes be easier if a family member has the same condition, removing a stigma, it can also be difficult if the parent had a bad experience with mental illness and therapy. What has worked for a parent may not work for a daughter either (Link et al, 2004). Socioeconomic status is a factor that tends to increase the likelihood of having psychological complications as financial difficulties are an added stressor. This is especially true
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with anxiety. An increased stress level that originates from a young girl having to help her family financially can result in an increased risk of generalized anxiety disorder and major depression (Ansseau et al, 2009). Most of the anxiety related cases in the media are characterized with social anxiety, and therefore, generalized anxiety disorder, which is classified as the excessive worry about everyday life, does not draw much attention. There is still much to learn on this subject especially since obtaining samples from lower socioeconomic status is difficult given that many young people do not or cannot afford to seek therapy (Ansseau et al, 2008). Sexual minority girls are subject to have larger levels of substance use and victimization experiences that their heterosexual peers. High rates of suicide and depression in sexual minority girls are concerning given evidence that adolescent girls suffer higher rates of depression than their male counterparts (Marshal et al, 2013). As shown in the art component of this paper, most social norms focus on the desire to appear desirable to men, and not conforming to a standard can be exhausting. An estimated eight percent of adolescent girls are part of a sexual minority group with a strong feeling of exclusion. Societal, familial and peer pressures they experience can lead to high levels of a multitude of psychological complications (Marshal et al, 2013; Johansson et al., 2007).

Panel Two All the factors listed above result in conditions for many which prompt seeking mental health assistance. In fact, according the National Comorbidity Survey-Adolescent Supplement (NCS-A), about 11 percent of adolescents have a depressive disorder by age 18, the leading cause of seeking therapy (National Institute of Mental Health). Yet even though needing and seeking psychological assistance is not uncommon, there are many stigmas which are associated with mental health. There is a clear disparity in regards to how mental health is viewed based on age and gender. In a 2007 study conducted by Johansson, adolescents were studied in their thoughts and perceptions of mental health. The two groups of thirteen and sixteen year olds in Sweden were surveyed to show that adolescents perceived mental health as an emotional experience, which could be positive or negative. The same study found that the younger test group found the concept of mental health as more difficult to understand and saw mental health as feelings more
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in relation to other people, friends first and foremost, and parents. However by age sixteen, mental health was viewed more as an individualistic process, much like how mental health is perceived in pop culture. Girls commonly viewed mental health as if you feel harmonious you feel strong. (Johansson et al. 2007). Stigmas regarding mental health have become much better in the years since mental hospitals were eradicated where people were locked up. Yet major issues still remain regarding how mentally ill individuals are treated. The Opinions on Mental Illness Scale (OMI) was developed to measure how stigmas shape opinions. The OMI reported, The notion of separation into us and them is evident in items such as A heart patient has just one thing wrong with him, while a mentally ill person is completely different from other people (Link et al. 2004). While majority of teenage girls seeking therapy are not in this predicament, they still face harsh stigmas about seeking help because an image of severe illness is conjured. In the popular movie, Girl, Interrupted, viewers saw a story of a womens ward at a mental hospital. As raising awareness to issues like those addressed in the film are important, one should acknowledge that most cases are not of that extreme and most young women do not face struggles that severe. As previously mentioned, family can play a critical role in the treatment of mental illness. As stated by Logsdon (2013), Adolescents are an underserved population. As the gatekeeper to mental health services, the mothers perspective is important to understand. For example, a clinician might ask a mother what she perceives her own role to be in obtaining mental health treatment for her adolescent daughter (perceived control). The same study which outlined how mothers deal with their daughters therapy, also talked about how parents may struggle to talk about something as personal as mental health without creating gossip which causes more issues for teenagers. Given the tendencies to assert oneself in an aggressive nature, dealing with mental health can be complicated for young women. Many girls end up in therapy due to the fact that they could not feel comfortable talking about their struggles in the first place. Therapy lends itself to being a place to talk and likewise instilling a sense of confidence in young women (Logsdon et al, 2013; Catanzaro, 2011). Matching this with the hostile nature of high school creates a disconnect that is often hard to fathom.

