Mental Load and Burnout Among Working Women: An Intersectional Analysis of Gender, Mental Health, and Non-Communicable Chronic Diseases

Copyright © ISRG Publishers. All rights Reserved. DOI: 10.5281/zenodo.17874717 365 ISRG PUBLISHERS Abbreviated Key Title: ISRG J Arts Humanit Soc Sci ISSN: 2583-7672 (Online) Journal homepage: https://isrgpublishers.com/isrgjahss Volume – III Issue -VI (November-December) 2025 Frequency: Bimonthly Mental Load and Burnout Among Working Women: An Intersectional Analysis of Gender, Mental Health, and Non-Communicable Chronic Diseases Elizabete Vieira de Camargo1*, Ludmila Vohryzek Sommer2, Samuel Martins de Jesus Branco3, Junamappe da Silva Cardoso Mendes4, Domilene Borges Costa5, Anelise Nogueira de Lima6, Ainoa Efa Fernandes e Souza7, Priscila Castro Cordeiro Fernandes8 1, 2, 3, 4, 5, 6, 7, 8 Wagner de Aguiar Raupp Rua Joao Tobias 15 38401066. Affiliation: PHD in Public Health – Universidad de Ciencias Empresariales y Sociales | Received: 01.12.2025 | Accepted: 06.12.2025 | Published: 10.12.2025 *Corresponding author: Elizabete Vieira de Camargo Wagner de Aguiar Raupp Rua Joao Tobias 15 38401066. Affiliation: PHD in Public Health – Universidad de Ciencias Empresariales y Sociales Abstract This study analyzes how mental load and burnout shape the mental and physical health of working women within a context marked by persistent gender inequalities. The literature shows that women continue to assume disproportionate responsibilities for unpaid domestic labor, caregiving, and emotional management, which interact with occupational demands to produce chronic cognitive and emotional strain. These intersecting factors intensify psychological vulnerability, especially among women who also experience racial, socioeconomic, or family-related inequities. Burnout emerges as a multidimensional syndrome resulting from prolonged exposure to psychosocial stress, characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment. These conditions are closely linked to the development and worsening of chronic non-communicable diseases, including hypertension, diabetes, depression, and anxiety, demonstrating the interconnectedness of mental and physical health. The findings also highlight that coping strategies and support networks offer partial protection but remain insufficient when structural barriers persist. Workplace support, flexible policies, and access to healthcare are unevenly distributed, particularly among women in precarious or informal employment. Institutional cultures that normalize overwork and stigmatize psychological distress further limit early intervention and effective care. Structural inequalities, combined with cultural expectations that naturalize women’s overload, reinforce cycles of stress and illness. By integrating an intersectional perspective, this review demonstrates that mental load, burnout, and chronic disease outcomes result from systemic and interdependent factors. The study emphasizes the need for institutional reforms, gender-responsive public policies, and organizational practices that recognize and address the structural roots of women’s unequal exposure to psychosocial stress. Keywords: mental load; burnout; women workers; gender inequalities. Copyright © ISRG Publishers. All rights Reserved. DOI: 10.5281/zenodo.17874717 366 Introduction The growing participation of women in the formal and informal labor markets has reshaped contemporary socioeconomic dynamics, yet it has also intensified longstanding gendered inequalities that directly affect women’s physical and mental health. While women experience significant advances in educational attainment and professional inclusion, these achievements coexist with persistent expectations related to domestic labor, caregiving responsibilities, and emotional management within family and community contexts (Bonalume et al., 2023). This unequal distribution of social and reproductive tasks produces what contemporary feminist scholarship identifies as mental load, a form of cognitive and emotional labor that is invisible, continuous, and largely unrecognized within institutional structures. For working women, particularly those situated at the intersections of race, class, and motherhood, mental load accumulates across domains and manifests as chronic psychological strain (Larangeira & Nakamura, 2023). This scenario is aggravated by the rising prevalence of burnout, a syndrome increasingly reported among women exposed to demanding and inflexible work environments. Burnout emerges not solely from occupational pressures but from the convergence of paid and unpaid workloads, role overload, and structural inequities that intensify psychosocial stress (Fonseca, 2025; Freitas et al., 2024). Research has demonstrated that symptoms such as emotional exhaustion, depersonalization, and reduced personal accomplishment are not only detrimental to mental well-being but also contribute to the development and exacerbation of noncommunicable chronic diseases (NCDs). This relationship underscores the interconnectedness of mental and physical health and challenges approaches that treat them as separate or hierarchically ordered. Understanding burnout in women therefore requires an examination of broader sociopolitical contexts that shape exposure to risk and access to protective resources (Matos & Albuquerque, 2023; Neves et al., 2024). At the institutional level, coping strategies and support networks function as essential buffers against chronic stress, yet they remain insufficient when structural barriers persist. The availability of workplace support, flexible policies, and