Habits and Hustle - Episode 417: Dr. Leonard Sax: The Collapse of Parenting and the Rise of Childhood Anxiety and Depression

Episode Date: January 21, 2025

Are you concerned about the rising levels of anxiety and depression in today's youth? In this Habits and Hustle podcast episode, I dive deep into this pressing issue with renowned psychologist and author Dr. Leonard Sax. We discuss the growth of a "culture of disrespect," exacerbated by the pervasive influence of social media, and the importance of conscientious parenting - both loving and strict - to produce the best outcomes. We also dive into issues such as the over-prescription of ADHD medication, the misdiagnosis of normal childhood behaviors as pathological, and the role of permissive parenting in the childhood obesity epidemic.  Dr. Leonard Sax MD PhD is a highly educated and experienced physician, psychologist, and author. He attended MIT and the University of Pennsylvania, earning a PhD in psychology and an MD. Dr. Sax ran a primary care medical practice in Maryland from 1990 to 2008, and since 2001, he has been visiting schools and speaking to parents about child and adolescent development. He has written four books on the subject, including the New York Times bestseller "The Collapse of Parenting," and has spoken in numerous countries and appeared on various media outlets. What We Discuss: (00:07) The Collapse of Parenting (13:04) Influences on Parenting Decisions (19:33) Parental Authority vs Discipline (25:52) Parenting in the Age of Normophobia (40:55) Prioritizing Self-Control Over GPA and Medication (48:31) The ADHD Medication Epidemic (01:02:12) Empowering Parents to Decide Family Meals …and more! Thank you to our sponsors: AquaTru: Get 20% off any purifier at aquatru.com with code HUSTLE Therasage: Head over to therasage.com and use code Be Bold for 15% off  TruNiagen: Head over to truniagen.com and use code HUSTLE20 to get $20 off any purchase over $100. Magic Mind: Head over to www.magicmind.com/jen and use code Jen at checkout. BiOptimizers: Want to try Magnesium Breakthrough? Go to https://bioptimizers.com/jennifercohen and use promo code JC10 at checkout to save 10% off your purchase. Timeline Nutrition: Get 10% off your first order at timeline.com/cohen Air Doctor: Go to airdoctorpro.com and use promo code HUSTLE for up to $300 off and a 3-year warranty on air purifiers.    Find more from Jen:  Website: https://www.jennifercohen.com/ Instagram: @therealjencohen   Books: https://www.jennifercohen.com/books Speaking: https://www.jennifercohen.com/speaking-engagement Find more from Leonard Sax MD PhD: Website: https://www.leonardsax.com/  Book: The Collapse of Parenting

Hi guys, it's Tony Robbins. You're listening to Habits and Hustle. Crush it! Before we dive into today's episode, I first want to thank our sponsor, Therisage. Their Tri-Lite panel has become my favorite biohacking thing for healing my body. It's a portable red light panel that I simply cannot live without. I literally bring it with me everywhere I go. And I personally use their red light therapy to help reduce inflammations in places in my body where honestly I have pain. You can use it on a sore back, stomach cramps,

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Okay, Leonard, let's do this. Yeah. Oh my God. Okay. What a schmageray to get going here. Technology. Yeah. I mean, it's kind of crazy.

I live in LA and it's not, I mean, the fact that thank God I have power is amazing here today. So I'm happy to have you. Yeah, I mean, it's kind of crazy. I live in LA and it's not, I mean, the fact that thank God I have power is amazing here today. So I'm happy to have you. I actually been looking very forward to having you on this podcast because I've been doing a lot of my own research deep dive into how to build mental resiliency with children. I actually just did a TED Talk myself on how the caudal culture, I thought, is part of the reason why kids resilience has been a miss of this generation. So, when I saw your work and I read your book recently, before I even did the TED Talk,

it was really interesting to me because even though it's the same outcome, by the way, the book is called The Collapse of Parenting. I highly recommend this book to anybody who is a parent. But what I was saying is I found it very interesting because we are all very familiar with Jonathan Haidt's Anxious Generation. What he says are the reasons for the decline of what's happening in this next generation, helicopter parenting, you know, social media,

all the same things that were, you know, you're saying the opposite, and I found that to be super, your whole thesis is that the collapse of this next generation is really because of actually the culture of disrespect, the collapse of parents actually parenting, and something else called normophobia. And I really wanna deep dive into this

because I found it to be fascinating. And let's start. So your background for people, this guy can speak with authority because you have a PhD from the University of Pennsylvania in psychology. You also- Incidentally, that's the same program that John Hyde graduated from is a curious point.

We know many of the same people and I want to emphasize I have great regard for John Hyde and he was kind enough to send me an advance reading copy of his book before it came out and I think the book is very useful but there's one key point that he doesn't mention anywhere in the book and that that is that this surge in anxiety and depression that is quite rightly a focus of his concern is not seen outside the English-speaking world. Kids in Greece, kids in Russia are just as likely to have smartphones as kids in England and the United States and Canada and Australia. But there has been no rise in anxiety and depression among kids in Greece and kids in Russia. Now, I'm not holding up Russia as a role

model by any means, but we have to ask what's going on in the English-speaking world that kids in the English-speaking world are showing this enormous surge in anxiety and depression, but kids in Greece and Russia are not. And that's the key point that John Hyde has not addressed. And that's the point that I'm trying to call attention to. And what would you say if you boil it down is that key point? Well, I think there's more than one.

