At 47, I Was Supposed to Be at the Bottom. My 12-Year-Old Might Get There First.
It’s Friday night. We’re at the dinner table when Tilda says Jane’s name.
Jane (not her real name) is in her class. They sit together at lunch.
“Jane is out of school,” Tilda says. “She isn’t coming back this year.”
I ask what happened.
“She’s going into therapy.”
I put my fork down. Tilda leans back, balancing her chair on two legs. Her mother has reminded her not to do that so many times. I did not think I would hear that word from my 12-year-old, slipped so casually into a story about her friend.
“What do you mean, therapy?”
“She has a lot of dark thoughts. She’s depressed. She’ll be in a clinic.”
She says it like she’s telling me a friend has a dentist appointment. The words just sit there. Dark thoughts. Depressed. Clinic. When I was twelve, I didn’t have words like that for a friend.
I ask another question. She answers. We keep eating. Both the 12-year-old at our table and the one in the clinic know words I never did at their age.
After the kids go to bed, my wife and I stay at the table. It’s all we talk about.
Two Curves
I am 47. Every paper I read in residency said this would be the lowest year of my life.
The U-curve of life satisfaction is one of the most replicated findings in modern social science. Plot self-reported well-being across the human lifespan, and you get a U. High in your 20s, low in your late 40s, high again in your 70s. The shape is the headline.
Tilda is 12. Every recent paper says this is the edge of her own cliff.
There’s a turning point between us at this table. The low point I was told to expect at her age is where I am now. The low point she faces is right here, as she eats risotto and names a friend who is being treated for depression.
Both stories matter. Most of what I learned about midlife came from the curve I was taught. What I see now, in friends raising teens, is shaped by a curve no textbook has described yet.
This piece is about both.
The Floor I Was Taught
The U-curve found its modern shape in the work of David Blanchflower at Dartmouth. His 2021 paper in the Journal of Population Economics pooled data from 145 countries and 14 survey series and found the average minimum at age 46.7 in advanced economies and 49.9 in developing ones [1]. Whatever sample, whatever instrument, whatever decade, the U showed up again and again.
The pattern persisted after controlling for income, marriage, employment, and health. A separate 2010 PNAS paper from Stone, Schwartz, Broderick, and Deaton tracked psychological well-being across 340,847 US adults: daily stress peaked in the 20s and declined with age, but worry peaked around age 50 [2]. The 47-year-old reads as the most worried adult in the room because she is.
Why 47, specifically? The drivers stack in the same year. Children are still dependent, parents are starting to decline, both at once. Career complexity peaks: senior responsibility, the narrowing pyramid, the colleagues who were not going to make partner now know. Hedonic adaptation is maxed out. The aspiration-reality gap has nowhere left to hide. The first funerals shift from grandparents to peers. The hours do not lengthen. The demands do.
The most striking confirmation came from chimpanzees. In 2012, Weiss, King, and colleagues published a PNAS paper on 508 great apes [3]. Caretakers rated each animal’s well-being. The chimps and orangutans showed the same U-shape, with a low point at their species-equivalent midlife. The apes had no mortgage and no career. The U was older than either.
Not everyone bought it. Frijters and Beatton (2012) showed the U flattened in within-person data [4]. Cheng, Powdthavee, and Oswald (2017) reported four longitudinal panels and a within-person nadir at ages 40 to 42 [5]. The U held.
For my generation of doctors, the U-curve was a comfort. If you hit the floor, you knew there was a way back up.
The Floor That Moved
In August 2025, Blanchflower himself published the obituary of his own curve.
The paper, published in PLOS One, was titled “The declining mental health of the young and the global disappearance of the unhappiness hump shape in age” [6]. Across the BRFSS (US, 1993 to 2024), UKHLS (UK, 2009 to 2022), and the Global Minds Project (44 countries, 1.7 million observations), the hump shape was gone. Ill-being now decreases monotonically with age. The youngest people are the unhappiest. The 47-year-olds are no longer at the bottom because the bottom moved.
