Are You an Eldest Daughter and a Caregiver

Warning Signs and Helpful Tips

The “eldest daughter syndrome” is a term that refers to a phenomenon wherein the oldest daughter of a family exhibits certain behavioral traits that are commonly associated with being bossy, perfectionistic, overachieving, people-pleasing, extremely responsible, and super family-focused. This phenomenon has been noted by family members and friends of the eldest daughters. If you are the eldest daughter and have been accused of displaying these characteristics, you may be experiencing “eldest daughter syndrome”.

Let me be perfectly clear, that this pop-psychology term is not yet an official diagnosis in the DSM-V. However, various scientific research has uncovered some strong evidence that could possibly lead to “EDS” becoming an official diagnosis. An official diagnosis could provide language for those women who are struggling with the negative results of the associated behaviors like difficulty setting and maintaining appropriate boundaries.

However, these traits can also be viewed as strengths that have helped you become the leader and role model that you are today. Embrace these qualities, continue to strive for excellence, and inspire others to do the same.

What is “eldest daughter syndrome”?

Kati Morton, licensed marriage and family therapist (LMFT) featured in a New York Times article, defined eldest daughter syndrome as “the unique pressures and responsibilities placed onto the oldest daughter in the family.” In a recent interview on NBC’s Today Show, she listed eight signs to look for.

1. You have an intense feeling of responsibility
2. You are an overachiever, Type A, and very driven
3. You worry a lot and probably have anxiety
4. You struggle with people-pleasing behaviors
5. You have a hard time placing and upholding boundaries
6. You resent your siblings and family
7. You struggle with feelings of guilt
8. You have a difficult time in your adult relationships

What’s all the buzz about?

Sanam Hafeez, PsyD, a New York City-based neuropsychologist and director of Comprehensive Consultation Psychological Services (CCPS) explained to Melissa Willets of Parents Magazine, “Many eldest daughters find themselves looking after younger siblings, helping with chores, and even taking care of sick family members from a young age.”

It’s not a new term. “The syndrome is a widely recognized phenomenon, especially among eldest daughters who often find themselves grappling with the impact it has on their identity and relationships within the family,” Dr. Hafeez adds.

‘Eldest Daughter Syndrome’ Warning Signs

Back to the question of whether “eldest daughter syndrome” carries too big a burden, Dr. Hafeez notes some girls in this position may develop “feelings of being overwhelmed, constantly responsible for others, and struggling to advocate for their own needs.”

Warning signs to look out for that the burden is too much for the eldest daughter include:

• Lack of personal timedue to family responsibilities
• Sacrificing personal development, such as education or social opportunities
• Struggling to set boundaries
• Reluctance to express needs

Nonrefundable ticket to caregiver university

There are familial and societal presumptions that the eldest child, especially eldest daughters, will be nurturers and exemplars. In the November 14, 2023 issue of The Atlantic magazine newsletter, Sarah Sloat discusses the social phenomenon with Yang Hu, a professor of global sociology at Lancaster University, in England. They conclude the presumptions are predominantly familial within certain societal frameworks.

A correlation between the “eldest daughter syndrome” and providing care for aging parents

[INSIGHT] I don’t know about anyone else but, it’s apparent to me that the transition from looking after siblings to caring for aging parents is tiny. Reading the research about adrenal puberty, the effects of maternal hormones on a fetus, and birth order on firstborn females feels a bit like an unavoidable, nonrefundable ticket to caregiver university.

Caregiver Statistics From Family Caregiver Alliance

A caregiver—sometimes called an informal caregiver—is an unpaid individual (for example, a spouse, partner, family member, friend, or neighbor) involved in assisting others with activities of daily living and/or medical tasks.

How Many Caregivers in the U.S.?