I think there's multiple things that have happened over the last 20 years. One is the breaking of bonds across generations. And again, this is a point where we have good data. We don't have to guess. Kids in the United States hang out with other kids their own age. The bonds across generations have been broken. This is much less true in Greece. It is much less true in Russia. Kids in, and it's much less true outside the English speaking world generally. I have good friends in Germany and in German speaking

Switzerland and I can tell you that in middle of Europe and all throughout central Europe, and I'm told also in Eastern Europe, kids hang out with grownups in their free time. This is not true in the United States. Kids in the United States very seldom spend their free time hanging out with adults. They used to in living memory, but they no longer do. The great majority of American kids now hang out with other kids their own age and actually not so much in person anymore, but online. And I think John Hyde is very right to be concerned about and his colleague, Gene Twenge, who he collaborates with very closely on this. Gene Twenge, of course, has done the lion's share

of the work documenting that American kids used to hang out with other kids in person 20 years ago, and they no longer do. Now they hang out online. And that's a real problem. And it's much less true outside the English-speaking world. So we have to do more than just lock down the smartphones. We have to offer a healthier culture.

We have to restore the bonds across generations. Let me just say one thing. So it's interesting because I don't know, I don't remember ever wanting to hang out with adults when I was a kid. Never, I never wanted to. I always wanted to be with my friends. And that was one of the points that you say in the book that I was kind of like confused by,

because I don't know any kid who wants to hang out with an adult, like ever. Not even just today, even when I was a kid, which was many, many moons ago. What I found interesting though, and what I wanted to really talk to you about, is the culture of disrespect, because you've taken, you've seen what, a hundred and, you're an actual day-to-day doctor and you've seen 120,000 patients over the last 30 years. That's right. And so you're taking real data in real time

and you saw a difference, an evolution of how children, parents, the relationship between the mom, the dad, the child has really morphed and evolved since 1989 until today, 2024. So what did you see? What are the main differences that you saw that really kind of became like the rise of this culture of disrespect?

That's been a big piece of why the kids are the way they are now. So that's absolutely right. The impetus for the book comes from my own experience as a family doctor and what I'm seeing in the office. And I actually wrote about this for the Wall Street Journal. Mom brings her son into the office and mom is doing all the talking.

Kid is looking at his smartphone, playing a video game actually on his phone. Mom is telling me how your son has a tummy ache and he hasn't been feeling well. The son just puts his phone down and very nonchalantly says, you don't know what the F you're talking about. Mom gives me this limp smile. That didn't happen 20 years ago.

It would have been unthinkable for a 12 year old boy to use the F word to his mother. But now it happens. And where is that coming from? So here you have to go just beyond anecdotes and experiences in the office. A team at UCLA looked at the most popular TV shows, targeting children and teens, going back to 1967

and looking every 10 years from 1967 through 2017. And they quantified the shows on 16 different parameters. What are the shows teaching, looking at the most popular TV shows, like the Andy Griffith Show in 1967 or Happy Days in 1977 or Family Ties in 1987, Buffy the Vampire Slayer in 1997. Those are very different shows, very different production values, but they found great consistency in 1967 through 1997. All those shows they found are teaching kids the most important thing is to do the right thing, to tell the truth even if it hurts, to be a good friend even when that's not easy. Being famous, number

15 or number 16 throughout that entire interval. But then they found that between 1997 and 2007, American culture flipped upside down. And suddenly being famous, winning, went from number 15 to number one between 1997 and 2007 and doing the right thing, dropped from number one to number 13 in 10 years. American culture flipped upside down and it's gotten only worse since 2007. And what drove that change? The UCLA researchers asked and the answer they gave is social media. Social media they believe transformed American culture to suddenly what really mattered is likes

and followers. Doing the right thing that's gonna get you voted off the island. Survivor and iCarly and American Idol were the three most popular shows in 2007 that they looked at and on all three of those shows winning and being famous and having lots of followers is what really matters. So American culture did change and being famous is what's important. And another mom in my own practice asked me about her eight-year-old son. She said, he's become so defiant and so disrespectful and he talks back. And I don't know where he's getting this from because his father and I never talked like that.

And I said, does he watch Disney, Nickelodeon, Nick Jr.? And she said, well, of course. I said, lock it down, turn it off. He's learning it from those shows. And three weeks later, mom called me and she said, it stopped. You're right. He's learning it. And you know, shows like Dog with a Blog and Liv and Maddie, these Disney channel shows teach kids that it's cute and funny to be disrespectful to adults. They are vectors of what I call the culture of disrespect. No, I couldn't. Listen, I can't agree more. I'm a mom of two kids, one's 11 and one is nine.

My nine-year-old loves those shows on Nickelodeon and Disney. All those shows that you mentioned, there's a couple other ones that you didn't mention that Ariana Grande is in. I can't remember the name. Isn't there something called Jessie? I don't know these shows. Jesse, yes. Jessie's another one. Bunked. And all these shows that I thought, okay, you know what I, what I did as a parent was I took away

YouTube, even YouTube Kids, YouTube Shorts, all of it. And I thought, okay, so my daughter will be safe. But what I noticed is, okay, and she now watches those shows. And I thought, okay, so my daughter will be safe. But what I noticed is, okay, and she now watches those shows. And I thought, great, they're rated G, like how bad can they be? But when I sat with her and listened to the tone of voice, the sarcasm, and the way they treat the parents, it was very concerning. And I have to tell you, my daughter has an attitude. She has that sassiness that I thought, didn't occur to me that it would be coming from those shows. But after reading your book, I really took a different look.

What are parents really like? The question is really, we can talk about all the reasons why what is there what is the answer or what do we do to change it right like how many barriers can we put on these children right yeah well and i want to emphasize is not just disney it's the whole weight of american popular culture me love mass x had hit, 12 weeks, at number one on the Billboard Top 100, his old-town road, where he sings, "'You can't tell me nothing. "'Can't nobody tell me nothing.'" This number one hit song, most popular song in the United States,

he's saying, "'You can't tell me nothing.' "'Well, if you can't tell me nothing, "'why go to school? "'Why listen to grownups? "'You can't tell me nothing. "'Can't nobody tell me nothing.'" You know, Bill Maher had a big best seller this last year and he observed that one of the fundamental truths

of the human experience is that young people are beautiful but stupid and old people are ugly, but more likely to be wise. So, Bill Maher says that any successful human culture will connect the beautiful young people with the ugly old people. You can't tell me nothing. Can't nobody tell me nothing. The culture of disrespect is summed up in that line from that number one song. You can't tell me nothing. Can't nobody tell me nothing. The culture of disrespect breaks the bonds across generations.

