In the late 1950s, a psychoanalyst named Elliott Jaques was the first to argue that people in their mid-thirties, primarily men, could experience a yearslong bout of depression brought on by the realization of one’s own mortality. Thus, the “midlife crisis” was born, exhibited by a sudden urge to seize control of respective circumstances and to reinvent oneself in increasingly improbable ways. 

Because of longer life expectancies, the onset of symptoms thankfully was not static at 35, but regardless of when people entered their midlife crisis, evidence of the phenomenon was observed around the world. Jaques himself was Canadian-born, and he first presented his thesis in 1957 to the British Psychoanalytical Society in London. But in the decades since, as some countries have taken steps toward reducing the burden of midlife depression in their society, mental health for the middle-aged has become a distinctly American problem.

While middle-aged adults in many modern nations are seeing their health and well-being stabilize or even improve, Americans born between the 1930s and 1970s are comparatively faring much worse, according to a study published Monday in the journal Current Directions in Psychological Science, led by researchers at Arizona State University. Leading the list of afflictions are unprecedented levels of loneliness, depression, and cognitive decline.

“It’s not just about buying a sports car. It’s just, ‘How do I get through life?’” Frank Infurna, a psychologist at Arizona State and the study’s lead author, told Fortune.

It’s not the lifestyle, it’s the system

The study compared American adults who were members of the Silent Generation or early Gen Xers with peers in Mexico and 15 other European and Asian countries. The research relied on metrics covering loneliness, depressive symptoms, memory, and grip strength to gauge physical health. 

Across all four categories, Americans fared equally or worse the later they were born, the only country where that pattern was observed. While in most of the world social policies have helped alleviate the factors that cause midlife crises, the same was not true in the U.S., the researchers found. 

The authors wrote that a series of “upstream” factors—including health care access, income inequality, and paid parental leave—left Americans particularly vulnerable. In real terms, public spending on child and family benefits in the EU rose 50.9% between 2000 and 2022, while in the U.S. it has mostly remained stagnant. It’s a similar story for income inequality. A 2022 analysis by the U.S. Government Accountability Office found that income and wealth disparities among Americans older than 55 were much wider than for peers in Canada, Germany, or the U.K. The ASU study found that wealth stagnation for middle-aged Americans compared with that of baby boomers weighed on mental well-being, factors exacerbated by the need to support millennial and Gen Z children who face their own set of financial struggles.

The U.S. also stands out on loneliness. While younger age groups are often considered the loneliest demographic, older Americans are no stranger to isolation. In a study of loneliness in 29 countries last year, the U.S. emerged as one of only two nations where middle-aged people were lonelier than older generations.

The midlife crisis trap

Other research has provocatively argued that the midlife crisis is disappearing in the 21st century, being replaced by a quarter-life crisis as twentysomethings struggle with a rise in “despair,” and that it’s an economic phenomenon. In the work of David Blanchflower and Alex Bryson, previously covered by Fortune, a widespread sense of meaninglessness drives dissatisfaction with work and therefore life. 

Seen under that lens, something similar could be happening to the middle-aged, even if it doesn’t neatly align with a stereotypical midlife crisis. Instead of impulsive purchases and behaviors, people in the midst of a midlife crisis are really just struggling with kitchen table issues, including tending to their physical and mental health and supporting extended family.

“I think you could call it a different type of crisis, but not one centered around a sports car or a total flip in one’s career,” Infurna said. “It’s about managing your finances, your health, your caregiving responsibilities with your aging parents or your adult children who come back home.”

Blanchflower and Bryson’s argument could align with Infurna’s research, as precarious economic conditions drive young workers into ill-fitting jobs, fueling a sense of despair that lingers into middle age if they are unable to improve their conditions. Bryson said a broken career ladder was a speculative but compelling bit of research: “Moving on up the ladder, it feels as if, perhaps, for some of them, somebody’s removed some of the rungs on that ladder,” he said, adding that he hadn’t seen research directly supportive of this sentiment.

With financial troubles of their own, millennials could encounter the very same conditions as the eldest of that generation start stepping into midlife themselves.

“I wish I could be optimistic,” Infurna said. “With the high cost of living when it comes to homes, and then student debt, and our wages not going as far, it’s trending in the direction that things will only continue to be this way for millennials.”