Anxiety In Elderly

Feeling anxious or nervous is a common emotion for people of all ages and a normal reaction to stress. Feeling anxious can help us handle problems and strange situations, and even avoid danger. It is normal to feel anxious about illnesses, new social interactions, and frightening events. But when one feels anxious often and the anxiety is overwhelming and affects daily tasks, social life, and relationships, it may be an illness.

Anxiety is a common illness among older adults, affecting as many as 10-20 percent of the older population, though it is often undiagnosed. Phobia—when an individual is fearful of certain things, places or events—is the most typical type of anxiety. Among adults, anxiety is the most common mental health problem for women, and the second most common for men, after substance abuse.

For instance, the death of a loved one, moving from work into retirement, or dealing with a serious illness can leave people feeling sad or anxious. After a period of adjustment, many older adults can regain their emotional balance, but others do not and may develop depression.

Older adults with anxiety disorders often go untreated for a number of reasons. Older adults often do not recognize or acknowledge their symptoms. When they do, they may be reluctant to discuss their feelings with their physicians. Some older adults may not seek treatment because they have suffered symptoms of anxiety for most of their lives and believe the feelings are normal. Both patients and physicians may miss a diagnosis of anxiety because of other medical conditions and prescription drug use, or particular situations that the patient is coping with. For example, the anxiety suffered by a recently widowed patient may be more than normal grieving. Complicated or chronic grief is often accompanied by persistent anxiety and grieving spouses may avoid reminders of the deceased.

Untreated anxiety can lead to cognitive impairment, disability, poor physical health, and a poor quality of life. Fortunately, anxiety is treatable with prescription drugs and therapy..

WHAT IS ANXIETY?

An anxiety disorder causes feelings of fear, worry, apprehension, or dread that are excessive or disproportional to the problems or situations that are feared. There are several types of anxiety disorders.

Potential triggers or causes for drug or alcohol addiction in the elderly include:

Social phobia (also called social anxiety disorder).Social phobia is when an individual feels overwhelmingly anxious and self-conscious in everyday social situations. An older adult might feel intense, persistent, and chronic fear of being judged by others and of doing things that will cause embarrassment. Some older persons suffer a social phobia because they are embarrassed about being unable to remember names or are ashamed of their appearance due to illness. A social anxiety disorder makes it hard to make and keep friends. Some with social phobia can be around others, but are anxious beforehand, very uncomfortable throughout the encounter, and, afterwards, worry how they were judged. Physical symptoms can include blushing, heavy sweating, trembling, nausea, and difficulty talking.

Generalized anxiety disorder (GAD). Those with GAD suffer constant worries, and there may be nothing or little to cause these worries. Those with GAD are overly concerned about health issues, money, family problems, or possible disaster. Those with GAD usually understand that they worry more than necessary. Older adults with GAD have difficulty relaxing, sleeping and concentrating, and startle easily. Symptoms include fatigue, chest pains, headaches, muscle tension, muscle aches, difficulty swallowing, trembling, twitching, irritability, sweating, nausea, lightheadedness, having to go to the bathroom frequently, feeling out of breath, and hot flashes.

WHY SHOULD AN OLDER ADULT BE CONCERNED ABOUT ANXIETY?

For older adults, depression often goes along with anxiety, and both can be debilitating, reducing overall health and quality of life. It is important to know the signs of both anxiety and depression and to talk with a physician about any concerns. Anxiety is also strongly linked to memory. Anxiety can interfere with memory, and significant anxiety can contribute to amnesia or flashbacks of a traumatic event.

WHAT LEADS TO ANXIETY DISORDER?

A number of things can contribute to an anxiety disorder:

Extreme stress or trauma

Bereavement and complicated or chronic grief

Alcohol, caffeine, drugs (prescription, over-the-counter, and illegal)

A family history of anxiety disorders

Other medical or mental illnesses or

Neurodegenerative disorders (like Alzheimer’s or other dementias).