If you can't tell me nothing, why should I listen to grandpa? He's got nothing to teach me. You can't tell me nothing. So you have to mindfully and intentionally create a different culture in your home, in your extended family. You have to think carefully about the weekend. What are we doing this weekend? What activities are we going to do? How am I going to connect my kids to other adults? Do I have a community of faith? Does that community of faith connect kids to adults and not just to other kids? And again, I do workshops for synagogues and for churches to say, look, your kid doesn't need a youth group where they eat pizza with other 12 year olds. They need connections with adults

to learn about traditions of the faith. And some synagogues and some churches are doing this. Most are not. They don't understand what their role is, which is to build bonds across generations. Well, I think people just don't know what to do. Like, you're right. Like I think people go to these youth groups,

my kid, and they're eating pizza. That's what they're doing with other kids. And the reality is like, life is busy, right? Like, this is the issue, right? Like, we also want to be realistic with people like in parents. Like, the world is not the same. Things move really, really fast.

Technology has completely has taken over the human interactions. There's no such thing unless you really make a concentrated effort, right? So I understand how that's become a situation. However, over the years, parental, you said this in the book, how parents have lost the confidence to actually parent, and they're more concerned with being the child's friend than they are to be the parent, and they will acquiesce to behaviors because they wanna be liked versus wanna be, you know, basically then not be liked, basically.

And so they let them eat whatever they want, they'll let them watch whatever they want. And so I guess you're whatever they want. They'll let them watch whatever they want. And so I guess you're saying that parents have to take back that authority and provide the discipline. But what's... Go ahead. Well, I'm always uncomfortable with the word discipline because people think that the book

is about discipline and it isn't. And parenting is easy when there's love. And there's a chapter in the book titled Joy, which is about finding the joy, doing fun things together with your kid. Because if there's love, then parenting is easy because your kid wants to please you, and they don't want to disappoint you,

they don't want to let you down. So what's the difference between parental authority and discipline? Can you give a distinction? Okay. So parental authority means discipline? Can you be can you kind of give a distinction? OK, so parental authority means that your kid cares what you think and that they look to you for guidance about what is important. And that's fundamental. That's essential.

And this is where parents are confused. And this is my big concern, this is where the impetus for writing the new edition came from, because 10 years ago, gentle parenting wasn't a thing. That's kind of a new term that has evolved over the last 10 years. But now a lot of parents are really into

this gentle parenting. And gentle parenting, you know, there's lots of different definitions and lots of different gurus out there. But one thing they have in common is that gentle parenting means letting kids decide. Well, letting kids decide is actually a really bad idea. And how do we know this? You know, the fundamental question is what is childhood for? What is childhood for? That's not a trivial question, and the answer is not obvious. A four-year-old horse is a mature adult.

The Kentucky Derby is raced with three-year-olds, and a horse is a bigger animal than a human. So the answer cannot be it's about biological maturation, because a horse is a bigger animal than a human, and it only takes four years for a horse to become fully mature. So the answer cannot be that it's about becoming biologically mature because it only takes a horse four years. Humans are children or adolescents for more years than most animals live. Why? Why does it take so long? We don't have to wonder. We have scholars like Dr. Melvin Connor at Emory who's devoted his entire career to addressing this question and comparing development in our species with development in other species,

like other primates. And he wrote this 800 page tome, The Evolution of Childhood, comparing development in our species with development in other species. And the answer the scholars give is that development in our species takes as many years as it does because it takes many years for the parents to teach the child right and wrong. That's your job. And I say that in the book. And then the next paragraph, I quote a column from the New York Times, Jennifer Finney Boylan, a longtime columnist, wrote a column on enlightened parenting in which she asserts that enlightened parenting means, and I'm quoting her, setting your child free to discover for herself her own right and

wrong. And if in so doing your child becomes a stranger to you, then so be it." Well, that may seem enlightened, but it's not. If you set your child free to discover their own right and wrong, and they have a device with internet access. What they'll discover is Cardi B, Megan the Stallion, mainstream pornography, a SZA, and a lot of really bad things out there. And you will end up with a child who is adrift, who is anxious, and who is depressed. Human development works when parents are authoritative. This is the work of Diana Baumann, the great scholar at Cal Berkeley, who spent 50 years following families and found that the parents who are both strict and loving, which is her definition of authoritative parenting, and she coined the phrase, parents

who are both strict and loving had the kids who had the best outcomes, least likely to be anxious and depressed, most likely to sustain romantic relationships, least likely to be convicted of felony, both strict and loving. But in the later decades of her career, she found that American parents are becoming confused. They think you have to choose between being strict or loving. They don't understand that the best parents are both strict and loving. And so that's what I'm trying to communicate to parents. You have to be both strict and loving. You have to set the guidelines, but also communicate love. A friend is a peer. A friend cannot command. A friend cannot say, I'm taking your phone from you at nine o'clock at night and putting it in the charger, which is going

to be the parent's bedroom, so you can get a good night's sleep. A friend cannot say that. Only a parent can say that. You've got to exercise your authority as a parent so your kid can get a good night's sleep. And if you don't do that, your kid will be literally in danger. You know, again, another example from my own practice, for 18 years, I was an attending physician at Shady Grove Hospital in Rockville, Maryland, admitting patients and consulting on patients. And one night I got a call from the emergency room. A 15 year old girl, a patient of mine, was a victim of sexual assault. But they were not calling me to admit her or to consult on her.

