What are the signs of a midlife crisis?

The history of the midlife crisis

The phrase "midlife crisis" was first used by Canadian psychologist, Elliott Jacques in his Death and the Midlife Crisis paper, published in 1965. In this paper, he noted that some of the most famous artists changed their style or lost creativity upon reaching their late 30s, but their creativity picked up again in their late 50s.

Historically, a midlife crisis was regarded as a turning point in someone's life, generally between the ages of 40-60.

Is midlife crisis a medical condition?

Although a midlife crisis is a popular term, it is not a real medical diagnosis. It is not defined as a mental illness either and does not appear in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

What is a midlife crisis?

Dr Deborah Lee of Dr Fox Online Pharmacy explains that a midlife crisis tends to span a period when adults experience a range of emotions related to the passage of time. Adults may be grappling with getting older or having career regrets or dealing with personal events such as divorce, loss or redundancy.

She adds that a person is likely to experience multiple demands at this time in their life. These include:

• Caring for teenage children.

• Looking after elderly or sick relatives.

• Battling with their own health.

• Empty nest syndrome after children leave home.

• Relationship breakdowns or infidelity.

"For those going through menopause, the hormonal upheaval can take a toll, as can the health consequences of ageing, poorer health and the unwanted changes associated with changing physical appearances such as grey and thinning hair, balding, wrinkles and weight gain," says Dr Lee.

How common is a midlife crisis?

It's difficult to say exactly how common a midlife crisis is especially as it's not a medical condition. We don't know whether it's avoidable or just a natural part of ageing. It is often believed to be a manifestation of stress, anxiety and depression.

However, depression and stress are most common in midlife. In 2020 men and women aged 45-49 years had the highest age-specific suicide rate which has been the case for a number of years. There were 457 registered deaths for males and 138 for females in this age group.

Dr Lee adds: "In one piece of research in the year 2000 the number of midlife crises reported was said to be 10%-20%. By 2013 a UK survey found 40%-60% of adults said they had experienced this.

"A midlife crisis is said to be strongly linked to ageing. Psychologists have recognised a U-shaped curve linked to happiness and ageing. This means adults are happiest in their youth and older age and least happy in middle-age."

What triggers a midlife crisis?

A midlife crisis looks different for each person so multiple life events can be a trigger.

Dr Lee explains how midlife tends to be a time when adults look critically at what they have achieved in their lifetime and may experience regret. This can be coupled with a realisation of their own mortality and feeling a lack of purpose.

"When crisis point is reached they go through a profound psychological breakdown, often accompanied by symptoms of stress, anxiety and depression."

Yuko Nippoda, psychotherapist and spokesperson for the UK Council for Psychotherapy (UKCP), adds that lack of energy and stamina can trigger a midlife crisis.

"When people are younger they are so energetic that they feel they can do anything they want but a decrease in liveliness makes them notice the limitations on life and their activities."

Who is most at risk of a midlife crisis?

Despite the difficulty in establishing how common midlife crises are, it's thought that certain people might be more at risk.

Factors that pose risks to overall health can contribute to a midlife crisis. These factors include smoking, excessive alcohol consumption, obesity and lack of exercise.

Caregivers can also be at increased risk of having a midlife crisis, especially adults who care for disabled children with additional needs. This can bring added pressure, a blurred work-life balance, exhaustion and financial problems.

Can you prevent a midlife crisis?

One study identified protective factors against a midlife crisis and depression when ageing, including:

• Healthy emotion regulation.

• Strong social connections.

• Positive health behaviours (such as getting better sleep and regular exercise).

These lifestyle factors have also been associated with longer telomeres. These are DNA segments at the end of chromosomes. Shortening telomeres are a sign of ageing. Therefore, not smoking, being physically active, becoming less stressed, less exposed to pollution and eating a balanced diet could slow your pace of ageing, while also helping to reduce your risk of disease.

"One of the key elements in preventing a midlife crisis is staying in control. Midlife is often hectic and a time for major financial decisions. Those who manage to stay in control seem less likely to succumb to the midlife crisis," adds Dr Lee.

What does a midlife crisis look like for a man?

Dr Lee explains some of the typical symptoms and signs of a midlife crisis, many of which occur in both men and women.

• Feeling sad and unfulfilled.

