Jean Coleman MSc, Andropause Society Secretary and Consultant Clinical Psychologist writes: The midlife crisis is not another way of describing Testosterone Deficiency Syndrome, also known as Andropause, Hypogonadism, the Male Menopause or androgen deficiency in the aging male (ADAM).
Emotional, not Hormonal? - The midlife crisis is concerned with emotional issues, Andropause or Testosterone Deficiency Syndrome as it’s increasingly being termed, is a condition caused by imbalance of hormones.
The midlife crisis strikes in the thirties in most cases. Recently, because of the way some young people can achieve material goals more rapidly, the onset may be earlier, early thirties or even late twenties.
Testosterone Deficiency Syndrome is encountered later in life - in most cases. Depending on predisposing events earlier in life, patients can begin to suffer from the typical symptoms much earlier than the usual late fifties to sixties. This syndrome can occasionally manifest in the thirties and even more rarely, in the late twenties.
The midlife crisis is not biased against either sex, both men and women can suffer from it. Testosterone Deficiency Syndrome is rarely found in the female of the species.
Technically, of course, it is possible for a man to suffer from both conditions at once. Not a pleasant combination with even more confusion arising for both the patient and those trying to help him.
So, what is the Midlife Crisis? - This characterized by low mood, dissatisfaction with life, a feeling of pointlessness in life. It is not always distinguishable from clinical depression. Patients are often treated with antidepressants, and this may be appropriate.
Those in crisis may show their distress by reacting in several different ways: by denial (by escape or overcompensation), by decompensation (with anxiety, depression or rage), or by regression. An individual may become discontented at work, resort to alcohol or risk taking behaviour.
The range of feelings experienced have been variously described as hollowness and lack of genuine enjoyment, emptiness and uncertainty, a mixture of strain and boredom, floating unfocussed melancholy and depression. This is the time when people are believed to be vulnerable to hypochondria, accidents, illness, alcoholism and suicide.
Midlife crisis is described as an existential crisis, that is to say, it is centred about issues of meaning and purpose in life. This is why it arises at the time it does, because by the mid thirties, young people have often achieved their initial goals in life (or realized they are not attainable).‘The hormone production levels are dropping, the head is balding, then sexual vigour is diminishing, the stress is unending, the children are leaving, the parents are dying, the job horizons are narrowing, the friends are having their first heart attacks; the past floats by in a fog of hopes not realized, opportunities not grasped, women not bedded, potentials not fulfilled and the future is a confrontation with one’s own mortality.’ (M.W.Lear, 1973). This brings the person to appoint in life where they need to review their life. Is this what I want to be doing? Do I want to do this job forever? Is this really the person I want to be with for the rest of my life?
Crisis, Transition or Life Review? - For most people, this period of review is not really that critical. It is a transition period to the second half of adult life and may not be experienced as a major problem. Where it does become a problem is with individuals who have significant unresolved issues from earlier in life, usually from childhood.
Becoming your own Person - For example, Tony spent his childhood trying always to be the person his controlling parents wanted him to be. He was given the responsibility for his younger siblings at the age of 6, and woe betide him if anything untoward happened! At only 17, he escaped to live with, and then marry, a lady who was ten years his senior and very happily spent the next 17 years being looking after by her, but in a much less unpleasant way, still trying to be the person she and her children needed. Suddenly he became very depressed, fled the marital home on a number of occasions and was found to be sleeping rough in his car. He felt he could not go on in this way and needed to change his life and be on his own.
He was overwhelmed with guilt at the way he felt he was letting down this gentle lady who unbeknownst to her, had been re-parenting him for all these years. Fond of her still, he felt a strong need at last, to go out into the world and live his own life, to be his own person. Often in similar cases, another woman is involved. In this case, it was not.
He never returned to his wife, and she had a difficult time coming to terms with his leaving, but the divorce was amicable and they continue to be friends. He couldn’t continue to be a family man because this involved continuing to be what other people needed him to be. He needed to live for himself for a while and learn to find his true identity.
