Are you having a midlife crisis? How can you tell if what you’re feeling, or not feeling, is a bout of depression, the gradual onset of menopause, or a normal part of transitioning from one phase of life to another?

It’s like you’re watching the Wizard of Oz in reverse. One day, everyone is singing and dancing. The colors are vibrant — emerald cities, ruby slippers, yellow bricks — and the next thing you know, everything is black and white, withered as a wheat field.

For some time, mental health professionals have debated whether midlife crises are real. The term “midlife crisis,” after all, is not a recognized mental health diagnosis. And though most people can tell you what a midlife crisis is, one long-term study found that just 26 present of Americans report having had one.

No matter what we call it, a prolonged period of malaise and questioning between 40 and 60 is nearly universal in both genders. Researchers have known for decades that happiness reaches a low point in midlife before rebounding as we age. In fact, numerous U-shaped graphs map the peaks and valleys of personal satisfaction, with recent studies pointing out the differences between men and women.

So what does midlife crisis look like in women?

It looks like crying all the way home from dropping off your college-bound kid. It looks like zoning out on a conference call because you no longer know why you’re doing this job. It looks like a reunion invitation crumpled in the trash because you didn’t become all you planned to become. Like waking up in the middle of the night, wracked with financial worry. Like divorce. And exhausted caregiving. And a waistline you don’t recognize.

Midlife crises were once defined according to gender norms: Women were disoriented and disappointed by relational changes and men by career changes. As more women pursue careers and become breadwinners, their midlife anxieties have expanded. What midlife crisis looks like depends on the woman who’s experiencing it.

What brings on the crisis for women?

As Nora Ephron once said, “You are not going to be you — fixed, immutable you — forever.” We all change, and a midlife crisis is evidence.

It’s partly physiological

During perimenopause and menopause, changing hormones can cause or contribute to the problem. According to Mayo Clinic doctors, declining estrogen and progesterone levels can interfere with your sleep, make your moods vacillate, and reduce your energy levels. Menopause can also cause memory loss, anxiety, weight gain, and decreased interest in things you used to enjoy.

It’s partly emotional

By the time you reach middle age, it’s likely that you will have experienced some trauma or loss. The death of a family member, a significant change in your identity, divorce, physical or emotional abuse, episodes of discrimination, loss of fertility, empty nest syndrome, and other experiences may have left you with a persistent sense of grief. You may find yourself questioning your deepest beliefs and your most confident choices.

And it’s partly societal

Our youth-obsessed society is not always kind to aging women. Like many women, you may feel invisible once you reach middle age. You may feel pressure to mask the signs of advancing age. You may be struggling to care for your children and your aging parents at the same time. You may have had to make difficult choices about family and career that men your age did not have to make. And divorce or the wage gap may mean you have chronic financial anxieties.

What can you do about it? 

In “Learning to Walk in the Dark,” Barbara Brown Taylor asks, “What if I could follow one of my great fears all the way to the edge of the abyss, take a breath, and keep going? Isn’t there a chance of being surprised by what happens next?” Midlife may be the best opportunity to find out.

If the U-curve scientists are right, your midlife malaise may resolve itself as you get older. But if you want to nudge the needle on your satisfaction meter sooner rather than later, here are some things you can do. Talk to a doctor. Many of the symptoms of midlife crisis overlap with depression, anxiety disorders, and hormonal imbalances. If you’re experiencing midlife blues, your doctor may prescribe hormone replacement therapy, antidepressants, or anti-anxiety medicines to help with your symptoms.

Talk to a therapist. Cognitive therapy, life coaching, or group therapy might help you work through grief, manage anxiety, and plan a path toward greater fulfillment.

Talk to your friends. A 2012 study shows what many women know from firsthand experience: Midlife is easier if you’re surrounded by a circle of friends. Women with friends have a greater sense of well-being than those who don’t. Not even family members have as great an impact.

Reconnect with nature. Studies show that spending time outdoors, even for a few minutes a day, can lift your mood and improve your outlook. Sitting by the seashore, forest bathingTrusted Source, and outdoor exercise all combat sadness and anxiety.

Try home remedies and healthy eating. Here’s more good news: You have reached the age where you never have to eat boxed macaroni and cheese again. Eat the good stuff — leafy greens, fruits, and vegetables in all the rainbow colors, lean proteins. Your diet can help you live longer and feel better. Melatonin and magnesium supplements can help you get a better night’s sleep, and they can also help reduce anxiety.

Write down what you’ve accomplished. Not just the big things like awards, degrees, and job titles. Write it all down: traumas you’ve survived, people you’ve loved, friends you’ve rescued, places you’ve traveled, places you’ve volunteered, books you’ve read, plants you have managed not to kill. This grey period is not your whole story. Take time to honor all you have done and been.

Take steps toward a new future. Novelist George Eliot said, “It is never too late to be what you might have been.” Take an online course, do some research for a novel, open a food truck, or a start-up. You may not have to radically overhaul your family or your career to make a material change in your happiness.

Read. Read books that inspire, empower, or motivate you to try something new.