Midway upon the journey of our life
I found myself within a forest dark,
For the straightforward pathway had been lost.
So read the first verses of Dante Alighieri's Divine Comedy, as translated by Henry Wadsworth Longfellow. According to experts, the speaker is 35 years old, precisely halfway through his allotted lifespan unless the bubonic plague gets him.
Dante, as you know, is on a long journey to paradise, but on his way there he must endure hell and purgatory.
In 1957, a Canadian psychoanalyst named Elliott Jaques cited these verses in a presentation to the British Psychoanalytical Society. What Dante describes here, claimed Jaques, is the kind of depression and confusion that people experience when they reach the crest of a hill from which they glimpse the end of the road, namely their own mortality, in the distance.
Jaques called this melancholic state the midlife crisis. The British psychoanalysts looked askance, and Jaques set the work aside for the time being.
Eight years later, his own midlife crisis now under control, Jaques published his paper in The International Journal of Psychoanalysis, from where it jumped into popular culture and was embraced by pop psychology.
The idea of the midlife crisis as an inevitable psychological upheaval related to age, regret and impending death gained widespread traction. And the white middle-aged man, with enough time for discontent and remorse and enough money for a sports car and a mistress, was its poster boy.
Meanwhile, the second wave of feminism arrived, and for women the midlife crisis was equated with liberation. As Pamela Druckerman recently wrote in The Atlantic, “What women hear is, ‘If you hate your life, you can change it'".
Psychologists began to search for evidence that the midlife crisis is indeed a universal experience, at least in affluent Western countries, and differed among themselves. Some claimed that about 80% of people temporarily derail between the ages of 40 and 60. Others argued that only 15% of men and women truly experienced a midlife crisis; the rest were simply crisis-prone or in need of an excuse to throw good judgement overboard.
As the conversation calmed, the case was presented in the mass media as follows: Women reach menopause at a certain age (hot flashes, mood swings). Men, at roughly the same age, are struck by a midlife crisis (disillusionment and a pursuit of youthfulness). Women who experience the disillusionment of a midlife crisis learn pole-dancing or pottery. Male menopause? We don't talk about that.
Goodbye, testosterone
One of the reasons we don't talk about male menopause is because it doesn't exist. Menopause refers to the absence of menstruation due to a decrease in oestrogen and progesterone (read Adri Kotzé's brilliant explanation here.) In the case of men, there is also a decrease in hormones, but it's not so much a pause as a long farewell.
The more accepted term, andropause, refers to androgens, a group of hormones in all genders that are converted to testosterone in the testicles, and to oestrogen in the ovaries. The amount of testosterone versus oestrogen in your body is determined by which reproductive system you were blessed with.
When you develop body hair, muscles, a deep voice and an even deeper interest in sex during puberty, it's androgens that are fuelling the fire. Between the ages of 35 and 40, androgen production in men gradually declines at a rate of 1%-3% per year. Around a quarter of all men have with low testosterone in their 50s, and nearly twice as many in their 60s. It's not really discussed around the braai fire.
Most men remain silent about symptoms such as depression, lower energy levels, sleep disorders, erectile dysfunction and the loss of sexual desire, confidence and motivation. Their midsection becomes thicker and their bones become thinner. They prefer not to wear T-shirts any more because their chests start to resemble a woman's.
The whole debacle is fuelled by factors such as obesity, lack of exercise, and an unhealthy diet, and if a man has used a cocktail of anabolic steroids, he now regrets it. Medical conditions such as diabetes, alcoholism, and liver and kidney diseases also play a role.
Perhaps a Harley Davidson and a younger woman will make him feel better. Probably not.
Writers, painters and missionaries
Krynauw du Toit is a retired industrial psychologist who years ago researched the midlife experience for his doctoral degree. In a recent letter to Vrye Weekblad, in which he also casually referred to Dante, he described the condition as follows:
“Something happens around the age of 40 that suddenly makes people think about how many years they have left before retirement. How much time is left to improve my knowledge and experience? How much time is left to make a change? A sudden urgency is felt.
“This awareness is caused by a few experiences. When parents reach this stage, their children are in their teenage years, and where would you find a more merciless critic than a teenager? The 40-year-olds' parents have also started to grow old, and suddenly there is the realisation that I, who have always been taken care of by them, may now need to start taking care of them. The experience of impermanence presents itself — another wake-up call.
“The grey hairs start to appear and are slyly plucked, but for how much longer?"
Sex also becomes an issue, said Du Toit. “Am I still attractive to her, and should I perhaps prove my virility to myself by seeking a sexual experience elsewhere?
“For many people, this is their first experience of depression, and unfortunately some take desperate measures. They quit their jobs, seek support from the bartender or from another man or woman. Some just pick up everything one day and go do a different job, even if it's for less money — doctors and dentists who move to a west coast town and start writing or painting or teaching or doing missionary work.