They were calling me because mom was in the emergency room. Hysterical is the word that the ER physician used and wanted me to come in and talk with her. So I came in to meet with her in the consultation room just adjacent to me there. When I came in to talk to mom, it was just her and me. And the first thing she said, mom said to me, I knew I shouldn't have let her go. It was a frat party at the college. She's 15 years old. I knew I shouldn't have let her go. And of course, you want to shake mom and say, well, then why'd you let her go? But I didn't say that because I knew the answer. The answer was she wants to be her daughter's best friend. And a friend cannot command. A friend cannot prohibit. So I was sharing this story with

parents in Tampa, Florida, and a mom came up to me afterwards and shared her story with me. Her daughter, 14 years old, came up to her and said, hey, guess what? We're all going to Cancun for spring break. And mom looked at her phone and she said, well, I can't get away that week, I'm busy. And mom said, I didn't say you're, daughter said, I didn't say you're going. Me, all the girls, we're going to Cancun for spring break. Mom said, wait, Cancun, that's where all the college men

go for spring break and you're 14, but you could easily pass for 18. I don't think it's safe. And her daughter said, oh, it's totally fine. It's safe, it's fine, we'll stay together. We'll have our phones, it's totally fine. And mom said, no, it's totally fine. It's safe. It's fine. We'll stay together. We'll have our phones. It's totally fine. And mom said, no, you're not going. And mom told me her daughter exploded,

started screaming at her. I hate you. I hate you. You're going to totally ruin my whole life. And mom said, well, honestly, sometimes I'm not so fond of you either. But I am your mother. And that's a job.

Like any job, it has a job description. And item one in my job description is I have to keep you safe. And I know more than you do about the behavior of junk, young men. And you're not going to Cancun without parents. If you're doing your job as a parent, there will be times

that your kid gets really angry with you. That's part of the job. You have to do your job. So, okay, so let's go back a bit. So basically, we all, so having boundaries as kids, kids need boundaries, kids need limits. They definitely need that. I 100% agree.

Now what is to you, it's helicopter parenting, all of this. I feel like it's come much more popular with the left woke, you know, the rise of the woke world and center to left. This is where the gentle parenting is, this is where the participation, the trigger warnings, the safe spaces, the helicopter parenting. What's your whole take on the difference?

Because if you're a helicopter parent, you're involved in every aspect of your child's life, which also can be very detrimental to building coping mechanisms and resilience. Well, here's where I really like and agree with what John Hyde says in the opening chapters of The Anxious Generation. He points out that we have been too intrusive in what kids are doing in the real world, but not intrusive enough in what kids are doing online. And I agree 100%. I think we need to let go and let kids do whatever they want or give them much more

freedom in the real world. And let eight-year-olds run around and play without adult supervision in the backyard, on the playground, let 10 year olds walk to the market and get stuff at the grocery store and walk back within reasonable limits. But absolutely I did that growing up in Shaker Heights, Ohio. And I took the bus to downtown Cleveland for my piano lesson at 10 years of age.

And I don't see why kids can't do that today. I'm all for free range parenting. Absolutely. But I agree with John Height that we need to severely limit what a 10 year olds are doing online. And I think he's absolutely right there. But the other aspect that I wanted to braise that I heard you mention a moment ago was this issue of normophobia.

So 15 years ago, I wrote a book called Girls on the Edge because back then, again, as a family doctor, you kind of get to see these things before they get written about. And I saw back then and wrote about how social media was causing a rising anxiety and depression. And I was very honored that Caitlin Flanagan at the Atlantic back then wrote how my book, Girls on the Edge, was the best book about what's going on with girls and young women in America. Because I'm proud to say I was kind of ahead of the curve

there because I was seeing it as a family doctor before we had all the studies. Back then, when I wrote that first edition of Girls on the Edge, I was seeing many girls who wanted to be effortlessly perfect. That was a thing back then. So the publisher asked me to write a second edition of Girls on the Edge, and I did. And I systematically interviewed a lot of girls and young women for that. But I found that things have really changed. Girls today don't want to be effortlessly perfect anymore. That's really not a thing. Effortlessly perfect today, that would be boring. That would be basic white bitch.

That's not interesting. You got to have a thing. You got to have something to talk about. Anxious, depressed, that's good. You don't want to be basic white bitch. That is lame. That is boring. Having anxiety, having ADD, it's all cool. Yeah, and the terminology that kids are teaching each other on social media, are you neuro-typical or are you neuro-divergent? Are you gender conforming or are you gender non-conforming? Well, who wants to be conforming and typical?

Conforming and typical are boring. What's neurotypical or neuro? What does that even mean? Neurodivergent means you're on the spectrum, or you have ADHD. Neurotypical means you're normal, but normal is boring. You don't want to be boring. So normal has become boring. It's become typical.

It's become conforming. These are the terms that the kids teach each other to use. Neurotypical versus neurodivergent. Gender conforming versus gender nonconforming. And so Mary Harrington recently coined this term normophobia to describe how anglophone kids, English speakingspeaking kids, are reluctant to be normal. They've got to have something to talk about to be their brand, that I'm neurodivergent, that I'm gender nonconforming, that I'm really struggling,

because otherwise you are basic white bitch and you are lame and you are boring. You know, 70 years ago, C.S. Lewis wrote a children's book called The Magician's Nephew, in which he said that the problem with trying to make yourself stupider than you really are is that you very often succeed. And some is too anxious or depressed, and you start to understand what is going on in the English speaking world. Now, John Height and I both are PhD graduates of the University of Pennsylvania Department of Psychology, which is where Aaron Beck rule. Okay, so Aaron Beck is University of Pennsylvania. Aaron Beck created cognitive behavioral therapy. Cognitive behavioral therapy

basically is that you think yourself into depression. You think yourself into anxiety. The way you think determines how you feel. The problem with trying to make yourself more anxious than you really are is that you become more anxious than you really are. English-speaking culture has become a culture of normophobia. It's become a culture where being normal is lame, is boring, is uncool, and parents don't understand this. On the contrary, parents who read the New York Times or listen to national public radio

have been taught that, hey, good parents validate their kids' feelings. And a kid comes home from school and they're like, oh, everybody else got invited to Emily's party and I wasn't invited and I'm really sad. And my mom was like, oh, I feel for you, I hear what you're saying and I feel so bad, oh, that's so sad.

