Middle adulthood is a complex period that requires a multidimensional view to understand all the processes and changes that are taking place. The many changes during adulthood include physical, cognitive, and social differences. Many of these changes create significant stress and it is important to understand ways to cope with anxiety. Many of these coping mechanisms include mindfulness and developing a sense of self-efficacy and mastery (p. 482). Many changes occur during adulthood that may require stress management techniques and interventions. During adulthood, biological and physical changes become apparent. During this time, visual perception, hearing and the reproductive system decline. Adults who have never worn glasses or contact lenses may begin to need vision correction (p. 424). During this time, adults may also need more light to see than their younger friends (p. 424). During middle adulthood, individuals, more often males, develop a lower sensitivity to high-pitched sounds (p. 424). This is why individuals at this stage have more difficulty hearing and interpreting other voices (p. 424). The female reproductive system begins to decline, slowly ending in menopause. The decline in the circulation of estradiol, the main hormone of estrogen, leads to many differences in reproductive health. In middle age, pubic hair thins, changes occur in vaginal chemistry, and the labia begin to thin and wrinkle (p. 424). Chemical changes in the vagina cause dryness and a greater risk of infections (p. 424). For men, the decline in testosterone during middle age is only small, but the decline leads to decreased bone density and loss of muscle mass...... middle of paper ... ...which can lead to a disorder in certain circumstances (p. 471). Stress can also cause immunosuppression, which suppresses the immune system, making it more likely that the individual will become ill (p. 472). Compared to Dr. Siegel's video, the key to happiness might be mindfulness and living in the moment. Many people think too much about the past or future and miss the present moment. In the counseling profession, I think middle age produces a lot of stress. I would suggest stress management techniques such as meditation and yoga. I would also suggest incorporating physical activity that increases endorphins in the body. For people with relationship difficulties, I would suggest marriage counseling so that they can understand each other's needs and learn to balance negative and positive effects in their relationship..