Twin stress: What happens to a woman's heart when she takes on too much at work and home?

WFH during the pandemic may well be detrimental to women's health physically. Photo / 123RF

As women try to balance their careers with their domestic lives, the pressure may be doing more harm than drinking, smoking or cholesterol.

It doesn't take a scientist to tell us that working hard while caring for a family can be highly stressful, but a new study reveals the true health cost to women's hearts of trying to do both well.

The study, published this week in The Journal of the American Heart Association, revealed that the combined strains of holding down a job and keeping up with social responsibilities increases the risk of coronary heart disease (CHD) for women.

This twin stress, dubbed in the study as "psychosocial stress" can be lethal, doing more damage to women's hearts than the effects of drinking, smoking, depression and high cholesterol.

According to the authors of the study, in which the mean average age of women was 63: "Daily life stressors and family problems may act synergistically with job stress, accelerating the development of CHD in women since they usually take more domestic and caregiving responsibilities."

During the pandemic, these stresses increased exponentially with women shouldering much of the emotional and physical labour of looking after the family as well as working – and the ripple effect is still ongoing.

"Psychosocial stresses are the demands put on you from finance, work and relationships and can be anything from looking after elderly relatives and diffusing family feuds to work deadlines and organising your children's daily activities," explains Professor Andrew Steptoe, head of the department of behavioural science and health at University College London.

"Focusing on work alone tends to traditionally be in the male domain which is why these toxic stressors are particularly associated with women who tend to carry more of the social burden and don't have the luxury often of being able to focus simply on work."

As busy, multi-tasking caregivers, Regina Giblin, senior cardiac nurse at the British Heart Foundation, worries that women aren't aware of the physical signs of stress and will ignore them – until it's too late.

"Palpitations, headaches, trouble sleeping, comfort eating, sudden weight loss or weight gain, easily getting angry or feeling numb are all symptoms of stress and women need to be aware of them," says Giblin. "Stress causes adrenaline to be released in the blood and for your heart rate and blood pressure to rise. This is the body's normal flight or fight response. Chronic stress can also cause inflammation throughout the body, rupturing the plaque inside the arterial walls, generating cells to go and fix it which can then cause a clot which could lead to a heart attack."

A 2017 study in the Lancet also linked constant stress to higher activity in an area of the brain linked to processing emotions. The results of the study suggested that when you are stressed, your amygdala (an area of the brain that deals with stress) signals to the bone marrow to produce extra white blood cells and this, in turn, causes the arteries to become inflamed, resulting in CHD.

While the post-pandemic WFH lifestyle may be a godsend for working women practically, it may well be detrimental to our health physically, overloading our bodies - and our hearts – with toxic stress.

"In theory, WFH is great for women because you lose the commute, can be closer for the nursery or school run and you can do little domestic things like load a dishwasher while you're on a work coffee break," says Christine Armstrong, researcher and vlogger on the Future of Work at Armstrong & Partners. "But recent research from Kent University revealed that the more flexibility we have at work the harder we tend to work and post-pandemic, we are now struggling to set boundaries. Being a great parent and being good at your job was easier when life was separated between work and home but when they crash into each other, it's much harder and is more stressful."

Armstrong quotes a recent McKinsey's Women in the Workplace study which polled more than 65,000 employees in the States and in which 42 per cent of women reported being burned out often or almost always in 2021, compared to 32 per cent in 2020.

Work, caregiving and household demands along with pandemic anxiety have clearly left women little to no time to catch their breath during the past 20 months and the hybrid workplace isn't helping.

"In a household with two flexibly working parents where they are carefully coordinating diaries, it's a fragile house of cards which can all collapse if there's one change and childcare or work arrangements need to be adjusted," adds Armstrong. "It generates household stress and more often than not it is the woman who takes it on and is the one trying to find the babysitter or look after the kids and work at the same time."

Inevitably, when people are stressed, they adopt unhealthy behaviours which increase their health risks.

"If you're stressed you're more likely to smoke or drink more and eat junk food and do less exercise and that will also increase your risk of CHD," says Giblin. " If you're feeling heart palpitations or anxiety, speak to your doctor about it. Coronary heart disease kills twice as many women as breast cancer and treatment delays are often why. Women need to take this seriously and take steps to diffuse their stress seriously."

Seven ways to combat twin stress and look after your heart

1. Think about your lifestyle
Giblin recommends exercising at least three times a week and, "get out into the fresh air if you can as this will release endorphins or "happy hormones" to make you feel better and less stressed." Eating healthy foods will boost your immune system and protect your body from inflammation. "At the British Heart Foundation, we suggest a Mediterranean diet of lots of fish and vegetables and red meat only twice a week," adds Giblin. Try to drink in moderation and stick to a healthy BMI.

2. Share out the home chores properly
Armstrong recommends sharing out the jobs at home more evenly, thinking about how often they're done and when. "In Eve Rodsky's book Fair Play she undertook some research on the jobs that women and men did and women tended to do daily jobs that had a time attached to them, for example, packing the school bags, making dinner, picking up from school, while the men did jobs such as running the finances or emptying the bins or doing DIY that could be done any time of the day," explains Armstrong. "To reduce the pressure, both men and women need to share the time-focused jobs more equally between them so it's not women always racing against the clock."

3. Create boundaries at work
"Practice, demonstrate and talk about boundaries with your team, for example, no emails after 8pm or at weekends," says Armstrong. "You will suffer less stress if you work it out as a team - it's like doing the Weight Watchers programme rather than dieting on your own."

4. Write an action plan
"People are still feeling the impact of the pandemic and trying to adjust and it can be very stressful," says Dr Becky Spelman, psychologist and clinical director of Private Therapy Clinic - www.theprivatetherapyclinic.co.uk. "The best thing to do is to try and break things down and to plan and write down the actions you're going to take in relation to anything that is causing you stress. It can feel a lot more manageable by tackling each stress in this way."

5. Be good – but not too good - at multi-tasking
If you can exercise in your work breaks or even work while you're on a Peloton treadmill, that's great. "But generally, we overestimate our ability to switch between tasks," says Armstrong. "If we're always doing fragmented tasks then there's no sense of achievement and it drains our energy. We need to learn to focus on one thing when it comes to work and our home life and then we're able to get it done and strike it off our list."

6. Keep an eye on your blood pressure
"Get your blood pressure checked so you know if it's under control. A healthy blood pressure is less than 140/90," says Armstrong.

7. De-stress
"Take managing stress levels seriously Try some tools to help with your stress such as mindfulness or meditation or yoga and build yourself a support system of people who you can talk to."