Dennis B. Kottler, MD
Westlake Village, CA
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Chronologically "mid-life" cannot be precisely defined. In fact, as we live longer, mid-life migrates to an older age. There are both physical and psychological issues. The physical issues can be obvious, such as balding or wrinkles, or more subtle, such as the mood and energy changes that may accomply changes in hormone levels. Of course, only a comprehensive examination (physical and psychological) can address these more subtle changes. Nonetheless, some of the broad issues that accompany mid-life are:
1- Have life goals been met or in the process of being achieved.
2- Has financial stability been met or in the process of being achieved.
3- Has one become reasonably comfortable with the aging process.
4- Has one become reasonably comfortable with changes in sexual functioning.
5- Has one achieved a satisfactory relationship with children and/or parents....or the death of parents.
6- Has one achieved a satisfactory relationship with a "significant" other person.
7- Has one suitably dealt with the issue of mortality...from such mundane things as estate planning to the psychological impact of contemplating declining health and eventual death.
Of course each phase of life has its own characteristic challenges and the manner of dealing with these issues significantly defines a person's "mental health."
These days there is the constant bombardment of advertisements for products to "keep young." These ads tout improved sexual potency, hair restoration, skin rejuvenation, tight abs, and on and on. While there may be value to some of these offerings, the message seems to be that aging is not inevitable. To the extent that one believes the hype this can only deepen the eventual disappointment. A healthy acceptance of the life cycle changes and a suitable adjustment of lifestyle may be more rewarding in the long run.
Of course, there can be many rewards of mid-life coming with a more seasoned view of relationships, finances, the development of new hobbies, career advancements, new friends, and other positive life experiences.
The above discussion is of necessity very general. In particular situations, specific mental or physical disorders may emerge, or re-emerge during mid-life. An example might be an aggravation of a pre-existing mood disorder or the exacerbation of obsessive compulsive symptoms.
On the other hand, some medical conditions might improve, such as the disappearance of migraine headaches, asthma, food allergies, or in some cases, peptic ulcer disease. Sometimes a chronic mental disorder, such as borderline personality disorder, bipolar disorder, or even schizophrenia (there are many other examples) may also attenuate with advancing age. The common element is change...nothing sits still.
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