Note: Over-functioning, perfectionism, self-sacrifice, and difficulty asking for help certainly aren't unique to women. But they can take on particular dimensions for women because they develop within a broader social context of gendered expectations around caregiving, emotional labour, appearance, relationships, and responsibility.
Many women come to therapy because they are stressed.
They feel overwhelmed, anxious, exhausted, irritable, or like there is simply never enough time. They may have difficulty relaxing even when they technically have an opportunity to rest. Their minds continue running through everything that needs to be done, everyone they need to respond to, and all the ways they might be falling behind.
Often, the initial question is:
How can I manage my stress better?
But sometimes there is another question worth asking:
Why am I carrying so much in the first place?
Because women's stress does not occur in a vacuum.
Women's stress exists within a larger social context
It is important not to turn every experience of stress into an individual psychological problem.
Women continue to navigate expectations around work, caregiving, relationships, appearance, parenting, household responsibilities, and emotional labour. Even as gender roles have changed considerably, many women have entered traditionally male spheres of work and achievement without necessarily being relieved of expectations traditionally placed upon women.
Research supports some of this imbalance. Reviews of unpaid labour have found persistent gender differences in the amount and type of unpaid work performed by women, with this unequal burden associated with poorer mental health among women. Research on what is sometimes called mental labour—the invisible work of remembering, anticipating, planning, organizing, and monitoring what needs to happen within a household—similarly suggests that women often carry a disproportionate share of this cognitive load.
The result can be a life containing an enormous amount of visible and invisible responsibility.
And then there is the emotional responsibility.
Remembering the birthday. Checking in on the struggling friend. Noticing that someone seems upset. Making sure everyone is comfortable. Anticipating what the family will need next week. Managing conflict. Maintaining relationships. Remembering appointments. Thinking about groceries while answering an email while wondering whether you have called your mother recently enough.
None of these things necessarily feels enormous on its own.
Together, they can become exhausting.
When stress feels invisible
There is another aspect of women's stress that I find particularly important: the experience of not feeling understood in it.
In the American Psychological Association's 2023 Stress in America survey, women reported higher average stress than men. Women were also more likely to strongly agree that no one understood how stressed they were and less likely to report being able to recover quickly from stress. Women were also somewhat more likely to say they could have used more emotional support than they received.
There is something particularly painful about that combination.
It isn't simply:
I have too much to do.
It can become:
I have too much to do, and nobody seems to understand how much I am carrying.
For some women, this is compounded by the fact that they are often the person other people turn to for support.
They may be highly capable. Dependable. Thoughtful. Emotionally perceptive. The person who gets things done.
And those can be wonderful qualities.
But sometimes being the person who can handle everything slowly becomes being the person who is expected to handle everything.
When being helpful becomes over-functioning
In therapy, I am often interested not only in what someone does, but in what a behaviour has come to mean.
Why is it so difficult to say no?
Why does asking someone else for help create guilt?
Why does resting feel uncomfortable when there is still something that could be accomplished?
Why does disappointing another person feel almost intolerable?
Why does taking care of yourself sometimes feel selfish while taking care of someone else feels unquestionably worthwhile?
For some women, over-functioning developed as an adaptation long before adulthood.
Perhaps being helpful earned approval.
Perhaps being low-maintenance kept the peace.
Perhaps you learned to pay close attention to other people's emotions because the emotional climate around you was unpredictable.
Perhaps achievement became a source of self-worth.
Perhaps you became the responsible child, the mediator, the helper, or the person who didn't create additional problems for an already overwhelmed family.
And sometimes these patterns are reinforced by broader messages about what it means to be a "good" woman: nurturing, accommodating, attractive, productive, emotionally available, relationally attentive, and somehow capable of doing all of this without appearing overwhelmed by it.
Eventually, over-functioning can stop feeling like something you do.
It starts feeling like who you are.
The problem isn't always poor stress management
When someone is overwhelmed, there is certainly value in learning ways to regulate the nervous system and cope with stress.
Sleep matters. Movement matters. Rest matters. Breathing exercises can help. Mindfulness can help. Therapy can help.
But sometimes our focus on stress management accidentally sends another message:
Here are some additional things you should be doing well.
Now, alongside everything else, you need to meditate every morning, exercise regularly, journal, meal prep, maintain perfect sleep hygiene, practice gratitude, take supplements, nurture your friendships, drink enough water, and somehow find time for a relaxing bath.
Self-care itself can become another performance standard.
Sometimes the therapeutic question needs to move beyond:
How do I become better at tolerating everything on my plate?
and toward:
Does everything currently on my plate actually need to be there?
Learning to recognize your own limits
There is an idea I return to frequently in therapy: human beings have limits.
This sounds obvious.
Emotionally, however, accepting it can be surprisingly difficult.
People struggling with perfectionism or what Schema Therapy calls unrelenting standards may live according to an implicit assumption that if they were organized enough, disciplined enough, emotionally healthy enough, or efficient enough, they could eventually manage everything.
But there will always be more that you could do.
You could:
- work harder.
- be a more attentive friend.
- keep your home cleaner.
- exercise more.
- spend more time with your family.
- answer messages sooner.
