Six signs you could be suffering from a midlife mental health crisis

How do you know if you’re experiencing a midlife mental health crisis? New research this week suggests middle age is the worst period for mental ill-health, with a double whammy of increased responsibility at home and work combining to make us more stressed. Between one in six and one in five of both baby boomers and generation X-ers suffered mental ill-health at the age of 50 according to a study by University College London. This represented a far higher proportion than at any other point in their lives.

The researchers attributed the findings to the fact we are more likely to have reached senior positions in our careers by this life stage, bringing greater pressures, and are often combining these more demanding jobs with caring for both children and elderly parents. The pandemic may also have made midlifers more concerned about job security and being able to meet their financial responsibilities.

Add the first signs of declining physical health into the mix – and for women the menopause, too – and you have something approaching a perfect storm.

But how can you tell if your mental health is seriously out of kilter? Here are six of the signs:

1. Two weeks or more of low mood

It’s natural for our mood to go up and down during the week, or even during the day, and we all suffer bad days from time to time. But if you’ve experienced nothing but bad days for a fortnight or more, it may be a signal something isn’t quite right. “If you find you’ve gone for more than a couple of weeks without a break in feeling quite desperately lonely and unclear then you deserve some attention,” says clinical psychologist Linda Blair.

We all have our own ways of picking ourselves up and dispelling our routine low moods when they arise. But if our usual techniques have somehow stopped making any difference, we may be suffering from something other than the usuals ups and downs.

“If you do summon the energy levels [to try and engage in something to lift your mood] and that doesn’t lift you, it’s a bit of a worry because it suggests the endorphins aren’t enough and means you’ve got yourself entrenched,” says Blair.

2. Tearfulness

Everyone has a different threshold when it comes to how easily they cry. But tearfulness that’s out of character could be of concern, warns Blair. “If you’re finding yourself just sobbing with a sort of despair, that’s not a great sign,” she says. “It’s not definitive, but it is a warning.”

3. Irritability

Increased irritability or grumpiness can have different causes and manifestations for men and women. Simon Shattock, family and couples psychotherapist at mental health provider Clinical Partners, says when middle-aged men are suffering from mental ill-health they are “more likely to internalise things and not talk; they might become grumpier, drink more and withdraw from family life.”

With women, however, the menopause could be causing them to become more irritable and suffer other symptoms of mental ill-health.

“The female hormones oestrogen and testosterone are very important for the way female brains function,” says Dr Louise Newson, a leading menopause specialist and founder of the Balance app, designed to provide women with menopausal support. “When levels of these hormones reduce during the perimenopause and menopause then many women experience psychological symptoms such as low mood, anxiety, reduced motivation, fatigue, memory loss and irritability. Far too many women are incorrectly diagnosed with depression and research has shown that antidepressants do not improve these symptoms if they are due to low hormones.”

For these women, hormone replacement therapy can make a big difference, she says.

4. A sense of hopelessness

“If you look at yourself in the mirror and can’t find anything to praise about yourself, that’s a worry,” says Blair. Hope is the first thing you need to get you back on track when your mood slips, so if it’s hard to find any, you may want to consider why this is.

The ongoing pandemic and lockdown restrictions can add to, or cause, a sense of hopelessness, of course. It is no coincidence the past 10 months have taken a toll on mental health in all age groups. But for those in midlife, a unique combination of pressures may be fuelling the problem: this group may be home schooling their children, trying to keep their jobs, worrying about their future employment security, and anxious about the health of elderly, isolated parents. “They’re the sandwich generation,” says Shattock of this demographic. “I’m talking to a lot of clients who feel they’re losing a sense of themselves and their personality. It’s a drip-drip of pressure [to which] the pandemic adds another layer.”

5. Memory loss

We all find ourselves forgetting things as we grow older, but in some cases, memory loss can be linked with stress, anxiety or depression. The NHS warns against self-diagnosing when it comes to memory loss. In 2018, US scientists found a link between symptoms of depression and changes in memory, with those suffering greater symptoms of depression also exhibiting worse episodic memory – the ability to recall specific past events.

6. Problems sleeping

Stress can lead to people feeling anxious at night and not sleeping, says Shattock. And as the Sleep Foundation has pointed out, sleep deprivation can worsen anxiety, “spurring a negative cycle involving insomnia and anxiety disorders.”

Studies have meanwhile estimated that between 65 per cent and 90 per cent of adults with major depression experience some kind of sleep problem, according to Harvard Medical School.

Our sleep patterns may well have been affected by the pandemic too, and it can be difficult unpicking causes and effects at a time like this. This could mean mental health problems are going unspotted, especially among those who spend all their time looking after others.

As Blair puts it: “They’re giving and giving and receiving zero.”

Finding help wherever we can is important, she stresses.

“What we lose when we give and give, is thinking we have the right [to help],” she says. “You do deserve it.”

Have you struggled with mental health during the pandemic? Tell us about your experience here