Whereas in fact, the role of the parent is to be an agent of reality and say, who the heck is Emily? I've never heard of Emily. Emily's not a friend of yours. Why do you care whether she invites you to her party? You've never mentioned Emily ever. Okay, a week from Saturday, great. Let's you and me go on the bike trail, walk it off. Whether or not you're invited to the party of a kid you don't even know is not that important. Help your kid to put things in perspective. Getting invited to a birthday party of a kid you don't know is not that important.

This is the role of the parent to put things in perspective, not to validate every feeling your kid has. So right. And so why it so where did this come from? Like, how did it start where this was more atypical back when I was a child, right? When I was a child, my mom gave me boundaries and there was authority. You can't do that. I wasn't allowed to go to college parties with the boys. All that was much more common. Now, I will say though, my friends who came from very wealthy families, I came from a regular middle-class, let's say family, but my friends who came from very wealthy families, they had so much freedom. They were able to like go anywhere and do anything that their parents were much more hands-off and quite frankly, you know, you look at these people 30 years later,

right, and they're no great shakes. They're not that successful. They're kind of like loafers. And the ones like me, who were kind of very disciplined, and I wasn't allowed to do this, I had very strict rules around me, you know, we kind of excelled in other ways. Can we can you talk about how and then you mentioned this in the book also, like affluenza, affluent families, these schools that are high achievement schools. There's like a very, there's like a contradiction. People think that these are going to give you this ability to be more successful. Let's talk about that.

Yeah. So that's the work of Sunia Luthar and she's the leading scholar in that. So let's talk a little bit about her work. So Sunia Luthar was doing these studies. So let's go way back. So back when I was earning my doctorate at University of Pennsylvania in psychology, we're talking about the early 80s. There were all these studies showing that kids who were in low income communities were

more likely to be anxious and depressed and struggling compared to kids from more affluent communities. And so Sunia Luther was doing a big study and she noticed that, huh, that doesn't seem to be true anymore. In fact, the reverse now seems to be true. She was the first scholar, she was then at Columbia, who found that, you know what, that finding that was so robust in the United States in the early and mid-20th century seems to have flipped. It is now the case that kids from affluent communities are actually more likely to be anxious and depressed than kids from low-income communities. And other scholars

pounced on this and replicated it, and it turned out to be a pretty robust finding. And other scholars coined the term affluenza to describe this finding that affluent kids are now more likely to be anxious and depressed than low-income kids. But then more recently, she went back and did a more granular look at the data. And she found that it isn't actually income per se,

it's what kind of school the kid is attending. Kids who are attending high-performing schools are the kids who are at greatest risk. So a kid from a low-income household who gets a scholarship to go to a high-achieving school is at risk, whereas a kid from an affluent home who's going to a school that's not high achieving is not at risk. Well, this is weird. Attending a high achieving school, a school that boasts that

all of our kids go to Ivy League schools or Stanford or MIT or whatever, attending such a school greatly increases the risk of being anxious and depressed. Yeah, it does actually. Why is that? Well, Sunil Uttar asserts that the mechanism is social comparison, that when kids are comparing themselves to other kids, they become anxious and depressed. So the worst thing you can do with your kid is to say, whoa, look at Melissa. She was accepted to Stanford and Princeton and she started her own nonprofit and she got a five on the AP Physics exam. Wow, you gotta try and be like Melissa.

That's the worst thing you can tell your child. You don't want to be comparing your kid to others. That's not a good strategy. You want your kid to focus on being the best that she can be. But comparing your kid to other kids is a major risk factor for anxiety and depression. That's what we learned from the work of Sunil Luthar and other scholars. How about success, overall success? Because people go to these schools because they think their feet are school.

Yes. Right? So indeed, in my book, The Collapse of Parenting, I asked the reader, what predicts success? At 12 years of age, or at 15 years of age, or at 18 years of age, is it your grade point average? Is it how popular you are? Is it emotional stability? Is it self grade point average? Is it how popular you are? Is it emotional stability?

Is it self-control? One of those predicts health, wealth, and happiness 20 years later, but only one of those. The other three do not. It's self-control and other measures of conscientiousness like honesty. Grade point average doesn't. And a lot of parents actually are aware of that,

and I know this, because when I do the presentations, that's the first question I ask. And nobody raises their hand for grade point average. They all have heard that grade point average does not predict health, wealth, and happiness 20 years down the road. They know that in their heads, but they don't know it in their hearts. Because I can tell you as a family doctor, when that ninth grader starts getting Bs and Cs, they're bringing the kid into the office and they're saying, what do you think? Should we start Adderall, By Vance? What's going on?

ADD, what's going on? They act as if grade point average is the most important thing, but the evidence is clear. Conscientiousness, meaning honesty and self-control, strongly predict health, wealth, and happiness 20, 30 years down the road. Grade point average and popularity and emotional stability do not. So it follows that your

top priority as a parent is to teach your kid to be honest and self-control. But isn't emotional stability part of having the self-control? Now, that's a wonderful question that very often comes up. What's the difference between self-control and emotional stability? Yeah. Emotional stability is what's going on inside. Self-control is about what you do.

It's about your behavior. And it's actually very encouraging and reassuring. You can be a mess in here as long as you just govern what you do, as long as you control your behavior. If you're all mixed up inside, that's okay. You don't have to have it together in here as long as you control your behavior. Control your behavior, self-control. You don't have to be a Zen master. You just have to govern yourself.

