Why Anxiety Hits Harder in Midlife — and What You Can Do About It: Anxiety Therapy Oakland
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If you are a woman in your 40s or 50s, you may find yourself surprised by how anxiety is showing up. Many overworked and undersupported women in middle age, may notice that their anxiety is showing up more loudly and in some surprising ways. If you’ve noticed your anxiety is on the rise, but can’t quite pinpoint what has changed, you are not alone. Maybe you find yourself feeling less patient, easily irritated, waking at night with a surge of anxiety and then having difficulty getting back to sleep or perhaps you are experiencing more bodily sensations of anxiety like tightness in your chest, tension throughout your body, a racing heart or struggling to breathe easy. And you don’t quite understand why! You’ve been overworked and overresponsible for years - nothing has really changed except now what once felt manageable now feels overwhelming.
While this experience may seem unique to you or like a personal failiing, you are in the same boat as so many other women in midlife. There are real, biological, emotional, and societal reasons why anxiety often spikes around perimenopause and menopause. Many changes are happening at the biological level and understanding more about this and how your body responds to stress can help you find some relief.
Your body under chronic stress responds in a way designed to protect you, but this can lead to your nervous system becoming disregulated. As an Oakland anxiety therapist, I see clients who are in a continual state of dysregulation due to working overtime to meet the demands of daily living. Understanding the forces at play might help you see how the anxiety picture is actually due to many intersecting factors that result from one person being tasked with carrying more than one should..
The Midlife Shift: When Life Feels Both Full and Overwhelming
Many adults, particularly middle aged women, have entered into what is referred to as the “sandwich generation” and are tasked with the dual caregiving role of raising their children and their aging parents. While it can be quite meaningful to be able to be there for your family across generations, it often adds a layer of stress, pressure on your time and emotional weight that isn’t always readily acknowledged by partners, friends or society at large.
The image of balancing on a unicycle while juggling comes to mind. Each ball you are juggling represents an important responsibility like your children, your partner, work, your home, friends, etc. It requires quite a lot of energy, emotional regulation and focus to stay upright and keep the balls in motion and not fall off. While you may look like a pro from the outside, you are exercising intense concentration and self-regulation to be able to maintain a balanced state.You may feel yourself on a wobbly base and know that with the slightest shift all can come crashing down. And dropping just one ball can feel like total failure. When you exist in this state of vigilance, your nervous system feels as if every wobble or near mistake could be disastrous. You live in a state of heightened anxiety even though nothing is actually falling. Anxiety grows the longer you are working to keep yourself and the balls balanced and pausing to rest doesn’t feel like an option.
What makes this season so challenging isn’t just the workload — it’s the invisibility of it. Women are conditioned to be the emotional thermostat of their households, keeping everyone else regulated while appearing “fine” and suppressing their own distress. Society values a woman who is “resilient,” “strong,” and “selfless,” but rarely provides the structural support (e.g. affordable childcare and a more flexible work schedule) to make it easier to balance the demands of home and work. As a result, many middle aged women have been on “on” mode for years, their nervous systems taxed and disregulated. It’s no wonder so many women feel anxious. You’re not overreacting, you’re depleted.
Why Your Brain and Body Feel Different Now
Your changing biology is also at play if you’re noticing that your anxiety is on the rise or you patience is running thin. Estrogen and progesterone, hormones that regulate stress and mood, fluctuate quite a lot during perimenopause and menopause. Hormonal shifts can amplify how your body responds to stress, making you even more sensitive to fight-or-flight hormones (cortisol and adrenaline).
Your highly attuned nervous system is now like a smoke detector that goes off when you’re making toast (rather than when there’s real smoke or fire). Your body’s alarm system is heightened and frequently misfiring.
Imagine your nervous system as a smoke alarm: once, it only went off when something was truly on fire. Now, it blares when someone burns toast. That’s what hormonal and life-stage changes can do — they turn up the volume on your body’s alarm system.
This hormonal and life stage is also often accompanied by hot flashes, disrupted sleep, muscle and joint pain, cognitive challenges, mood changes, changes to the skin and hair, and genitourinary symptoms, and more… (Frozen shoulder anyone?!) So much is going on it’s hard to keep up with your changing body and possibly surprising shifts in your mood. Not getting enough rest, of course, can amplify these symptoms too.
