Jane Morgan (not her real name) has a high-stress job in a high-stress state. A project consultant for a New Jersey marketing firm, Morgan was in the process of interviewing a new client when she began feeling strange.

"I had been out late the night before and hadn't slept well, as usual," recalled Morgan. "I was interviewing some clients about a project I was working on when I felt a very sharp pain in the middle of my breastbone."

At first Morgan thought it was just an attack of heartburn, but when the pain began radiating across her left shoulder, she grew increasingly distressed. Not wanting to unduly upset the clients, she asked for a glass of water and tried to calm down.

Later, while driving home in bumper-to-bumper traffic on New Jersey's Garden State Parkway, Morgan felt herself being overtaken by a full-fledged panic attack. Her pulse was racing. She had trouble breathing. "I didn't want to lose consciousness going 70 miles an hour on the Parkway," she said. She pulled off at the next exit and drove to the nearest hospital. After hours on a heart monitor in the emergency room, Morgan began to feel better. Her EKG and all the other tests they'd performed at the hospital turned up no physical reason for Jane's sudden symptoms.

"The doctor said it didn't seem to be a heart problem," Morgan said. "He said maybe it was a low-grade virus."

She was sent home with a recommendation to see her family physician the next day. After a thorough check-up, Morgan and her physician agreed on a one-word diagnosis: stress.

The buildup of tension on the job had set Morgan up for a crash. "Because I'm a consultant," she says, "clients look at me like the meter's running. With the level of competition out there, if you want to be a success, you have to run at the same pace everybody else is."

The consequences, as Morgan experienced firsthand, can be serious. Morgan's frightening, physical reaction to the mental and emotional pressures she faces daily on the job aren't, unfortunately, unique. Nor are they solely the problem of women.

Life in twenty-first century America isn't for the faint of heart. Millions of us wake to that jolt of adrenaline that follows the annoying bleat of our clock-radios. From that moment far into the night's dark, we're racing and chasing to meet our commitments at work and at home.

But, experts say, the burden of those commitments tends to fall twice as heavily on the shoulders of women as it does on the shoulders of men. That means that women today tend to experience more stress for longer periods than men and to react to it differently.

Studies have implicated the overwhelming pressures of modern life that we refer to as stress in a multitude of illness and physical problems ranging from heart disease to chemical addictions. Behind the "stress" buzzword is a complex network of physiological/psychological events that can have a dramatic effect on the intricate machinery of our body.

Stress, it has become clear, isn't an abstract, psychological concept, but a physical process that can radically impact our health and well-being. The origins of stress lie in the "fight or flight" mechanism implanted deep in the human brain. The center of that response lies in the hypothalamus, an organ about the size of a walnut that lies at the center of the human brain.

According to the Women's Complete Health Book by Jeanne Spurlock, MD, the hypothalamus acts as the "ultimate link" between mind and body, controlling the hormonal responses to emotional prompts throughout the body. At least nine different hormones are released by the hypothalamus in response to a wide range of human emotions.

"Extreme fear, for example, affects the body in many different ways," Spurlock noted in her book. "Your pupils will widen to let in more light. You will experience an increase in alertness because of more neurotransmitters in your brain. Your adrenal glands will begin to pump more adrenaline and other hormones into your bloodstream; your heart races, your blood pressure rises, your muscles tense. Your liver starts converting starches to sugars for energy and digestion slows. Experts have even determined that your blood's clotting powers will be enhanced during stressful situations. Sweat production increases and the hair on your body may feel prickly and actually stand on end. All these physical reactions were designed to save your life. Your body is getting ready to defend itself. But these reactions are no longer physiologically useful in modern life and can actually be harmful if you keep yourself in such an alert state for too many hours each day."

We're programmed to react to a perceived threat by aggressively defending ourselves or, when the threat is overwhelming, by running away. In the earliest days of humanity's presence on the earth, that might translate to shimmying up a tree to avoid being eaten by a hungry lion, or to pelting an attacking wildebeest with a barrage of big rocks.