access to healthcare services varies widely across sectors, with women in precarious or informal employment facing significant disadvantages (Castro et al., 2024; Alves et al., 2025). Moreover, the cultural normalization of women’s self-sacrifice and the stigmatization of psychological suffering hinder early detection and adequate intervention. These conditions contribute to a cycle in which individual coping efforts are insufficient to counteract systemic inequities that maintain disproportionate burdens on women’s time, energy, and health. As such, a comprehensive analysis of mental load, burnout, and NCDs demands an intersectional approach that accounts for how gender interacts with race, class, and labor conditions to shape health vulnerabilities (Bitencourt, 2024). Given this complex landscape, scholarly and policy attention to the mental health of working women remains both urgent and insufficient. Existing literature acknowledges the presence of psychosocial stressors but often fails to integrate them within a broader structural framework capable of explaining why specific groups of women experience greater health risks. There is a need for analytical models that move beyond individual-level explanations and situate women’s experiences within systemic inequalities that cut across work, family, and public policy. By examining mental load, burnout, and chronic disease as interconnected phenomena, this study contributes to a growing body of research committed to advancing gender equity in health. Therefore, the objective of this study is to analyze how mental load and burnout affect the mental health and non-communicable chronic disease outcomes of working women, considering gender inequalities and other intersecting social markers. Methodology This study is a narrative literature review, a methodological approach that enables the collection, analysis, and synthesis of available evidence on a specific phenomenon. This strategy integrates studies with diverse research designs and methods, allowing for a broad, critical, and contextualized understanding of how mental load and burnout affect the mental health and noncommunicable chronic disease (NCD) outcomes of working women from an intersectional perspective. The guiding question of this review was: How do mental load and burnout influence the mental health and the development or worsening of noncommunicable chronic diseases in working women, considering gender inequalities and other intersecting social markers? The literature search was conducted in the PubMed, SciELO, and LILACS databases, selected for their relevance to research in mental health, working conditions, gender studies, psychosocial factors, and chronic disease epidemiology. These databases offer extensive coverage of national and international studies addressing social determinants of health, women’s health, work-related stressors, and the impacts of mental overload on the development of NCDs. Controlled descriptors and free-text terms were used in Portuguese, English, and Spanish, combined with the Boolean operators AND and OR. The main terms included: “mental load,” “burnout,” “women workers,” “gender inequalities,” “mental health,” “noncommunicable chronic diseases,” “psychosocial stressors,” and “intersectionality.” Studies published within the last five years were included if they addressed mental load or burnout among working women, focusing on mental health outcomes, psychosocial determinants, gender disparities, or associations with non-communicable chronic diseases. Articles discussing challenges, impacts, intersectional factors, and coping strategies related to physical and mental illness in working women were considered eligible. Excluded from the review were duplicate articles, nonsystematic reviews, editorials, letters to the editor, experience reports, and studies that did not directly address mental load or burnout in working women or did not explicitly relate the topic to mental health, social markers, or NCDs. The analysis of the selected studies was conducted rigorously, considering thematic relevance, methodological quality, and each study’s contribution to understanding the psychosocial determinants influencing women’s health. Data synthesis enabled the identification of recurring thematic categories, which supported the organization of the results and guided the critical discussion on the mechanisms linking mental load, burnout, gender inequalities, and chronic illness. These categories also highlighted factors that either intensify or mitigate these impacts on working women. Copyright © ISRG Publishers. All rights Reserved. DOI: 10.5281/zenodo.17874717 367 Results and Discussion Intersectional Determinants of Mental Load Among Working Women The literature consistently demonstrates that the mental load experienced by working women emerges from a complex interplay of structural, sociocultural, and relational factors that exceed the boundaries of individual responsibility. From an intersectional perspective, gender operates not as an isolated variable but as a dimension that intersects with race, class, age, family structure, and caregiving roles, producing differentiated experiences of cognitive and emotional burden. This intersectional positioning shapes both the expectations imposed on women and the material conditions of their daily lives, thereby influencing their exposure to chronic stressors (Miranda et al., 2024). Gender-based expectations, rooted in persistent patriarchal norms, continue to assign women the primary responsibility for managing domestic tasks, emotional labor, and family organization, even when