Women and Stress: Manage It-or It May Kill You

A single
session of massage
can significantly lower
one’s level of the stress hormone
cortisol. Full body massage
every three weeks can reduce
it to almost zero.

Andrea GuerreroAndrea Guerrero

Heart disease is the number one killer of women in the United States. It is also a major cause of disability; only a third of women who have heart attacks make a full recovery. One woman in five has a heart or blood vessel disease.

Stress contributes directly and indirectly to heart disease— and stress is rampant among women on campus. Stress also affects your job performance and life satisfaction. If you feel you have too many worries, too much responsibility, too little time, too many people to satisfy, too much job ambiguity, too many crises or too little say over decisions that affect you—welcome to the world of stress.

While stress is a part of life, the good news is that you can do things to manage its impact. This will make you a stronger leader as well as a happier, healthier person.

Dr. Sandra Watkins, professor of educational leadership at Western Illinois University, and Andrea Guerrero, administrator at Springfield IL High School and doctoral student in educational leadership at the University of Nebraska, provided information on stress management.

They shared the latest research and recommendations at the University of Nebraska’s conference on Women in Educational Leadership in Lincoln in October 2012 in “Women under Fire: The Impact of Stress on Performance and Personal Well Being.”

Who is at risk?

Women experience more minor daily stressors than men, studies have found. Women with children experience more strain than those without, regardless of whether they are single parents or share responsibilities with a partner. Women are more likely than men to be filling multiple caregiver roles. Stress outside of work affects perceptions of distress even more than work stress.

Stressors decrease with age but increase with job responsibilities. “As you climb through the administrative ranks, you experience more stress,” Watkins said. Research supports the impact of work stress on physical health.

• Among nurses in Denmark, a 15-year study found the risk for heart disease in women below age 52 correlated directly with work pressure.

• Among white-collar workers in Beijing, researchers found a relationship in women (but not men) between job strain and thickening of the carotid artery wall, a cardiovascular warning sign.

• Among women in Gothenburg, Sweden, a 40-year study found that women who reported frequent disturbing interruptions were nearly twice as likely to describe their health as poor, compared to those who did not. “Do not let your day be interrupted,” Watkins said. Figure out ways to protect your focused time.

How stress affects health

Stress works on the body in many ways. Faced with an acute emergency such as an attack by a predator, the adrenal glands above the kidneys release fight-or-flight hormones such as adrenaline and cortisol. They increase the amount of sugar in the blood, boost the heart rate and elevate blood pressure, while drawing resources away from the immune and digestive systems to meet immediate demands.

Once the perceived threat passes, the body returns to normal. Unlike the predator in the jungle, though, our stressors today tend not to go away. Worries about money, work or family go on and on. Chronic activation of the stress-response system works havoc on bodily systems, increasing the risk for sleep problems, depression, short-term and long-term memory impairment, sleep problems, skin conditions and indigestion in addition to heart disease.

Stress has indirect effects as well. Women under stress may turn to alcohol, fast food or cigarettes to make it through the day. While these may feel relaxing, they actually increase stress while contributing directly to such health issues as liver failure, clogged arteries and cancer.

Obesity has become a national epidemic, linked to stress in a self-perpetuating cycle. Feeling stress contributes to poor food choices, whether it’s because we crave comfort food or because we think we don’t have time to eat healthy. Stress hormones can increase cravings for sugars and fats, and neuropeptide Y—a molecule released from nerve cells during stress—promotes accumulation of fat.

Obesity in turn contributes to stress. We feel less good about ourselves, we have more health problems and it’s harder to move or exercise. Obesity reduces the likelihood that we’ll walk or bicycle instead of taking the car. Obesity is taking 400,000 lives every year. It contributes directly to high blood pressure, high blood sugar and cholesterol. It is a risk factor for stroke, arthritis, breathing problems, depression, osteoporosis and gall bladder disease. Even slightly overweight women have a one-third higher risk of developing breast cancer.

A study released in September by Trust for America’s Health and the Robert Wood Johnson Foundation projects that adult obesity rates will top 60% in many states and 44% nationwide by 2030 if present trends continue. “What kind of role model are we to our students?” Watkins asked.

Out of balance

Picture your washing machine when it gets out of balance. It makes noises, jumps around and eventually stops. Even while still in motion, it’s not getting the laundry done.

Something similar happens to women who get out of balance. “We’re all doing two jobs instead of one due to downsizing,” she said. Bullying and harassment add to workplace stress, which varies with job status, work hours, overtime, commuting time, work autonomy and job security.

Meanwhile we’re trying to balance all that with a personal life, where stress levels vary in relation to underage children, aging parents, relationship status and hours of housework. Small wonder balance is a constant challenge for women.

