When she started working in the male-dominated realm of commercial real estate two years ago, Rachel (whose name has been changed for this story) knew she’d be clocking long hours making deals and managing clients. But she wasn’t prepared for stressors that weren’t listed on the job description.

“In the first six months, most people were really excited to meet me, thinking I was one of the partners’ wives,” says the 32-year-old. (She’s actually the chief operations officer at her Los Angeles company.) “Even knowing what my role in the business is, I’ve had some [clients] say, ‘I won’t talk to you, I’ll only talk to [your male bosses].’ And then others will make comments about my looks or my attitude. It just infuriates me.”

As the #MeToo movement has proven, women from all walks of life have been internalizing—and indeed burying—the emotional effects of sexism, harassment, and trauma in an effort to keep the peace professionally.

Although she usually brushes these situations—and times when she’s mistaken for a secretary—off with a smile and a clever comeback, Rachel admits the overt displays of sexism are tough to take. “In addition to doing a good job, you [have to think about] presenting yourself as feminine, poised, intelligent, and assertive—but without being emotional, bitchy, or over-controlling,” she says. “There’s an energetic and emotional toll it can take. Most of the time when I say I’m exhausted, it’s because I’m emotionally exhausted.”

This kind of experience—working hard to maintain a chill-girl façade while internally suppressing the urge to lose it—isn’t uncommon among women at work. In fact, there’s a term for it: emotional labor. Coined by sociologist Arlie Hochschild in 1983, it’s been studied by academics for decades, mainly in the context of service jobs like nursing or waitressing. But it’s definitely not limited to these professions: As the #MeToo movement has proven, women from all walks of life have been internalizing—and indeed burying—the emotional effects of sexism, harassment, and trauma in an effort to keep the peace professionally. But at what cost?

Here’s how emotional labor in the workplace could affect your health—and what to do if it’s happening to you.

What is emotional labor?

No matter what kind of job you have, chances are you’ve experienced emotional labor at some point. Journalist Gemma Hartley—whose book on the topic, Fed Up, is coming out in fall 2018—describes it as “the unpaid, often unnoticed labor that goes into keeping those around you comfortable and happy.”

Experts often point out that putting on this kind of performance requires actual work. In other words, fending off a coworker’s flirtatious advances during a meeting—and doing it gracefully without making everyone else feel weird—is a job skill, just like, say, proficiency in public speaking or project management.

Sociologist Rebecca Erickson, PhD, adds that employees in less powerful positions tend to perform the most emotional labor. And since women are still underrepresented at the top of most industries, it tends to be women who experience its negative effects most often, by default.

Fending off a coworker’s flirtatious advances during a meeting—and doing it gracefully without making everyone else feel weird—is a job skill, just like, say, proficiency in public speaking or project management.

But even those with high-level job titles aren’t immune. “In a study of lawyers and paralegals, the one female attorney [in the office] was expected to manage emotions like a man in her work, but then was subject to criticism due to the fact she wasn’t doing feminized—friendly or nice—emotion management, and was thus seen as a ‘bitch,’” Erickson notes.

Studies have found that women of color carry, perhaps, the biggest emotional labor load of all. “[Researcher] Louwanda Evans found that African-Americans working in predominantly white institutional spaces perform a ‘double shift’ of emotional labor, as they are subjected to race-based stressors or microaggressions requiring additional forms of emotion management,” says Erickson.

So why is there such pressure on women to keep their true feelings in check, and do it with a smile? It goes all the way back to our hopscotch days. “Girls are typically socialized to be pleasing to others—they learn at an early age that their relationships are smoother when less conflict is present,” says Jill Weber, PhD, a clinical psychologist on the team at emotional well-being app Mindsail. “So, although they feel negative feelings, they are often careful about how they handle these feelings.”

While this can certainly happen in any office, there’s a unique experience of it when a woman is considered a minority in her industry, racially or gender-wise. “[In this kind of workplace,] a woman is less likely to be able to talk through her feelings,” says Weber. “When we feel validated, we’re less likely to self-doubt and are more likely to call people out and stand up for ourselves.”

The real costs of emotional labor

Although women may think they’re making their lives easier by smiling and nodding every time a colleague engages in a bout of mansplaining (or worse), experts argue that’s not the case. “When women are dealing with a work environment that requires a lot of emotional labor, it detracts from the mental energy they could otherwise be using for their actual paid work,” says Hartley.

The result, says Erickson, is burnout. And this is bad news for women, as burnout can bring on a whole host of negative mental and physical symptoms. Rachel can attest. After suppressing her less-than-stellar feelings about her job for months, she broke down emotionally during a salary negotiation. “The results were not good,” she says, and her concerned bosses suggested she see a therapist.

“When women are dealing with a work environment that requires a lot of emotional labor, it detracts from the mental energy they could be using for their actual work.” —Fed Up author Gemma Hartley

And while she did get one, she now feels pressure to put on a front at work. “That experience made me think more about how I’m perceived. I now question things like my tone in email. If I don’t put an exclamation point at the end of a sentence, do I sound like a mean person? I’ve also started looking more at my appearance. What is it about me that I can improve upon, stylistically, to present a stronger front?”

All of this mental noise just compounds the stress many women feel from their actual job duties—not to mention the fact that they’re often undercompensated for them.

What can we do to reduce emotional labor loads?

The first step is simply recognizing that it exists. “People often view emotional labor as something women ‘are,’ rather than something women ‘do,’” says Erickson. She suggests tracking the emotional labor you engage in each day, and then talking about it with someone you trust at work. “Point out that it is part of the job as much as any of your physical or cognitive work—and that something would be lost by the organization were you to stop doing it,” she says.

If you don’t have any allies in your office, Weber recommends finding a female mentor. “It helps to know what you are experiencing is real, and feeling less alone with it may give you the confidence to voice what needs to be voiced,” she says.

But ultimately, both Erickson and Hartley agree that the burden shouldn’t be on employees, but on businesses to create a culture where women feel like they can speak freely without negative repercussions. “Within a patriarchal society, emotional labor and its outcomes are not personal problems, but public issues,” Erickson says.

“More than any other time, I think young women, in particular, are recognizing they now will likely be more tolerated for speaking their mind.” —Clinical psychologist Jill Weber, PhD

“Change needs to come from the top down because of the power dynamics at play,” Hartley adds. It just makes good business sense to bring emotional labor into the open, adds Erickson, noting that burnout is associated with high staff turnover and absenteeism.

Weber says things seem to be shifting on the emotional labor front, thanks to the #MeToo movement. As she’s observed in her practice, “Women are reflecting more on their tendency to suck up their feelings to keep others happy with them. More than any other time, I think young women, in particular, are recognizing they now will likely be more tolerated for speaking their mind. But they still feel they have to ‘pick their battles’—that is an expression I hear quite a bit.”

For Rachel, talking about emotional labor has, indeed, been therapeutic—she says she’s had some candid conversations with her male bosses about the sexism she experiences in her role, and that they’ve been standing up for her with badly behaved clients. “It’s something all women go through, but we don’t necessarily talk about it in the context of the bigger picture,” she says. “But if you do, it gets better.”

Another emotional labor minefield: the annual review. Here’s how to handle criticism without taking it personally, and how to negotiate your salary like a boss.