The High Cost of “I’m Fine”

I love this podcast! Aviva Romm, MD—OB/GYN, midwife, educator, mom, and grandmother—speaks frankly about so many topics, but this one feels especially present in my daily life. I’ve been reading and listening to Aviva for decades and have learned so much about my body, my health, the bridge between Western and Eastern medicine, and other healing modalities. She has a gift for creating a space where women can speak openly and honestly.

In this episode, Aviva speaks with Helen Marie, a UK-based psychotherapist and author, about perfectionism, burnout, and stress—how they often show up in women’s lives as silent grief, anxiety, trauma, and depression.

They explore the dysregulation of our nervous systems and how it impacts nearly everything—our hormones, immunity, heart health, metabolism, mood. The cost of always saying “I’m fine” while managing families, schedules, work, holidays, and the wider world is immense. It’s like living as a frantic little brain on tiny legs, rushing endlessly through life.

But what goes unseen? Anxiety and depression don’t have a “look”—which is why they’re so often missed in our culture. Many of us don’t feel safe to share, we carry shame, and we’re taught to believe we must hold it all together. This puts immense pressure on the nervous system. Meanwhile, our bodies send us signals all day long that things are not fine—through physical symptoms, hormonal imbalances, digestive problems, chronic pain, or anxiety and depression. Yet our minds keep insisting we act “fine.” It’s unsustainable.

I often imagine it like a basket inside myself. All day and night it fills with cortisol, adrenaline, and disrupted hormones. The overflow shows up as digestive issues, anxiety, memory problems, irritability, vertigo, poor sleep, and more. And when the basket finally tips over, we face health crises—autoimmune conditions, high blood pressure, insulin resistance, chronic inflammation—the kinds of illnesses now advertised endlessly on TV.

Some people manage their symptoms for years, but for others, the signals escalate until we can’t ignore them. In a strange way, those of us who are “knocked over the head” may be the lucky ones. Our bodies sound the alarm: big changes need to be made, now.

This is why it’s so vital to talk openly, especially with other women. When I gather with my friends, I choose the ones who are willing to hear about my dysregulation, my fears, and the ongoing waves of symptoms. It’s not sustainable to stay silent. As human beings, we are meant to lean on community, to discharge fear, anger, and loneliness—and to laugh together.

This is also why I believe in choosing a yoga studio that feels like home. A space where your nervous system can dial down, where your body can breathe, where you feel warm, cozy, and truly seen. Yoga—through movement, breath, and focused awareness—helps recalibrate the nervous system, slowly emptying that basket. It creates space and resilience for the times when life asks us to be strong for ourselves and our families.

And it doesn’t have to stop at yoga. Self-care can look like massage, Reiki, talk therapy, Feldenkrais sessions, writing workshops, restorative practices, meditation, and more.

Take a listen to this podcast episode—it’s full of wisdom, compassion, and reminders that we are not alone.