Panel Three No matter the reason is for a teenage girl to seek psychological assistance, there is so much for her to gain through the experience. For mental health conditions such as anxiety, depression, and apprehension regarding sexuality, it is critically important for women to seek assistance as these conditions can be vitally severe and require medication to regulate symptoms in addition to talk therapy. In severe cases of depression and the depressive symptoms do not begin to improve within 6 to 12 weeks, or if symptoms worsen, an antidepressant medication may be recommended in addition to talk therapy (NIMH, 2014). For anxiety, it is a matter of learning to manage anxiety. The protocol for treating anxiety with medication follows a similar format to that of depression (NIMH, 2014). Overall, in a successful and harmonious therapy session, many young people can gain a greater sense of awareness of accomplishment and recognition of personal success, making the process of getting help worthwhile for women. Studies have shown that, despite the stigmas associated with mental health, the benefits outweigh the risks and stigmas in most cases (APA). The American Psychological Association is working to advance research on teenage girls and the many stressors within their lives. Johanssons research touches on the work APA is attempting to do. The prerequisites of feeling well are relational, according to this study. The adolescents mentioned family, friends and school as the three most important determinants of mental health (Johansson et al, 2007). Likewise, the relational assistance young women can get is imperative to their success, whether that assistance comes from friends, family, or mental health professionals. APA states in their report on Adolescent Girls, For adolescent girls to thrive, they must be assisted in navigating the challenges that face them by mental health professionals who can both protect and strengthen them. (2014). Therapy is a great resource for young women no matter the severity of their challenges as every girl deserves to be awarded the opportunity to talk about her unique challenges.

Conclusion As showcased in the art component, when a sense of acceptance for oneself is achieved, one can live a fulfilling life. Perfection in the sense of how it is presented in Panel One is not realistic for young women because perfection comes from within. Instilling self-esteem through
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therapy is a benefit of the process and likewise the confidence gained can be built upon. Overcoming the stigma described in Panel Two and seeking therapy throughout their lifetime and often starting early can be the best way to build upon confidence. Panel Three shows what is to gain from therapy. Women can gain so much from getting assistance, and although it is difficult to reach out and ask for help, the benefits are so important for the success and prosperity of young women.

References American Psychological Association (2014) Psychological Education and Practice Issues A New Look at Adolescent Girls Ansseau, M., Fishlet, B., Dierick, M., Albert, A., Leyman, S. and Mignon, A. (2008) Socioeconomic Correlates of Generalized Anxiety Disorder and Major Depression in Primary Care, Depression and Anxiety, Vol. 25, Issue 6, pp. 506-513. Brannon, L. (2008) Gender Psychological Perspectives, Allyn and Bacon Publications, 6th edn, Boston, MA. Catanzaro, M. (2011) Indirect aggression, bullying and female teen victimization, Pastoral Care in Education, Vol. 29, Issue 2, pp. 83-101. Johansson, A., Brunnberg, E. and Eriksson, C. (2007) Adolescent Girls and Boys Perceptions of Mental Health, Journal of Youth Studies Vol. 10, No. 2, pp. 183-202. Link, B., Yang, L., Phelan, J. & Collins, M. (2004) Measuring Mental Illness Stigma, Schizophenia Bulletin. Logsdon, M., Pinto, M., LaJoie S., Hertweck, P., Lynch, T. and Flamini, L. (2013) Intention to Seek Mental Health Treatment for Adolescent Girls: Comparison of Predictors in Mothers and Daughters, Journal of Child and Adolescent Psychiatric Nursing, Vol. 26, Issue 4, pp. 239-245. Marshal, M., Dermody, S., Shultz, M., Sucato, M., Sucato, G., Stepp, S., Chung, T. and Hipwell, A. (2012) Substance Use and Mental Health Disparities among Sexual Minority Girls, Journal of the American Psychiatric Nurses Association, Vol. 19, No. 5, pp. 1-9 National Institute of Mental Health (2014) Depression in Children and Adolescents: Fact Sheet National Institute of Mental Health (2014) Anxiety Disorders

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