Here's a little vignette (it's a true story): a 15-year-old girl attends London's top girls' school. Her less brainiac little sister goes to another league-topping school nearby, only marginally less exalted. Their mother is collecting Girl A from School A, and remarks out loud on how very thin everyone is, indeed much thinner than the girls at the rival establishment. Girl A, with a toss of her hair, says: "Yeah, we even do anorexia better than them."
Extreme? Actually, no. Being faux-cynical, pouty and contrary has long been part of growing up, but there's a distinction between making it your life's work to annoy your parents and teachers and having serious mental health issues. It turns out that this line is being crossed by Britain's teenage girls, especially "high-achieving" girls from comfortable backgrounds, in vast and alarming numbers.
In a highly credible recent study, "GHQ increases among Scottish 15-year-olds 1987 - 2006", published in Social Psychiatry and Psychiatric Epidemiology, it has become apparent that young girls are officially the most depressed section of the population.
The number of 15-year-old girls experiencing psychological distress is rocketing; the study shows they are the most mentally ill group of people in the country, with 43% of them emotionally distressed and 27% suffering mental illness (severe depression or anxiety). What on earth is going on?
It's that time of year again: the countdown that will lead, in a few weeks, to the inevitable pictures of clever girls brandishing their exam results on the front pages of the newspapers. There will be the usual trills about how girls have, once again, wiped the floor with boys, about how they reign supreme when it comes to brains - the discrepancy in achievement kicking in at the age of five, we were told last week. There will be the usual photogenic gaggle, all long hair and longer limbs, waving their pieces of paper triumphantly.
Some of the girls will look, to the eyes of well-upholstered middle age, alarmingly skinny. Some will wear long sleeves, even though the sun is shining. Because now is also the time of year when parents spend proper amounts of time with their teenage daughters, see them in swimming costumes and think "God - I can see her ribs" or "What are those marks on her arms?"
Then we'll all move on and the girls who worked so hard, for so long, to achieve their spectacular exam results will be dismissed. Because we all know girls are clever, that they work harder, that they do better than boys, blah, blah.
"It happened last year," says Grace, now 17. "It was like, yeah, you're a girl, so you did well. Obviously. What do you want, a medal?" It was as though suddenly the longed-for prize, the string of A*s, became meaningless overnight. "Media pressure," she says. "For me, it's not to do with seeing skinny girls in Vogue. It's to do with the papers all saying exams are getting easier, that As are easy to get - expected, if you're a girl. So you get them and no one's very surprised or especially pleased-seeming. It doesn't make you feel good. You should be really happy, but you're not."
The results may be stellar but the cost of achieving them is sky-high. Felicity, 21, is smiley and cheerful, stylishly dressed, not remotely the kind of person you would imagine has spent half her life crippled by insecurities and low self-esteem. She always wears long sleeves to hide the scars from years of self-harming - she started at 13: "I had a board in my room with all the days of the week in sections and I would write on all of them 'Work harder, eat less' every day."
For her, cutting herself was "a coping mechanism. And almost an achievement in itself, because you could see the results". She says: "There's so much pressure to be the perfect student - sociable, outstanding, academic. If your sense of self is bound up in achievement, you need to keep achieving. Otherwise your sense of self is lost and you feel worthless. I remember being told by a teacher that unless we were going to university then we might as well drop out and go on to a management training scheme at Sainsbury's.
"The media doesn't help at all. They have these massive education supplements, always criticizing the results, and every year you need to do better. The government want so many people to go to university and so there are so many more applicants and it gets more and more competitive. I'm sure that even by GCSE, girls are aware of how crucial it is to do well at every stage, because otherwise they'll never get a job at the end."
Felicity's story does not surprise Helen Sweeting, one of the three academics who interviewed a wide sample of 15-year-olds from the same place in Scotland in 1987, 1999 and 2006 for the study in Social Psychiatry. She has collected figures that are far scarier than any single tale of woe. (More than 2,000 mid-teens were quizzed for the 1999 survey, more than 3,000 for the 2006 one.)
The 1999 results show that common mental disorders such as anxiety, depression, panic attacks and loss of capacity to experience pleasure had increased since 1987 for girls from 19% to 32%. The increase for boys was a mere two percentage points, to 15%.
The most recent 2006 results show a dramatic increase: girls are on 44%, with boys on 21%. More than a third of girls agreed "they felt constantly under strain"; those who "felt they could not overcome their difficulties" had more than doubled to 26%. The number who "think of yourself as a worthless person" had trebled between 1987 and 2006.
By 1999 the distress rates in girls in the top social class had risen from 24% to 38%. The kind of distress that can require hospitalization tripled, from 6% to 18%. A further study found that in 2006, girls from the top social class had continued to increase their rates of distress to 43%. For the first time girls from lower social classes have almost caught up, with 41%.
