Middle years


Anxious feelings at midlife are common and likely to be related to the physical changes to your body that come with menopause and all the other things that are happening in your life at this time. Symptoms like hot flushes, increased irritability and getting tired a lot can tip into anxiety. You might be more aware of your heart beating faster or feel slightly ‘on edge’ more often. Many women talk about having episodes of panic at midlife and feelings of nervousness and apprehension about the future. Often it feels like you are always on the run with so many balls in the air nothing gets finished, particularly in the way you would like it to.

Is this you?

LEARN Have a look at the different stories and images below, listen to a podcast or watch the video.

THINK Then, to understand more about what causes anxiety you can explore the different social, psychological and physical things that can increase anxiety. In this section you will find questions to ask yourself about each cause to see if it affects you.

DO Once you have explored the causes of anxiety then it is time to do something. Go to the ‘Toolkit’ to find a range of different tools to help yourself try and reduce anxiety.

View the causes of Anxiety for Middle years

Do you relate to these?

“A [wo]man's subconscious self is not the ideal companion. It lurks for the greater part of [her] life in some dark den of its own, hidden away, and emerges only to taunt and deride and increase the misery of a miserable hour.”
P.G. Wodehouse

someecards.com - She's crazy. And just when you think you've reached the bottom of her craziness, there's a crazy underground garage.

“Her forehead was a maze of anxious little grooves, from a lifetime of wondering about whether everyone within range was OK.”
Tana French

“I have accepted fear as part of life – specifically the fear of change... I have gone ahead despite the pounding in the heart that says: turn back....”
Erica Jong

It catches me unawares. I can be just driving to work and out of the blue I start thinking about what a hopeless mother I have been and whether something awful might happen to one of the children and then I decide my marriage is a train wreck. I generally follow that up with a detailed review of my entire career and where I went wrong. By the time I get to work, I want to go home. 

I never realised that life has no guarantees. There is no warranty card. Things get broken, don’t work and go wrong and it turns out it’s all a lot more precarious than I thought. It makes me feel very unsure. I wish there was some kind of safety net.

someecards.com - Look, I'm trying to rant here. Stop interrupting me with

It scares me because I look in the mirror and I can see the years have passed and I think, so that was it, I hadn’t realised I would get here so fast. And then I don’t really know what to do next. I know it’s silly but that doesn’t make the feelings go away.

Causes of anxiety for Middle years

What happens

Some personalities are more prone to anxiety - you might be a bit of a perfectionist, yet midlife is a time when your inner perfectionist may be really challenged. You can have a lot of changes and demands going on such as responding to aging parents and growing teenagers or changing work roles. It can feel like your ability to complete tasks and get things done to any standard has completely disappeared. The hormonal changes of menopause are often unpredictable and may well increase your sense of things being out of control, which can increase your anxiety.

Questions to ask yourself

Is it in my make up to be anxious?

How much do I like to feel in control?

How anxious am I about ‘losing’ control because of all the changes that are happening in my life?

What happens

Frightening or anxious thoughts can cause anxious feelings. It can be a thought that you don’t even notice, but it sets off a cycle of fear. You might have an unhelpful thought such as that something bad is about to happen, or you blame yourself when something goes wrong and say “I’m hopeless”. These thoughts are faulty and inaccurate but are difficult to challenge - you start to experience physical symptoms of anxiety such as a racing heart and fast breathing and all you want to do is run away.

Questions to ask yourself

When I feel anxious what are the kinds of thoughts that I can remember having?

Are these thoughts unhelpful or faulty?

For example, do I:

  • have only negative thoughts
  • jump to the wrong conclusions
  • use words like “should” or “can't”
  • think something really bad is about to happen

What is the evidence to support my thoughts?

What is the worst thing that could happen? How likely is this?

What happens

Having a negative attitude to aging and menopause can make you more likely to be fearful and nervous about the future.

Questions to ask yourself

How negative is my attitude to getting older and/or menopause?

What happens

Having little confidence in who you are, not valuing yourself, or doubting your achievements can result in increased anxiety.

Questions to ask yourself

How much do I focus on my achievements?

How much do I value myself?

How much do I believe I am a valuable person?

What happens

You might have started to worry less about what people think of you but you may also be coping with a sense you now have different views to Gen Y and Gen Z at home and in the workplace. This can make you feel your thoughts and opinions aren’t judged to be as relevant as they used to be. You may begin to feel anxious that people are not taking your thoughts and viewpoint as seriously as they used to, or they don’t value what you have to say.

Questions to ask yourself

How anxious do I get about what others think of me?

How do I feel when people don’t appear to listen to what I have to say?

Do I feel valued by others?

What happens

When you focus on your appearance, all the little changes of growing older – the pull of gravity on your skin and breasts, the lines of laughter, sun and worry around your eyes and mouth can make you feel anxious.