So how can you teach this to a young child? How can you teach how to be more self, how to have more self-control? And how do you teach conscientiousness if you don't have it naturally? No dessert until you eat your vegetables. No video games until all the chores are done and all the homework is done. No TV in the bedroom. No screens in the bedroom. And if that hasn't been the rule in your home, I encourage you to make it the rule in your home. If that hasn't been the rule in your home, sit down with your kids and say,

hey, we've been doing some things wrong. We're going to make some changes. If that hasn't been the rule in your home, when you make that announcement, there will be an explosion. And the older the child, the longer and louder the explosion. But if both parents stand their ground, emphasizing the word both, after six weeks, you will have a child with better self-control. Not after one week. The first week is pretty tough. But after six weeks, you will have a child with better self-control and usually a happier child as well. You mentioned something I think is very important that I see has become a huge epidemic here, which is parents are more and more just putting their kids on medication because they if the

kids are badly behaved or they do something out of line, they think it's ADD or bipolar or behavioral issue or mental health problem, anxiety. Let's just go with anxiety, for example. Every kid I know seems to be on anxiety medication at a very young age or ADD medication. You mentioned in your book how parents prefer to either get a diagnosis of a mental health issue than a behavioral issue and then do the work to fix a behavior issue. Can we talk about how that's become a really big problem and how can we encourage people to stop that behavior and really eliminate the, I guess these overprescribing and the diagnosis is because if you say to your kid, Oh, you have ADD, then they, they, they rest on that Laurel and act as if like you were saying earlier, right? If you just, if you tell your kid,

Oh, I have bipolar or I have ADD, then that's their excuse to not do something because you've given them that. Right? I've written, I've written a lot about this because I see it. And again, one of the unusual features in my background is I'm both a medical doctor, MD, but I also have a PhD in psychology. This is actually how I got into this because a lot of parents would bring their kids to me

because I can do the assessment and also prescribe the medication. Psychologists can do the assessment, but a PhD psychologist as a role cannot prescribe the medication, but a PhD psychologist as a rule cannot prescribe the medication. But I can. And on so many occasions, I've been in the situation of saying to the parents, look, Justin does not meet criteria for attention deficit disorder. And the parents will say, yeah, but the doctor prescribed Vyvanse, and it was so helpful.

You know, I spoke at Harvard at a conference on how to learning and the brain. And I would love to tell you that my presentation was the buzz of the conference. It wasn't. The presentation that everybody was really excited about was a presentation by Dr. Gabrielli from MIT. Dr. Gabrielli somehow got permission

to give Adderall, a stimulant medication for ADD. He got permission to give Adderall to normal kids, kids without ADHD, and to withhold medication for kids who had severe ADHD, and then to study how kids with and without ADHD learned on and off medication. And he found that medication helps normal kids more than it helps kids with ADHD. That's a tremendously important finding.

Because for decades, the pharmaceutical industry has been telling us that these medications are specific, that they only help kids with ADHD. That was a lie. They never had any evidence for that. And studies like Dr. Gabriele's, low Zephyr smithurines, these medications help normal kids as much or more than they help kids with ADHD. Okay, so these medications help everybody.

They help everybody to concentrate and focus. They boost energy. They compensate for the sleep deprivation. What's not to like? Why not just put all the kids on medication? Well, the problem is we now have many studies, 18 studies to be precise, showing that these medications, Adderall, Bivans, Concerta, Medidate, Focal Medidrana,

damage the motivational center of the brain, the nucleus accumbens. That's a pretty serious concern. And they are often overprescribed or unnecessary. So another story from my own practice. Boy is off the chart on the counter scale, not paying attention in any of his classes. Parents take him to the child psychiatrist.

He says, absolutely meets criteria. Let's go ahead and prescribe Vyvanse, which is tremendously helpful for this boy. But now he's getting jittery and his palpitations, no appetite, losing weight. Parents saw an article I wrote for the New York Times about the dangers of the medication, so they bring them to me for a second opinion.

And I do a careful sleep history. I ask the parents, does he get a good night's sleep? Mom says, oh, absolutely. We make sure he's in his bedroom every night at nine o'clock. We wake him up next morning at 6 a.m. That's nine hours, that's enough, isn't it? And I say to the boy, do you have a video game console in your bedroom?

He says, well, of course. Doesn't everybody? I said, well, were you playing video game last night? He said, of course. Doesn't everybody? I said, what were you playing? RDR2. I said, excellent game. Really great game. When did you finish? 1.30, 2.00? Mom's like, you were playing video game till 2.00 in the morning. Is that pretty typical? Yeah, it's pretty typical. Mom's like, you play video games till 2.00 in the morning. Is that pretty typical? Yeah, it's pretty typical. Mom's like, you play video games till two in the morning? He's playing video games after midnight most nights. He's playing video games till one or two in the morning. He's planning to get up at six.

He's sleep deprived. Sleep deprivation perfectly mimics ADHD of the inattentive variety. There is no Conner scale. There is no Vanderbilt interview that can distinguish ADHD of the inattentive variety from sleep deprivation. Bivance, Adderall, tremendously helpful. What's Bivance? What's Adderall? They're amphetamines. They compensate for the sleep deprivation.

They're speed. But the appropriate remedy for sleep deprivation is sleep, not scheduled to amphetamines. And this was a board certified and experienced child psychiatrist who misdiagnosed this kid. This kid doesn't have ADHD. This kid should never have been put on medication. You get the video game console out of the bedroom and this kid is fine. Off medication. Doesn't need to be on medication and I see this all the time. This is epidemic across the United States. I wrote a book for a French publisher, Carrefour, Le Gosson, Perrier, Les Filles Se Mettent en Blanchet.

It's basically my book, Boys Adrift and Girls on the Edge combined into one, because we were able to throw out chapters, including the chapter on ADHD, turned out working with French colleagues. I learned that in all of France, there are fewer than 6,000 kids on medication for ADHD. In all of France, a nation of 67 million people. There are more kids in Los Angeles on medications for ADHD

than there are in all of France. Because in France, medication is the last resort. In the United States, medication is the first resort. Let's try Adderall and see if it helps. You have to be the jealous advocate for your kid. If a doctor recommends medication for your kid, you have to say to your kid, doctor, are you aware of the 18 studies showing that these medications may damage the nucleus accumbens? I can promise you in the United States, the doctor is not aware. Outside of the United States the doctors know about this. In this country they don't. I own the copyright to Boy's Adrift. Give the doctor your copy of Boy's Adrift.