Choosing the Right Goals - Young people set out in life as adults with a series of goals they wish to achieve. This is what they believe will make them happy. To marry well, to have this many children, to achieve this in my career, to buy my own mansion; these are examples of life goals. When these have been achieved, what do you do next?
Sometimes the goals set are inappropriate, as in the case of Peter. Peter was a highly intelligent child, but he got in with the wrong set where brawn rather than brains was the thing to aspire to. He became leader of the gang, the school bully and learned to use coercion to get what he wanted.
Soon after the birth of his first daughter, he found he had no interest in his job as a store man. He could do this standing on his head. He was paid well and already had his own, small, house. His main interest suddenly was in nature and wildlife. There was no one to share this with. He no longer loved his wife and felt she’d be better off without him and his aggressive outbursts. His friends didn’t understand him and wanted nothing more than to drink to oblivion or get into a fight.
He became depressed and thought of ending it all. Eventually, he gave up his job and left his wife and child in the family home to escape off round the world where at least he could find interest in plants and animals. Peter had ended up in the wrong life altogether as a result of his poor choices earlier in life.
A Sense of one’s own Mortality - Completing one’s initial life goals may be one precipitant. Another is said to be a sudden clear awareness of ones own mortality. Midlife crisis is often preceded by the death of a parent or other close family member; or even worse, the death of a friend close to one’s own age.
It’s as if the person suddenly feels vulnerable, ‘my parents generation is old, we children are now the grown ups in this society. We are the next generation who will die. What’s the point of all this if we are going to die anyway!’
A Purpose in Life - It’s answering this last question that resolves the midlife crisis. The person needs to find something which gives them a purpose in life or which makes life worth living. What this might be is different for everyone. For some it may be grandchildren, for others it might be a new wife, a new job, revisiting an interest from the past or becoming involved in spiritual matters.
If the question is successfully answered, the person can move on into a potentially more productive or creative phase of life. If it has not been dealt with, then the person may continue to be depressed or unhappy indefinitely. Some writers maintain that the person in continuing crisis may go on repeating unhelpful patterns of behaviour or be subject to physical health problems . Some may decide to end it all.
Midlife Crisis and Creativity - Jaques (1965) maintained that the pattern of midlife crisis is often seen in the lives of writers, composers and artists. Their early work flows easily from pen, brush, chisel or whatever. In the second half of life, things progress more slowly and with more of a struggle; but the results are more meaningful, stronger, in many people’s eyes, they are greater works of art.
Shakespeare’s earlier works had a lighter, often more comedic style; but it is his later works of tragedy that have the deeper messages. So it is also with musicians and other artists. Jaques would maintain that the great work of Bach, Constable and Goya emerged in mid-life.
Jaques studied ‘some 310 painters, composers, poets, writers and sculptors of undoubted greatness or genius’. In this study, he found a tendency for creativity either to cease, sometimes the person actually died, or subsequent works were changed in nature. The quality of work is no longer a spontaneous expression but becomes a ‘sculpted creativity’.
‘There is no longer a need for obsessional attempts at perfection, because inevitable imperfection is no longer felt as bitter persecuting failure. Out of this mature resignation comes the serenity in the work of genius, true serenity, serenity which transcends imperfection by accepting it.’
Levinson (1976) also comments on the link between resolution of the crisis and continuing effective creativity, ‘Men such as Freud, Jung, Eugene O’Neill, Frank Lloyd Wright, Goya and Ghandi went through a profound crisis at around 40 and made tremendous creative gains through it. There are also men like Dylan Thomas and F. Scott Fitzgerald who could not manage this crisis and who destroyed themselves in it.
Surviving the Midlife Crisis - Although many writers describe the possible negative outcomes of this transitional period of life, [‘psychological disturbance, depressive breakdown, strengthening of manic defences’, Jaques, ‘under severe conditions many do not survive it and commit suicide’ Rogers (1974), Levinson (1976), others are more positive in their conclusions.
Marmor (1968) asserts that ‘the significance of the crisis, psychotherapeutically, is that at such periods of stress, properly presented interventions can be of maximum efficacy’. Brim (1976) concludes that ‘these changes, even when they occur in crisis dimensions, bring for many men more happiness than they had found in younger days’.