they participate fully in the labor market. The concept of mental load (or cognitive labor), emphasized in contemporary feminist studies, refers to the constant need to plan, anticipate, coordinate, and supervise domestic and caregiving activities. Unlike physical chores, these tasks remain largely invisible, unremunerated, and undervalued, yet they demand continuous mental vigilance and emotional regulation (Pereira, 2024). Socioeconomic status further shapes the magnitude and nature of this burden. Women in lower-income households often face limited access to supportive resources such as hired domestic help, flexible working arrangements, or high-quality childcare services. As a consequence, their mental load tends to be intensified by greater material insecurity and restricted autonomy over time management. Conversely, even women in higher socioeconomic strata continue to report elevated mental load, revealing that increased access to resources does not fully mitigate gendered expectations of household and caregiving coordination (Barbosa, 2024; Castro et al., 2024). Race emerges as a critical axis within this intersectional framework. Black and Indigenous women are disproportionately represented in precarious employment, informal work, and occupations with higher physical and emotional demands, conditions that exacerbate both workplace stress and domestic responsibilities. Structural racism compounds these vulnerabilities by limiting access to health services, opportunities for career progression, and social protection systems, thereby amplifying chronic mental strain (Carmo, Silva, & Campos, 2023; Alves, 2023). Caregiving responsibilities, whether involving children, elderly relatives, or family members with chronic illnesses, operate as another central determinant. While caregiving is often framed as a moral or affective duty, the literature highlights how the organizational and emotional management required to sustain such responsibilities significantly increases cognitive overload. The ―double shift‖ (paid work combined with unpaid domestic work) often becomes a ―triple shift‖ for women who also manage complex caregiving tasks, further intensifying mental fatigue and reducing recovery time. (Felisbino, 2023; Bonalume et al., 2023). Taken together, these intersecting determinants generate a persistent pattern of cognitive and emotional overload that cannot be understood merely as an individual experience. Rather, mental load reflects broader structures of inequality that position women, especially those marginalized by race and class, at heightened risk for chronic stress, psychological distress, and associated health complications, including non-communicable chronic diseases. The evidence underscores the need for policy interventions and workplace reforms that acknowledge the intersectional nature of women’s lived experiences and address the structural roots of mental overload (Alves et al., 2025; Faria & Paula, 2022). Burnout, Psychological Distress, and Their Association with Non-Communicable Chronic Diseases (NCDs) The literature consistently demonstrates that burnout is not merely an occupational phenomenon but a multidimensional syndrome rooted in chronic exposure to psychosocial stressors in environments characterized by high demand and limited control. Emotional exhaustion, depersonalization, and diminished personal accomplishment operate as interconnected dimensions that erode women’s psychological resilience, especially when combined with gendered expectations and unequal labor conditions. When these stressors accumulate, they induce a persistent activation of neuroendocrine pathways, particularly the hypothalamic–pituitary– adrenal (HPA) axis, which plays a critical role in the pathophysiology of several non-communicable chronic diseases (NCDs) (Fernandes et al., 2023). Evidence indicates that women exposed to prolonged occupational strain exhibit heightened physiological reactivity, often manifested through systemic inflammation, dysregulated cortisol secretion, and metabolic imbalance. These biological alterations contribute to increased susceptibility to hypertension, insulin resistance, cardiovascular dysfunction, and other NCDs frequently documented among women working under high-pressure or precarious employment conditions. The sustained mismatch between workplace demands and available coping resources accelerates psychological distress and precipitates long-term health consequences (Bitencourt, 2024). Psychological distress, comprising symptoms such as anxiety, irritability, cognitive overload, and persistent rumination, functions as both a precursor and a consequence of burnout. For many women, this distress is compounded by the accumulation of roles and responsibilities, including unpaid care work and emotional labor within domestic and social spheres. The overlapping burden generated by these structural and interpersonal demands intensifies vulnerability to depressive disorders and chronic somatic conditions, reinforcing cyclical patterns of illness (Bisi & Nakamura, 2023). From an etiological perspective, the literature emphasizes that the relationship between burnout and NCDs is mediated by chronic stress exposure, which disrupts immune function, autonomic balance, and metabolic regulation. Women who face an enduring dissonance between their professional roles, personal identities, and sociocultural expectations tend to report higher levels of psychosomatic symptoms, such as migraines, gastrointestinal disorders, and musculoskeletal pain, conditions often overlooked in clinical assessments despite their strong association