Did you hear the news from the U.S. Surgeon General recently? Dr. Vivek Murthy issued an advisory called “Parents Under Pressure,” outlining the ways in which the 63 million-plus parents and caregivers in the U.S. are struggling—really struggling. Even as a parent who is a child psychiatrist, I was shocked by some of the data.
An analysis of parents’ responses from the 2023 Stress in America survey, conducted by the American Psychological Association, showed that 41% of parents “strongly agreed” with the statement, “Most days, I feel so stressed I cannot function,” and 48% “strongly agreed” with the statement, “Most days, my stress is completely overwhelming.” These numbers are nearly double those reported by adults who aren’t parents.
So, why is this happening, and what can we as physicians do about it?
To summarize the rest of the advisory briefly, there are many reasons parents are overwhelmed. To begin with, moms and dads are working more in 2023 than in 1985 (moms have gone from 20.2 to 26.7 hours, and dads from 39.8 to 41.2). We’re spending more time in direct care of our children each week than in 1985 (moms have gone from 8.4 to 11.8 hours a week of direct childcare—a 40% increase—and dads have seen a 154% increase, going from 2.6 hours to 6.6 hours).
This is certainly significant, but the numbers can’t be the whole story. Sleeping eight hours a night means moms have, on average, 73.5 hours of free time, and dads have, on average, 64.2 hours of free time every week.
So, what the heck is going on?
The advisory goes on to discuss additional sources of stress for parents:
- rising costs of childcare,
- difficulty finding childcare,
- financial stress, which is greater for parents than non-parents (duh!),
- the burden of caring for aging parents and young children (the so-called “sandwich generation”),
- the fact that three out of four parents are very worried their child will develop depression or anxiety,
- anxiety about school shootings, which is reawakened every year as kids go through “lockdown” drills,
- worries about increasing competition for jobs and coveted college spots,
- loneliness.
All of this adds up to parents being twice as likely to be depressed as non-parents. Parental mental illness takes a toll on kids’ well-being, and kids’ mental illness takes a huge toll on parental well-being—and down the spiral goes.
The advisory states that 70% of parents feel it’s harder to raise kids today than it was 20 years ago. Reading this sentence from the advisory made me stop in my tracks and ask, “Is this true?”
Write down the differences between what your parents had at their disposal while raising you and what you have at your disposal. Ask yourself, would I trade places? The next time you’re in a group of parents complaining or feeling bad, guide them through the same thought experiment. This is an exercise in practicing gratitude—intentionally noticing the gains we have made that help us. When we catch ourselves feeling things that make us feel bad, we must learn to reflexively get curious and ask, “Is that really true?” to challenge the thought. As physicians, we are natural leaders, and we can teach this skill to our patients, parent friends, community members, and children.
Beyond just retelling our stories to change how we feel, we can also act as leaders in our workplaces to advocate for more parental leave and support for childcare—both financial and logistical. If we can’t do this in our private practices and medical groups, how can we expect our national politics to change? We need to see the positive impacts on our level, then announce and display them as examples.
On the national stage, we physicians are in a position of respect and authority, and we can do a better job lobbying our national lawmakers to create lasting change that supports parents, starting with those at highest risk. The most jarring statistic of all was that nearly 25% of survey respondents said they worried about paying rent or having money for food in the prior 12 months. When basic needs aren’t met, it’s nearly impossible to overcome the survival pathways activated in our brains. When survival pathways are running the show, nothing good can result. We can’t perform our best, be creative, or be generous or thoughtful when we feel our survival is at risk. This isn’t just a fact for “the poor”—it’s a fact for all humans. I’m not a policymaker, and I don’t know what the best solution is. I know that all things we try will be imperfect and will include success stories as well as stories of people “milking the system.” But we must keep trying. If we keep trying and measure outcomes, we will continue to see improvements.
Although wealth gaps are large, the rates of extreme poverty worldwide have been cut in half in the last 20 years. Life expectancy in the U.S. has increased 160% in the last 150 years (from 45 to 72). Violent crime has been on the decline for decades (a great read about this is Steven Pinker’s The Better Angels of Our Nature). I could go on.
The point is, when we focus on the bad, we feel like it’s hopeless and things will only get worse. When we focus on the good, we see how far we’ve come. (A great read about this, and one of my favorite books for families to read together, is The Gap and the Gain by Benjamin Hardy and Dan Sullivan.) Our emotions are driven by our state of mind, and our state of mind is driven by the words we tell ourselves and accept as true, as well as by the actions we take. As physicians, we can lead ourselves, our patients, our children, and our communities to understand this better—and to suffer less as a result.
I challenge all of you, especially physician parents but really all physicians, to think about how you can support the parents in your life, whether they be those in your community, those in your practice, or those in your own family. Loneliness is a very common feeling among adults in America, and I can tell you it’s a problem among kids too. I think we all need to start by leading by example through connection—connecting with other parents, prioritizing friend groups, giving back through community service, and performing acts of kindness for others on a regular basis. Giving is living, and when we give and connect, we silence our survival brain pathways and open the pathways for connection and joy.
Marissa Caudill is a child and adult psychiatrist.
