“Should” Is Toxic: How It Affects Cortisol, Immunity and Mental Health
Regret is the heavy echo of decisions we wish we'd made differently. Those continuous “what ifs” and “if onlys” that loop in the mind and weigh heavy in your the chest. For women over 40, regret often accumulates like clutter: career choices or education not pursued, relationships tolerated too long, health and self-care deprioritized, dreams set aside for the sake of everyone else.
Left unchecked, regret does more than sting emotionally, it actively derails health and wellness.
Regret doesn’t have to be a life sentence. Recognizing regret, reclaiming those lessons learned, and redirecting that energy into clear boundaries, simpler choices, and small, fierce acts of self-trust transforms regret from a trap into a teacher. Each intentional choice chips away at regret and rewrites the story from “I should have” to “I will now.” For women over 40, that transformation is the gateway to a simpler, stronger life from burnout and further regret.
Here’s how regret sabotages wellness, especially in women over 40:
Drains energy and motivation: Constant overthinking about past choices saps the mental fuel making change feel impossible.
Fuels perfectionism and people-pleasing: Regret can morph into a fear of making more "wrong" choices, driving over-functioning and an exhausting need to control outcomes to avoid future remorse.
Erodes boundaries: Guilt over past decisions often leads women to over-compensate by saying yes to others, sacrificing rest, nutrition, and personal priorities.
Worsens stress and sleep: Persistent regret activates the stress response, increasing cortisol and disrupting restorative sleep — two pillars of physical and mental health.
Stalls self-compassion and growth: When the inner voice is dominated by blame, it’s hard to practice self-kindness or take the imperfect steps that lead to real change.
Triggers unhealthy coping: Emotional pain from regret often gets numbed with food, busyness, alcohol, or avoidance which are all quick fixes that deepen burnout.
What Chronic Regret Does to Your Body
I’m not going to sugar coat this. When regret keeps you in a state of ongoing emotional distress, your adrenal glands keep releasing cortisol, and chronic exposure to stress hormones can suppress immunity over time. You may get sick more often, heal more slowly, and feel run-down even when nothing else is visibly wrong.[1]
Your immune system can be slowly reduced by the story you keep telling yourself about your past.
Research confirmed that women experiencing intense life regrets experience significantly higher volumes of cortisol, with a steeper spike first thing in the morning, and reported acute physical symptoms as a result.² Your body, brilliant and loyal as it is, cannot distinguish between a real threat and a memory you keep replaying. Every time you revisit a regret, your system floods with cortisol and adrenaline as though the threat is happening right now.[1]
Chronic emotional stress also elevates blood pressure and drives up inflammation markers in your bloodstream and these aren't just temporary spikes. When regret becomes a daily companion, your heart and blood vessels experience cumulative strain that builds quietly over time.[1]
Losing sleep? Regret-based overthinking intensifies at night when distractions are reduced and your mind has more freedom to wander which creates fragment rest and prevents the deep, restorative sleep your body needs to recover.[1]
And then there's depression. Research consistently finds that life regret is associated with lower life satisfaction and increased depressive symptoms.[3] Mount Sinai researchers found that the way the brain processes regret may be directly linked to an individual's ability to cope with stress, and that this processing is altered in psychiatric conditions like depression.⁴
Regret and depression do not politely take turns, they pile on.
Rates of depression and anxiety are notably higher in midlife, especially among women.[5] You are not imagining the feeling that life is much heavier. You're carrying a physiological burden that the wellness industry tells you to treat with green tea and a gratitude journal. No wonder you never feel better.
If you suspect perimenopause or menopause is amplifying everything you're feeling right now, you're probably right. This article can help you learn more, Your Doctor Calls It Stress. Your Body Calls It Perimenopause.
The Two Types of Regret (And Why the Difference Matters)
Not all regret is the same beast and treating it as such is exactly why most advice about regret is useless.
Group One: The Regrets You Cannot Change
The relationship that ended before you were ready. The parent you lost before you made peace. The years you spent managing everyone else's feelings while yours turned to sediment at the bottom of our dreams.
You survived the best you could with what you knew at that time.
Psychoanalyst Erik Erikson’s final stage of human development is, simply put, about looking back on life and deciding if you feel it was well lived, which is referred to as ego integrity, or full of regrets, which leads to despair. [6] When we see our lives as unproductive, feel guilt about our past, or feel that we did not accomplish our life goals, despair often leads to depression and hopelessness.[7]
But Erikson's theory understood what the self-help industry does not: the goal is not to eliminate regret entirely. We can experience both ego integrity and despair and learn from them without living in eternal bitterness.⁸
You might imagine that reducing regret would create a serene, floaty peace with your past. If only that were possible. What you are aiming for is the weight to lift and this is accomplished by learning to accept your past and understanding that you were doing the best you could as the person you were back then.