- cook healthier meals.
- read more books, develop more hobbies, become more successful, look better, and somehow also be more relaxed...etc
At some point, healing involves grieving the fantasy of infinite capacity—one of the many forms grief work can take in therapy.
We cannot become gods.
We do not have infinite time, energy, money, attention, or emotional resources.
Something has to matter more, and something has to matter less.
And accepting that reality can be surprisingly liberating.
Self-attunement as a practice
This is why I think self-attunement can be more useful than simply talking about self-care.
Self-attunement means developing the habit of noticing yourself.
Not just when you're already at your breaking point.
Regularly.
It means asking:
- What am I feeling right now?
- What does my body seem to be telling me?
- What do I need?
- How much capacity do I actually have today?
- Do I genuinely want to do this, or am I afraid of what will happen if I don't?
- Am I helping because I want to, or because I feel responsible for another person's feelings?
- What would I choose if guilt weren't making the decision for me?
- Is there something I need to ask for?
For someone accustomed to orienting toward everyone else, these can be surprisingly difficult questions.
You may not immediately know the answers.
That's part of the practice.
Self-attunement is learning to turn some of the sensitivity you use to monitor the external world back toward yourself.
Learning to ask for (and receive) help
There is another side to over-functioning that receives less attention.
We often talk about learning to say no.
But sometimes the more vulnerable skill is learning to receive.
To ask your partner to handle something.
To tell a friend you're struggling instead of waiting for them to notice.
To delegate something and tolerate the fact that someone else may do it differently.
To allow another person to comfort you without immediately reassuring them that you're okay.
To accept generosity without needing to repay it immediately.
To say, simply:
I can't do all of this myself.
For someone whose identity has been built around competence, independence, or caretaking, receiving support can initially feel uncomfortable.
It requires acknowledging need.
And many women have become very skilled at having needs without allowing those needs to inconvenience anyone else.
Sometimes someone else will be disappointed
There is also an uncomfortable reality to boundaries that isn't always acknowledged.
Setting healthier limits does not guarantee that everyone around you will enthusiastically support them.
Someone may be disappointed when you say no.
Someone may wish you were more available.
Someone may dislike having to do something you previously did for them.
Someone may interpret your boundary as selfish.
Sometimes that means the boundary needs reconsideration.
And sometimes it means another person's disappointment is the emotional cost of no longer abandoning yourself.
Part of therapy can involve learning to distinguish between having genuinely harmed someone and simply having failed to meet their preference or expectation.
Those are not the same thing.
The answer to women's stress cannot only be individual resilience
There is something else we lose when stress becomes entirely an individual problem.
We lose the importance of community.
Human beings were never designed to meet every emotional, practical, relational, and caregiving need independently.
And yet our culture can idealize an extraordinary degree of self-sufficiency.
When someone becomes overwhelmed, the solution is often framed as becoming more resilient, organized, regulated, or efficient.
But sometimes what a person needs isn't another coping skill.
They need someone to help carry the groceries.
They need someone to watch the children.
They need a friend who asks how they are doing and actually wants the answer.
They need people with whom they do not have to perform competence.
They need relationships in which care moves in both directions.
For many women, relationships with other women can be particularly important here. There can be something deeply relieving about being understood by people who recognize some of these pressures from the inside.
Community doesn't eliminate structural inequality, relationship problems, financial pressure, caregiving demands, or stress.
But it can challenge the belief that we are supposed to carry all of those things alone.
Therapy for stress can involve changing more than your coping skills
Therapy can absolutely help you develop better ways of responding to stress.
But sometimes therapy also asks something more challenging.
It asks you to examine the life producing the stress.
It asks where responsibility has quietly become over-responsibility.
Where kindness has become self-sacrifice.
Where competence has become over-functioning.
Where high standards have become impossible standards.
Where independence has become difficulty receiving.
And where caring about other people has gradually required disconnecting from yourself.
The goal isn't to stop being generous, ambitious, capable, nurturing, or deeply invested in the people you love.
It is to make room for another person inside that circle of care:
you.
Maybe the question isn't only:
How can I cope with everything better?
Maybe it is also:
What can I put down?
What do I need?
Who can I ask to help me carry this?
And perhaps most importantly:
What would change if I believed my own needs were worthy of my attention, too?
____________________________________
Rebecca Steele | Smart Therapy®
Registered Social Worker, Psychotherapist (MA, MSW, RSW, CCC)
Rebecca Steele is a psychotherapist in Ontario who supports adults experiencing anxiety, obsessive-compulsive disorder (OCD), relationship patterns, self-worth, emotional neglect, and high sensitivity (HSP traits). Her work integrates depth psychology, emotion-focused and psychodynamic approaches with evidence-informed treatment to help clients better understand themselves and create lasting change. She may also incorporate the Enneagram as a tool for self-understanding and personal growth.
Looking for Additional Support?
If you're located in Ontario and are looking for support with mental health concerns, therapy may be the best fit. Book a therapy appointment here.
If you're outside Ontario, or are primarily seeking support for personal growth, self-understanding, life transitions, or creating meaningful change rather than treatment for a mental health condition, coaching may be a better fit.