All this has coincided with two things, the first being the period in which girls began to outperform boys academically. In 1987 there was hardly any difference in how well the genders did at GCSE level, but girls started streaking ahead by 1999, when 43% of boys got five or more at grades A to C, compared with 53% of girls. It also coincided with our obsession with celebrity culture, with the bewildering and media-led glorification of super-skinny, apparently brainless "celebrities" and the grim suggestion that these women are somehow desirable role models.
There is a great deal of irony in the fact that young girls feel pressured to be super-brainy on the one hand and super-inane on the other. Who wouldn't feel confused and unhappy by being asked to be a size zero particle physicist with improbably large breasts and really good hair extensions?
First things first: is the Sweeting study simply giving us a depressing snapshot of the mental state of young Scottish girls? No, says Helen Sweeting: "There is no reason to think teenagers in and around the west of Scotland are different from others in the UK. A number of other studies, both in the UK and elsewhere, have had similar findings."
What does she think is going on? "A number of authors, in both the scientific and in more general literature, have speculated on possible reasons for increased distress. One is that admitting to feeling distressed may simply have become more acceptable over time.
"However, assuming the increases are 'real', then potential explanations include changes in family life, consumerism (pressure to have things, to look good etc), educational factors (pressure to succeed), values and beliefs (cynicism, individualism and so on)."
Ah, educational factors. It is hard to disengage from the demonstrable fact that the rise in teenage girls' misery has coincided with the rise of their academic success.
Dr Dee Dawson, medical director at Rhodes Farm clinic in London, a center for anorexic children, says: "I think girls in their mid-teens are coming under enormous pressure to achieve - the kind of pressure we've never known before.
"There was a time when, with two As and a B you could probably get into Oxford and read medicine. Now if you don't get three or four As, you're finished. It's the same with degrees: everyone in my day got a 2:2; the 2:1 was as rare as a first and a first was practically unknown. Now if you don't get a 2:1 you have failed.
"I see working like Trojans. They've either got sisters or brothers who have done very well and so they're expected to, or they've got an offer of three As and they know that if they don't get them they won't get into anywhere decent. And so they work all hours of the day and night."
There is one other contributing factor. "I only know about eating disorders," Dawson says, "but there are hundreds of thousands of children who are distressed about the way they look."
"We are becoming a nation of people who are completely over the top about health and fitness. When I was a child we would eat sponge pudding and custard every day. We didn't get fat because we were walking everywhere, we didn't have computer games. We ate food that they would say today is terribly unhealthy - but it was absolutely fine."
Dawson astutely points out that encouraging children to be competitive academically is all very well, but competitiveness seeps into all parts of life.
"The high achievers have always been competitive, but it used to be much easier. You could get the A and 2 Bs and be a size 12 or 10 and be regarded as 'perfect'. Now you have to have three or four As and be a size zero. And the gap between what you see in the papers - Kate Moss, Victoria Beckham, Mischa Barton - and what you are is constantly widening, so it's almost unachievable now. We're comparing ourselves with people who starve themselves to death."
Susie Orbach, author of the seminal Fat is a Feminist Issue and, more recently, of Bodies, a rousing polemic on the western obsession with physical perfection, says: "Things started to get worse for teenage girls about 15 years ago but have accelerated recently, particularly with regard to body issues - what we think of as 'normal' now in the way girls relate to their bodies would have been considered serious cause for concern 20 years ago.
"It's to do with the aspects of celebrity culture that are proffered to them - the post-Thatcherite notions of success and money as a fast track to happiness; the rapid growth of the beauty and style industries, which prey on teenage girls, the hypersexualisation of the culture - and the ambitions of their parents, who want their daughters to feel the world is their oyster."
Emma, 21, a sparky, bright-eyed woman who appears to have conquered her demons, first ran away from home when she was 15: "My parents looked like they were divorcing, I had guy issues and there was so much GCSE pressure as well. There was the feeling: if I muck this up then I'm screwed later on. It starts in year 7 with the Sat tests. There's a lot of pressure to perform academically and also to be popular. That involves image, hair, make-up, dress sense . . . plus your hormones are going crazy. You don't know how to cope.
"My mum didn't face the same level of pressure academically. She went to the local comp. And there was less divorce in her day - there wasn't that fear of 'Dad is going to walk out today'. I couldn't talk to her about my self-harm or my drug use.
"The number of guys I hooked up with became ridiculous. I would give hand jobs, blow jobs. I would get with anyone who was remotely interested and it didn't matter whether I liked him or not. It stemmed from insecurity: after parties we'd spend hours discussing who got with whom and it was nice to be part of the gossip. There was so much pressure to conform - but you wanted to stand out, to be noticeable."
