Midlife: The Forgotten Frontier

Louise Stanger, Ed.D., LCSW, CDWF, CIP and Roger Porter

unhappy elderly couple drinking

The only time you really live fully is from thirty to sixty. The young are slaves to dreams; the old servants of regrets. Only the middle-aged have all their five senses in the keeping of their wits. ~Theodore Roosevelt

The iconic academy award winning film American Beauty expertly mines the humor and hijinks, sadness and regret many people experience when their 20’s and 30’s fade in the rearview mirror and come into 40. The protagonist of the movie, a father stutter-stepping into a mid-life crisis, reflects about middle age to his rebellious, confused and insecure teenage daughter. “I wish I could tell her that’s all going to pass, but I don’t want to lie to her.”

Like many middle-aged men seeking prowess in material objects, this father purchases a brand new ‘muscle car’ and parks it in the front driveway to show off to the neighbors – the quintessential object of an ego redefined by machinery in one’s 40’s and 50’s. For women, it may be a new home, an adventure to an exotic land, an extramarital affair, fancy clothes, a prescription for opioids or even a whole new face.

What is middle-aged exactly? It’s usually defined as the life stages between the ages of 40 and 60 – the period after young adulthood and before the onset of old age. Maybe that’s just a textbook definition. A looser definition comes from 2,000 adults commissioned by British healthcare provider Benenden Health, citing that middle age comes if “they enjoy afternoon naps, moan when they bend over, are frustrated by modern technology and choose comfort over style when it comes to clothing.”

Other more comical signs of entering middle age include: stiff joints, pain in newfound places, hair in ears and nose, fleeting memory, misplacing car keys and wallet, and a general feeling of being out of touch with younger people. Biologically, bodies change- women experience perimenopause and menopause amid testosterone levels that change in men, skin sags, eyesight changes, and gums may be more susceptible to periodontal disease.

What is it about entering these middle passages that triggers a reevaluation of all that has transpired? This appears to be a moment when you look in the mirror and ask the question that everyone asks themselves at one point or another in this cosmic journey we call life: “Who am I?” Even worse, how does this age transition bring on or magnify addiction, chronic pain, process disorders and other mental health issues?

Despite research that shows life expectancy is getting longer, entering the forties has long been seen as the halfway point. Major life milestones – school and graduation, sexual identity, career experiences like being hired, changing jobs or even being fired, marriage and starting a family, buying or leasing a home and cars, saving for retirement and college funds – have largely come and gone, leaving an air of “Is that all there is?” in its wake. If life brings a whole second act after intermission, what is there to do on stage with all that time?

Ageism and the relentless chase for the fountain of youth play a role. In Hollywood, many actresses can’t find a leading role past the age of forty, which prompts more than a few lifts and tucks, the pull of gravity be damned. Middle class women may also look to advancements or changes in career, bigger houses and lavish vacations. The physical changes that come from menopause – a major milestone in a woman’s life – may even prompt an Eat, Pray, Love journey of the soul.

For men, the feeling of being trapped in mortgages and car payments, soccer practice and family vacations trigger nostalgic memories of bachelorhood and the freedoms that came with it. And for both sexes, marriage and divorce are common experiences. Per the American Psychological Association, 40-50 percent of couples in the United States divorce and the rates for subsequent marriages are even higher.

Reasons for divorce vary, however, a common reason is that an older partner is a constant reminder of one’s own age. A younger partner is life-affirming, a way of staving off one’s own fear of aging and mortality. Sometimes divorce and remarriage are about giving life a new coat of paint to make it look shiny and new.

Physical changes play a part in the way we live and function in the world. Our bodies are no longer well-oiled machines – they creak and groan a bit. They are no longer capable of taking the strain of a 60-mile bike ride, climbing Machu Picchu or backpacking through a wilderness trail. What was once a thrilling activity may feel challenging and tiresome.

In some cases, people in their 40’s and 50’s may experience an injury that sidelines them and causes chronic pain, a serious condition affecting millions of Americans that can lead to easy access of prescription painkillers, which may cause a debilitating addiction, further exacerbating them and causing more severe problems. Middle-aged men and women who experience chronic pain have the potential to impair mental and physical functioning, as well as quality of life.

