Midlife Depression in Women

Middle-aged women (age 40-55) have been found to be at higher risk for depression. Part of it stems from the natural hormonal alterations of perimenopause and menopause. However, it tends to be about more than just hormone changes: Midlife can be a time marked with greater losses, like empty-nest syndrome, ailing and/or deceased parents, career changes, and a loss of former friendships, marital and love partnerships. Additionally, women in midlife have reported higher rates of pain and physical ailments.

Coping strategies like excess alcohol, overuse pain medication, and increased food consumption combined with social withdrawal and less activity exacerbate inflammation and associated physical pains and depressive symptoms. Finally, women in midlife may grieve the loss of childbearing abilities and fear their sexual appeal and value have waned. Thus, it is more important than ever for women in midlife to cultivate healthy coping strategies and find new (or deeper) meaning in their lives.

One thing a woman in midlife can do is to pause and write down the issues she is confronting. Consider categories such as family, career, self-esteem, grief, fears, friendships, love relationships, future trajectory, faith, and health; then, fill in current issues for each one.

Second, circle all areas of concern in each of these categories. Third, write down healthy coping strategies and unhealthy coping strategies for dealing with the circled areas of concern. If this exercise has been difficult and you find you are struggling with unhealthy coping strategies and a lack of social support, please consider reaching out to someone for help.

Additionally, do a physical and mental health checkup. Work with your doctor to check your hormones, bloodwork, and overall health. Identifying any underlying medical conditions is particularly critical at this juncture of change. Mental health checkups can reveal that some anxiety-producing thinking patterns have set in. For instance, beware of perfectionism, all-or-nothing thinking, mind reading, and Chicken Little reactivity (“The sky is falling.” “Everything is falling apart.” “I’ll never be XYZ.” “I can’t win.” “Nobody likes me.” “Everybody is against me.” “It’s all their fault.” “I’m worthless.”)

While midlife can bring changes and losses, OB/GYN and author Christiane Northrup describes midlife in women as a time of fully giving birth to one’s Soul. She says women have been nurturers to everyone else and that midlife is marked with significant labor changes that can bring the most profound and joyous days ahead. The younger maiden and mother roles were powerful and happy, yet older women may derive meaning and joy in other ways. It can be a deep heartfelt joy detached from external ego comparisons.

An older woman who has successfully given birth to a new identity at midlife has become differentiated, wise, and trusting in their flow. Her thinking is balanced, and her heart space is clear. She is comfortable in her body and brings an exuberant spirt that happily anticipates each moment. She is like a butterfly that has emerged from the midlife cocoon.