Binge-Performing Disorder: Growing Up Perfect

binge performing disorderThere are many “vulnerable” groups that have come to our society’s attention–voicing demands for reform.  When these groups have a political and social “voice” they are granted the ears of legislators and have progressed to some extent.

However, a significant number of these at risk groups do not have a voice and consistently sink from our view until sudden, often bloody crises make headlines.

One of the most vulnerable of these groups is the adolescent population whose lack of viable political and social voice has led to severe problems that have not been addressed.

They do not organize and protest. They hide from scrutiny and mistrust authority and this behavior is expected during the teen years.

Teens lean heavily upon peers for support and typically shun parental, school or psychological intervention when they are troubled.

The suicide rate for adolescents in general is increasing. Families and others are shocked by cluster suicides and fatal acts that are performed by affluent, privileged teenagers. There has been a flurry of research that is not integrated and therefore, in terms of prevention and protection, is not as useful as it must be.

Affluent Teens

It’s important to examine the oppression of “affluent” teens who are growing up privileged, powerless and programmed to fail at life’s greatest challenges.

The factors that we identify are important in the domain of prevention and treatment before tragedy. There is a need for parents, schools, community and society to look at these factors as a comprehensive whole and apply them in the home, the school environment and to include them in screening and treatment scenarios.

We can go beyond the widely known indicators for suicide; depression, early childhood abuse, suicide in the family (or friend) abandonment, bullying and chemical addiction.

We must look at the lesser known factors; affluence, social connectedness, fear and anxiety, age range and loss of agency that, when considered together, are extremely relevant.

During adolescence there is a particularly sensitive period of time during which a teen who has emotional problems is more likely to think about and attempt suicide.

The age range from 13 or 14 to 16 is what we must focus upon. Research backs this fact up, demonstrating that younger teens are more likely to harm themselves than older teens.

In addition, girls rather than boys predominate in this scenario. Here we find a window of opportunity that may well be missed by all who interact with teens.  Parents must become more attentive and supportive in order for evaluation processes to be initiated and for treatment of depression and anxiety to commence.

Neglected Features

Fear and anxiety along with depression are significant and neglected features in suicidal behavior. Studies are now showing that there are two pathways in the brain that are activated by threats and that one of these produces very impulsive behavior when there is the perception that a threat is imminent.

This pathway is non conscious and a teen may be primed by prior experiences for this pathway to be activated. The identification of a teen with prior fear-based priming would be based upon his/her anxiety level.

Prime Candidates

Adolescents who are chronically anxious, who avoid new or challenging experiences, who  have compulsive ritualistic behavior to counter anxiety, who talk about being “nervous” or on edge or who use drugs for anxiety are prime candidates for therapy.

Anxiety is not to be “normalized” especially for our younger group of teens. When the youngster “senses” a threat situation which could be an exam or athletic competition coming up, the impulsive pathway may be activated.

Affluence is not a protective feature for many teens. Recent studies point to the devastating effects of adolescents feeling stressed and pressured to perform perfectly.

This feeling is intensified when the school and parents have values that prioritize top level achievements in academic and athletic domains. Within a community of materialistic successful families, the oppression may become unbearable for vulnerable teens who have internalized these values.

There may be no overt rebellion; only a disturbing and disabling feeling of fear and hopelessness.

A new report cites clinically significant depression or anxiety or delinquent behaviors at a rate two to three times the national average. Starting in seventh grade, the rich cohort includes just as many kids who display troubling levels of delinquency as the poor group.

The reality of constant and intense social connectedness is also an important factor. Information containing inflammatory and anxiety-provoking content spreads like a virus among peers and others.

A new study reports a higher degree of social connectedness along with a homogeneous culture in a community can increase teen suicide risks. On line discourses that become shaming or threatening experiences are provocative and incite impulsive behavior.

A teen may infer being unfavorably perceived because of underlying anxiety and depression. Many young adolescents do not have the cognitive capacity to carefully evaluate messages that appear quickly often accompanied by emoticons that add pain to the message.

These communications then spread through the peer group. They take these messages as factual and are often devastated without anyone with whom to share their misery.

It is relevant to address the issue of parent power and the common problem of fostering independence and mastery while protecting and guiding youngsters. The great debate about how much independence to grant a youngster goes on and voices on both sides may sound realistic.

Each teen should be seen as a unique individual although their behaviors are often very similar. When a parent experiences discomfort about their child’s behavior whether it is verbal or otherwise they should seek professional guidance.

In general, keeping a youngster within the supportive bosom of the family is always a positive move. Other “protective” factors when a teen is identified as being under pressure and is anxious or depressed are documented in the literature. However the emphasis is on early identification and timely treatment.

It is also vital to eliminate any shaming and blaming. Shame is a terribly toxic emotion that dehumanizes the individual, leading to loss of meaning in life and to desperate attempts to demonstrate worth or “agency.”

The voice of a young teen:

I remember just not being happy about anything, and I just couldn’t make it slow down. And I thought there would never be any escape.”

Binge-Performing Disorder: Growing Up Perfect

Margaret Altman, LCSW, MSW

Margaret Altman is a crisis intervention specialist and has intervened in many explosive situations within jails, emergency rooms, suicide prevention centers and psychiatric units. She is a featured writer on the Mad in America website and has more more than 35 years of experience as an LCSW in psychiatry, corrections and private practice. Her book, "Developing Your Child’s Emotional Intelligence" is on Amazon. Margaret currently focuses on issues of minority and marginalized populations in order to give them a voice in the mental health domain.


APA Reference
Altman, M. (2016). Binge-Performing Disorder: Growing Up Perfect. Psych Central. Retrieved on October 27, 2020, from


Scientifically Reviewed
Last updated: 13 Sep 2016
Last reviewed: By John M. Grohol, Psy.D. on 13 Sep 2016
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