Ask the doctor to read chapters four and eight with the scholarly citations. Doctors can only practice wisely if they know the risks of the medications they're prescribing. In this country they don't know. We can talk about how the pharmaceutical industry has influenced the practice of medicine in the United States that's especially profound in psychiatry and the prescribing of psychiatric medications. You've got to be the advocate for your kid. A kid in the United States is 14 times more likely to be on medication for ADHD compared to a kid in the United Kingdom. And a kid in the United Kingdom is many times more likely to be on medication compared to a kid in France. You know, the kid in the United Kingdom is many times more likely to be on medication compared to a kid in France.

You know, the original title of the collapse of parenting, the title of the book I sent to the publisher was The Collapse of American Parenting. And the subtitle was, Why Most Kids Would Be Better Off Raised Outside North America. And I was leaning heavily on the fact that American kids are many times more likely to be on psychiatric medications compared to kids outside North America.

But if you're not a celebrity, you don't get to choose your title, and the publisher nixed it. But it is a fact that American kids are now many times more likely to be on psychiatric medications and kids outside North America. Would Canada be in that as well? Yes. Canada is drifting more and more to the United States in that parameter. Then what about anxiety? That's the other one, right?

So ADD is one that the kids are always on part of the medication for. And the other one is anxiety. Like how, isn't that kind of an arbitrary thing? How do you know if your kid actually has anxiety or ADD? Well, and it's normal to feel anxious. And at what point does that anxious feeling, because after all, adolescents,

you don't know what you're gonna do with your life. You don't know who your life partner is going to be. You don't know where you're going to college, or even if you're going to go to college. It's normal to feel anxious about those things. And we have pathologized a lot of the normal anxiety of adolescents so that that girl, that boy who's understandably anxious because they don't know

what they're gonna do, they don't know where they're gonna go, they don't know who their partner's going to be, all normal sources of anxiety. Now in American culture, it's very easy to, for parents to think, oh, my kid's anxious, so they should be on a medication for their anxiety. Well, no, they probably shouldn't. And outside the United States, they wouldn't be. I don't talk about that as much though, because the evidence is simply not there. The dangers of Lexapro are simply not as great as the dangers of Adderall-Vivance.

Adderall and Vivance, the evidence is very clear that they damage the motivational center of the brain. We can talk about the dangers of Lexapro and the other serotonin SSRIs, and I do have concerns about them, but they're not as profound as the concerns that I have about Adderall, Vyvan's Concerta, Medidate, Focal and Dutrona. So what are some ways you could, how a parent can help change the behavior to eliminate that option of medication for ADD?

Like, because again, it's an arbitrary thing, right? The kids are not paying, if they If the kids are having bad grades or not paying attention or acting out or whatever the reasons are, right? At the end of the day, you know, big reason, when you say this, I'll also talk about this, is that it's an easier parenting strategy to put your child on medication, right? Because it takes a lot of time and effort to parent and to tweak and change the behaviors of your child, right? So I really had a fight with the publisher of my book, Boys Adrift. So Boys Adrift has two chapters, chapters four and eight, that are a deep dive into ADHD. What are the five

criteria for the diagnosis of ADHD? And what should you do if your kid's not paying attention in class and what strategies can you deploy? And my publisher didn't like it. They said, Dr. Sacks, are you seriously suggesting that a parent, after reading your one book, is qualified to question the judgment of an experienced board-certified child psychiatrist with years of experience. I said, absolutely, absolutely. I said, not only that, they have to,

because who else is going to push back when the psychiatrist recommends medication? And so our compromise was there is a disclaimer at the front of the book that says, this book offers general guidance only, it shouldn't be a substitute for recommendation made by your, and in particular, you shouldn't stop medication without consulting your health care professional because the publisher didn't want to get sued. But I do offer very detailed

guidance regarding ADHD in my book, Boys Adrift, for a parent who really wants a step-by-step guide about the diagnosis and management and evaluation of the child who's not paying attention in school, which is most more often a boy than a girl, but it could be a girl and it can be a girl. And I've advised many families of daughters as well as sons. But I'll tell you one thing, start with sleep because a lot of boys are staying up past midnight playing video games. A lot of girls are staying up past midnight strolling through Instagram and TikTok. And there is no way you can pay attention in school and learn Spanish grammar and algebra

if you are sleep deprived. No screens in the bedroom. At nine o'clock at night at the very latest, you're taking the device from your kid and you're turning it off and you're putting it in the charger, which is gonna stay in the parent's bedroom. This has to be the parent's job.

And a lot of parents push back and they're like, no, no, no, no, no, no, come on, my daughter will totally freak out if I take her phone. I say, look, this is not, it is not reasonable to put this, this decision, whether or not to have a phone in the bedroom in the lap of your 14-year-old daughter. What is she supposed to say tomorrow in school when her friend says, hey, I tested you last night at midnight, I tested you last night at midnight, how come you didn't answer? Is your 14 year old daughter supposed to say, well, researchers have found that sleep deprivation in adolescents is a major risk factor in the etiology of anxiety

and depression. That's ridiculous. You can't expect her to say that. You got to allow her to say, Hey, my evil parents take my phone every night at nine. Won't let it add back till the next morning. This has to be the parent's call. You've got to take your phone from your daughter every night and turn it off and put it in the charger. That's your job as a parent. I love that. And you mentioned sleep before. Give me one more actionable thing a parent can do. With regard to ADHD? Yeah. Instead of, yeah, for a behavior attack to help with behavior.

Second thing is you have to look at the school. Very often, and I got blacklisted. I have been blacklisted by a number of schools because I have gone into the school. Very often, and I got blacklisted. I have been blacklisted by a number of schools because I have gone into the school as part of my evaluation. And sometimes I have found that the problem is not in the kid, but in the school. Sometimes you've got schools that are just deadly dull. And the kid's not paying attention because I wouldn't pay attention, because the instruction is deadly boring. And I have had firsthand experience with more than 100 kids, more than 100 kids firsthand in my years of practice,

where this kid was on medication at school A and off medication at school B because the teachers at school A are deadly dull and the teachers at school B are exciting and alive and running around the classroom and jumping up on the desk and fun and funny. And sometimes the problem is not in your kid, but in the school.