With menopause your body shape will change and fat starts to move up from your hips to around your stomach.  

Some days you feel invisible, some days are good and some days you wonder - who is the middle aged woman staring at you from the mirror.

Questions to ask yourself

How anxious am I about how my body looks?

How anxious am I about being invisible to others?

What does ‘growing old gracefully’ mean to me?

How anxious am I about the changes of menopause?

What happens

At midlife, you can find the ways you used to cope when things got difficult don’t work as well anymore. Perhaps you used to push through your feelings, or perhaps you increased your activity or went and had coffee with friends. If your ways of coping aren’t working as well and your anxieties are increasing you need to understand what is happening and what may be different in your life to cause this.

Questions to ask yourself

Do the ways I usually cope still work?

What has changed in my life that I no longer can rely on the ways I used to cope?

Do I need to change the ways I cope when I am anxious?

Do I need new ways of managing my anxieties and the hassles of life?

What happens

If you experienced maltreatment in your life or violence in your close relationships this can cause you to be vulnerable to worry. Any kind of abuse such as emotional, mental or physical can cause you to worry about dangerous or risky situations in different ways than others who have not had these experiences. You may react more strongly to criticism, be anxious that others do not like or value you and that your thoughts or feelings are not important.

Questions to ask yourself

Have I been exposed to violence:

  • as a child
  • from people close to me?

Have I felt:

  • neglected
  • threatened
  • that I might be harmed at any time during my life?

Has maltreatment or violence caused me to be more anxious?

What happens

Having roles that give you meaning are important to your mental and emotional health. You might be a friend, a mother, a sister, a volunteer, a worker… there are many roles you may have in life. Sometimes these roles are given to you and at other times you choose the roles you have. At midlife, some roles may begin shifting for instance from daughter to carer for a parent; from rising star to part of the furniture at work or from carefree to a bit careworn. If you feel good about your roles it is easier to not feel so anxious.

Questions to ask yourself

What meaning do I have in my life?

What roles and sense of purpose do I have?

How anxious am I about any of the roles I have?

Do I feel good about the roles I have?

Social causes →
What happens

Problems with your family can include lots of things as midlife is a time of big change. It might be your parents are getting older and more reliant on you, or you have lost a parent, or both parents. Perhaps your relationship with a brother or sister is changing. You might be busy with your children, or your children are busy with their own lives, or they are teenagers and your relationship is changing. Perhaps you don’t have children and midlife is a reminder you won’t have your own children. Relationship changes can happen also. Midlife can be a time of reassessment - some women can question whether they want to be with their current partner for the next 30-40 years? Being in an unhappy relationship can make you more anxious.

Questions to ask yourself

Are there family problems that cause me to be anxious?

Have there been changes to my family that I am anxious about? If so, what are the changes?

How anxious am I about the relationship with my children (if relevant)?

How anxious am I about not having children (if relevant)?

Am I anxious I am not in a happy relationship?

What happens

Friends can accept you for all that you are and sometimes they can reject you. This happens at every age and stage of your life. Midlife can be a busy time and perhaps you are not able to spend as much time with your friends as you would like. Their lives can be changing and you may be anxious about them also. As you get older you may get anxious about finding opportunities to make new friends.

Questions to ask yourself

Do I feel accepted by my friends?

Who accepts or does not accept me?

How anxious am I that my relationship with friends is changing?

How anxious am I about having opportunities to make new friends?

What happens

Sometimes the trauma from a past event comes up again when you are older and you find yourself reliving some of the anxious thoughts and feelings you had at the time. This may not be a full on anxiety disorder but it can make you nervous and unsettled.

Questions to ask yourself

Are my anxious feelings and thoughts associated with an event that happened in the past?

What happens

The many changes that can occur at midlife can make you feel anxious if you are someone who finds change stressful.

If you have friends or family with a serious illness or suffer the death of someone you love, then the causes of anxiety and distress may be strong.

Questions to ask yourself

How do I feel about change?

Have I experienced any distressing or difficult events recently? If so, what were they?

What happens

Having people to talk to when you need support is one of the most important ways to feel good about yourself. This might be friends, family, people in groups you belong to, or the people you mix with where you work. As you grow older some supports change, perhaps because your circumstances have changed, you have moved, changed jobs, or perhaps through illness. Losing reliable support networks can negatively impact on your mental and emotional health. You may start to get anxious about who will be there to support you if you need.

Questions to ask yourself

Do I have good friends, family or people I trust who can be there for me?

Who do I have that I can talk to or turn to for support if I need to?

Have people who I turn to for support moved on, or are no longer there for me?

What happens

How much anxiety you feel about money will depend on your financial situation. At midlife there can be a lot of expenses and at the same time you are being told you need to save for your future, or if you are near retirement, the end of your working life. Money can be a lifelong issue but at midlife you can be anxious about covering your present expenses and uneasy about providing for the future.

