Meeting the needs of employers, spouses and children while negotiating creche closing times, traffic and supermarkets - working mothers have an increasingly frenetic and demanding routine. As a result, west Dublin GP Dr Zita O'Reilly has noticed a dramatic increase in the number of women at her surgery suffering from stress or depression.
In an average session, Dr O'Reilly sees 15 to 18 people, and on some days half of these are women who feel so unable to cope with the pressures of looking after a family and working outside the home that they burst into tears minutes after sitting down.
Initially, they may present with physical symptoms, says Dr O'Reilly, but when asked if they are under stress they will often break down, saying it is a great release for them to be able to cry their eyes out.
Over the last six months, there has been an increase in collective societal stress, says Dr O'Reilly. There is cumulative pressure from traffic problems, shortage of staff in the workplace, children attending an ever wider range of activities - and such pressure is eroding the quality of life.
A lot of those attending Dr O'Reilly's surgery want to stop this demanding schedule, but they feel trapped. "I facilitate them to stop or offload," says Dr O'Reilly.
She encourages them to try acupuncture, reflexology or massage. "Pharmacology is also available and, used judiciously, can help a person handle a crisis and make progress," she says. Most women who come into her surgery would love the opportunity to work limited hours. They enjoy the stimulation of work and having their own money, but they want to be around their children too. Several of Dr O'Reilly's patients have sought more flexible hours at work, but their employers have been unwilling to facilitate them.
Women are conscientious workers, says Dr O'Reilly, especially if they work part-time. She believes women underrate their contribution. Their perception that they have secondrate status can be self-fulfilling. Employers tend to view staff as the staff view themselves.
Men do have similar problems, but they are much more likely to present with a physical ailment. They tend to be more resistant to going for a massage or talking to a counsellor. Instead, they want their illnesses fixed.
"Men are under siege. They are under pressure with their changing role. It is unfair to expect men to behave the same way as women. No wonder employers get entrenched, because, as men, they are under siege. It is wrong to expect men and women to operate in the same way - we are complementary. But this is very difficult, especially when the balance of power in the workplace is one way," says Dr O'Reilly.
Dr Rachel Kidney, who practises in south Dublin, says that when she asks anyone, man or woman, how their work is going, they almost invariably say: "Very stressful." Dr Kidney also says men find it difficult to open up and will only come to the surgery when they have something physically wrong with them.
"Women come in to try and change themselves; a lot of women feel it is all their fault. It is very difficult to get men into counselling, and if there is a relationship problem, it won't be solved by the woman alone getting therapy," says Dr Kidney.
"A lot of couples with kids and both partners working are sticking with the relationship, but they are miserable. We are lucky in Ireland because we do still have a family/friend support network, but this brings its own costs in terms of guilt."
DR KIDNEY believes everyone has become very materialistic and people should question why they are so motivated: is it greed, ambition, a need for power or success? It is unfortunate that people only re-evaluate their lives when they are diagnosed with a physical illness. Clients are under pressure at work and come in because they want medication to get them back on track.
"Their companies own them and they feel guilty about taking time off if they are sick," says Dr Kidney.
People's feeling that they should be able to lead glamorous lives is leading to excessive use of alcohol, says Dr O'Reilly. Women in particular are drinking more, even though their bodies cannot cope with as much alcohol as men's. This problem is more evident in working-class areas where there are poor local resources, outlets are limited and the pub is still the social focus. Ireland has a long history of negativity based on its colonial past, but now the economy is thriving, we need a more positive outlook, says Dr O'Reilly.
"The Government needs to be pro-active and have longterm planning to provide a better quality of life for everyone. Issues such as childcare have been dealt with as they arose - there is no long-term planning. The Government has a huge case to answer as to why it is not putting funds into state-of-the-art leisure facilities in workingclass areas," says Dr O'Reilly.
Guinness and the ESB deserve recognition, she says, for being two of the first employers to provide leisure facilities for their staff.
"If businesses were farsighted, especially in female dominated professions like nursing, they would introduce a new model of power-sharing," says Dr O'Reilly. "Instead of an organisation's power being wielded by one person, there would be a redistribution. This would give more job satisfaction and help to alleviate the staff shortage.
"Management should aim to be inclusive and bring more people into the power structure. Women shy away from management jobs because they think they will have too much on their plate. But power, like health, should be in the hands of the person."