We may need a subspecialty of middle-aged psychiatry to support midlife health.

Rob Whitley, Ph.D.

Reviewed by Gary Drevitch

KEY POINTS

- Research suggests that stressful life events, like divorce or unemployment, have a more negative effect on #men than #women.
- Middle-aged people with lower educational attainment have been found to be more vulnerable to poor #mentalhealth than others.
- There is a need for specific, gender-sensitive support and services for vulnerable middle-aged #adults struggling with unwelcome life experiences.

There are many psychiatric subspecialties focused on specific age categories. These include #child psychiatry, #youth #mentalhealth, and geriatric psychiatry. But there is no subspecialty known as "mid-life #mentalhealth" or "middle-aged psychiatry."

This is concerning, as statistics indicate that this can be an especially vulnerable period. For example, suicides in Western countries are particularly pronounced in the 40-60 age group, with especially high rates in middle-aged #men.

Evidence suggests that the experience of sudden life events that often occur in the middle years of life, including job loss and divorce, can particularly damage men’s #mentalhealth. (For more, see my new book Men’s Issues and Men’s #MentalHealth.)

Unemployment and Job Loss

The postwar years have seen massive socio-economic changes across the Western world, mainly in the form of a transition from an industrial economy to a knowledge economy. This shift has led to a major decline in industries such as manufacturing that once gave secure and meaningful employment to blue-collar and less-educated #men, who have subsequently experienced high rates of unemployment and job loss.

Such unemployment can have severe #financial consequences, and in worst-case scenarios can lead to severe debt, bankruptcy, and foreclosure. Several studies show that these factors increase the risk of midlife #male #depression and middle-aged #male #suicide.

Some research indicates that job loss and unemployment tend to have a more negative effect on #men than #women. Indeed, one seminal study of over 1,000 opposite-sex dizygotic twin pairs examined sex differences in pathways to #depression, finding that past-year stressful life events related to financial, employment, and legal issues were strong risk factors for #male #depression, but not for #female #depression.

This greater impact on #men has been related to several factors by a variety of different studies. First, #men still tend to shoulder the burden of being the primary family breadwinner, and their income is often essential to support a household. The loss of this income can have a devastating impact on family quality of life. Second, #men tend to derive more purpose and meaning from their work than #women, meaning that the loss of a job can create a painful vacuum. Third, unemployed #men are often stereotyped and stigmatized by wider society, which can negatively affect social inclusion and #self-esteem.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleOrder your copy of James Donaldson's latest book,#CelebratingYourGiftofLife:From The Verge of Suicide to a Life of Purpose and Joy

http://www.celebratingyourgiftoflife.com

Educational Attainment and Midlife #MentalHealth

Evidence suggests that middle-aged people with low educational attainment are more vulnerable to poor #mentalhealth than those with higher educational attainment. Indeed, one U.S. study found that #suicide rates among the middle-aged were 2.4 times greater among those with a #highschool diploma or less, compared to those with a college degree.

Another study examined over 440,000 suicides in the U.S. and found that #adults who possessed a college degree had the lowest #suicide rates, while those with just a high-#school diploma had the highest rates. Other research indicates that people with just a high-school education have higher rates of #adult #depression and #anxiety compared to those with a graduate or professional degree. This is consistent with other studies which have found that high-#school dropouts had higher rates of #adult #depression than high-school graduates.

Importantly, mounting evidence suggests that low educational attainment is much more common among #males than #females, with research indicating that #males are more likely to fail exams and drop out of high #school, and less likely to attend university and obtain a bachelor’s degree. Such educational underachievement in young #males is widely unrecognized and has not been a policy priority, despite its negative impact on society.

Marital Status and Divorce

Divorce and separation are common occurrences in the middle years of life. Much research indicates that this can have a negative impact on #mentalhealth. For example, a large-scale U.S. study found that unmarried #men aged 40-60 were 3.5 times more likely to die by #suicide compared to married #men of the same age, with markedly higher rates for unmarried #men compared to unmarried #women.

Of note, several elements of the research literature indicate that the #psychosocial experience of divorce can be particularly painful for #men, acting as an acute stressor with chronic consequences. For example, one study found that men experience a much greater loss of social support after divorce compared to #women, mainly because #women tend to maintain stronger links with friends and family throughout marriage than #men.

All of this can leave divorced and separated #men lonely and isolated precisely when they need social support the most. Indeed, fathers are typically separated from their #children after a divorce, with over 80% of custodial #parents in the U.S. and Canada being mothers. This separation from #children can create a particularly painful void for the affected #men, which can breed shame, guilt, grief, a sense of failure, and #psychological distress.

Conclusion

For many people, the middle years are a time to enjoy the fruits of their education and labour among family and friends. But for others, it can be a time of severe financial strain, loneliness, and existential despair. As such, concerted action is necessary to address these issues.

- First, the provision of appropriate education, training, retraining, and vocational opportunities in the middle years should be considered an essential component of an integrated #mentalhealth policy.
- Second, there is a need for specific and tailored #gender-sensitive supports and services to help vulnerable middle-aged people undergoing unwanted life transitions such as job loss and divorce.
- Third, there is a need for more focused #mentalhealthresearch on midlife #mentalhealth and evaluation of promising programs, with specific attention paid to #gender differentials.

As yet, there is no subspecialty known as "middle-aged #mentalhealth," let alone a focus on #gender differentials. This has to change.
https://standingabovethecrowd.com/2022/08/jamesdonaldson-on-mentalhealth-the-mentalhealth-troubles-of-middle-aged-men/