The Changes is set in the deep South during the depression. A fifteen year old girl, whose main ambition is to finish school and go to college, witnesses her mother’s intentional starvation. The family attributes their mother’s irrational behavior to menopause, believing that all women going through "the change" become crazy.
The young daughter not only fears that her mother’s insanity is hereditary, but also that it may be partly her fault. The reader suspects that the mother may have intended to die in order that her daughter could afford to go school. The family seems to feel that the daughter’s presence in the household somehow drove her mother to insanity.