With chronic pain and subsequent opioid abuse an issue for middle-aged people, research shows it disproportionately affects middle-aged women. According to a report published by Pacira Pharmaceuticals titled The United States for Non-Dependence, researchers found “middle-aged women, ages 40-59, are particularly at risk, as they were prescribed more opioids than any other age group… receive twice as many prescriptions as their male counterparts… and are 40% more likely to become dependent than men.”

This information is especially worrisome because “women between 45 and 54 years old have the highest death rate from opioids among all females,” researchers found.

Women aren’t alone. Middle-aged men also experience chronic pain – a $635 billion dollar a year problem, which affects more people than cancer, heart disease, and diabetes combined – and positions the United States as the leader in the use and abuse of prescription pain medications.

Additionally, research shows this age group is battling alcoholism in record numbers. In a report published by the Proceedings of the National Academy of Sciences of the United States of America (PNAS), researchers found an “increase for non-Hispanic white people… in death rates from drug and alcohol poisonings, suicide, and chronic liver diseases and cirrhosis.”

Alcohol is also contributing to an overall decline in health for this age group. “Self-reported declines in health, mental health, and ability to conduct activities of daily living, and increases in chronic pain and inability to work, as well as clinically measured deteriorations in liver function, all point to growing distress in this population.”

And like opioids, studies show middle-aged women have the highest rates of alcohol consumption. “13 percent of women aged 45 to 59 are drinking an average of more than two glasses of wine at night, which could be placing them at risk of serious illness,” a Queensland University of Technology researcher reports.

Many adults stepping into middle age have children, a mixed responsibility that complicates every aspect of life. Financial strains, emotional highs and lows and the persistent gnaw that one wants them to turn out healthy and happy eats away at parents. As the children near adulthood and leave the nest, middle aged parents feel the tug of loss, a closing chapter in one’s life that brings on feelings of loneliness and abandonment.

Not only do middle-aged folks contend with financial and emotional tug of- war with children, many of them have aging parents who can bring added stress and obligations. This is often referred to as the ‘sandwich generation’ because of the responsibilities of taking care of an older parent and younger children. “Nearly half of adults in their 40’s and 50’s have a parent age 65 or older and are either raising a young child or financially supporting a grown child (age 18 or older),” reports the Pew Research Center. “And about one-in-seven middle-aged adults is providing financial support to both an aging parent and a child.”

For folks who enter middle age and struggle with substance abuse, mental health or process disorders, there are newfound freedoms in recovery. For this age group, a multimodal approach for treatment and recovery is possible. As such, folks who are financially independent in this age group may also work with their treatment providers to adjust their schedules to fit the needs of their professional pursuits with their treatment plan. Folks can redefine their purpose, discover meaning and be of service in new enriching ways with clarity and precision. Middle age can become an opportunity for new discoveries and growth.

Turning forty, in fact, may well be fortuitous. In an opinion piece published by the New York Times about reflections on turning forty, one responder wrote, “the funny thing to me, as a woman who loves being in my 40s, is that although we are told that young women are more valued by society, this is actually not true… young women are treated as things by people who want an attractive decoration… young women are dismissed and devalued on a regular basis. I can’t wait for my hair to get even grayer, for people to stop seeing me as that object.”

Men feel the change, too. “I have felt over the past few years that I have never been treated better by society,” writes a 43-year-old man about coming into his own skin. “When I interact with people in stores, on the street, people give me their full attention, stand up straight and often say “sir” and “excuse me.”

Another responder who went to grad school and changed careers at 40, opines about wisdom and respect she never knew before becoming middle aged. “I could flatter myself and say that it was just because I was really good at my job, but the fact is that my age and life experience had provided me with the gravitas necessary to appear more knowledgeable than my younger peers.”

These are the gifts, as I tell my clients, of leaning into the discomfort of change. Middle age doesn’t have to be about taking something from us, it can be about giving us the tools to become a better version of ourselves. “Call me “madame” anytime. To me, it’s a badge of honor for achieving wisdom.”

Dr. Louise Stanger founded All About Interventions because of her passion for helping families whose loved ones’ experience substance abuse, mental health, process addictions and chronic pain. To learn more, watch this video: www.youtube.com/watchv=hDf5262P7I8 and visit her website at www.allaboutinterventions.com.

Roger graduated with two degrees from the University of Texas at Austin. He works in the entertainment industry and writes for film and television.