If you’ve ever sat with the thought ‘I know other people have it so much worse’, this post could be for you.
It’s a common thing I hear from women over 50, often after months or years of quietly struggling. They may be apologetic, already half-justifying why they’re seeking therapy. They’ve got good lives and people who love them. They know they should be grateful, but something feels profoundly wrong, and has done for a while.
That instinct to minimise, to feel that your pain needs to meet some extreme threshold before it earns the right to be taken seriously, is itself something worth exploring in therapy. But I’ll come back to that.
First, here are some numbers that matter.
These statistics tell a story we need to hear
Close to 66% of women over 50 in the UK have struggled with their mental health.
Almost 90% of them hide it.
This means that nearly two thirds of women in this life stage are struggling. And nine out of ten are doing so in silence.
The British Association for Counselling and Psychotherapy (BACP) recently launched a campaign called ‘No More Stiff Upper Lip’ specifically to address this. The campaign calls attention to how under-supported this group is and encourages women to seek help without shame. These are the striking statistics behind it. But, I don’t think they will surprise anyone who works with women in this age group. Or anyone women who’s living it.
So why is this happening? And why, even when support is available, do so many women hesitate to reach for it?
When everything shifts at once
Midlife for women rarely arrives as a single change. More often, it comes as a cluster of transitions that hit simultaneously and the cumulative weight of that is something that can be badly underestimated.
The women I see in my counselling practice are often navigating some combination of the following: children leaving home, divorce or relationship breakdown, the illness or death of parents or loved ones, retirement (their own or a partner’s), a relocation, a significant career change, or a shift in their sense of purpose after years of defined roles. Any one of these would be a significant life event. Several at once, with little space to process them, can quietly erode a sense of self.
Perimenopause, menopause, post menopause and anxiety
Running alongside all of this, is perimenopause, menopause, or the post-menopausal years. Whilst menopause is getting more press now, how adds to the impact of other life events still needs greater understanding. Anxiety is one of the most common and least discussed symptoms of perimenopause. Many women I work with have been lost in it for years without making the connection. It crept up on them, often coinciding with other big changes, and by the time they seek support, it’s become the water they swim in. They don’t recognise it as something that arrived. It just feels like who they are now.
Added to this, is the reality that many women at this stage are also managing long-standing physical health issues. These are often inflammatory conditions that are connected to years of unprocessed stress. Bodies have a way of keeping score, and midlife is frequently when those issues start to become apparent.
And yet, the response of many of these women is not to look after themselves and ask for help. It’s to throw themselves further outward, taking on new commitments, continuing to show up for everyone else, filling their time with busyness. The idea of taking time for themselves can feel not just indulgent, but genuinely wrong.
The inheritance of getting on with it
This doesn’t come from nowhere. For many women over 50, it’s a pattern that was modelled for them long before they were old enough to question it.
Their mothers and grandmothers were women who got on with things and didn’t complain. Who managed the household, absorbed the family’s emotional life, supported everyone around them, and rarely, if ever, asked for the same in return. Therapy wasn’t part of their world, partly because access to it was limited, but also because the culture simply didn’t make space for it. You carried what you carried, and did so quietly.
That legacy lives on. Not as a conscious choice, but as an inherited script. It’s a deep, unexamined belief that needing help is a weakness, that other people’s needs come first, and your own struggles aren’t serious enough to warrant attention. The voice that says I’ve got nothing to complain about really. It’s the woman who ends a short course of therapy feeling a bit better, but quietly relieved not to be taking up any more of anyone’s time.
What makes this particularly complex is that the present generation of women over 50 have, in many ways, lived far more demanding lives than their mothers did. They have navigated careers alongside family life. They have managed more, juggled more, and been expected to do both seamlessly. The pressures are different and, in many ways, greater. I would argue they’ve become more critical of themselves as they strive to keep up appearances. The internal permission to seek help and prioritise their own wellbeing is often lost in a need for self-control.
The result is a generation of women carrying an enormous amount, with a deeply ingrained instinct to minimise it.
The waking up
There’s something else happening at this life stage that’s really important to understand.
Women’s hormone expert, Dr Mindy Pelz, describes a neurochemical shift that happens in women at this stage of life that, rather than representing loss or decline, can act as a kind of awakening. The hormonal changes of menopause and beyond don’t just affect mood and physiology. They can bring to the surface things that have long been buried such as old wounds and unprocessed experiences. Mindy describes it as ways in which women wake up to the fact they have been betraying their authentic selves to please everyone else1 . This exposes the unmet needs, the crossed boundaries, the self quietly set aside during decades of putting others needs first.
This resonates deeply with what I see in my practice. It’s not uncommon for women to come to therapy at this stage and discover, often with some surprise, that what they thought was a current crisis is partly something much older finally asking to be heard. Past experiences including complex trauma, loss, abuse or difficult family dynamics which they created coping strategies for, have a way of resurfacing during this mid life period. The body, too, often starts sending louder signals about emotions and issues that have been ignored for years.
This can lead to life changing breakthroughs
This is not bad news. Instead, it can represent a breakthrough waiting to happen.
It’s about gaining an understanding of the layers that have built up over the years. Of finding a perspective on what the root causes are of the issues they’re experiencing now. For women who have defined themselves through what they do for others – through career, through being a mother, a carer, a partner – this can be hard to establish alone. The issue for other women may be more about coping with shifts in the roles they hold. For example, I have worked with women who built successful careers, retired to beautiful places, thrown themselves into new communities and found they feel quietly purposeless, surrounded by people who have no frame of reference for the life they’d lived before. The external picture can look fine. Inside, something essential is missing.
Navigating the issues that can arise at this time can be disorientating and it deserves to be taken seriously. And this is exactly where therapy can be valuable.
What therapy can offer and why you don’t need to be in crisis to come
Therapy for women at this life stage is often about having a dedicated, unhurried space that belongs solely to them. A place where they can make sense of what they’re carrying. Where they can to explore their thoughts, and reconnect with who they really are beneath all the roles and responsibilities.
Sometimes that means short-term work focused on a specific transition. Sometimes it means longer-term exploration of patterns that have been running quietly in the background for decades. Each women’s needs are unique. What I do notice, though, is that women who come for a short piece of work and then pull back – perhaps because they feel they’ve taken up enough time, or they’ve got nothing to complain about — sometimes leave before they’ve reached the thing that was most worth reaching.
You don’t need to be in crisis to deserve support. You don’t need to have had really dreadful things terrible happen to you to justify seeing a therapist.
If you’re a woman over 50 and something in this post has resonated or touched a nerve, whether that’s the anxiety that crept up on you, the sense of purposelessness, the feeling that you’ve lost yourself somewhere along the way, or something else, please do feel free to get in touch with.
This is the kind of work I do, and I would be glad to have a conversation about whether having place to talk might help you navigate what you’re experiencing and create positive changes.
1 Cynthia Thurlow, NP. (16/12/2025). The Real Brain Shift in Menopause: What Women Need to Know | Dr. Mindy Pelz. YouTube. https://www.youtube.com/watch?v=d3AxHZ-jAEI
