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Author Katrina Alcorn says women walk a fine line between ‘everything’s fine’ and ‘total collapse.’

For Katrina Alcorn, the moment she knew the demands on her time were too much didn't come while working to a deadline as a Web designer or when she was caring for her three children. It came while she was driving to Target for party supplies to celebrate her and her husband's birthdays. The ensuing panic attack led Alcorn to seek help. After taking an extended leave and blogging about her experiences, she realized what she'd gone through was as much about a broken system as it was about her own issues.

In her new book, Maxed Out: American Moms on the Brink, Alcorn writes that she's sure the solutions lie not in individual treatments for mental illness, but elsewhere, in activism and workplace reform.

We spoke to Alcorn at her home in Oakland, Calif., where she lives with her husband and three kids.

What does "maxed out" mean?

It can mean different things to different people. People can use that term to say they just feel stressed. I've been using that term to mean stressed to the point of getting sick.

You write about dealing with panic attacks and anxiety. Is this a book about mental illness or everyday stress?

We're talking about a cultural illness. It manifests in something that looks an awful lot like individual mental illness. It's true that I'd had issues with anxiety before, but at what point is that a normal response to a crazy situation?

What pushed you too far? Too much work? Too many kids?

We don't know we have those physical and emotional limits until we hit them. In my case it was a perfect storm of having that second or third child, depending on how you count my step-daughter, and simultaneously having the economy go into the great recession. So when I normally would have quit, I didn't feel I could quit. There's so much economic uncertainty and we all end up scrambling more to keep our jobs and do more work with less people.

The factors that push us from 'everything's fine' to 'total collapse,' it's a fine line. I've heard from thousands of women. Sometimes it's having a child with special needs. Sometimes it's having that second or third kid, or having the first. A lot of times I've heard change in management, getting a new boss, pushes them over. This has a huge effect on our well-being at work – who our manager is.

It puts that sense of euphoria you have when you get it all done on a good day into perspective.

It's a high-stakes game we're all playing. It would be disingenuous to say it's all bad. Sometimes we're on top of the world because, despite all the barriers to making it happen, it feels great and it's great for our sense of confidence and it's great for our families because they need our income. It can take very little to push us to crumbling. One flat tire. We're one sick kid away from everything suddenly not being manageable.

One of your doctors said something like "there's wisdom in your anxiety." What does that mean?

That was the big breakthrough for me. I did have issues with panic attacks when I was a teenager and I'd come to think of anxiety as the enemy. What I realized while I was recovering from this breakdown was that anxiety was another part of myself telling me something was wrong and to pay attention. It was trying to help me, protect me.

And contrary to a lot of the popular advice, this is not about loosening your standards, letting the house get a little dirty or buying cupcakes for the school bake sale instead of baking from scratch.

Exactly. The problem I have with that whole meme – "let go of perfection" – is it makes it sound like we are neurotic and that's why this is hard. My point is no, you can take out all the extra stuff, all the neuroticism and guilt, and it's still too much for a lot of us. That's where we have to look at collective solutions. We have to look at things like policies even though no one wants to talk about it, especially in America. And we have to look at culture and how we treat each other in the workplace.

Such as?

If we want to see women rise in their careers and be leaders, we have got to challenge this idea that to be a leader you must work long hours and you can never take any extended time off. In any job, whether you're a knowledge worker or an industrial worker in a factory, what the research shows again and again is working more than a six- to eight-hour day is actually not good for business. It's not good for employee health, but it's not even good for profits.

So let's let go of this idea that the people working these insane schedules are heroes, because often they're not.

At the same time, we have Sheryl Sandberg telling us to "lean in."

I did lean in to my career, and I'm glad I did for a certain period of time. What I'm not happy about is I leaned in too far and it made me sick.

We are making it almost impossible for women to lean in unless they are wildly rich and don't mind missing out on the intimate details of their kids' lives.

Follow me on Twitter: @traleepearce

This interview has been edited and condensed.

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