Anxiety therapy can help you look at the full picture and support you with recalibrating your mind and body to know you are not in imminent danger.
The Invisible Load: Carrying Too Much for Too Long
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And the cognitive load! Beyond hormones, you likely have an ever-growing to-do list running through your mind. You’re working to remember your child’s doctor appointment, deadlines at work, messages you need to send or forgot to send, birthdays, what to make for dinner and your mother’s next doctor’s visit. You’re working on overdrive to anticipate everyone else’s - this cognitive labor is often unseen by one’s partners but also to ourselves. Even when you may have time to rest, the mental labor of planning, tracking, and executing tasks is running in the background.
Every item on the list may feel like a priority that requires your immediate attention, and your nervous system grows more vigilant raising your baseline anxiety (without you even realizing this is happening). And it’s draining you. A common response is to work “harder” - to do more, faster as these demands are depleting you.
The Emotional Weight of Unrealistic Expectations
Women from all walks of life are expected to meet impossible standards: to excel at work while remaining nurturing at home, to look youthful while aging gracefully, to stay composed while handling crises. And for BIPOC women, these expectations are compounded by cultural and oppression and lack of support — the need to be strong, to hold the family together, to succeed against inequity. When you’re continually putting others’ needs over your own, your nervous system doesn’t get to rest.Your anxiety isn’t a sign that you aren’t handling what life throws at you well, it’s an important signal from your body telling you that you need help carrying it all.
Anxiety Shows Up in Everyday Life (Even When You Don’t Call It That)
Anxiety during midlife can show up in a louder way (like panic attacks) or can manifest as irritability, forgetfulness, or an inability to stop your mind from running. You might find yourself snapping at your partner, struggling to focus in meetings, or jolting awake at 3 a.m. imagining your worst fears. These are more all signs that your nervous system is in survival mode. Financial stress, deadlines and your family’s needs are being perceived as constant threat and your nervous system turns its focus to survival. The body doesn’t naturally move toward relaxing when in detecting threat mode. Anxiety therapy can help teach your body that you don’t have to live in constant “react” mode by teaching it new experiences of safety. Techniques such as breathing and grounding exercises and co-regulation with your therapist can help your nervous system learn that it doesn’t have to exist solely in the state of high alert to keep everyone else okay.
From Surviving to Soothing: What Helps When Anxiety Peaks
Because you have your own unique neurochemistry and lived experiences, there isn’t a one-size-fits-all solution to anxiety. Here are a few general tips for finding your way back to balance.
Name It. Start by acknowledging you are struggling with anxiety because of how much you’re actually holding. Just recognizing the cognitive and emotional weight you carry can help you feel relief.
Slow it down. When anxiety peaks, focus on one simple grounding practice to slow the cycle of anxiety. Getting into your body by focusing on what you can sense like how your body feels in your chair, describing in detail five things you can see, or focusing on your breath can cue your nervous system to downshift.
Change your mindset. Tap into your strength (you are doing SO much and honestly probably pretty well) and reframe how you think about what it means to be strong and resilient. “Rest is resistance” - (and really good for you). It takes strength to know when you need help and to reach for support, and doing so builds resilience far more than “pushing through”.
Challenge your self-expectations. Inquire about where your values and beliefs around productivity, independence and perfectionism come from. Are these your values or familial or societal values you internalized? Reflection can allow you to connect to your own values and can help you relax unfair expectations. .
Connect with others. Relationships and connection is where healing happens — whether through friends, community, or therapy. You don’t have to hold it all alone.
Finding Relief and Connection with and Anxiety Therapist in Oakland
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Anxiety in midlife, especially in American culture, is extremely common. Itt’s your body’s way of saying you need support and care. Anxiety therapy in Oakland can help women understand what their anxiety is trying to communicate — and how to work with their nervous system instead of against it.
Oakland Anxiety Therapist
Author Bio:
Lara Clayman, LCSW, is a psychotherapist providing anxiety therapy in Oakland and online therapy throughout California. She works with multicultural women navigating anxiety, identity, and life transitions through a trauma-informed and relational approach that honors both personal and cultural context. She also loves to support parents and their relationship with their children and counseling for men.