The stresses and changes that sometimes go along with aging—poor health, memory problems, and losses—can cause an anxiety disorder. Common fears about aging can lead to anxiety. Many older adults are afraid of falling, being unable to afford living expenses and medication, being victimized, being dependent on others, being left alone, and death.

Older adults and their families should be aware that health changes can also bring on anxiety. Anxiety disorders commonly occur along with other physical or mental illnesses, including alcohol or substance abuse, which may hide the symptoms or make them worse.

It’s also important to note that many older adults living with anxiety suffered an anxiety disorder (possibly undiagnosed and untreated) when they were younger.

A stressful event, such as the death of a loved one, can cause a mild, brief anxiety, but anxiety that lasts at least six months can get worse if not treated.

SIGNS OF ANXIETY DISORDER

• Excessive worry or fear
• Refusing to do routine activities or being overly preoccupied with routine
• Avoiding social situations
• Overly concerned about safety
• Racing heart, shallow breathing, trembling, nausea, sweating
• Poor Sleep
• Muscle tension, feeling weak and shaky
• Hoarding/collecting
• Depression
• Self-medication with alcohol or other central nervous system depressants

WHAT ARE THE TREATMENT OPTIONS?

Treatment can involve medication, therapy, stress reduction, coping skills, and family or other social support.

A mental health care provider can determine what type of disorder or combination of disorders the patient has, and if any other conditions, such as grief, depression, substance abuse, or dementia, are present.

Those who have been treated before for an anxiety disorder should tell their provider about previous treatment. If they received medication, they should indicate what was used, dosage, side effects, and whether the treatment was helpful. If the patient attended therapy sessions, he or she should describe the type, how many sessions, and whether it was helpful. Sometimes individuals must try several different treatments or combinations of treatments before they find the one that works best for them

THERAPY

Therapy or psychotherapy involves talking with a trained mental health professional, such as a psychiatrist, psychologist, social worker, or counselor, to discover what caused the anxiety disorder and how to deal with its symptoms.

In cognitive-behavioral therapy, therapists help people change the thinking patterns that contribute to their fears and the ways they react to anxiety-provoking situations. A therapist can teach new coping and relaxation skills and help resolve problems that cause anxiety. When a patient is ready to face his or her fears, a therapist can teach exposure techniques to desensitize the patient to the situations that trigger anxious feelings. Therapists also teach deep breathing and other relaxation techniques to relieve anxiety. Behavioral therapy is short-term therapy of 12 or fewer sessions.

WHAT ELSE CAN A PERSON DO TO RELIEVE ANXIETY

• Acknowledge worries and address any fears that can be handled (for example, if an individual is worried about finances, a visit to a financial planner may be helpful)
• Talk with family, a friend or spiritual leader
• Adopt stress management techniques, meditation, prayer, and deep breathing from the lower abdomen
• Exercise

Avoid things that can aggravate the symptoms of anxiety disorders

• Caffeine (coffee, tea, soda, chocolate)
• Nicotine (smoking)
• Over-eating
• Over-the-counter cold medications
• Certain illegal drugs
• Certain herbal supplements
• Alcohol (While alcohol might initially help a person relax, it eventually interferes with sleep and overall wellness, and can even contribute to anxiety, depression, and dementia.)
• Limit news of current events. It is important to stay current, but too much negative news can contribute to anxiety.
• Allow time for treatment to work

CONCERNED ABOUT AN OLDER FAMILY MEMBER OR FRIEND?

If you suspect an older adult you know might have a problem with anxiety, notice and ask about any changes in:

Daily routines and activities. Is the person avoiding situations and activities he or she once enjoyed?

Worries. Does he or she seem to worry excessively?

Medication. Is he or she taking a new medication, either prescription or over-the-counter? Or has the dosage changed for one of the medications?

Is he or she drinking more alcoholic drinks than previously?

Mood. Is the older adult tearful, lacking emotion, or “just doesn’t feel right.”

When talking with an older adult who has an anxiety problem:

Be calm and reassuring

Acknowledge their fears but do not play along with them

Be supportive without supporting their anxiety

Encourage them to engage in social activities

Offer assistance in getting them help from a physician or mental health professional