by Kevin Schofield

---

Elliott Jaques, a 20th century psychoanalyst, is credited with coining the term “mid-life crisis” in an article he wrote in 1965, though he in turn credits author and artist Richard Church for defining it in his autobiography:

There seems to be a biological reason for men and women, when they reach the middle thirties, finding themselves beset with misgivings, agonizing inquiries, and a loss of zest.

Jaques believed that the heart of the “mid-life crisis” is being forced to come to terms with the certainty and inevitability of one’s own mortality.

Certainly the notion of a mid-life crisis has been fodder for endless songs, movies, and television episodes — as well as the impetus for real-life adventures of people in their 40s and 50s. It is also frequently laughed off as a “phase” that someone is going through. But is the midlife crisis a real thing? A forthcoming research paper suggests it is — and at a much larger scale than we might care to admit.

The researchers took a comprehensive look at studies of several measures of personal distress in rich nations, including suicide rates, sleeping problems, alcohol dependence, difficulty concentrating, memory problems, job strain, migraine headaches, suicidal ideation, and depression. They found the same recurring pattern: Rates were low in the very young and the old, and they peaked in middle age. They found that this pattern has been consistent over decades. For example, here is the data for suicide rates in England and Wales among different age groups each year from 2001 to 2020:

So there is a clear and consistent pattern of high levels of distress for people in middle age; what isn’t clear is why. It carries across rich nations (though there is less data on poorer nations to know whether it’s a pattern there too); perhaps it could be something related to “rich nation” economies, governments, or societies. The researchers speculate that it might relate to “unmet expectations” in midlife, or “rising wisdom” in elder years as a cause for the rapid decline in these measures of distress. They are unable to conclude whether midlife crisis is a timeless part of human nature or a temporary “byproduct of today’s affluent world.” 

Nevertheless, midlife crisis is apparently widespread and has serious consequences on the lives of people in their 30s, 40s, and 50s — enough so that it makes one wonder whether public health agencies should be paying attention.

Certainly, health researchers have been digging into this for a while — and that leads us to dive into a second “read” this week, a research paper from 2015 that the midlife crisis researchers cited in their work. The paper highlights that “all cause” mortality — the rate of people dying for any reason — trended steadily downward for middle-age people in most places in Europe and North America between 1970 and 2013, except for one group that bucked this trend starting in 1999: U.S. white non-Hispanic persons between the ages of 45 and 54.

By comparison, the all-cause mortality rate dropped substantially for middle-age Black non-Hispanics and for middle-age Hispanics. Dissecting the data further, the researchers found that all of the increase for white non-Hispanics comes from those whose education level reached a high-school diploma or less. In fact, mortality decreases slightly for those with some college and by a larger amount for those with a college degree, but the increase for those with less education is so large that it overwhelms those other demographic groups.

The researchers then looked for patterns in the causes of death among this group. They found that the increases were being driven by a small set of “external” causes, most notably chronic liver disease (from overconsumption of alcohol), poisonings (often from drug use), and suicides.

Then, they looked at “morbidity” for this group, the medical conditions and diseases they reported, and how they had changed over 15 years. The researchers found that overall health had declined for people in middle age, reports of pain had increased, mental health assessments had declined, alcohol consumption had increased, and they had more difficulty with regular daily activities, such as walking, climbing stairs, shopping, and socializing. All this is consistent with what the midlife crisis researchers had found: the middle years are a time when distress increases. But it is apparently most acute for white people in the U.S. with low levels of education. 

It’s not difficult to recognize the societal and political ramifications of this. There is ample data documenting that education level and income level are correlated: People with low levels of education — of all races and ethnicities — have lower incomes in our society and often have jobs that do not provide benefits, including essential ones, such as health care. For People of Color without higher education, we know they are disproportionately drawn into the criminal justice system’s revolving door and often remain there for the rest of their lives. White people with low levels of education are pulled into the criminal justice system less often, but as we have seen, the data shows they are clearly not thriving in their middle years, and that makes them easy prey for the new generation of “white gangs,” such as the Proud Boys and Oath Keepers, that offer them ways to ease some of their midlife distress: a social connection to peers and a feeling of purpose.

Now, let’s be clear: This in no way justifies, excuses, or praises anything that these far-right groups do or stand for; the evidence shows they are racist, homophobic, toxic, and violent. But just as we can recognize that criminal justice reform requires moving upstream and understanding the events and circumstances that lead someone into contact with the criminal justice system — or, similarly, the circumstances that lead someone to join a street gang — if we want to stop the proliferation and growth of white nationalist gangs, we need to understand the set of circumstances that leads a person to the point in their life where they are open and susceptible to being recruited into one. 

These two papers start to give us new insight into what’s happening. Generally speaking, when people in so-called “rich countries” such as ours reach their middle-adult years, they hit a crisis: Most measures of distress, including those related to health, stress, work, mental fitness, mental health, and substance abuse, peak at that time. Many of them turn to drugs or alcohol; some of them begin to ideate about taking their own lives; and some look to join a cohort of peers that promises (usually falsely) to provide an escape from their physical and emotional distress. And the data shows that in the U.S. today, this crisis is particularly profound for middle-age white persons with low levels of education. 

Our society has many problems. One extremely serious problem is that we fail to provide access to an equitable education and economic opportunities to many young People of Color that will allow them to thrive as adults, and then we use the criminal justice system as a weapon to try to subjugate them. Another problem, it seems, is that we also fail to provide access to a decent education and economic opportunities to many young white people that will allow them to thrive as adults, and then we abandon them to the worst aspects of our society: drugs, alcohol, violence, and white-nationalist gangs. If we want to rescue our country from the abyss many believe we’re hurtling toward, it seems clear we’ll have to solve both of these critical problems.

The Midlife Crisis

Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century

---

📸 Featured image by Johnny Silvercloud/Shutterstock.com.

---