In plain language: the path through your regrets is to change how you hold their story.
Group Two: The Regrets That Still Have a Door Open
Some of what keeps you in the regret cycle is not grief, it’s recognition. The career pivot you never took. The creative work you set down in your thirties because someone needed dinner made and forms filled out and logistics coordinated. The places you always meant to go. The degree you haven’t finished. The version of yourself filed away under "maybe someday when the kids are grown".
Someday has an expiration date of right fucking now.
If you're ready to figure out what actually matters to you at this stage of your life, The Essential is the category where that work begins. You can learn more here: Essentialism: The Art of Focussing On What Really Matters.
How to Sort Through Your Regrets
Grab a piece of paper, this is going to be a messy triage exercise.
Step One: Write them down. All of them. The embarrassing ones, the quiet ones, the ones you've been pretending aren't there. Give them air. Regrets kept in the dark grow larger and more frightening than they actually are.
Step Two: Sort into two buckets. Bucket #1:The regrets you genuinely cannot change — the past is closed, the person is gone, the window has shut. And Bucket #2: the regrets where a door, even a small one, is still cracked open.
Step Three: Work the two buckets differently.
For the closed ones: Practice the shift: recognize that you were a different person, operating under different constraints, with different information. Ego integrity means the arc of your life holds together even when the individual chapters were a mess.[11] That is not the same as saying everything was fine, you are recognizing that you were always doing what you thought was reasonable given what you had to work with
For the open ones: Make a list that looks suspiciously like a to-do list, because it will be. What would it look like to take one small step toward that one thing that you regret not doing but still have the opportunity to accomplish it? Begin with just one step. A phone call. A search. A conversation. An enrollment. A ticket purchased.
Then do it again with another.
The Woman on the Other Side of Regret
She will not be a cleaned-up, lighter version of who you are right now.
She's fiercer.
She got there by sorting her regrets with clear eyes instead of running from them, by accepting what she could not change without turning that acceptance into self-punishment, and by treating the open doors like the opportunities they are.
If you’re in midlife, this is the time the “should-haves” have lost their power because you stopped using them to prosecute yourself. It’s a time to pause, regroup, and think about how you can do better for the next half.[13]
If this article spoke to you or answered questions you don’t have answers to, leave me a comment below, I respond to every comment. You might inspire other women who are struggling with their identity.
Melissa
Sources
Reachlink. (2026). What regret does to mental health and how to heal. Reachlink.
Wrosch, C., Miller, G. E., Lupien, S., & Pruessner, J. C. (2007). Regret intensity, diurnal cortisol secretion, and physical health in older individuals. Health Psychology, 26(4), 418–425.
Linden, M., Maercker, A., & Müller-Werdan, U. (2024). The relationship between life regrets and well-being: a systematic review. Frontiers in Psychology, 15, 1515373.
Sweis, B., Durand-de Cuttoli, R., & Russo, S. J. (2022). Brain's sensitivity to different types of regret may impact mood disorders like depression. Science Advances. Mount Sinai Health System.
Wiener, J., Alessi, N., & Stone, D. (2026). Understanding midlife crisis symptoms: Signs and solutions. Fast Psychiatry.
Erikson, E. H. (1982). The life cycle completed. Norton.
McLeod, S. (2025). Erikson's stages of development. Simply Psychology.
Psychology Town. (2025). Embracing integrity vs. despair in later adulthood. Psychology Town.
Tranter, L. J., & Koutstaal, W. (2008). Achieving ego integrity: Personality development in late midlife. Journal of Research in Personality, 42(4), 1004–1019.
Wrosch, C., Bauer, I., & Scheier, M. F. (2005). Regret and quality of life across the adult life span: The influence of disengagement and available future goals. Psychology and Aging, 20(4), 657–670.
Vanden Berghe, W., Vansteenkiste, M., Soenens, B., et al. (2021). The role of ego integrity and despair in older adults' well-being during the COVID-19 crisis. PMC, 7914386.
Social Work Exams. (2024). Erikson's integrity vs despair stage: A complete analysis. Social Work Exams.
Kentucky Counseling Center. (2025). Regrets after midlife crisis: How to make peace with your past. Kentucky Counseling Center.
