At one point in my life, I found myself surrounded by grown daughters. Each of us carried the same invisible burden: the stress of managing the expectations of family, friends, partners, larger ecosystems, and ourselves. We were united by our elevated cortisol, the looming threat of diabetes and blood pressure, frequent weight fluctuations, stress eating, and, greatest of all, a perpetual sense of exhaustion from caregiving fatigue.
“Eldest daughters are almost ready to handle it all: from family responsibilities to emotional support, overcoming professional roles and taking care of siblings,” shares Dr. Almas Fatma, a Mumbai-based family physician and digital health artificial intelligence expert. Fatigue begins to manifest as headaches or body aches. We feel tired after resting, chronically exhausted. This causes disruptions in the sleep cycle, affecting our hormones, gut health, and mental health.
“In my experience, the mental burden of this role takes a heavy toll: chronic stress, hypervigilance, and self-sacrifice resulting in both physical and mental health challenges. These women must model perfection for their younger siblings, maintain the family’s reputation, fulfill household duties, and carry the emotional labor of the entire family system,” adds Priya Rednam-Waldo, a US-based licensed clinical therapist specializing in feminine and maternal mental health for South Asian women.
Over time, the body forces rest through illness or poor functioning, Rednam-Waldo adds, when women can’t choose rest for themselves. His words were close. The eldest daughters are known for their hyper-independence; the belief that asking for help is a weakness. I’ve been guilty of it too. The instinct to hold everything together can feel like a badge of honor, until it becomes a slow act of self-erasure.
A growing awareness of how birth order influences well-being has led experts to focus on preventing burnout in the eldest daughter, rather than recovery. “With my clients, healing eldest daughter burnout begins with this recognition: Being a ‘good daughter’ shouldn’t cost you health, contentment, or joy,” says Rednam-Waldo. “You can honor your family and care for others while still valuing your own identity and well-being.”
So what’s it like to cure eldest daughter burnout?
1. Reflect periodically. “Talk to yourself,” suggests Dr. Fatma. “When you can name your emotions, you begin to understand what nourishes you and what pushes you toward burnout.”
2. Have them check your numbers. Dr. Fatma recommends regular full body checks including thyroid, sugar parameters, vitamin D, B12, magnesium, B6, folic acid, liver profile and complete blood count. “It’s a way to manage the internal stress your body might be under.”
3. Eat and move on time. “Running on small fuels will only increase cortisol,” he explains. Prioritize balanced meals and daily movement—any way that sparks joy instead of guilt.
4. Ask for help. “Delegating is a survival skill,” says Rednam-Waldo. “Older daughters often wait until the breakdown to reach out. But seeking help before the breakdown is the way to prevent it.”
