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Forbes - ForbesWomen

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The Hidden Cost Of Anxiety—Why So Many Women Don’t Realize They’re Struggling
Maia Niguel Hoskin · 2026-05-04 · via Forbes - ForbesWomen
Shot of an attractive young businesswoman sitting alone in the office at night and feeling stressed

This stress is something else

getty

Anxiety looks like answering emails late at night, remembering every detail, anticipating problems before they arise, and holding everything together at work, at home, and in relationships. This is exactly why it often goes unrecognized. Anxiety among women is not new, but it is intensifying, and, in many cases, hiding in plain sight.

A Growing Crisis

Research consistently shows that women are significantly more likely than men to experience anxiety disorders. According to data cited by the American Psychological Association, women report higher levels of stress and anxiety across multiple areas, including work, finances, and family responsibilities. Epidemiological studies have long found that women are nearly twice as likely as men to be diagnosed with anxiety disorders. In fact, a 2024 study published in Frontiers in Psychiatry found that the prevalence of anxiety disorders among women more than doubled between 1990 and 2021.

But diagnosis rates only tell part of the story. Many women experiencing chronic anxiety never receive a formal diagnosis at all. Instead, their symptoms are reframed as personality traits. For instance, being driven, high-achieving, detail-oriented, or always on top of things. What often goes unnamed is the psychological toll required to sustain that level of functioning. This is what experts are now calling high-functioning anxiety.

Why Anxiety Is Increasing for Women

While anxiety is influenced by biological factors, the recent rise in reported stress among women is closely tied to sociocultural and economic realities. Women continue to carry a disproportionate share of unpaid labor, including caregiving, household management, and emotional support within families. At the same time, they are navigating increasingly demanding professional environments that reward constant availability and performance.

Add to that the ongoing effects of economic uncertainty, rising costs of living, and sociopolitical instability. The result is a sustained state of pressure with few opportunities for true rest. For many women, this creates what psychologists often describe as chronic stress activation, a near-constant state of mental and physiological alertness. Over time, that state becomes normalized.

When Anxiety Does Not Look Like Anxiety

One of the reasons anxiety goes unrecognized is because it rarely presents in obvious ways. Instead, it often shows up as over-functioning. Common, but frequently overlooked, signs of anxiety include:

  • Persistent overthinking and difficulty “turning off” thoughts
  • Irritability or emotional reactivity, especially under pressure
  • Perfectionism and fear of making mistakes
  • Difficulty relaxing, even during downtime
  • Physical symptoms such as muscle tension, fatigue, or disrupted sleep
  • A tendency to anticipate worst-case scenarios
  • Feeling responsible for managing everyone else’s needs

In high-achieving environments, many of these behaviors are rewarded. Being thorough, proactive, and detail-oriented are often seen as strengths. But when those behaviors are driven by fear, hypervigilance, or a constant sense of urgency, they can become unsustainable.

The Cost of High-Functioning Anxiety

High-functioning anxiety can be particularly difficult to identify because it often coexists with external success. A woman may be excelling in her career, maintaining relationships, and meeting expectations while simultaneously feeling overwhelmed, mentally exhausted, and unable to slow down. Over time, this disconnect can lead to burnout, emotional depletion, and even physical health consequences.

Chronic stress has been linked to a range of outcomes, including sleep disruption, weakened immune function, and increased risk of cardiovascular issues. For Black women and other women of color, these effects are often compounded by structural stressors, including systemic inequities, workplace bias, and what public health researchers have termed weathering, the cumulative impact of chronic stress exposure over time.

Why So Many Women Do Not Seek Help

Despite the prevalence of anxiety, many women delay or avoid seeking support. Part of the reason is normalization. When anxiety feels like a standard part of daily life, it becomes difficult to distinguish between what is typical and what is harmful.

There is also a cultural component. Women are often socialized to prioritize others’ needs, to be dependable, and to maintain composure -- even under pressure. As a result, admitting to struggling can feel like a failure to meet those expectations. Additionally, access to mental health care remains uneven, with barriers including cost, time constraints, and stigma particularly in communities where mental health conversations are still emerging.

What It Looks Like to Interrupt the Pattern

Recognizing anxiety is the first, and often most challenging, step. For many women, this involves reframing long-held beliefs about productivity, worth, and rest. Some practical strategies include:

1. Identifying patterns
Pay attention to recurring thoughts and behaviors, particularly those driven by urgency or fear. Awareness can help distinguish between intentional action and anxiety-driven responses.

2. Creating boundaries around time and energy
Reducing overcommitment and allowing for genuine downtime can help regulate stress levels, even in small ways.

3. Practicing cognitive reframing
Challenging worst-case thinking and perfectionistic standards can reduce the intensity of anxious thought patterns.

4. Supporting the nervous system
Techniques such as deep breathing, mindfulness, and physical movement can help shift the body out of a constant stress response.

5. Seeking professional support when needed
Therapy and other forms of mental health care can provide tools for managing anxiety more effectively, particularly when symptoms are persistent.

Rethinking What We Call “Normal”

Perhaps the most important shift is cultural. When anxiety is consistently reframed as ambition, responsibility, or strength, it becomes harder to address. The very traits that help women succeed can also mask the need for support.

Recognizing anxiety does not diminish capability. If anything, it creates the opportunity for more sustainable success, one that does not rely on constant pressure or silent strain. For many women, the goal is not to eliminate anxiety entirely, but to understand it, name it, and learn how to navigate it without sacrificing well-being in the process. Because being “busy” and being overwhelmed are not the same thing, and treating them as interchangeable comes at a cost.