By Dr. Simbiat Adighije, PMHNP, MBBS, PhD
Psychiatric and Mental Health Expert | Founder & CEO, Conscientia Health
Forbes Business Council Member
Originally published October 01, 2026, 11:00am EDT
The first thing women who run companies and sit on boards often still get asked is how their children are.
As a woman, you are often raised to take the children automatically. There are fathers who do it, but much of the time, the default still lands on the mother. Women are often raised to be poised. They’re expected to be present for every recital and every board meeting. They’re often told to start having kids young. Women are expected to juggle it all.
In the C-suite, the script does not change. You are still the one who knows the pediatrician’s number. You take the late flight and the early school drop-off. You close the round and pump in an airport bathroom. You are praised for being “remarkable.” I believe “remarkable” is often a polite word for “unsupported.”
The question we still do not ask often enough is not, “How are you doing?” It’s, “How are you managing?”
How Competence Can Mask the Load
Let me go first. I am a CEO. I have built a company, held a license, signed payroll and been the person a child looks for at the door. None of that made me immune to the load. It made the load look like competence.
Competence is a brilliant disguise. It is also how high-functioning women disappear in plain sight. We keep the calendar full. We answer the Slack message at 11:40 p.m. We tell the board the quarter is on track. We tell the school we will be there. We tell ourselves that collapse is what happens to other people, people who are less organized, less resourced, less “together.”
That is a lie the culture sells us, and we buy it because it lets the meeting start on time.
Management, in the sense I mean it, is not about time-blocking. It is the quiet inventory of what you are carrying that no dashboard shows: sleep debt, decision fatigue, the unpaid emotional labor of being the family’s chief risk officer, the identity split between the woman who can close and the woman who is supposed to soften. Add a perinatal mood or anxiety disorder, a loss, a lawsuit, a sick parent or a partner who travels, and the inventory stops being theoretical.
I have sat with executives who can recite EBITDA and cannot remember the last time they said, out loud, that they were scared. I have sat with clinicians who saved other people’s babies and did not know how to ask for help with their own nights. The common feature was not weakness. It was fluency in endurance.
The Cost of Overload
Business culture is fluent in performance and clumsy with load. We measure output. We rarely measure the cost of being the person who cannot drop the ball because there is no one assigned to catch it.
If you lead, this is not only a wellness footnote. It is an operating risk. Silent overload does not stay in the home. It can show up as attrition of your best women, as brittle judgment, as the high performer who is suddenly “fine” until she is not. It can show up as the junior woman who watches the senior woman and learns that the price of the seat is invisibility.
Conversations about mental health can produce good statements, but statements do not pick up a child from school. They do not sit with a woman at 3 a.m. when the story she is telling herself has turned cruel. They do not change a board culture that treats a leave as a loyalty test.
The Question, Used Properly
“How are you doing?” is a greeting. “How are you managing?” is an audit.
Ask it of the woman who just made principal. Ask it of the founder who is pregnant and fundraising. Ask it of the nurse leader, the general counsel and the operator who has not taken a week off in three years. Ask it of yourself before you ask it of your team, or the question is theater.
Then do the unfashionable things that follow a real answer: Reduce the load, not the woman. Put coverage around the school calendar the way you put coverage around a product launch. Stop praising “remarkable” when you mean “alone.” Treat perinatal mental health as a clinical and corporate fact, not a private embarrassment. If you have an employee assistance program brochure and no executive who has ever used it in public, in my view, you do not have a program. You have stationery.
Women who run companies already know the load. What we have been trained to do is stay silent inside it and call that leadership.
Say the true sentence first:
I am managing this. I am managing too much. I need the load to move.
That is not a confession that disqualifies you from the seat. It is how you stay in it.
How are you managing?
Support Should Be Part of the Strategy
Carrying responsibility does not mean carrying everything alone. If stress, anxiety, burnout, or the demands of leadership are affecting your well-being, Conscientia Health provides personalized mental health support designed around your needs.
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