with stress dysregulation (Faria et al., 2022). Workplace environments characterized by inflexible schedules, emotional strain, and limited organizational support further exacerbate burnout symptoms. Research shows that women in caregiving professions, informal labor sectors, or high-demand service industries experience disproportionate exposure to Copyright © ISRG Publishers. All rights Reserved. DOI: 10.5281/zenodo.17874717 368 emotional exhaustion and role conflict, which increases their risk for developing chronic pain syndromes, sleep disturbances, and metabolic disorders. These conditions contribute to the early onset of NCDs and hinder the maintenance of healthy lifestyle behaviors (Larangeira & Nakamura, 2023). Additionally, burnout has been associated with maladaptive coping strategies, including emotional withdrawal, social isolation, and unhealthy behavioral patterns such as sedentarism, irregular eating, and increased use of substances like alcohol or anxiolytics. These behaviors function as intermediary pathways linking psychological distress to the development and exacerbation of NCDs. The inability to recover adequately from work-related stress compounds physical deterioration and reduces resilience against chronic illnesses (Copatti et al., 2023). The interaction between psychosocial stress and chronic disease development is further intensified by socioeconomic inequities and limited access to health care, particularly among marginalized groups of women. Barriers to preventive services, poor working conditions, and the cumulative effects of discrimination, whether based on gender, race, class, or occupational status, significantly elevate the risk of burnout and associated NCDs. Such inequities reveal that health outcomes are profoundly shaped by structural determinants rather than solely individual behaviors (Coelho, Oliveira, & Mello, 2023). Taken together, the literature underscores that burnout among working women is both a public health concern and a manifestation of broader systemic inequalities. Its association with NCDs cannot be attributed to isolated psychological factors; rather, it reflects the convergence of biological, social, and institutional forces that shape women’s lived experiences. Addressing this multifaceted issue requires interventions that promote gender equity, improve working conditions, and integrate mental health within chronic disease prevention strategies, ensuring a holistic approach to women’s health (Neves et al., 2024). Coping Strategies, Support Networks, and Structural Barriers to Health Promotion Individual coping strategies employed by working women are shaped not only by personal resources but also by the sociocultural and institutional environments in which they operate. Women often adopt cognitive and behavioral strategies such as time management, compartmentalization of emotional demands, and self-imposed productivity routines to maintain functionality in the face of chronic overload. Yet, the effectiveness of these strategies is uneven and frequently undermined by structural constraints that limit autonomy and recovery (Fonseca, 2025). Emotional coping mechanisms—such as seeking validation in personal relationships, practicing mindfulness, or engaging in spiritual and community-based rituals—play a significant role in regulating stress responses. These practices, while beneficial, tend to function as compensatory tools rather than structural solutions, highlighting how emotional labor continues to be privatized and feminized. The reliance on internal resources to manage systemic pressures exposes the inadequacy of institutional support within workplaces (Giroto & de Paula, 2024). Social support networks, including family, friends, and community groups, are consistently identified as protective factors that buffer the psychological impact of mental load and burnout. However, these networks are not uniformly available to all women, with marginalized groups facing reduced social capital, overburdened family structures, or precarious living conditions that weaken their support systems. In such contexts, the absence of stable networks exacerbates vulnerability to both mental health deterioration and chronic illness (Brito, Albiero, & Machado, 2023). Workplace support—manifested through collegial solidarity, supervisor empathy, and collaborative environments—also plays a crucial role in mediating burnout risk. Nevertheless, many organizations fail to institutionalize psychosocial support, relying instead on informal interactions that may not suffice for women exposed to persistent or intersectional stressors. As a result, experiences of isolation, undervaluation, and professional invisibility remain common (Freitas et al., 2024). Institutional coping mechanisms, such as mental health programs, employee assistance services, and occupational health initiatives, are frequently underdeveloped or inaccessible to women in precarious employment arrangements. Even in settings where such programs exist, they often adopt individualized approaches that overlook structural inequities and gendered workloads, thereby limiting their effect on long-term well-being (Oliveira, 2023). Organizational flexibility, through remote work possibilities, flexible hours, or workload adjustments, has demonstrated potential to reduce stress and increase autonomy. However, research shows that flexibility can simultaneously intensify expectations for constant availability and blur boundaries between work and personal life, particularly for women who already shoulder disproportionate domestic responsibilities. This ambivalence