Anxiety Disorders in Older Adults
By Dr. Stephanie van Ulft
Anxiety disorders are the most common of all the mental illnesses with estimates that, at any given time, up to 7.5% of all Americans exhibit symptoms. However, when studies have been done to evaluate the elderly in particular, the rate of anxiety disorders seems to drop and estimates are that 5.5% of the elderly suffer from these disorders.
The most common illnesses in this category include phobias, obsessive-compulsive disorder, and panic disorder. Generalized anxiety disorder (GAD), Post-traumatic stress disorder (PTSD) and social phobia are less common. Many older adults experience situational anxiety when visiting physicians, handling financial transactions, traveling or encountering an unfamiliar situation. Adjustment anxiety can occur when someone is diagnosed with new or life-threatening illness, when a move is made, when family relationships change (death, divorce, illness) or when retirement occurs.
Although the term "anxiety disorders" refers to a complex group of illnesses, they share many common symptoms. When people talk about their condition, they often include these descriptions: shakiness, trembling, muscle aches, sweating, cold/clammy hands, dizziness, jitteriness, tension, fatigue, racing or pounding heart, dry mouth, numbness or tingling of hands/feet, upset stomach, nausea, diarrhea, lump in throat, increased pulse, shortness of breath, fearfulness, feeling "trapped," feeling loss of control, felling that they will have a heart attack or other catastrophic condition. These symptoms may last minutes or hours. Often a person feels that they must escape the situation that seems to be provoking the symptoms. As symptoms continue to occur over time, a person may begin limiting their social contacts or travels outside their home in hopes of avoiding the anxiety.
In older adults, anxiety is often a key symptom of depression and the two syndromes overlap frequently. Therefore, when a complaint of "anxiety" is made, it is especially important in the elderly to also review the symptoms of depression and make this diagnosis, if appropriate. Treatment of the depression will usually resolve the anxiety symptoms as well.
Regardless of the specific anxiety disorder, treatment generally consists of both psychotherapy and medication. Anxiety disorders often respond quite well to supportive therapy, relaxation therapy, cognitive therapy and reassurance. In some cases, medications may be used to help control the symptoms. Anti-anxiety medications and antidepressants can both be beneficial. Treatment is usually aimed at helping a person gain a sense of control of a threatening situation. Patients can often help in controlling their anxiety by following some common sense guidelines: eat a well-balanced diet, exercise regularly, get an adequate amount of sleep, include recreation in your regular routine, practice deep-breathing, avoid caffeine, learn to prioritize, and say "no" to projects that will be draining or anxiety-provoking.
If you are interested in learning more about anxiety disorders, in having a comprehensive psychiatric evaluation, or have questions about this article, please feel free to call Heartland Human Services Gero-Psych Specialist, Linda Warner at 217-347-7179.