These days, however, the threats we face are dramatically different. We're no longer in the wilderness — but we're still in the jungle, whether it's the corporate jungle or the deceptively peaceful-appearing suburbs where women in particular must experience the emotional pushes and pulls that characterize the modern family.

When life gets overwhelming, we may want to grab the car keys and run away to some tropical island. We might want to respond aggressively; but we can't. We're stuck in the traffic of life like an overheating car, and there's just no easy way out.

Because women have traditionally been the caretakers in society, they often experience conflict over their need to be everything to everyone. They often neglect their own needs for comfort and security in order to provide comfort and security for those they love. That's a precursor to a lot of negative emotions, including guilt, frustration, anger, sadness, and, not surprisingly, a chronic sense of exhaustion.

Margaret Chesney, a clinical psychologist and professor of medicine at The University of California School of Medicine in San Francisco, believes that the mounting stresses on women are at epidemic levels.

Chesney, who is frequently asked to lecture on the topic of women and stress, points out that the societal role changes that have occurred in America since the 1960s have created a deep sense of conflict for women. Women in their forties and above were, in general, raised with an expectation that their primary roles would be that of wife and mother. Instead, thousands of those women found themselves at the epicenter of a cultural revolution that saw women enter the workplace in numbers never before seen.

But even as they surged forward into colleges, law and medical schools, even as they braved the boardroom and locker room, they carried with them the sense that they were responsible for the emotional well-being of everyone else.

In the fervency of their commitment to improving the lives of women, many of the pioneers of women's equality in the workplace passed to their daughters the idea that it's possible to have it all. But the price of even attempting to have it all is dangerously high.

"We tend to blend it all together," Chesney says. "We love our roles as social beings, and the work roles have been incredibly rewarding in terms of self-worth. The dramatic transformation that has occurred in the lives of women is sometimes given short shrift. Few of us live through our husbands anymore, but our grandmothers really were "Mrs. John So-and-So.'"

These days, the roles of men and women at home and at work are evolving at a rapid pace, but it's still true that women in general have simply piggybacked their new obligations onto the old, which makes for a awesome burden. "Basically, we've just doubled our roles," Chesney says.

A secretary who spends all day as an appointment-scheduling, note-taking helpmeet to her boss may face the same job, second shift, when she goes home to a husband tuckered out from his own day at the office. While men are helping out more at home than ever before, according to Chesney, women still fill the role of family manager, carrying the ultimate responsibility for how things function at home.

Considering the workload the average wife, mother and worker contends with every day, it's no wonder women feel more like beasts of burden than wonder women when all is said and done.

In a study of male and female managers at a Volvo factory in Sweden, Marianne Frankenhauser, a professor at the University of Stockholm, and her team of researchers, found that men and women had generally the same physiological responses throughout the day. But at 5 p.m., blood-pressure readings and levels of adrenaline and other hormones measured via urine tests continued to rise in women while men's hormone levels dropped dramatically. "What is the toll on the body of being at work for that long a period of time and then starting the second shift?" Chesney asks. While research into possible health effects is ongoing, "It's pretty clear that it increases your risk for adverse events including heart disease and possibly causes damage to the immune system. We know that heart disease is correlated with increased blood pressure. And, women who have achieved things undreamed of by the average female in previous generations — becoming attorneys and physicians at rates near equal to those of men — they still frequently face resentment, discrimination and sexual harassment on the job."

According to the results of a study conducted by Erica Frank, MD, MPH, a family physician at Emory University School of Medicine in Atlanta and her colleagues, that feeling of control and power is just as vital among high-achieving women physicians. Frank's and her colleagues' analysis of data compiled for the Women Physician's Health Study showed that women physicians who felt they had the greatest control over their work environment scored more than 11 times higher on measures of career satisfaction than those who had little control.

"With the exception of radiologists," the study noted, "physicians in 'controllable lifestyle' specialties of anesthesiology, dermatology and pathology showed high satisfaction vs. those in some primary care specialties, in particular, general internal medicine and general practice." The study also revealed strong associations between the amount of stress on the job and the amount of control and the level of dissatisfaction with their jobs the woman reported. "Those reporting severe work stress were almost three times more likely than all other physicians to express a strong interest in changing their specialty," the study related.

