Dr Sho Cares

The Mental Load Women Carry

Women's mental load

Many women are carrying an inordinate mental load for society. Whether women are single or in a relationship, have children or not, are working in the home or outside the home or both, women in 2023 are still carrying a disproportionate mental load for society. This is not to say that some men are not carrying a similarly heavy mental load, but they are much fewer in number. There is also the concept of the invisible mental load that women carry for society. This refers to the strategic thinking and logistical planning that women do in the home and professional environment that are taken for granted. These include; meal planning for the family, shopping and stocking of the home, arranging social events, keeping the home clean and organized, managing the family diary, amongst many others.

In the professional environment, we see women, even very senior women, taking on similar duties not often included in their job description, but it is often assumed that they are better skilled at some of these logistical details and it is left to them. As society has partially evolved, some women may now get more help with the doing but often get less help with the thinking. Much of society takes it for granted that because women can be more adept at finer logistical details and multi-tasking, they can handle more.

Women make up the most part of the so-called « sandwich generation » i.e. supporting both the older and younger generations at the same time. But, capability is not the same thing as capacity. As a result of this, many capable women live so close to the top end of their capacity, that it just takes one unexpected challenge to bring them to breaking point. Furthermore, the impact of hormonal variations that women experience throughout their lives such as the menstrual cycle and premenstrual tension, side effects of contraception, trying to conceive (especially if having assisted fertility), pregnancy, the post-partum period, and the peri/menopausal period can greatly heighten an already heavy mental load and vice-versa.

Why is this important?

It is important because of the physical and mental health effects of this on women. The biggest health risk from this is chronic stress which is a driver for a whole host of poorer care outcomes including anxiety, depression, suicidality, burnout, hypertension, obesity (which can lead to increased cardiovascular risk and diabetes), and certain cancers. Women also have less chance of maximising their full potential because of the weight of a heavy mental load leaving little time for self-discovery, self-care and self-actualisation.

What drives this mental load?

There are general issues such as the historic patriarchal society which prevailed and continues to be prevalent in many parts of the world. However, moving on from that in modern western societies has proved tricky as it has been replaced by a view that women can have it all; which is true, but the qualification is; usually not all at the same time. Here is where it has gotten really difficult to have honest conversations about women’s roles in a modern society. There are other forces at play; what I refer to as the ‘Weights’. The weight of history could be a personal story and/or a more general story of women’s rights, family and cultural expectations. There is also the weight of our perceived potential, as well as, the weight of comparisons with false equivalents.

Additionally, there is the weight that can be carried from the biological complications of being female such as premenstrual tension, pregnancy, infertility, miscarriage, and anxiety driven by the female biological clock, perimenopause and the postmenopausal period. Furthermore, there is the weight of internalized trauma from external factors to which women are more vulnerable such as abuse, gender-based discrimination, unexpected singlehood, over-sexualisation of younger women and the de-sexualisation of older women. These are deeply personal and highly emotive issues for many women which can make it difficult to broach. But we cannot continue to ignore the massive elephant in the room.

What can women do?

  •   Review your mental load and aim for a manageable amount: This is not always possible and there is often an intersection with various types of  privilege on how realistic it can be to modify your mental load. For example, being a single mother on a limited income is in my experience one of the hardest groups of women that can make significant modifications and hence are at highest risk of the physical and mental health impacts; this can also be heightened by other challenges such as being from an ethnic minority, reduced literacy and being from a lower socioeconomic group. This is part of a much larger conversation and deserves its own attention. However, for most women, there are general things to consider: workload in the home and/or professional environment, the invisible mental load (logistical and strategic thinking and planning for self, partners, work colleagues, dependants, etc), caring responsibilities for younger and/or older dependents. What are the priorities? What can be removed? What can be shared? What can be outsourced? Educate family, friends, work colleagues, managers and anyone who can provide support and understanding about the mental load women are carrying and the impact it has on health and productivity.  It is crucial to build a village of people to have support from and do life with. It might be helpful to have these conversations with a therapist or life coach.
  •   Assess your capacity and leave room for the unexpected: Honestly reflect on how much you can manage without being overstretched. Identify low hanging fruit that expend precious mental with low value yield such as notifications from emails, messages, news and social media apps; these can be quietened so that your interactions with these platforms are more intentional. Use Focus or “Do not disturb” modes on smartphones. Create clear boundaries with work/life balance, immediate & extended family relationships, and volunteer obligations. Learn healthy habits to recharge such as meditation, journaling, spending time in nature, adult colouring/painting, etc. Try to live at 80% of your capacity to leave space for unexpected challenges such as an infertility journey, an acute/chronic health issue, bereavement, divorce/separation, etc that can heighten the experience of an already heavy mental load. Remember, symptoms rarely exist in isolation. The biology of hormonal changes from puberty to the menopause can be affected by the weight of the mental load you are already carrying. It is a bio-psycho-social dynamic.
  •   Up your physical activity: Studies have shown that 30 to 45 mins of exercise 3 times a week gets your heart pumping and prevents heart disease. Keep in mind that heart disease is the leading cause of death worldwide, so this really is a boon for your current and future physical and mental wellbeing. It also reduces any negatively felt effects of hormonal variations on your mind and body , boosts your mood, and can help to achieve a healthy weight. Strength building exercises are also important for muscle, joint and bone health and flexibility exercises such as Pilates, Yoga and TaiChi can also help with this, as well as, calming down the mind and reducing stress. But remember, all movement counts. Many modern women are time poor, so if all you can do is try to sit less and walk more, thats a great start! Another tip is to build it into your lifestyle such as incorporating physical activity into social events with friends and family or as specially scheduled, and prioritised, me time”.
  •   Self care: This is important for stress management and can help to improve symptoms. Prioritise time for doing what you enjoy. This is protected me-time”. I advocate a block of three to four hours a week for this. It is time that should be free of work or caring responsibilities and can be for anything such as personal grooming, hobbies, spa time, nature walks, brunch with friends, attending the theatre, group sports, singing in a choir, watching a movie/TV series etc. For time-poor women, this is often left on the backburner, but it is so important. Utilise family and friend networks to achieve this.
  •   Quit smoking: This protects you from cancers, respiratory disease, and risk of heart disease and strokes in the future
  •   Try to eat a healthy diet and have a moderate caffeine & alcohol intake.

In conclusion, women are generally incredible, capable and resilient but so many are currently one step away from burnout because of this inordinate mental load that they are carrying.  We have our whole lives to achieve all our goals and we should plan our lives forward with a knowledge of the pros and cons of the decisions that we make rather than plunge in and then try to live life backwards. Therefore, we need to start having a better understanding of the physical and mental health risks to women of all ages by carrying an inordinate mental load for society. Many women are near breaking point and having to make impossible decisions on life choices because we are not having honest conversations about the roles of women in modern society. There is no one size fits all approach and there are probably more questions than answers, but we need to elevate this issue to its rightful place as a healthcare emergency that can potentially impact approximately 50% of the population.

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