Stress in Women: Why Your Body Is Keeping Score and What to Actually Do About It
April is Stress Awareness Month. Your first reaction is probably something like: No kidding. What month, what week, what day am I not aware of stress? Exactly. Because for most of the women I work with at SHEchiatry, a women's psychiatry and therapy practice in Nashville, chronic stress is not a buzzword. It is just Tuesday.
But here is what most stress content, even the good kind, fails to address: not all stress is the same, and the difference matters enormously for your mental health, your physical health, and your quality of life. In this article, I will walk you through what chronic stress does to the female body, explain the critical distinction between good stress and harmful stress, and share two concrete strategies that have genuinely moved the needle for my patients and for me personally.
What Is Chronic Stress? Why Are Women So Vulnerable to It?
Stress, at its most basic, is the body's response to any demand placed upon it. A small amount of stress is not only normal, but also necessary. But chronic stress, the kind that does not turn off, the kind that runs as a low-grade hum beneath everything you do, is a different animal entirely.
Women are disproportionately impacted by chronic stress. We work full-time jobs, manage households, carry the emotional labor of our relationships, raise children, care for aging parents, volunteer, lead, and somehow also try to keep ourselves together. We take on these responsibilities often without being asked, without being compensated, and without recognizing that we have taken them on at all.
The result? Headaches that will not quit. Stomach issues your gastroenterologist cannot fully explain. Cognitive fog so thick you lose your train of thought mid-sentence. An inability to sleep even when you are exhausted, because your brain simply will not stop. Daily anxiety that feels like background noise you’ve stopped noticing.
If any of this sounds familiar, you are not alone, and you are not bad at handling stress. Your nervous system is doing exactly what it was designed to do. The problem is that it was never designed to do it all the time.
What Chronic Stress Actually Does to the Female Body
This is the part most people, even those who consider themselves health-conscious, tend to underestimate.
When the body perceives stress, it releases cortisol, the body's primary stress hormone. In short bursts, cortisol is your friend. It sharpens focus, mobilizes energy, and helps you respond to a real or perceived threat. But when cortisol stays elevated day after day, the picture changes dramatically.
Chronically elevated cortisol:
Drives systemic inflammation throughout the body
Disrupts sleep architecture, preventing restorative deep sleep
Impairs immune function, making you more susceptible to illness
Disrupts hormonal balance, which is critical for women navigating perimenopause, PMDD, or postpartum changes
Negatively impacts gut health through the gut-brain axis
Contributes to mood disorders, including anxiety and depression
Put simply: a body under chronic stress is a body living in a state of low-grade emergency. And a body in that state, over time, becomes a body primed for disease.
This is why at SHEchiatry, we take a whole-person, functional psychiatry approach to women's mental health. The mind and body are not separate systems. Treating anxiety or depression without addressing the chronic stress that fuels it is like mopping the floor while the sink is still overflowing.
Eustress vs. Distress: Not All Stress Is the Enemy
Here is something I want you to sit with, because it genuinely changes the conversation: eliminating all stress is not the goal, and it’s not possible anyway.
There are two fundamentally different categories of stress:
Eustress (Good Stress)
Eustress -pronounced YOU-stress- is short-term, positive stress that motivates, energizes, and improves performance. It is the pressure that sharpens your focus before a big presentation. The productive anxiety of a deadline that gets you to the finish line. The exhilaration of a physical challenge or a creative stretch.
According to research, eustress is associated with improved cognitive function, increased engagement, and a sense of accomplishment. It is the kind of stress that, once it resolves, leaves you feeling capable and satisfied rather than depleted.
I will be honest with you: I wrote every single paper in college and graduate school the night before it was due. I needed that pressure. That was eustress; it worked for me. And I do not think I’m alone.
Distress (Harmful Stress)
Distress is the chronic, overwhelming, relentless kind. It’s what we’re trying to address. Unlike eustress, distress does not resolve after the task is done. It lingers. It compounds. It rewires the nervous system over time in ways that create lasting physiological and psychological harm.
The key difference is not just the intensity of the stress, but also the duration and the lack of a sense of control. Distress is chronic. It feels inescapable. And it rarely comes from one dramatic source. More often, it comes from the accumulation of a multitude of small obligations we've taken on. Slowly, invisibly, without ever consciously signing up for them.
Two Things You Can Do Right Now
As a psychiatric provider, I always advocate for professional support when chronic stress is affecting your mental health and quality of life. If you’re in the Nashville area and ready to talk to someone who understands the full picture of women's mental health - including how stress, hormones, sleep, nutrition, and mood interact - I would love for you to connect with us at SHEchiatry.
But there are two things you can do right now that genuinely make a difference.
Tip #1: Stop Giving Yourself Jobs
My husband and I were having a conversation… Honestly, it might have been an argument, and I said something like, “You don’t even know how to order your own hair gel.” And he said to me, “Do not get mad at me for a job you gave yourself.”
