Eldest Daughter Syndrome
Mira*, a 28 year old working in London, sits across from me, reading from a journal she often writes in before our counselling sessions. ‘Why am I always responsible for them? Nothing gets done if I don’t do it. My parents, my younger siblings, sometimes even colleagues, I feel like I have to take care of them all.’ Mira’s feelings aren’t uncommon. In fact, they are shared by millions of other women in an increasingly common phenomenon called ‘eldest daughter syndrome’.
Eldest daughter syndrome, while not a clinical diagnosis, has been a trending topic on social media and has resonated with women across the world. It refers to an experience where eldest daughters are tasked with duties far beyond their years, leading to parentification, hyper-independence, and anxiety. This widespread social media discourse reflects deeper cultural expectations, and the posts have amassed millions of views on TikTok and Instagram. They feature young women sharing feelings of responsibility for their family's emotional wellbeing, struggling with perfectionism, and grappling with anxiety.
The trend has particularly resonated with women from immigrant families. Many of the posts are tinged with humour – eldest daughters poking fun at their high achieving tendencies, their perfectionism when organising family events, and their inability to relax without feeling guilty. One of the most common jokes is how often eldest daughters end up in caring professions, often an extension of the caregiving role they have played in their families.
Cultural expectations
To understand eldest daughter syndrome, it is important to examine the cultural and familial factors at play. Eldest daughters often find themselves at the intersection of family expectations and their individual values. Cultural guilt, particularly for children of immigrants, can come with a feeling of debt for the many sacrifices made by the parents, and this can prevent daughters from forming a strong identity outside of their family roles. ‘Parents may rely on their older daughters for more than just physical help, seeking emotional support and guidance in unfamiliar situations, leaning on the older daughter and increasing responsibilities,’ says psychotherapist Gurchehn Singh MBACP.
Many eldest daughters find themselves in the role of a 'second mother' within their families, shouldering significant emotional and financial responsibilities for their younger siblings. This role often involves a range of duties, from mediating conflicts to preparing meals, and can persist well into adulthood. These expectations are typically rooted in gendered assumptions about caregiving, which disproportionately affect women in both Eastern and Western societies.1 For daughters of immigrant families, the intersection of familial duty, gender expectations, and cultural adaptation can exacerbate this challenge.
Media
Many movies and books show an idealised portrayal of selflessness in eldest daughters. Kate Sharma in Bridgerton, for example, puts all of her energy into finding a suitable match for her younger sister Edwina. Jane in 27 Dresses, Nani in Lilo & Stitch, Fiona in Shameless, also act as stand-in parents. These media portrayals highlight the deeply ingrained cultural expectations for eldest daughters, and can have an impact on social and political views.2 Women may internalise the narratives shown in the movie version of the older sister, potentially reinforcing the pressure to model certain behaviours, which applies to everything from marriage eligibility to career progression.
Using media examples in therapeutic work can be a helpful tool to provide a relatable way for clients to discuss their experiences, and can serve as a starting point for more personal discussions. They are also helpful in forming a more critical perspective; therapists can use these narrative arcs to explore personal dynamics and cultural influences.
Childhood
Research suggests that early childhood experiences impact women’s development more than men’s, and eldest girls mature significantly more quickly than boys, especially when their mothers experienced heightened stress during pregnancy. Participants in a study on women caregiving for their families in Korea described this role as ‘nothing but duties’, but also felt compassion for their families, sometimes even believing that they could compensate for their mother’s hardships by caring for them.3 This dynamic often leads eldest daughters to fear disappointing others, and can often manifest as a struggle to receive care and give up control in other relationships.
The challenge for many eldest daughters lies in balancing familial duties with personal aspirations. This is particularly complex for those with hyphenated identities, and for those whose educational or career goals differ from family expectations.
Mobeen Akhtar, an eldest daughter and an integrative psychotherapist, shares her experience: ‘For my siblings, I’d be down for any emergency contact, attending parenting meetings and arranging support. For parents, I’d be a sound board and a bridge between siblings and parents. Growing up, my relationship with my siblings hadn’t felt like a “typical” sibling relationship as there is a sense of “be careful what you say and how you behave around me”, rather it being a fun/playful sibling dynamic. However, going through therapy myself helped me understand family dynamics and generational behaviours that influenced relationship dynamics. As a result, I have found ways to reshape my relationship with siblings and parents.’
