Understanding midlife anxiety in women
Why am I so anxious all of a sudden?
By Aviva Boxer, Registered Psychotherapist
Think back to your younger self, that you in your 20s and 30s, the one who was finishing your first or second degree, busy working at your first grown-up job, juggling projects, seeing your friends, getting promoted, staying out late having fun, being busy all the time. That you who wasn’t getting a ton of sleep or eating the most nutritious foods, but still feeling good, clear, focused and able to handle it all. Maybe you found a partner, got a dog, bought a place, had a couple of kids, and even with that added chaos, you were still keeping all those spinning plates in the air, getting it all done, plus of course having your share of rough days, but who doesn’t? You bounced back.
And then wham, you hit your mid-40s and it feels like you’ve slammed into a brick wall. Suddenly you are anxious. Maybe you felt some anxiety in the past but not like this — the dial on it has really been turned up high. Your mind races, especially in the middle of the night, and you can’t stop it. You wake up to get away from your thoughts, heart racing, sweaty, all those stresses that you used to more easily put aside or push past now overflow and overwhelm you when you least expect it. This is what midlife anxiety can feel like and it can sneak up on you and leave you wiped out and wondering how you got here.
So many factors contribute to midlife anxiety, especially in women.
“When the mental load becomes constant — juggling work, caregiving, relationships, aging parents, and personal expectations — it can quietly tip into anxiety. ”
If you look up the causes of anxiety in midlife women, perimenopause is usually considered the culprit. But so many factors can contribute to midlife anxiety, especially for women. We are most often the ones, in heteronormative relationships, who carry the bulk of the mental load. We tend to carry all the details of family life in our heads, knowing who prefers and needs what, what needs to be bought at the grocery store (even if we are not the ones to actually buy the groceries), when all the appointments and activities are and who needs what for each activity, when the pets need their vet checkups and what medications they need and when.
We are often the ones who are still doing the bulk of the domestic labour in our homes, those monotonous jobs that restart as soon as they are done — like laundry, dishes and cooking.
We often care for extended family as well, including older parents and inlaws, we do much of the holiday and birthday organizing and shopping, not to mention that we are likely working full-time in addition to all of that. So it is no surprise that anxiety can hit women especially hard at this turbulent time of life.
When the mental load becomes constant — juggling work, caregiving, relationships, aging parents, and personal expectations — it can quietly tip into anxiety. The brain, in a state of ongoing over-responsibility, starts scanning for danger even when there’s none, leading to racing thoughts, sleep issues, irritability, or a sense of impending doom. What feels like “just holding it all together” can actually be the nervous system stuck in high alert.
Maybe this is when you start to notice that this anxiety you have been feeling for who knows how long, is more acute than normal. You might be sleeping poorly too, which only amplifies the anxious feelings, as well as not having enough time for self care and reflection because of all that you have on your plate.
Sometimes just realising for the first time that you are overwhelmed and it’s not your fault, can be a relief and bring with it a torrent of emotion that you were maybe holding back because there was no room to even feel it. For the clients I talk to who are experiencing midlife anxiety, having the space to dump out all the feelings they have been carrying for so long, can feel like a huge weight has been lifted. When you are the person who cares for everyone else, thinks about everyone else, plans for all the contingencies for everyone else, who is the person who does this for you? Who is there to make sure you have what you need? Sometimes it’s a partner or a friend, but most often it’s neither.
I checked in on the topic with my friend Chat GPT and when I asked her who supports the women who carry the mental load in their families, she answered: “That's such a powerful and important question — and honestly, for many women who carry the mental load in their families, the heartbreaking answer is: often, no one consistently does.” I repeat — no one! I laughed to myself when I read this because I already knew the answer. That means the women who are doing ALL the caring for everyone else have NO ONE caring for them in the same focused and attentive ways. Is it any wonder so many of us are anxious?
Spending years carrying the load for everyone else can be a huge contributor to midlife anxiety in addition to the hormonal changes that come with perimenopause. Women coping with midlife anxiety are most-often carrying this heavy load alone and do not have someone to share it with who understands and is there for them both emotionally and to do the work. That is part of the reason why therapy can be so transformative. Your therapist is there completely for you. They are there to hear you and help you, to provide a safe space for you to share your burdens, to explore the emotions you are feeling and to help you find strategies, express your needs, set boundaries and feel cared for and supported.
If you are ready to share your feelings and let go of the emotional weight, we are here to help! We have therapists on our team who have lived experience of this time of life as well as professional training in supporting women navigating menopause. Reach out to us for a free consultation.