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Anxiety in the Elderly 

By Eileen Bailey

It was previously thought that as a person ages, the level of anxiety and the increase in anxiety disorders in the elderly decreased. According to the Anxiety Disorders Association of America, however, that “anxiety is as common in the old as in the young, although how and when it appears is distinctly different in older adults.”

While worry is a normal reaction to certain situations, chronic or excessive worry is not. Although there are several different types of anxiety, all with specific symptoms, there are also a few common characteristics of anxiety disorders:

•    Constant, exaggerated or excessive worry.
•    Physical symptoms such as rapid heart rate, sweating, dizziness, headache, stomachache, tense muscles, or trembling
•    Feeling on edge, restless, being startled easily or irritability
•    Trouble sleeping
•    Avoidance of situations that may cause anxiety

Recent research indicates that one in every five elderly persons suffer from anxiety severe enough to warrant treatment. There are a number of reasons this may be true:

Physical illness – As people age, medical problems increase. The stress associated with physical illness or chronic medical conditions can increase anxiety.

Psychological and Emotional Issues – The elderly are less likely to discuss psychiatric or emotional problems, leading these to go untreated and increase anxiety. Depression, a concern for many elderly people, is often accompanied by anxiety.

Increase in the Use of Prescription Medication – Certain medications can increase or cause symptoms of anxiety or can mimic symptoms of anxiety.

Lifestyle Changes – As people age, there are many changes in lifestyle they must deal with, including loss of independence, loss of friends and loved ones, and loss of going to work each day. All of these are major changes in lifestyle and each one is enough to cause anxiety, however, as people age, they often must deal with many major changes in lifestyle within a short period of time.

Treatment for Anxiety

The treatment of anxiety in the elderly is the same as treatment for those younger. Antidepressant medications, (SSRI type of antidepressants) are the most common medication treatment used to treat anxiety in the elderly.

Cognitive behavioral therapy has also been shown to help and can include relaxation training and exposure therapy. This type of treatment has been shown to be effective in treating many forms of anxiety and frequently takes several months of therapy before improvements are seen.

Treatment for anxiety in the elderly often begins with the family physician or primary care physician. This may be the someone that has developed a relationship with the patient over a number of years and someone the patient feels comfortable talking to about anxiety symptoms. It is important, however, for the physician, the patient and their family to work together. Family can be instrumental in monitoring medication use and symptoms of anxiety as well as improvement or worsening of symptoms.

Specific Symptoms of Anxiety in the Elderly

•    Avoiding situations or social events that once were considered to be enjoyable.

•    Excessive or chronic worrying without reason or worrying more that the situation calls for.

•    Insomnia, trouble sleeping or sleeping more than normal (can be a sign of depression – depression and anxiety are common co-existing conditions)

•    Symptoms such as shortness of breath, trembling, or irregular heartbeat. (These symptoms can also be a sign of physical illness as well, the physician should check for the presence of physical illness before making a diagnosis of anxiety).

•    Depression symptoms such as loss of interest in activities, increased sadness or withdrawal from family and friends. Depression and anxiety are common co-existing conditions and if depression has been diagnosed, the physician may want to discuss the possibility of anxiety as well.

Untreated anxiety can decrease quality of life, but is a treatable condition. With the proper treatment and support, elderly people suffering from anxiety (or depression) can fully enjoy life.

“Anxiety”, 2005, Feb 5, Author Unknown, The AGS Foundation for Health and Aging
“Anxiety in the Elderly” Date Unknown, Author Unknown, Anxiety Disorders Association of America
“Anxiety in the Elderly”,  Date Unknown, Glenn Brynes, PhD, M.D., Northern County Psychiatric Associates

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