“Yes, especially missionary work sounds like a forgivable excuse for many to make drastic changes. They feel called. (I have even dissuaded men in my practice from becoming missionaries — I might be punished for it one day.)"
Doctor, doctor
For the physical manifestations of the challenging middle years, there is advice. Skip the Harley shop and head to your general practitioner or urologist, and listen to what they say about weight loss, exercise and healthy eating. Have your prescription medications checked, because drugs such as statins and opioids can worsen matters.
If your new, healthier lifestyle doesn't achieve a breakthrough, hormone therapy can help to boost testosterone levels and alleviate symptoms in certain cases. As with hormone therapy during menopause, people are cautious about health risks and side effects, and your doctor will also ensure you don't have prostate cancer.
What not to do: For heaven's sake, do not order testosterone online and use it unsupervised. You're all grown-up now.
Once you have the physical symptoms under control, the forest may already seem less dark. But what if you're still lost on the path or stuck on the crest of Elliott Jaques' hill, and the wake-up call of your mortality grows louder?
Can you turn the hill upside down?
A curve, not a crisis
In The Atlantic, Jonathan Rauch from the Brookings Institution, an American think-tank that conducts research in social sciences, writes about the U-curve of happiness and how this idea, originating from economics, applies to the midlife crisis.
The curves emerged from surveys on how happy people consider themselves in various countries, which were analysed by economist Richard Easterlin in the 1970s. In the 1990s, David Blanchflower, an economist specialising in the relationship between work and happiness, examined the same curves. His conclusion is that there is indeed a correlation between happiness and age.
People's satisfaction with life decreases over several decades in their adult life, reaches a low point in their 40s or early 50s (deep sympathy if you're between 47 and 51), then begins to increase, often making them happier than ever around the age of 60 and beyond.
This phenomenon is observed in most countries where the research takes place and seems to be independent of the material and social circumstances in which people find themselves.
Psychologists are sceptical because the findings are based purely on statistics (and why the hell are economists messing around with happiness anyway?), but several longitudinal studies that track individuals' life experiences over a period of time support the curves. There's a new hill as well: the use of antidepressants nearly doubles in midlife.
Rauch puts it like this: It is possible to be happy in your middle years, but it is more difficult for many people.
Wisdom comes with greyness
Insights that help make sense of these curves come from analyses by another economist, Hannes Schwandt, based on a 13-year German study that aimed to determine how happy people expected to be in five years. Schwandt was surprised to see that future satisfaction is generally overestimated by younger people and underestimated by older people.
The optimism of younger people is rewarded with disappointment five years later, while the pessimism of middle-aged individuals is met with pleasant surprises. The convergence of disappointment and pessimism hits people like a double blow around the age of 50, after which lower expectations are gradually surpassed by reality and the world starts to look brighter in general.
Lower expectations may sound somewhat sad in a context where we are taught to strive for more and better. But what if this kind of resignation, along with qualities such as compassion, empathy and tolerance, signals wisdom?
Rauch recounts his conversation with the esteemed psychiatrist and neuroscientist Dilip Jeste, who focuses on helping people age meaningfully and successfully and seeks a biological basis for the characteristics associated with wisdom.
Jeste has not yet found definitive evidence, but one would agree with Rauch that the idea of a (sometimes) challenging transition to wisdom creates a more dignified and fairer image of the midlife crisis than the reckless behaviour and loss of control portrayed by the media.
It makes equal sense that the reckless choices that give the midlife crisis such a bad reputation arise because people do not understand this period and attribute blame to the wrong causes.
Jeste speculates that wisdom from an evolutionary perspective may be the reason Homo sapiens continue to live long after their fertility wanes. Wisdom is indeed advantageous for any community and a way for older people to contribute to species survival.
The light returns
This mindset aligns with what the German-American psychologist Erik Erikson (to whom we owe the concept of an identity crisis, among other things) had to say about generativity (a desire to give back to society, whether through raising children, mentoring others, contributing to one's community or pursuing a fulfilling career) versus stagnation — his view of what he considers the seventh of eight stages of life.
This seventh stage occurs between the ages of 40 and 65, according to Erikson, when people either strive to create a better world for future generations or remain indifferent and make no contribution out of selfishness and a lack of growth.
Generative individuals in their middle years are generally healthier, more engaged in their communities and experience greater satisfaction. Those who get stuck buy sports cars, wander around, refuse to wear masks in stores, vent their anger on Facebook, and become increasingly contemptuous of Donald Trump as they pour themselves more brandy.
Compassion should also be shown to them because the foot of the hill where the valley ends is a frightening place if you miss the U-curve of happiness:
But after I had reached a mountain’s foot,
At that point where the valley terminated,
Which had with consternation pierced my heart,
Upward I looked, and I beheld its shoulders
Vested already with that planet’s rays
Which leadeth others right by every road.
As Dante says: Hold on tight, things get better.
♦ VWB ♦
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