So you have to be alive to that and consider switching schools. Wow. I haven't heard anyone say that before because it's such a controversial thing to say. I've seen it firsthand. Okay. Okay. I haven't heard anyone say that before because it's such a controversial thing to say. I've seen it firsthand. Okay. Okay. I like that. Then I have so many questions for you, but I feel like I'm going to have to have you back because there's too many things to go over, right? Like there's

so much more, way more stuff to go over. Would you come back on the show? Actually, could I have to ask one more question? Because this is actually important because I want to talk because this is a big area what I do is health and wellness, right? And so you mentioned in the book about kids and obesity, and how kids are more obese and less in shape and all these things and the and food with the children today. What's the correlation? Because you were saying it wasn't so much about, is it because of the technology or is there other reasons behind it that are making these kids less healthy,

less fit, eating badly? In my book, The Collapse of Parenting, I have a chapter on food. In 1971, 4% of American kids were obese. Today, 20% of American kids are obese. So basically a five-fold increase. Why did that happen? There's a bunch of reasons why that happened.

And I go into different things that have happened, but in just the few minutes we have remaining, I just wanna focus on one thing that happened, and that's what kids eat. 50 years ago, parents chose what kids ate, but increasingly parents let kids decide what kids eat. So I was speaking to parents in Chappaqua, New York, and husband and wife told me how husband and wife

had prepared a healthy and nutritious supper. And their son and daughter came home and said, oh yeah, we don't wanna eat that, we just ordered pizza. So dad got out his phone and pulled up the Domino's Pizza app and the son dictated his order for his personal pizza, and the daughter dictated her order for her personal pizza. I asked dad, why don't you do that?

Why don't you just tell them this is what's for supper. If you don't like it, you could go to bed hungry. Dad said, I don't believe in using starvation as a means of discipline. I said, they're not going to starve. But 50 years ago, if mom made a healthy and nutritious supper and the kids didn't want it, she would not run out and buy them a pizza. She would say, this is what's for supper. If you don't like it, you can go to bed hungry. If you let 12-year-olds decide what's for supper, there are some 12-year-olds who will choose broccoli, brussels sprouts, cabbage, cauliflower, spinach, asparagus, and kale.

But there are other 12-year-olds who will insist on pizza, french fries, potato chips, and ice cream. If you let kids decide what's for supper, you're going to get more fat kids. That's part of what's going on. It's not the whole story. It is not, and I go into other factors in play, but That's part of what's going on. It's not the whole story. It is not, and I go into other factors in play, but it's part of what's going on. This is why kids, this is one part of why kids have parents.

Parents need to decide what's for supper. They should not be letting kids decide what's for supper. And one of the motivations I had for writing the book is to empower parents to make the call. Parents, you need to decide what's for supper. And one of the motivations I had for writing the book is to empower parents to make the call. Parents, you need to decide what's for supper. Your kids don't get to decide what's for supper. Well, it's kind of one of these things. I mean, overall, and it's like the kids are, it's like the inmates are running the asylum overall, right? That's what that general consensus is that parents are giving these kids, you know, the authority to basically like rule the roost.

I mean, I have people I know, my friends, some of my, the people I know, their kids are brutal because the parents just say, well, it's up to Jan, it's up to Mary, it's up to who, what they do, how they do or what they eat. And these kids are brutal. These are the kids that I don't want my kids to be playing with because it's not, they're not the kids that I feel that I want as a, you know, as a peer. But you're

right. And I feel like there's like a way the parents have to take the the the onus on them to parent the child. What's another reason why the kids are obese? Is it really because they're not playing besides the obvious, which our kids are not playing outside as much they're on video games or on social media so they're not moving as much so like activity is a matter activity is the second one and sleep is the third one kids are getting less sleep and we now understand that sleep is fundamental to not only to good health but to good weight if you get less sleep you end up eating more and you throw your metabolism out of alignment. It's kind of counterintuitive, but getting insufficient sleep is a major risk factor for being overweight. You've got to get the right amount of sleep.

If you are sleep deprived, you're more likely to be overweight. So, the three things why kids are more obese and less fit are, of course, less activity. The second is less sleep than they've gotten before. And sleep regulates your hormones, obviously, that too. And the third, from what I understand, is the parents are allowing the children to choose what they eat versus taking the ownership.

Yeah, eating too much of the wrong things. Yeah. There you go. Wow, okay. So, thank you. First of all, the book is called The Collapse of Parenting. It is an amazing read. I really, really enjoyed it. In fact, actually, I'm not even finished yet.

I think I have another chapter left, but I've recommended it to so many of my friends to read the book. I saw you on something and I really loved your perspective, and I thought it was a very refreshing perspective, and that's why I really wanted you to be on the podcast. But there's so many other questions I have. So if it's like I said, I'd love to have you back.

Well, I also want to put in a plug for the audiobook. For the first time ever, the publisher allowed me to read the book and a very dictatorial Israeli who lives in Santa Monica was the producer and it was 20 hours to produce a 10 hour audiobook, but it's actually doing much better than the hard copy. So people must like it. I love that, by the way, that's what I'm listening to on Spotify, your audiobook.

Yeah. It's great. It's great. In fact, are your other books on, do you have audio books? They're all on audio books, but they wouldn't let me read them. They didn't like my voice. Oh my God. By the way, that's so interesting because I thought your voice was great. Thank you.

Yeah. I thought it was great. No, I really did. Like I said, I have a million more questions, but thank you again. Thank you for being on the show and let's schedule part two if that's okay with you. Very good. That'd be great. Thank you. Bye.

All right. Bye-bye.