One additional handicap for women is their reluctance to express the anger they feel. While men are much freer to express negative emotions, women have been trained to believe that they must be nice; that everyone should like them. Instead of confronting an annoying colleague or complaining about an untenable situation, women practice denial; they inhibit their hostile impulses; they even hold their breaths. That's a perfect invitation for a panic attack.

"We're tense a lot," says Chesney. "That's a big problem." And when the pressures pile up and women finally blow, instead of feeling better, they feel worse. "If you act out, you really feel ashamed," Chesney says. "It's a real problem with women." Bottling up those negative emotions puts women at risk for depression and for substance abuse.

When people are depressed, they tend to do exactly the opposite of what they should be doing to feel better: they sleep less; they exercise less; they eat more; they drink more.

"Women are drinking a lot," Chesney says. "It's a major issue."

The chronic stressors often result in a feeling of inescapable depression. "It's like the '8' ball," Chesney says. "You shake it once and it says, 'I feel bad,' you shake it again and it says, 'I feel overwhelmed,' you shake it again and it says, 'I feel down.'"

One worrisome indicator of dangerous overload occurs when pleasant events seem like chores — the lunch with a friend; a date at the theater. When that happens, "You really need to stop and set some priorities for yourself," Chesney advises.

Studies have shown that people who frequently experience feelings of anger and hostility are at much greater risk for heart attacks. And when those feelings are denied and repressed, the physical toll is even greater.

But with the planet spinning madly and we with it, just how do you do get control? As the comedienne, Roseanne Barr, once remarked, "No one gives you power. You have to take it." More often than not, control is something that has to be taken, too.

Taking control can mean something as simple as unplugging from our sources of stress — turning the phone off when we sit down to dinner; getting up an hour before dawn to savor some badly needed quiet time. Taking control, for women, also means taking care — of themselves. It means letting go of unrealistic expectations.

One woman alone shouldn't expect to maintain the perfect house, be the perfect wife, mother and worker. You just can't do the dinner party for eight and the merger in Dallas; the homemade cookies and the housing project — at least not all the time, and not forever.

As Nancy Reagan put it in another context, women must learn to "just say no." And they have to be prepared to be criticized for it when they do. "People will get angry with you," Chesney warns. "You will disappoint your children, your friends, your co-workers. People will start giving you feedback that you are not doing what they want you to do. The plus side of that equation is that your health — both mental and physical — will be far the better for it."

Virtually anything women do to lower their expectations of what they should be doing and comfort themselves should help. It's important to let go of the notion that we can do all things perfectly — or even that we can do all things. It's important to take a good look at what truly matters in our lives and what doesn't — then make the necessary subtractions.

And, no matter how serious life gets, it's important to find time to laugh. Since the episode on the Parkway, Jane has been making an effort to take much better care of herself. She's still doesn't feel as if she's entirely beyond the grasp of the stress monster, but she's working on it.

Jill, a systems analyst, found solace in Tai Chi, a gentle form of oriental exercise that helps to quiet the mind, thus helping the body.

Many women praise the merits of massage for their overstressed physiques and psyches. It feels good, improves circulation, reduces muscle tension and relieves the effects of stress. It increases lymph flow and blood circulation thus aiding in removing metabolic waste and bi-products of tissue damage and inflammation from the body and delivers oxygen and nutrients to tissue cells. Before having a massage, women should inform their practitioner of their health history. Massage is not healthy for anyone with a serious heart condition, uncontrolled high blood pressure or diabetes, blood clots and some types of cancers.

"You can't have it all," Chesney emphasizes. Friendships can provide a vital safety valve for those of us caught in the maze of "shoulds" that mark the life of a modern woman. "Women need to support each other," advises Chesney. 

Eileen Moon is a freelance writer
from Atlantic Highlands, New Jersey.

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