The hidden price of privilege: upper-middle-class kids are increasingly facing some serious problems. Expert Madeline Levine tells why.

They may be rich, but they are really unhappy. Surprising new studies show that privileged adolescents are more likely than any other socioeconomic group to suffer from depression, anxiety disorders, and substance abuse. What's going on? We sat down with Madeline Levine, a Marin County, California, clinical psychologist of 25 years, and author of the new book The Price of Privilege (HarperCollins), to talk about what it means to teach kids and teens in some of the priciest school districts and private schools in the country.

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These kids have so many advantages. What's wrong?

It's true that on the surface, many upper-middle-class children seem to have everything--the newest toys and technologies, devoted, involved parents, and money for all the extras, like tutors, music lessons, and summer camp. And in the classroom, these are the kids that sound polished. They often get good grades and are the soccer captains or class presidents.

Yet, behind the facade, you'll often find children who are deeply troubled. Teachers know this. The students I see complain bitterly of being too pressured, misunderstood, anxious, angry, sad, or empty. They describe themselves as "being at loose ends" or "missing something inside." One young patient of mine used a razor to cut the word "empty" into her arm.

With so many truly at-risk children, why focus here?

A suffering kid is a suffering kid. We can't ignore troubled kids in the middle class because there are troubled kids in poverty. They're all tragedies. Preteens and teens from affluent, well-educated families experience among the highest rates of depression, substance abuse, somatic complaints, and unhappiness of any group of children in this country. Past the age of 11 or 12, increases in material wealth do not translate into advantages in emotional health; on the contrary, they can translate into significant disadvantages. When you have three times the rate of depression, a 200 percent increase in anxiety disorders, substantially higher levels of substance abuse, you're not talking about kids being spoiled. You are talking about kids who are impaired.

You often use the word "empty." Why do these children have so little sense of self?

The adolescents I see--and I hear similar reports from others in the field--don't seem to know themselves very well. They lack practical skills for navigating out the world; they can be easily frustrated or impulsive and have trouble anticipating the consequences of their actions. Parental pressure to achieve and the culture of affluence have left many young people with little time to develop their own internal compasses.

Have upper-middle-class parents lost their way?

Some parents--certainly not all--have come to approach raising kids almost as a business endeavor, rather than an endeavor of the heart. In trying to build a successful, irreproachable family, they pour time, attention and money into insuring their kids' performance, consistently making it to the soccer game while inconsistently making it to the dinner table. Meanwhile, research shows that families who eat together five or more times a week have kids who are significantly less likely to use tobacco, alcohol, or marijuana.

Is it all about creating their idea of the "successful" child?

You have parents who implant in their kids from a very early age: "This is who you are going to be. You are going to be successful. I don't expect anything less than straight As." I see parents who are over-involved in arranging their children's lives and under-involved in the notion of acquired listening--being emotionally available with no agenda.

Why is over-involvement so harmful to kids?

I'm sure teachers will recognize this. Parents who persistently fall on the side of intervening for their child--as opposed to supporting their child's attempts to problem-solve--interfere with the most important task of childhood and adolescence: the development of a sense of self. One of the examples in my book is a mother staying up all night rewriting an assignment for her child. The parent is trying to help--trying to save her child a night's sleep--and ends up interfering with the learning and emotional growth of her child. But this is common today.

How do we know when we are doing too much for kids?

It is easier to know what to do when children are younger. We can see how always tying shoelaces for a child would be impairing his autonomy. A 10-year-old needs to tie his own shoes. But when do we start allowing children to begin to find solutions to their own problems, to fix their own mistakes? To be honest, it's hard. The stakes are raised when children are older.

What happens when we never let kids take the lead?

Intrusion and over-involvement prevent the development of the kinds of skills that children need to be successful: the willingness to engage in trial-and-error, as well as the ability to be a self-starter, to delay gratification, to tolerate frustration, to show control, to learn from mistakes, to be flexible, and to be a creative thinker.

If we know better, why do we intrude so much?

We're busy and tired. And we're really anxious. The 20th century was supposed to be the century of the child. I think it turned out to be the century of anxiety about the child. We hover over our kids as if they're at tremendous risk.

What about the importance of down time?

There is so much anxiety that there is no room for kids to develop what I'm calling the authentic self. They need some time for just hanging out, thinking about nothing--or thinking about the world, what they want to do, or who they want to be. Many of my patients have no time for that because they are so scheduled.

Yet, you say affluent children often feel isolated from their families--how so?

Affluent teens are less likely to feel close to their parents than children in lower socioeconomic groups. Controlling and over-involved parents typically leave kids feeling angry or alienated, neither of which is conducive to emotional closeness. These are super-busy, successful parents. When social and professional demands are highly time consuming, there is often a lack of "family time." In the safety of my office, kids always say they want more time, not less time, with their parents.

Why don't affluent parents set reasonable limits?

Discipline often takes a backseat. Busy parents already feel guilty about the little time they have to spend with their children. Few of them want to "waste time" in conflict and as a result are happy to sidestep discipline issues. The unfortunate result is that children do not learn how to take responsibility, control impulses, or be thoughtful.

How can teachers deal with "helicopter parents"?

I think every parent is really trying to do the best for their child. And the challenge is when parents are so anxious and obnoxious that it makes you angry. Meet these parents with compassion and talk to them in a quiet way. It's tough when teachers are asked to be therapists along with everything else that they do. Your response should be something like: "It seems like you're really, really worried," and leave it at that.

How can we help excite disaffected kids about learning?

I'd love to see less grading. In the best possible world, kids would write and do projects and discuss their work as a class. Grades teach kids to be performers. If you are going to grade anything, grade effort and improvement.

How can schools help honor individual kids?

Sit in a circle and have children bring in something that is meaningful to them--a frog, a dress they made--and share it with the class. Ask children: "Tell me something about yourself that means something to you." It's a cool exercise for the kids, because it is respectful of who they are and allows everyone to be unique.