Midlife Crisis: Transition or Depression?

What do you do when a midlife crisis turns into depression?

Medically Reviewed by Brunilda Nazario, MD on November 11, 2009
5 min read

What's a midlife crisis? It's the stuff of jokes and stereotypes -- the time in life when you do outrageous, impractical things like quit a job impulsively, buy a red sports car, or dump your spouse.

For years, midlife crisis conjured those images. But these days, the old midlife crisis is more likely to be called a midlife transition -- and it's not all bad.

The term crisis often doesn't fit, mental health experts say, because while it can be accompanied by serious depression, it can also mark a period of tremendous growth. The trick, of course, is to realize when the transition is developing into depression so you can get help.

Beginning in the 1980s, the term midlife crisis got a lot of attention, says Dan Jones, PhD, director of the Counseling and Psychological Services Center at Appalachian State University, Boone, N.C. He has researched adult development and transitions.

"It was never a formal diagnostic category," he says of the term midlife crisis. And the age at which midlife crisis strikes can vary, he says. When midlife occurs depends on whom you ask and partly on such factors as how long they expect to live.

A midlife crisis might occur anywhere from about age 37 through the 50s, he says.

By whatever term, the crisis or transition tends to occur around significant life events, he says, such as your youngest child finishing college, or a "zero" birthday announcing to the world that you're entering a new decade.

"The death of parents can be a marker, too, for these midlife events," Jones says.

Men and women are equally likely to experience a transition or crisis, Jones says. "But it looks different in both genders," he says.

"The stereotype is a man buys a red sports car," he says. That's not always the case, of course, but Jones says men do seem more intent on wanting to prove something.

Men might gauge their worth by their job performance, he says. They may want to look successful, for instance, even though their achievements don't measure up as they had hoped.

"Women often get validity through relationships," he says, and that's true even if they've had a lifelong career. So at midlife, they are likely to evaluate their performance as a wife, mother, or both.

The midlife transition is looked on, more and more, as a normal part of life. Yale psychologist Daniel Levinson proposed in his well-regarded theory of adult development that all adults go through a series of stages. At the center of his theory is the life structure, which is described as the underlying pattern of a person's life at any particular time.

For many people, the life structure involves mainly family and work, but it can also include religion and economic status, for instance. According to his theory, the midlife transition is simply another, normal transition to another stage of life.

In midlife, people often reevaluate their priorities and goals, Jones finds.

Women, feeling they have raised their children, may want to go back to school, even if they have been in the work force, reasoning they can now do whatever they wish, work-wise.

"They're able to follow up on some dreams," he says, that might have been abandoned due to family responsibilities.

"Men may get more in touch with their feminine side," Jones says. That could mean taking up cooking or art or volunteering with children.

Meanwhile, midlife women may become more selfish, Jones says, even though they value relationships. They may feel they have "paid their dues" and not be willing, say, to babysit the grandkids every time they are asked.

The midlife transition can be enlightening for some but also tough, agrees Joan R. Sherman, LMFT, a licensed marriage and family therapist in Lancaster, Pa.

Whether a midlife transition will develop into serious depression or into an opportunity for growth depends on a number of factors, including support from partners and other loved ones.

Sherman recalls a woman who came to her for counseling. She was in her late 40s, married to a man about the same age who had traveled extensively for his job throughout their marriage. That left her with full-time household responsibility, raising the kids.

She had been a nurse, but gave that up to be a full-time parent. When the kids went off to college, she thought, "What now?" Sherman says. The woman told her she felt she had lost her whole identity.

The husband, who also talked to Sherman, became concerned after his wife spent nearly a week sleeping and crying.

The next time Sherman saw the woman in therapy, she offered her an alternative thought: "You're not losing your identity. You have an opportunity to create a new one."

Yes, her parenting role would change, but having much less responsibility -- as her kids were now in college -- would free her up to develop a new image and identity. The thought appealed to her. The next week, she went to a college placement service to explore her options.

Not everyone glides through their midlife transition that easily, of course, Jones says.

In midlife, people need to be aware of symptoms of serious depression, such as:

  • Change in eating habits
  • Change in sleeping habits, fatigue
  • Feelings of pessimism or hopelessness
  • Restlessness, anxiety or irritability
  • Feeling of guilt, helplessness or worthlessness
  • Loss of interest in activities once enjoyed, including sex and hobbies
  • Thoughts of suicide or attempts at suicide
  • Physical aches or pains such as headaches or gastrointestinal upset that don't respond to treatment

Behavior or "talk" therapy, as well as prescription antidepressant medication, can help treat major or clinical depression, says Anita H. Clayton, MD, professor of psychiatry and neurobehavioral sciences at the University of Virginia, Charlottesville.

In a study published in the Journal of Consulting and Clinical Psychology, Stanford University researchers compared medication alone, talk therapy alone, or a combination in 656 persons with chronic depression. They found that the combination produces a faster, fuller remission of chronic depression.

If depression is milder, Clayton says, a single approach may be enough.