I am a licensed clinical social worker, and I meet this woman often in my work with executives, physicians, attorneys and founders. She is a composite, drawn from common patterns rather than any one person, but almost every high-achieving woman I know will recognize some part of her. Many of them are running on empty, and almost none of them will say so out loud.

The Numbers Behind the Silence

This is not just a feeling. Deloitte's 2026 Women @ Work global survey, which asked 7,500 women across 15 countries about their working lives, found a striking pattern of silence.

Here is the part that surprises people. Struggling and succeeding often happen at the same time. From the outside, many high achievers look like they are thriving. From the inside, they are barely holding on.

Why "I'm Not Okay" Feels So Dangerous

For many women in leadership, admitting strain does not feel like honesty. It feels like a risk. There are real reasons for that.

• Competence has been your safety. Many high-achieving women learned early that being excellent was the way to be taken seriously. When your place at the table was earned by never dropping the ball, admitting you are tired can feel like handing someone a reason to doubt you.
• You are often the only one. The first woman in the role, the only woman on the leadership team, the one people are watching. When you represent more than yourself, every sign of struggle can feel like it counts against everyone like you.
• The load is invisible. Much of what women carry — the planning, worrying, remembering and caring for others — does not show up on any calendar. It is hard to ask for help with work no one else can see.
• Strength has become your identity. If you are "the strong one," then not being okay can feel like losing yourself, not just having a hard month.

Silence has costs: to your sleep, your health, your relationships and, eventually, your work.

Three Ways to Start Saying It

You do not have to announce anything to your whole team. Start smaller.

1. Tell one person the whole truth. Choose one person — a partner, a close friend, a sibling, a mentor outside your organization — and tell them how you are actually doing. Not the edited version. Many women discover they have dozens of contacts and no one who knows the real story. One honest conversation breaks that pattern.
2. Replace "fine" with something true. You do not need to overshare. Try a sentence that is honest without being exposing: "It's been a heavy stretch." "I'm more tired than I'd like to be." Small truths build the muscle for bigger ones, and they give the people around you permission to be honest too.
3. Get support before the crisis. Too many women wait until their body, their marriage or their health forces the issue. You do not need to fall apart to deserve help. Persistent poor sleep, a shorter temper with people you love, a sense that you are performing your own life, or relying on a glass of wine to switch off every night are all reasons enough to talk with a licensed therapist. Therapy is one of the few relationships where you do not have to be strong for anyone.

The Strongest Thing You Can Say

The woman I described at the beginning does not need to become less capable. She needs to stop carrying everything alone.

Radical self-regard does not mean doing more for yourself on top of everything else. It can mean something simpler and harder: telling the truth about how you are, and letting someone help.