Therapeutic approaches
The parentified eldest daughter is taught to manage chaos. For daughters from immigrant families, this can involve practical support that extends to duties like filling out important forms, translating during medical appointments, and many other tasks that are not age appropriate.
In addition to helping with practical tasks, eldest daughters may feel a sense of emotional responsibility which leads to constant mood monitoring, a psychological habit that has been referred to as ‘empathy’s evil twin’.4 Mood monitoring for others involves checking body language, anticipating needs, getting ahead of the next ‘fire’. This can lead to overcorrecting by checking in with others and distracting when potential conflicts arise. Although this creates a constant state of overwhelm, many eldest daughters view this feeling as a personal responsibility. Family members may reinforce this with statements like, ‘we need you’, or ‘this family would fall apart without you’.
With this context in mind, one of the most important elements of working with eldest daughters is regulating the nervous system and emphasising emotional release without guilt. Intellectual playfulness, a form of analysis focused on curiosity and enjoyment, can also be a way to encourage reflection without stress or expectation. Many eldest daughters may not realise they are experiencing a sense of emotional loneliness. They may have a support network, but that does not necessarily mean they can discuss the specifics of being an eldest daughter or have supportive loved ones with lived experience.
When working with eldest daughters, a culturally sensitive approach is also crucial. For example, language around setting boundaries looks different in Asian cultures. Therapists must support identity development and individuation without going against the client’s core values - this may include exploring individual interests, reflecting on internalised beliefs, and discussing why self worth may feel tied to achievement and caregiving.
Research
The conversation around eldest daughter syndrome is more than just a trending topic – it's an opportunity for broader discussions about family dynamics, cultural expectations, and mental health. A 15-year longitudinal study conducted at UCLA shows that there may actually be scientific evidence to support ‘eldest daughter syndrome’.5 According to UCLA anthropologist Molly Fox, from an evolutionary perspective, early maturation can help first born daughters with childcare and supporting their mothers. Co-author Jennifer Hahn-Holbrook notes, ‘When times are tough and mothers are stressed...it's in the mother's adaptive best interest for her daughter to socially mature at a quicker pace’.
However, awareness of the impact of family dynamics is growing and younger parents are more conscious of mental health issues, particularly since the COVID 19 pandemic.6 Support is also more accessible through online communities like The Eldest Daughter Club, a social group started by Sherri Lu, who hosts online and in-person events in the US, and the unique challenges of eldest daughter syndrome are being discussed more than ever.
For therapists working with eldest daughters, this evolving landscape presents both challenges and opportunities. Eldest daughter syndrome intersects with various other aspects of identity, including race, class, and cultural background. The key is to help clients find a balance between cultural practices and individual needs.
While acknowledging the challenges, therapists can also help clients recognise how their caretaking experiences can be applied to their own care. With Mira*, the client who voiced her frustration with constant family responsibility, this was a key part of reframing her situation and using these skills to meet her own emotional needs. The goal isn't to dismantle family structures, but to create space for individual growth and wellbeing within them. By continuing to explore eldest daughter experiences, we can establish more nuanced, effective therapeutic approaches that benefit eldest daughters and families as a whole.
REFERENCES
Seedat S, Rondon M. Women's wellbeing and the burden of unpaid work. BMJ 2021;374: n1972.
Kubrak T. Impact of films: changes in young people's attitudes after watching a movie. Behavioral Science (Basel) 2020;10(5): 86.
Choi Y, Nam SI. Daughters rewarding mothers' piteous lives: eldest daughters caring for ageing mothers. Journal of Women & Aging 2024:314-327.
Torres-Mackie N. Empathy's evil twin: understand and manage the monitoring of emotions. [Online]. Psychology Today 2020, 6 January.
Fox MM et al. Mothers' prenatal distress accelerates adrenal pubertal development in daughters. Psychoneuroendocrinology 2024;160:106671.
BBC. Child mental health: parents have their say. [Online]. BBC Bitesize Parents’ Toolkit. bit.ly/3YnRfEk
Black SE, Grönqvist E, Öckert B. Born to lead? The effect of birth order on noncognitive abilities. The Review of Economics and Statistics 2018; 100(2): 274-286.
About the author
Ragini is a qualified counsellor who has lived and worked all over the world. After many years of conducting research in clinical and educational settings, she established her private practice, Cardamom Counselling, and hosts connection-focused, psychoeducational, and creative workshops for South Asians in London. You can find her at cardamom.community on Instagram or through her website cardamomcounselling.com.