• Constantly looking back at the past.

• Feeling like life is meaningless.

• Developing sudden impulses (for example, making unhabitual expensive purchases).

• Having an affair.

• Feeling like everyone else is happier than you are.

"Men often experience erectile dysfunction and intense feelings of sadness during a midlife crisis," she adds.

What does a midlife crisis look like for a woman?

A woman's midlife crisis tends to be affected by the hormonal imbalances associated with going through menopause which is natural and expected.

Perimenopause (the time around menopause when the body makes a natural transition to the end of its reproductive years) can start at various ages but tends to last for five years, sometimes longer. In the postmenopausal period, when the body is adjusting to life without oestrogen, these changes can contribute to the experience of a midlife crisis or mental health issues.

Dr Lee explains that oestrogen deficiency can cause a range of unpleasant symptoms, such as hot flushes, night sweats, insomnia, exhaustion, mood changes, joint pains, vaginal dryness and painful sex.

Nippoda adds that changes in appearance and body shape can bring on a midlife crisis in women.

"They realise they are no longer who they used to be and they might experience a loss of confidence or sadness or fear that nobody cares about them."

"Many women struggle mentally while going through menopause. One specific problem they face is menopause-related depression which is depression that appears to be specifically precipitated by oestrogen deficiency," says Dr Lee.

There is an increased likelihood of experiencing depression during menopause if you have been diagnosed with depression in the past.

"Women have to accept the physical changes brought on by menopause and ageing which can be difficult. Women tend to be more affected by their emotions in midlife and may weep more than men."

One study found that the majority of women aged 60 and over say they cry "every few months," while men over 60 mostly said they "never" cry.

How long does a midlife crisis last?

"It's hard to say when a midlife crisis is likely to be over but it tends to happen when the person reaches a stage of acceptance about their life changes," says Dr Lee.

Nippoda says the length of someone's midlife crisis depends on the person.

"Although it might be a great shock initially if the person accepts that this is part of life they can start to focus on what they can do according to their age and continue to enjoy life. However, some people find it difficult to admit they're changing and want to stay young," she says.

If this happens, a person's mental well-being can be deeply affected, as they are disappointed about the gap between their perception and the reality of who they are.

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What are the signs of a midlife crisis?

The American Psychological Association offers useful advice on how to spot the signs of a midlife crisis in a loved one - or in yourself.

• A notable change in personal behaviour.

• Lack of usual personal hygiene.

• A dramatic change in sleeping habits (either being unable to sleep or sleeping all the time).

• Reduction in work performance.

• Emotional outbursts (including anger, irritability or anxiety).

• Preoccupation with death.

• Withdrawing from social activities.

• Giving up on relationships.

• Drinking more alcohol.

• Smoking more heavily or abusing illegal drugs.

• Becoming obsessed with appearance.

These symptoms can come on suddenly but it's more likely you will notice them gradually over a period of time.

How to help someone with a midlife crisis

If a midlife crisis has affected your relationship with a loved one, or they act out of character, it can be difficult to know the best way to support them, especially if they are often stressed.

However, communication remains of utmost importance.

Keep talking to the person you are worried about. You can approach the topic in a sensitive way using open-ended questions such as, "You don't seem yourself at the moment and I'd really like to help if I can. How are you feeling?". This can help a person feel like you are genuinely concerned as opposed to scrutinising them.

Other ways to show your support include:

• Staying calm and being patient.

• Allow for quiet time and listen when they want to talk.

• Look for signs of depression or concerning behaviour.

• Encourage them to develop resilience and learn coping skills.

• Encourage them to become accepting of the changes they are facing and practise self-care.

• Help them develop a more positive mindset by being optimistic yourself.

Remember, there is no "quick fix" for a midlife crisis but your loved one can get through it gradually and you can help by showing them compassion and helping them embrace life again.

Where to find support during a midlife crisis

If you are worried about suicide, contact The Samaritans on freephone 116 123.

The Samaritans also offer resources for supporting someone else.

Relate can help if a midlife crisis is affecting a relationship.

You can also make a GP appointment if you are struggling to cope and would like to be referred for therapy or prescribed antidepressants. You can take someone with you to the appointment so it isn't as daunting as going alone.

UKCP has a list of counsellors and therapists who can help you too.