Let’s Talk About Anxiety In Older Adults

We accept that certain things occur as we age: our metabolism slows, our skin wrinkles, our eyes see less clearly. 

What is less understood are the possible changes in mental health for seniors, especially around anxiety disorders. 

Anxiety is more likely to go overlooked by both the patient and the physician when it’s camouflaged by physical illness. Untreated anxiety can lead to cognitive impairment, depression, poor physical health, and lower quality of life. 

Per the Geriatric Mental Health Foundation, “anxiety affects 10 to 20 percent of the older population though it is often undiagnosed. Among adults, anxiety is the most common health problem for women, and the second most common for men, after substance abuse.”

Anxiety disorders are largely misunderstood by seniors and may be a source of embarrassment. Plus, seniors are more likely to believe that emotional problems are a weakness of character best resolved on their own. 

Here, we highlight what anxiety is, how to spot possible symptoms, and a broad look at the range of treatments. 


What is Anxiety?

Anxiety is an emotion characterized by feelings of tension, worried thoughts, and physical changes like increased blood pressure. The real problem is in determining the difference between normal anxiety and a possible mental health issue, because some level of anxiety is part of being human. 

In any dangerous situation we face, our brains respond with an alert. Anxiety is a mechanism meant to protect us that, once ignited, can become a vicious loop of illness. 

The problem with anxiety (also known as “fight-or-flight response”) is that it can become a self-fulfilling prophecy of brain activity. We feel anxious regarding particular triggers, even when the triggers are no longer a danger to us, and then cycle back to that emotion again and again. 

Anxiety impacts people of all ages, but seniors come to it with a unique perspective. During their lifetime, the topic of mental health has changed quite a bit. What was once taboo is now much more acceptable. 

It has only been in recent decades, however, that society has looked upon mental illness not as a weakness but an imbalance requiring treatment. By the time seniors today experience symptoms like excessive worry or fear, avoidance of social situations, poor sleep, and hoarding, it’s likely that they’ve endured the symptoms for a lifetime. 


A History of Our Understanding of Anxiety

Anxiety disorder manifests in varied ways that are often unique for the individual. For seniors who are more isolated or less active, the symptoms tend to increase, because there is no social source to help recognize the issue. The irony of untreated anxiety disorders is that they produce more of the same behaviors which lead to more anxiety! It’s a vicious cycle. 

Anxiety has been cloaked in misunderstanding for thousands of years. When Greek philosophers pondered it in the 5th and 4th centuries BC, they surmised it was associated with women. In fact, the word “hysteria” derives from the word uterus. From there and through the Victorian era into the 19th century, hysterics were the realm of the ladies. 

Then, after the American Civil War, doctors recognized something they termed “irritable heart syndrome” in men after they returned home from the war. Today, that illness is known as Post-traumatic stress disorder (PTSD). 

Finally, fast forward to the 1950s when talk therapy became popular. The use of drugs and psychotherapy continued to evolve, and the language of mental health became more familiar in society’s vocabulary. By the 1980s, the term anxiety disorder was officially recognized by the American Psychiatric Association.


Anxiety Categories

With time and study, the mental health profession has refined and identified anxiety disorder categories and how they may manifest in individuals. There are several, but the most common forms of anxiety for seniors include: 

Phobias: An intense fear of a place, thing or event that isn’t truly a threat. Some phobias are fear of heights, fear of enclosed spaces, and fear of germs.  

In elders, a certain social fear commonly with age where a person feels embarrassed about the inability to remember names or the like. Some physical symptoms of social phobia that can appear in these cases include heavy sweating, heart palpitations, shortness of breath. 

Generalized anxiety disorder (GAD): Constant obsessive worry about a wide range of things from personal health to family issues or the fear of impending disasters are considered GAD. Symptoms like shortness of breath, chest pain, irritability, nausea, and difficulty sleeping may surface in these cases.

Post-traumatic stress disorder (PTSD): A person who suffered physical or emotional harm (to themselves, or if they were a witness). A person experiencing PTSD might experience flashbacks. People with PTSD sometimes also feel emotionally numb between episodes and find it difficult to feel affection for others. PTSD often shows outwardly with someone who loses interest in things and becomes aggressive or violent.


How to Talk About Anxiety with Your Health Care Professionals

Because anxiety so often goes untreated, it can become the gateway to other mental disorders including depression and cognitive impairment. There is a close association of anxiety and memory, for example. 

People dealing with ongoing anxiety sometimes have underlying health issues such as chronic fatigue and syndrome, too.

The key to getting answers and treatment for anxiety is to discuss persistent symptoms openly. If you receive home care, talk about your concerns with your health care professional in order to get tips and advice for how to take the discussion to the next level. 


Treatment Options

There is no one-size-fits-all treatment to remedy anxiety. Each person’s care must be tailored to their situation. Learn about your options and then work with your doctor to decide what steps to take. 

Anxiety.org offers extensive information on the many treatments available. If you feel overwhelmed once you’ve spoken to your doctor or mental healthcare experts, consider working with an Aging Life Care certified professional. He or she will help you weigh the options and manage the communication between all your medical care providers.

Most treatments for anxiety require assistance from medical and mental health care staff in tandem. The most common treatments fall broadly into these areas: 

Professional Therapy: A number of these therapies involve talk with a mental health professional. Patients work through their anxiety symptoms and identify the underlying triggers and practice coping skills. Therapies run a gambit of types, including cognitive behavioral therapy, group therapy, and even hypnosis. 

Medications: Pharmaceutical research is ongoing. The current drugs available for anxiety-related ailments include antidepressants, anti-anxiety drugs, and beta blockers. None of these are intended to be used without some form of talk therapy as well. Working with a psychiatrist or counselor is part of the treatment mix, and anti-anxiety drugs are not generally intended to be used indefinitely. 

Brain stimulation: Therapies have advanced dramatically since electroshock therapy of the 1950s. Today, brain stimulation treatments are often done under anesthesia and are targeted with the use of electrodes and electrical stimulation of areas of the brain. 

Self-help: A big step in resolving anxiety disorders comes with knowledge. Be your own advocate and explore self-help books, meditation, diet and nutrition, and exercise as avenues to alleviate symptoms. 


Learn and Talk About Mental Health

The ongoing push in the mental health field has been to normalize the conversation about anxiety. Teaching the public that there is no shame in having mental health problems is an ongoing effort. 

Your doctor can’t help you if you don’t talk about the symptoms you experience. The good news is that there are many treatment options available, and you don’t have to endure the pain of an anxiety disorder silently.