These are the numbers to remember.
Despair among US women under 25 rose from 5.6% in 2009 to 9.3% in 2023/24. Among UK women under 25, the same measure went from 4.4% to 12.7%. Across the 44-country Global Minds dataset, 48% of under-25s are now clinically at-risk, 13.4% classified as distressed.
A companion working paper by Twenge and Blanchflower (2025) examined six English-speaking countries (US, UK, Canada, Australia, Ireland, and New Zealand) and found the U-shape had gone in all six [7]. Young adults’ life satisfaction has fallen sharply across all six since around 2014. The Anglo-Nordic axis is where the floor moved first. The global generalization rests on thinner evidence than the US/UK claim, but the direction is consistent.
The person who shaped the U-curve is now the one closing the chapter.
Where the Descent Begins
The empirical bottom of the new curve lies in the 18-24 band. The descent begins earlier.
The CDC’s 2023 Youth Risk Behavior Survey reported that 52.6% of US female high school students experienced persistent sadness or hopelessness in the past year. 27.1% seriously considered suicide. 12.6% attempted [8]. Half the girls are feeling it. A quarter considering it. One in eight is trying.
The US Surgeon General’s 2023 advisory documented the exposure: 95% of US teens 13 to 17 use social media, a third “almost constantly,” and more than three hours a day doubles the risk of depression and anxiety symptoms [9]. Pew Research, surveying US teens in 2024 (published April 2025), found 48% of them now say social media has a “mostly negative” effect on others their age, up from 32% in 2022 [10]. The kids themselves are naming it.
The Lancet Psychiatry Commission on Youth Mental Health (McGorry et al., 2024) synthesized the international evidence across more than 20 countries and called the deterioration an early warning signal accelerating across two decades, predating COVID but worsened by it [11].
Jane is what the data describes. Tilda stands at the edge.
What Is Driving It
The trend is real. The mechanism is contested.
The strongest peer-reviewed causal evidence is Braghieri, Levy, and Makarin (2022) in the American Economic Review [12]. They used the staggered rollout of Facebook across 775 US colleges between 2004 and 2006 as a natural experiment. When Facebook arrived on a campus, the share of students with severe depression rose by about 7%. Generalized anxiety disorder rose by about 20%. A natural experiment with random timing of treatment is as close to a causal claim as a social scientist gets.
The synthesizing hypothesis lives in Jonathan Haidt’s 2024 book The Anxious Generation [13]. The argument is that phone-based childhood replaced play-based childhood, with early adolescence as the most vulnerable window. Girls take the worst of the social-comparison and body-dysmorphia load. Boys retreat into gaming and pornography. The losses are different. The neural substrate is the same.
One layer specific to this audience: Suniya Luthar’s work on affluent-youth distress (Luthar & Latendresse, 2005) [14]. Children of high-achieving parents show elevated rates of anxiety, depression, and substance use compared to peers. The drivers Luthar identified (achievement pressure and parental isolation) predate the smartphone era. They compound the load.
The counter-position is in Nature. Candice Odgers (2024) argued that most empirical evidence shows small or null effects, that the smartphone-causation thesis outruns its data, and that structural causes (post-2008 precarity, climate anxiety, declining civic infrastructure) may be undercounted [15]. Orben and Przybylski (2019) in Nature Human Behaviour found that digital technology use explains roughly 0.4% of variance in adolescent well-being [16]. The mechanism is contested even when the trend is not.
If your child is at this table, all three pressures are here at once.
The Upward ARC
This sits in the Capacity pillar of my Upward ARC framework. The long arc of what you can know, decide, and become over thirty years. Recover is the second pillar. The infrastructure that lets the climb back happen at all.
Lachman, Teshale, and Agrigoroaei (2015) identified the protective factors that predict midlife recovery: sense of control, physical activity, and social engagement [17]. My generation needs them for the climb back. She has to build the foundation for the first time. The protocols below are split for that reason.