"It doesn't help that we're all expected to go to university," says Isobel, who is 20 and a recovering anorexic. The expression in her dark eyes is unreadable, her shoulders are tiny, she weighs 5½ stone and evidently still feels it's too much for she seems to want to occupy as little space as possible. "Not everyone is meant to go to university. Not everyone is better off going to university. But we're all told we have to, otherwise there's no chance for our future."
Isobel has had anorexia "for about 10 years. I've had depression, too, the most severe bouts correlating with the most severe weight loss. I was asked a lot whether I was suicidal and I always said no, but then it occurred to me that just because I wasn't tying a noose around my neck or slitting my wrists doesn't mean I wasn't killing myself. I was just doing it the more passive way.
"I think pressures on my self-esteem were less to do with the media than with closer influences, like my family and myself. In year 10, the first year of GCSEs, I decided I wanted to do medicine, so there were self-imposed pressures - I needed to achieve a certain quality in my results to have even a chance. I'd have wanted to achieve highly anyway but now I had to achieve highly. I knew it was expected of me.
"There was a sense with some in my peer group that you need to do something extraordinary to stand out. They all expected me to do well. Once people label you as something that's it - you're stuck. And so I had to keep working to maintain the 'image' after that."
Scratch a teenage girl near you and countless similar stories come tumbling out. They are scared - of their parents splitting up, "failing" at school (where "failure" means insufficient A*s), not looking like the girls in the gossip magazines - even if the girls in question have drug habits, eating disorders, personal stylists and pretend, Photo-shopped lives.
They feel their achievements are belittled, what with talking heads everywhere banging on about how easy it is to excel academically nowadays and about how devalued exam results have become. Just compare this year's GCSE papers with those from the golden days of grammar schools. Implication: children are morons; everything's too easy.
As we can see, though, nothing is easy. Everything is much harder. There is more to cope with. And of course young girls are more hormonally confused than ever before: improved diets, sedentary lifestyles and, in some cases, the rise in childhood obesity mean young girls - children - are hitting puberty about two years earlier than they would have done 30 years ago, ie, between the ages of eight and 11 as opposed to 10 and 13. Some studies have found girls as young as seven beginning to show signs of physical maturity. They are starting to look like Barbies while still playing with dolls.
It's not just that something's got to give, it's that something's been giving over the past 10 years and nobody seems able to do much about it. The debate about celebrity culture and role models, for instance, isn't much of a debate any more: everyone has become slightly bored by it - everyone, that is, except for the young women it affects on a daily basis. The idea that going to some third-rate university might be a waste of time is never mooted: "uni" is seen by parents and by the government as the be-all and end-all. Why? Young adults have degrees coming out of their ears and it clearly isn't making them happy (or indeed employed).
My batch of over-achieving teenage girls includes many whose parents were high achievers themselves and who have therefore pushed their daughters in the same direction - but it was so easy then, back in the mists of time: nobody placed a disproportionate value on appearance, eating disorders were few and far between (I encountered one person with anorexia throughout the years of my rich and varied school career), self-harm was unheard of and - speaking subjectively - we worked because it was interesting, not because we had the sense that there was a gun to our head and the alternative was loser oblivion.
If you're a teenage girl reading this, take it from someone who never took academic achievement remotely seriously: the alternative is not loser oblivion. The alternative is exhaling, stopping living your parents' fantasies for them and having a nice life. These are all good things. Achievements, even.
The post-feminist generation has made a complete hash of bringing up children, especially girls. The assumptions we have are outdated and inapplicable in the 21st century; they are part of the past and have nothing to do with the future, let alone the present.
Our robust dismissal of the fact that 14-year-olds might find the pictures in magazines or the programs on television traumatic in some way has not filtered through to our daughters, who can't see the smoke and mirrors for the Hollywood smiles.
You can see how it happened: we may have watched our clever mothers excelling at house-wifery and observed how their good brains were wasted on Victoria sponges and pretty dresses. Encouraged by said mothers, we may have bucked the trend and assumed our daughters would follow our dazzling trail - but at what cost? Armies of super-clever girls with scars up their arms, eating disorders and feelings of utter worthlessness? Armies of not-so-clever girls, less privileged, without the qualifications but with the same scars?
Because it's hard to see in what way this constitutes a happier outcome than that represented by the stay-at-home mother, zonked on Valium, cocktail in hand, the 1950s model that women have been running screaming from for the past 60 years.
At least the zonked housewife was an adult and at least people finally twigged that she was crying out for help. Today our daughters are the most mentally ill people in the country. It's not what you'd call a result. "Work harder and eat less", as Felicity had it throughout her teenage years. The horrific thing is, there will be people reading this - mothers among them - thinking, "So what? It's not a bad motto."
Here's a better, less fashionable one to wish on your children: "Relax. Be happy."
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