You are currently viewing Dealing With the ‘Midlife Crazy’

Like it or not, we all have to go through the ‘midlife crazy’. For some it’s an inconvenience, but for others it might be a full-on crisis. The good news is that there are things you can do to ease into this often rewarding new phase of life.

You will likely start feeling your age as you approach and enter your 40s. However, a healthy lifestyle will go a long way to making the midlife stage child’s play. 

Middle age creeps up

We’re all destined to experience physical, hormonal and even emotional changes as we get older. Other than a decline in hearing and sight, as we age, we’ll also begin to experience:

  • a decrease in height
  • greying hair
  • an increase in wrinkles
  • a metabolism slowdown that can result in a middle-age spread
  • bone mass deterioration
  • steady decline in strength.

Men don’t get menopause

Men will experience a gradual decrease in their testosterone levels. This tends to happen between the ages of 45 and 50. When this drop happens at a quicker rate, the condition is called andropause. Andropause, however, doesn’t affect all men the same way that menopause affects all women. For women, a decrease in oestrogen levels is what eventually ushers in menopause. These hormonal changes in both sexes can give rise to moodiness, fatigue and nervous system changes. By understanding what’s happening to us and what our partners may be experiencing, the changes of midlife need not become an overwhelming crisis.

Effects on skin

Research shows that skin ageing is affected by our genes as well as by external factors, for example, overexposure to the sun. The intrinsic ageing of our skin usually begins in the mid-20s when collagen production slows down. Visible signs of this process include fine wrinkles develop and thinner, more transparent skin. A drop in oestrogen levels, which often starts long before menopause, can result in drier skin and even acne around the mouth and jawline for women. Our genes control just how quickly these signs appear for each of us.

Premature ageing, on the other hand, is something we can control. External factors that will prematurely age skin include repetitive facial expressions, gravity, sleeping positions and smoking. “Sun exposure is the biggest contributor. It not only causes visible signs of skin damage, such as age spots and deep wrinkles, but also skin cancer,” says Dr Ishaan Ramkisson, a Durban-based dermatologist. “Skin cancer is the most common cancer in South Africa. But, it is highly curable with early detection and proper treatment. If you notice anything changing, growing or bleeding on your skin, consult a dermatologist immediately,” he advises. Ramkisson also stresses the importance of using a good, broad-spectrum sunscreen all year round. In addition, he recommends wearing protective clothing and wide-brimmed hats when outdoors for extended periods.

Loss of bone mass

As we age, our bones shrink in size and density. “We reach our peak bone mass at around 20 years of age,” explains Dr Stanley Lipschitz, a geriatrician from Rosebank, Joburg. “In the absence of disease, we maintain bone mass and bone quality until the 40- to 45-year mark, but natural bone formation decreases from this age.”

Menopause also contributes to a decrease in bone mass. This can make post-menopausal women susceptible to osteoporosis, a disease causing bones to become porous and prone to fractures. The National Osteoporosis Foundation of South Africa (NOFSA) reports that one in three women and one in five men will get this disease. “Women have a lower peak bone mass than men, so bone loss is more problematic given that they may lose large amounts of bone in the first two to five years of menopause,” says Lipschitz. “Younger men and women can preserve bone by following a healthy lifestyle. For example, a good diet with adequate calories, protein and calcium, moderate exercise, not smoking and moderate alcohol consumption. In addition, bone loss, especially in later life, can also be prevented by medication – calcium, vitamin D, hormone therapy, where appropriate, and other bone specific agents.”

Spare tyres

Men and women often struggle to maintain a healthy body weight as they age. Muscle mass naturally diminishes as we get older. If we don’t exercise enough and follow a healthy diet, our body composition shifts to more fat and less muscle.

A woman’s hormonal changes in her 30s and 40s can also affect her weight. The most profound weight gain, according to the Mayo Clinic, happens in the years leading up to menopause, but is not inevitable after menopause. The reason is a combination of lifestyle factors and genetics. Excess weight gain after menopause increases the risk of high cholesterol, high blood pressure, type 2 diabetes and cancer, particularly colon and breast cancer. Research shows that gaining as little as 2kgs at age 50 can increase the risk of breast cancer by 30%. Alcohol can play a major role in the overall health and well being, especially for women.

Men today have about 20 percent less testosterone on average than men the same age did 20 years ago. The jury is still out as to the specific reasons for this, but there is evidence that suggests weight gain and a sedentary lifestyle have an influence. “Being overweight may result in a greater decline in a man’s testosterone, but the natural age-related decline in the hormone is not necessarily a reason for weight gain,” points out Dr Zaheer Bayat, an endocrinologist at Helen Joseph Hospital, which is attached to Wits University. “Genetic and lifestyle factors contribute to potential weight gain, so it’s important to watch what you eat and get enough exercise. A healthy lifestyle will actually boost testosterone levels, which will have many benefits, including fighting depression, improving cognitive function, increasing muscle mass and decreasing body fat, strengthening your heart and bones, and improving libido and erections,” he adds.

Critical junctures

The so-called midlife crisis is widely documented, but clinical psychologist and Unisa senior lecturer Dr Lesiba Baloyi says the phenomenon should be considered more of a defining moment than a crisis.

“In my experience, the psychological impact related to ageing is rather complex. It’s not a given that a man will turn 50 and suddenly adopt out-of-character behaviour or rush off and have an affair,” explains Baloyi. “It does happen, of course, that middle-aged men in particular, will try to find an alternative reality. The more common issue I deal with in my practice is the inability of men to adapt to their life changes, or what I call the midlife developmental stage. In these cases I find that there are far deeper issues than just growing old that need to be addressed. He may be experiencing irritability and decreased energy, possibly because of a natural decrease in testosterone, but an emotional distance from his partner is the bigger issue. It’s important to explore the underlying relational or emotional reasons for this. I strongly advise that people find ways of healthy engagement with their loved ones. There is no substitute for positive conversation,” he says.

Culture can further complicate matters for those of us reaching our middle years. Baloyi says that the concept of manhood in black culture is inexplicably linked to sexuality. So, a flagging libido or erectile dysfunction can create more stress for black men, sometimes resulting in clinical depression.

Live long and prosper

Ageing is inevitable, but our lifestyle clearly impacts on just how healthy we will be into advanced age. Okinawans in Japan seem to have got it right. They have a history of ageing slowly and delaying or avoiding the chronic diseases of ageing. And, they also have the lowest death rates from cancer, heart disease and stroke, which are the top three killers in the US.

According to the Okinawa Centenarian Study, the secret to their longevity is a combination of genetics and lifestyle factors. They eat fewer calories, resulting in a lower level of free radicals in their blood. This improves their cardiovascular health and lowers the risk of cancer. They have 80% less risk of breast and prostate cancer and 50 percent less risk of ovarian and colon cancer. The traditional Okinawan diet is rich in complex carbohydrates and plant-based foods, and low in fat. Plus, they stay physically active.

All the specialists consulted recommend that we pay careful attention to our lifestyle. This involves following a healthy diet, getting enough sleep, staying physically active, managing our stress and keeping a positive outlook. Regular medical checkups are also advised to ensure that any potentially detrimental health changes are detected early and treated.

Marc de Chazal