Questions to ask yourself

How anxious am I about money?

How anxious am I about being able to afford today’s living costs?

How anxious am I about providing money for my future living costs?

Community causes →
What happens

The community in which you live is important to your mental health. Feeling safe, that there are places to go, ways to get there and things to do can help you to feel connected to your community and that you belong somewhere. If you move to a new community you may be anxious about finding your way around, and finding the same type of services you are used to.

Questions to ask yourself

How do I feel about the community where I live?

How connected do I feel and do I feel that I belong in my community?

If you have recently moved - can I find the same services I had where I used to live?

What happens

You can feel more vulnerable and less safe in your community if you feel anxious about your safety or the safety of your parents or children or other people you care for. This might be physically, such as feeling more vulnerable to a physical attack, or emotionally, where you feel you or they are more vulnerable to being exploited or financially cheated.

Questions to ask yourself

How safe do I feel in my community?

How anxious am I about myself or someone close to me being physically attacked?

How anxious am I that I or someone close to me could be financially cheated or exploited?

What happens

Work can provide a source of anxiety such as:

  • how satisfied you are in your job
  • how safe and secure you feel in your job
  • how flexible your workplace is so you can meet other commitments
  • how demanding your job is of your time and energy
  • how much the politics and gossiping of a workplace affects you
Questions to ask yourself

How anxious am I about my work?

How secure do I feel in my job?

Do I feel exhausted by my job?

How supported do I feel by my boss and work place?

Physical causes →
What happens

Midlife is often the start of feeling more aches and pains, of emerging problems with high blood pressure and cholesterol, and the likelihood illnesses such as arthritis and diabetes can increase. These developments can cause you to feel anxious about yourself and uneasy about your future health.

Questions to ask yourself

How anxious am I about my health and body strength?

How anxious am I about any illnesses I might have?

How anxious am I about any illnesses I might get in the future?

What happens

Midlife is a time when your hormones start to change and you become menopausal. The stages of menopause you are most likely to encounter at midlife are:

  • Perimenopause - when hormone changes start to happen, you start to feel hot and your periods may be irregular and or heavy
  • Menopause – when it has been 12 months since your final menstrual period
  • Postmenopause – when you no longer have a period, but you can still have symptoms of hot flushes and a dry vagina

These hormonal changes can make you feel more anxious. They may also combine to make a cocktail  - a nice mix of grumpy, irritable, tired, sad and/or moody!

Questions to ask yourself

Am I starting to go through menopause?

Do I have any symptoms of menopause such as:

  • Hot flushes?
  • Night sweats?
  • Dry vagina?
  • Moodiness?

Do I feel more anxious at different times in my cycle?

Am I more anxious since I started to have changes associated with menopause?

What happens

Excessive drinking (defined as more than two standard drinks on any day and with no alcohol free days in a week) can:

  • make you focus more on your anxieties
  • be a sign you are trying to cover up or numb your feelings of anxiety.
Questions to ask yourself

How much am I drinking?

Do I feel I drink too much?

What happens

Side effects from some medications including medications for blood pressure, asthma and steroids, such as cortisone, can cause you to have anxious thoughts and feelings.

Questions to ask yourself

What medications am I taking that could cause anxiety symptoms?

What happens

Quality sleep can often be difficult to achieve. Interrupted sleep can impact on your ability to cope with the daily hassles of life because if you feel tired, it is harder to think clearly. And if your sleep is affected because you are waking with menopausal night sweats, you may lie there feeling anxious about how to cool down, about whether you will ever get back to sleep as well as the hassles of the coming day or your life.

Questions to ask yourself

How much sleep do I get per night?

Is it hard to get to sleep or do I wake in the night and find it hard to go back to sleep?

Are night sweats affecting my sleep?

How much do my anxieties affect my sleep?

What happens

An unhealthy diet made up of high fat and sugary food affects your mood and can make you more prone to anxious feelings. Skipping meals or eating only one large meal a day doesn’t help your mood either. On top of this, if you are also not exercising enough, you have another reason why you may be feeling anxious.

Questions to ask yourself

Do I generally eat a range of healthy foods or do I eat too many sugary or fatty foods?

Do I exercise at least 3-4 times per week for more than 30 minutes?

Created on 18/08/2013 | Updated on 10/12/2015
References for this page

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About Jean Hailes

Jean Hailes is Australia’s leading and most trusted women’s health organisation. We believe in physical and emotional health and wellbeing in all its dimensions for all women in Australia throughout their lives.

We offer a range of free resources and easy to understand information on women’s health and wellbeing. Appointments at our specialist women’s health clinics can be made in person (East Melbourne and Clayton, VIC) or across Australia via our Telehealth consultation service. www.jeanhailes.org.au

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