Try This Today
The Floor Acknowledgment. Say where you are. The floor is a real dip with a known shape and a real way back up. Calling it a crisis leads to the wrong choices: the convertible, the affair, the boat. Calling it a floor leads to the right ones: the protective factors, the relationships you still have, the work that still matters. Different posture, different next step.
The Protective Three. Lachman’s factors, weekly cadence. Sense of control: one immovable 90-minute block this week that is yours. Physical activity: 150 minutes of moderate-intensity work across the week, the WHO floor. Social engagement: one in-person conversation with someone outside your work circle, this week.
The Aspiration-Reality Audit. One scheduled hour, no device, paper, and pen. Two columns. What you thought at 30, you would have by now. What you actually have. The gap is the source of the dip. Engage it honestly. The 47-year-olds who climb back are the ones who do this audit on purpose.
The Phone-Free Bedroom (for the parent). The charger lives in the kitchen. The phone is not in the child’s bedroom overnight. The Surgeon General advisory is explicit on this one because the sleep displacement effect is among the cleanest mechanisms we have. The conversation with your 12-year-old is not optional. The “her phone, her choice” position is what the data calls a mistake.
The In-Person Calendar (for the parent). Restore the lost hours deliberately. One sleepover, one in-person hang, one unmediated weekend afternoon per week. Calendar them. The protective effect of in-person socialization runs throughout the literature. “She will find her friends online” is the default that is hurting her.
Back to the Table
The conversation ends. Tilda is in bed. Her chair is back on all four legs. The dishwasher hums in the background.
My wife and I stay at the table. We talk about a 12-year-old we love who now uses the words of a 25-year-old in therapy, and about her friend who already has the diagnosis. The curve I expected at her age was still 35 years away. The curve she faces was never in any chart I saw in residency.
The work is bigger than this dinner table. It is also just as small as this dinner table.
For the 47-year-olds: the floor is real, the climb back is proven, the steps are simple, and the work is the work. For parents of 12-year-olds: the protective factors are the same, but you have to build the foundation, and the window is now.
Both happen at the same table.
Stay healthy.
Andre
PS: If you read this and you are either standing at the empirical floor of the old curve or raising a kid at the cliff edge of the new one, forward it to one parent of a teenager you trust. The conversation my wife and I had at that table after the kids were in bed is the one they may not have had yet.
References
[1] Blanchflower, D. G. (2021). Is happiness U-shaped everywhere? Age and subjective well-being in 145 countries. Journal of Population Economics, 34(2), 575-624. https://doi.org/10.1007/s00148-020-00797-z
[2] Stone, A. A., Schwartz, J. E., Broderick, J. E., & Deaton, A. (2010). A snapshot of the age distribution of psychological well-being in the United States. Proceedings of the National Academy of Sciences, 107(22), 9985-9990. https://doi.org/10.1073/pnas.1003744107
[3] Weiss, A., King, J. E., Inoue-Murayama, M., Matsuzawa, T., & Oswald, A. J. (2012). Evidence for a midlife crisis in great apes consistent with the U-shape in human well-being. Proceedings of the National Academy of Sciences, 109(49), 19949-19952. https://doi.org/10.1073/pnas.1212592109
[4] Frijters, P., & Beatton, T. (2012). The mystery of the U-shaped relationship between happiness and age. Journal of Economic Behavior & Organization, 82(2-3), 525-542. https://doi.org/10.1016/j.jebo.2012.03.008
[5] Cheng, T. C., Powdthavee, N., & Oswald, A. J. (2017). Longitudinal evidence for a midlife nadir in human well-being: Results from four data sets. The Economic Journal, 127(599), 126-142. https://doi.org/10.1111/ecoj.12256
[6] Blanchflower, D. G., Bryson, A., & Xu, X. (2025). The declining mental health of the young and the global disappearance of the unhappiness hump shape in age. PLOS One, 20(8), e0327858. https://doi.org/10.1371/journal.pone.0327858
[7] Twenge, J. M., & Blanchflower, D. G. (2025). Declining life satisfaction and happiness among young adults in six English-speaking countries (NBER Working Paper No. 33490). National Bureau of Economic Research. https://doi.org/10.3386/w33490
[8] Centers for Disease Control and Prevention. (2024). Mental health and suicide risk among high school students and protective factors: Youth Risk Behavior Survey, United States, 2023. MMWR Supplements, 73(4), 79-86.