I stopped. Because he was completely right. I had taken that on. Nobody asked me to. He is an adult who can manage his personal care products. I took ownership of it, as I do with a thousand other things, because that is what women do. We see the gap, and we fill it, often before anyone has registered that a gap exists.
The first step in reducing chronic stress is recognizing how many of the stressors in your life are jobs you assigned to yourself. Some of them are genuinely yours to carry. Many are not. Putting down what you did not have to pick up is not laziness; it is wisdom. Dani Williamson, MSN, FNP, wrote a fantastic book called Wild & Well: Dani’s Six Commonsense Steps to Radical Healing. She has a chapter called De-Stress Well, and she quotes “You can’t pour from an empty vessel”. She’s correct!
Ask yourself: What is on my plate right now that I never actually agreed to take on? What could I let go of, delegate, or simply not do without meaningful consequence? Start there.
Tip #2: Understand the Difference Between Self-Care and Self-Maintenance
I was recently talking with a patient who told me she was taking good care of herself. When I asked what she was doing for self-care, she said she was getting her hair cut.
I love her, and I gently had to tell her that that is not self-care. That is self-maintenance.
If a man goes to the barber, no one calls it self-care. Getting your hair cut, making your medical appointments, keeping up with your skincare routine — these are acts of basic maintenance. They matter. But they are not the same as intentional self-care, which is something fundamentally different.
True self-care is dedicated, exclusive time to genuinely unplug and recover. You’re meant to be still, to laugh, to play, to disengage from responsibility long enough for your nervous system to actually regulate.
It looks different for everyone. For some women, it’s a long walk alone or 45 minutes reading a novel in a coffee shop. For others, it’s dancing badly in the kitchen to a playlist that has nothing to do with anyone else's needs.
The keyword is scheduled. Self-care that is not on the calendar is self-care that does not happen. Put yourself on your own to-do list, not as an afterthought, but as a non-negotiable commitment.
When Stress Is More Than You Can Manage Alone
There is a point at which chronic stress crosses a threshold that lifestyle adjustments cannot fully address. When it has dysregulated your nervous system, disrupted your hormones, compounded into clinical anxiety or depression, or simply gone on so long that your body has forgotten what baseline feels like.
That is not a failure. That is a medical reality. And it deserves medical support.
At SHEchiatry, I offer integrated psychiatric care exclusively for women, combining therapy, nutritional psychiatry, and when necessary, medication management in one relationship, with one provider, without the fragmentation that leaves so many women feeling unseen. We also offer TMS therapy through our sister practice Transcend TMS, a non-medication, FDA-cleared option for treatment-resistant depression and anxiety.
If you’re a woman in Nashville, Brentwood, Franklin, Murfreesboro, or surrounding Middle Tennessee and stress has been quietly running your life, I would love to have a conversation.
You do not have to be in crisis to deserve support. You just have to be done settling for a life where chronic stress is the norm.
Frequently Asked Questions About Stress in Women
What are the most common symptoms of chronic stress in women?
Common symptoms include persistent headaches, digestive issues, brain fog, difficulty concentrating, insomnia, chronic anxiety, irritability, and low mood. Many women also experience worsening PMS or PMDD symptoms, as stress hormones directly interact with the reproductive hormonal cycle.
What is the difference between eustress and distress?
Eustress is short-term, positive stress that motivates and energizes - like a performance deadline or a physical challenge. Distress is chronic, overwhelming stress that causes physiological harm over time, including elevated cortisol, systemic inflammation, and increased risk of mood disorders and disease.
How does chronic stress affect hormones in women?
Chronically elevated cortisol can interfere with the production and regulation of estrogen and progesterone, worsen symptoms of perimenopause and PMDD, disrupt the HPA (hypothalamic-pituitary-adrenal) axis, and negatively affect thyroid function - all of which compound the mental and physical toll of chronic stress.
What is the difference between self-care and self-maintenance?
Self-maintenance refers to routine upkeep - haircuts, medical appointments, skincare. Self-care is intentional, restorative time set aside exclusively to recover and recharge. Self-care can include being still, playing, laughing, disconnecting from responsibility. Both matter, but only true self-care meaningfully reduces the physiological impact of chronic stress.
Is SHEchiatry accepting new patients in Nashville?
Yes. SHEchiatry is a women's psychiatry and therapy practice in Nashville, Tennessee, serving women in Nashville, Brentwood, Franklin, Murfreesboro, and surrounding Middle Tennessee communities. We offer integrated psychiatric care, nutritional psychiatry, therapy and medication management with one provider. Plus, TMS therapy through Transcend TMS. Visit SHEchiatry.com to connect.
Resources
Maggie Throckmorton, PMHNP-BC is the founder of SHEchiatry, a women's psychiatry and therapy practice in Nashville, Tennessee. She specializes in integrated mental health care for women navigating perimenopause, PMDD, postpartum, ADHD, treatment-resistant depression, and the chronic, compounding effects of stress on the female body and mind.