Take a moment to write down the leading stressors you’re dealing with today. Are you spending too much time at work? Are you grappling with legal or financial problems? Have there been major changes in your workplace or home life? Are you experiencing social isolation?

Like the out-of-balance washing machine jumping and jerking, we show physical symptoms before we finally grind to a halt. They can take the form of backache, stomach pain, headache, weight gain, sleep problems or depression. We may notice eczema, hair loss or dark circles under the eyes. We may just feel vaguely unhealthy or discouraged.

“Once you get out of whack, it’s tough to get back,” Watkins said.

To begin restoring balance, she suggests:

Look at how you spend your time. Eating an apple takes no longer than picking up a burger at the drive-thru. Some carve out time to exercise over the lunch hour.

Assess whom you associate with. Do you surround yourself with positive people or those who lower your mood? Negative emotions not only reflect stress but also contribute to it.

Watch your self-talk. When stressed, do you become more critical of yourself and others? Many women lose confidence when they feel out of balance. “Stress often compromises self-efficacy,” she said.

Leave work at work. Wind down before bed. Although few have the leisure to follow Thomas Jefferson’s advice literally, we can apply it for an hour or two each day: “Leave all the afternoon for exercise and recreation, which are as necessary as reading. I will rather say more necessary because health is worth more than learning.”

Taking action

“As you progress up the ladder, you need to develop a support network,” Guerrero said. Friends or family can help you process the external events that happen to you as well as the internal fears, uncertainties and beliefs that compound your stress. There are also times to turn to therapists, physicians or clergy. Know when to ask for help.

“I was always active but needed to learn to manage my stress,” she said. Guerrero has made significant lifestyle changes, including:

  • She changed what she eats.
  • She has cut out soda pop, a huge change for her.
  • She drinks only one cup of coffee or tea each day.
  • She now runs ten miles a week: “I found I do have the time; it’s how I choose to use it,” she said.
  • She has lost 75 pounds.

After just one month, she began to feel better. Today she is healthier and has a more positive outlook. People noticed that she is happier, and it affects other parts of her life.

Physical well-being focuses on weight, exercise, nutrition and sleep. (“When you go to bed, don’t think about your day,” she advised.) These are the foundation for all the other areas; if the physical is out of balance, it is hard to balance anything else.

Relaxation techniques add powerful defenses against stress. They come in many forms including deep breathing, guided imagery, meditation, progressive muscle relaxation, relaxing to music, yoga, tai chi and repetitive prayer.

Researchers at Cedars-Sinai Medical Center in Los Angeles found that a single session of massage can significantly lower one’s level of the stress hormone cortisol. “Full body massage every three weeks can reduce it to almost zero,” she said.

Journaling about painful emotions has been found to reduce their intensity, resulting in fewer doctor visits over a sixmonth period. Some studies suggest that regular journaling can strengthen the immune system.

Reaching out

Look for ways to scale back. Consider taking up a hobby. Other suggestions to lower stress are to practice a sense of humor, limit work-related intrusions into your non-work life, seek professional counseling when needed and foster healthy relationships.

According to psychologist Edward Denier, dozens of studies confirm that happy people live healthier, happier lives, other things being equal. Optimists live longer than pessimists or those with chronic anger. Positive moods reduce stress hormones and improve immune function.

Happiness, he found, is mostly about relationships. They reported his data on what makes people happy:

Relationships with children

Friends and friendships 76%
Contributions to life of others 75%
Relationship with the love of your life 73%
Degree of control over your life/destiny 66%
Leisure time activities 64%
Relationship with parents 63%
Religious and spiritual life 62%

To enjoy health and a long life, manage inevitable stress by taking care of your body, practicing relaxation and cultivating meaningful relationships.

Regardless of your job title or position on campus, stress is probably a part of your daily life on and off campus. Learning to manage it will make you happier, more productive and a stronger leader. It may even save your life.

Risk Factors for Premature Heart Disease

Some risk factors for premature heart disease are under your control; others are not. The list below is adapted from Fitness Magazine (July/August 2012).


Low Risk High Risk
Age under 45 60 or over
Blood pressure <120/80 >140/90
Body mass index under 25 30 or more
LDL cholesterol 30 or lower 160 or more
Smoking not in family you smoke
Waistline <30 inches >35 inches
Exercise >30 min/day rarely
Family history of it no parent/sib Both parents/sib
Diabetes No Yes


If you have two or more high risk factors, check with your doctor about screening tests and interventions. If you’re in the low risk group on eight of the nine factors, do your best to stay there!


Cook, Sarah Gibbard. (2013, January). Women and Stress: Manage It—or It May Kill You. Women in Higher Education, 22(1), 22-23.

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