• Approximately 43.5 million caregivers have provided unpaid care to an adult or child in the last 12 months. [National Alliance for Caregiving and AARP. (2015). Caregiving in the U.S.]
• About 34.2 million Americans have provided unpaid care to an adult age 50 or older in the last 12 months. [National Alliance for Caregiving and AARP. (2015). Caregiving in the U.S.]
• The majority of caregivers (82%) care for one other adult, while 15% care for 2 adults, and 3% for 3 or more adults. [National Alliance for Caregiving and AARP. (2015). Caregiving in the U.S.]
• Approximately 39.8 million caregivers provide care to adults (aged 18+) with a disability or illness or 16.6% of Americans. [Coughlin, J. (2010). Estimating the Impact of Caregiving and Employment on Well-Being: Outcomes & Insights in Health Management.]
• About 15.7 million adult family caregivers care for someone who has Alzheimer’s disease or other dementia. [Alzheimer’s Association. (2015). 2015 Alzheimer’s Disease Facts and Figures.]

Economic Value

• The value of services provided by informal caregivers has steadily increased over the last decade, with an estimated economic value of $470 billion in 2013, up from $450 billion in 2009 and $375 billion in 2007. [AARP Public Policy Institute. (2015). Valuing the Invaluable: 2015 Update.]
• At $470 billion in 2013, the value of unpaid caregiving exceeded the value of paid home care and total Medicaid spending in the same year and nearly matched the value of the sales of the world’s largest company, Wal-Mart ($477 billion). [AARP Public Policy Institute. (2015). Valuing the Invaluable: 2015 Update.]
• The economic value of the care provided by unpaid caregivers of those with Alzheimer’s disease or other dementias was $217.7 billion in 2014. [Alzheimer’s Association. (2015). 2015 Alzheimer’s Disease Facts and Figures.]

Gender

• 65% of care recipients are female, with an average age of 69.4. The younger the care recipient, the more likely the recipient is to be male. 45% of recipients aged 18-45 are male, while 33% of recipients aged 50 or higher are male. [National Alliance for Caregiving and AARP. (2015). Caregiving in the U.S.]
• Upwards of 75% of all caregivers are female and may spend as much as 50% more time providing care than males. [Institute on Aging. (2016). Read How IOA Views Aging in America.]
• Male caregivers are less likely to provide personal care, but 24% helped a loved one get dressed compared to 28% of female caregivers. 16% of male caregivers help with bathing versus 30% of females. 40% of male caregivers use paid assistance for a loved one’s care. About 14.5 million caregivers are males out of the 43.4% who care for an older family member. [National Alliance for Caregiving and AARP. (2009). Caregiving in the U.S.]

Find Yourself In The Statistics Above?

^[INSIGHT] The character traits used to describe “eldest daughter syndrome” sound very negative and demeaning. Even referring to the behavior pattern as a syndrome gives it a negative connotation. Providing care for people other than yourself, your children, and a spouse is often a very draining and overwhelming experience. My point of reference is a focus on providing care for one or both aging parents.

Caring for one’s family of creation is difficult enough but adding aging parents to the mix increases the level of emotional complexity. The takeaway from acknowledging the “warning signs” as true and real issues, allows eldest daughters an opportunity to take a breath and allow themselves to seek help.

1. ^[TIP]Frame your “traits” in a positive way (leader, advocate, dependable)
2. ^[TIP]Be willing to talk about your feelings of overwhelm, guilt, resentment
3. ^[TIP]Seek professional help if your “traits” are causing problems
4. ^[TIP]Join a support group of other eldest daughter caregivers
5. ^[TIP]Exercise…going for a walk outside is helpful
6. ^[TIP]Self-care through a healthy diet, sufficient sleep
7. ^[TIP]Meditate
8. ^[TIP]Journal

What’s My Point?

I am curious about the number of eldest daughters among the 32.6+ million female caregivers (calculated from the statistics above) and how the societal and familial presumptions, coupled with the negative stereotypes of eldest daughters, have created an environment in which the eldest daughter feels obligated to take on the role of caregiver. I also wonder how discussing the symptoms, insights, and effects of the “eldest daughter syndrome” could help improve family dynamics overall and the lives of eldest daughters specifically those who are caregivers.

If you are a caregiver or eldest daughter, please contact me to share your experiences on these topics.

Dr. Judy Butler