[9] Office of the U.S. Surgeon General. (2023). Social media and youth mental health: The U.S. Surgeon General’s advisory. U.S. Department of Health and Human Services.
[10] Faverio, M., & Sidoti, O. (2025, April 22). Teens, social media and mental health. Pew Research Center.
[11] McGorry, P. D., Mei, C., Dalal, N., Alvarez-Jimenez, M., Blakemore, S.-J., Browne, V., Dooley, B., Hickie, I. B., Jones, P. B., McDaid, D., Mihalopoulos, C., Wood, S. J., … Killackey, E. (2024). The Lancet Psychiatry Commission on youth mental health. The Lancet Psychiatry, 11(9), 731-774. https://doi.org/10.1016/S2215-0366(24)00163-9
[12] Braghieri, L., Levy, R., & Makarin, A. (2022). Social media and mental health. American Economic Review, 112(11), 3660-3693. https://doi.org/10.1257/aer.20211218
[13] Haidt, J. (2024). The anxious generation: How the great rewiring of childhood is causing an epidemic of mental illness. Penguin Press.
[14] Luthar, S. S., & Latendresse, S. J. (2005). Children of the affluent: Challenges to well-being. Current Directions in Psychological Science, 14(1), 49-53. https://doi.org/10.1111/j.0963-7214.2005.00333.x
[15] Odgers, C. L. (2024). The great rewiring: Is social media really behind an epidemic of teenage mental illness? Nature, 628(8006), 29-30. https://doi.org/10.1038/d41586-024-00902-2
[16] Orben, A., & Przybylski, A. K. (2019). The association between adolescent well-being and digital technology use. Nature Human Behaviour, 3(2), 173-182. https://doi.org/10.1038/s41562-018-0506-1
[17] Lachman, M. E., Teshale, S., & Agrigoroaei, S. (2015). Midlife as a pivotal period in the life course: Balancing growth and decline at the crossroads of youth and old age. International Journal of Behavioral Development, 39(1), 20-31. https://doi.org/10.1177/0165025414533223
A note for new readers:
I’m a trained reconstructive facial surgeon, medical doctor, and dentist. Before launching this newsletter, I had a varied career: competitive freestyle wrestler, management consultant (McKinsey), entrepreneur (Zocdoc, Thermondo, and docdre ventures), and corporate executive (Sandoz). Today, I’m a Managing Director and Partner at BCG.
Husband of one. Father of three. Split between Berlin’s urban pulse and our Baltic Sea retreat. I’d rather be moving than sitting. Not just hobbies. Research. My body is my primary laboratory; I’ve been conducting experiments for decades.
If this is your first time here, welcome. I’m excited to share what I’ve learned and will continue to learn with you.
DISCLAIMER:
Let’s get one thing straight: None of this, whether text, graphics, images, or anything else, is medical or health advice. This newsletter is here to inform, educate, and (hopefully) entertain you, not to diagnose or treat you.
Yes, I’m a trained medical doctor and dentist. No, I’m not your doctor. The content here isn’t a replacement for professional medical advice, diagnosis, or treatment.
If you have questions about your health, talk to your physician or a qualified health professional. Don’t ignore their advice or delay getting care because of something you read in The Upward ARC. Be smart. Do your research. And, as always, take care of yourself.