complicates the potential benefits of workplace flexibility (Vidigal, Paradela, & Costa, 2023). Structural barriers to health promotion are deeply embedded in labor market inequalities, gender norms, and public policy deficits. Limited access to quality healthcare, long waiting times, and geographically uneven distribution of services impede preventive care and exacerbate untreated symptoms of stress and chronic disease among working women. These gaps in healthcare provision highlight systemic shortcomings rather than isolated failures (Ferraz & Figueiredo, 2020). Another major barrier lies in the institutional culture of many workplaces, which normalizes overwork, celebrates productivity at any cost, and minimizes the legitimacy of psychosocial distress. Such cultures perpetuate stigma around seeking psychological support and discourage discussions on gendered labor inequities, reinforcing environments where burnout becomes an expected outcome rather than a preventable condition (Pires, Ribeiro, & Cruz, 2024). Intersectional inequities further compound these obstacles. Women who are Black, Indigenous, from low-income households, or employed in informal sectors encounter intensified structural barriers, including discrimination, job insecurity, and limited access to supportive networks. These overlapping vulnerabilities heighten their exposure to stress and reduce their capacity to engage in effective coping strategies or access health-promoting resources (Tonelli, 2023). The lack of integrated public policies that address gender, work, and health simultaneously contributes to persistent gaps in health promotion. Although some initiatives exist within the Brazilian context, such as programs aimed at reducing occupational risks or supporting women caregivers, they often lack funding, continuity, Copyright © ISRG Publishers. All rights Reserved. DOI: 10.5281/zenodo.17874717 369 or intersectoral coordination necessary to address the complexity of women’s lived experiences (Wynnek et al., 2023). Moreover, cultural expectations surrounding femininity—such as self-sacrifice, emotional availability, and moral responsibility for household well-being—shape women’s perceptions of their own suffering. These expectations may lead to normalization of exhaustion, delaying the seeking of medical or psychological assistance and reinforcing the invisibility of their mental and physical health needs within broader social structures (Morosini, 2023). The evidence indicates that coping strategies and support networks, while essential, are insufficient to counteract the structural barriers that undermine women's health promotion. Sustainable improvements require systemic transformations, including equitable labor policies, accessible healthcare, and institutional cultures that genuinely value well-being. Addressing these multifaceted barriers is fundamental to reducing the burdens of mental load, burnout, and chronic illness among working women, ensuring more just and supportive environments (Matos & Albuquerque, 2023). Conclusion The analysis of the three thematic categories—Intersectional Determinants of Mental Load, Burnout and Its Association with Non-Communicable Chronic Diseases (NCDs), and Coping Strategies, Support Networks, and Structural Barriers to Health Promotion—reveals a complex and deeply interwoven set of factors that shape the health experiences of working women. Taken together, these findings demonstrate that mental load and burnout cannot be understood as merely individual phenomena; rather, they emerge from intersecting social structures that distribute burdens unevenly across gender, race, class, and occupational contexts. The first category underscores that women’s mental load is rooted in persistent patriarchal norms, unequal domestic responsibilities, and intersectional determinants that disproportionately burden marginalized groups. These structural and symbolic expectations generate chronic cognitive and emotional strain, which extends beyond workplace demands and infiltrates all spheres of daily life. Building upon this foundation, the second category shows that burnout functions as a biopsychosocial outcome of cumulative stress exposure, with clear implications for physical health. Its association with non-communicable chronic diseases demonstrates how prolonged psychological distress triggers physiological dysregulation, accelerating the onset and progression of conditions such as hypertension, diabetes, and depression. This reinforces the need to view mental health and chronic illness as interdependent rather than separate domains of care. The third category highlights that although women employ a variety of coping strategies and rely on social and workplace support networks, these mechanisms are frequently insufficient to counteract structural barriers to health promotion. Persistent inequalities in labor conditions, limited access to healthcare, inadequate organizational policies, and cultural norms that naturalize women’s overload restrict the effectiveness of individual coping and perpetuate cycles of exhaustion and illness. Collectively, the findings reveal that addressing mental load, burnout, and associated chronic diseases requires a multidimensional approach that integrates gender-sensitive labor policies, equitable access to healthcare, and organizational practices that challenge rather than reinforce gendered norms. Policies and interventions must move beyond individualized solutions and confront the structural determinants that underpin women’s unequal exposure to psychosocial stress. 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