By Julie E 
Photo Credit ( Pixabay )
People of all ages frequently experience anxiety or nervousness, which is a typical response to stress. Anxiety can help us deal with issues, navigate unfamiliar situations, and even stay safe. It’s common to experience anxiety in response to terrifying situations, new social situations, and illnesses. However, frequent worry that interferes with everyday activities, social interactions, and relationships may be a sign of a medical condition.
As many as 10–20% of the elderly population suffers from anxiety, a common ailment that frequently goes undetected. The most common form of anxiety is phobia, which occurs when a person is afraid of particular objects, locations, or occasions. Anxiety is the most prevalent mental health issue among adults for women and the second most prevalent for men, behind drug abuse.
For a variety of reasons, older persons with anxiety problems sometimes do not receive treatment. It’s common for older folks to be unaware of their symptoms. When they do, they can be reluctant to talk to their doctors about how they feel. Because they have had anxiety symptoms for the majority of their life and think the emotions are typical, some older adults may choose not to seek therapy. Because of various medical disorders, prescription drug use, or specific scenarios that the patient is coping with, both patients and doctors may fail to diagnose anxiety. For instance, a newly widowed patient may have greater anxiety than is typical during the grieving process. Grieving spouses may avoid reminders of the departed, and complicated or chronic mourning is frequently accompanied by ongoing worry.
A low quality of life, poor physical health, cognitive impairment, and disability can result from untreated anxiety. Thankfully, therapy and prescription medications can be used to manage anxiety.
Anxiety: What is it?
Feelings of fear, worry, apprehension, or dread that are excessive or out of proportion to the issues or circumstances being feared are symptoms of an anxiety disorder. Anxiety disorders come in several forms.
Particular phobias
An extreme, illogical fear of a location, object, or occasion that genuinely presents little to no danger is known as a particular phobia. Heights, escalators, tunnels, driving on highways, enclosed places, flying, and spiders are a few examples of typical specialized phobias. The fear of being alone, going out in public, or leaving one’s house is known as agoraphobia. Older persons are more likely to suffer from phobias related to dental treatments, mortality, and family disasters. Extreme anxiety or a panic attack (chest pain, palpitations, shortness of breath, dizziness, or nausea) might be triggered by confronting or contemplating certain circumstances or objects.
Another name for social phobia is social anxiety disorder.
When someone has social phobia, they experience extreme anxiety and self-consciousness in normal social settings. An older adult may experience a severe, ongoing, and chronic anxiety of being scrutinized by others and of making embarrassing mistakes. Some elderly people have social anxiety because they feel ashamed of their appearance because of disease or embarrassed about their inability to recall names. Making and maintaining friends is difficult for those with social anxiety disorder. Some people with social phobia are able to interact with others, but they feel nervous before the interaction, extremely uneasy during it, and then worry about how they were perceived afterward. Blushing, profuse perspiration, shaking, nausea, and trouble speaking are examples of physical symptoms.
GAD, or generalized anxiety disorder
People with GAD worry all the time, and there might not be much or anything to worry about. GAD sufferers worry excessively about their health, finances, family dynamics, or potential calamity. Most people with GAD are aware that they worry more than is necessary. GAD affects older persons who have trouble focusing, sleeping, and relaxing. They also become startled easily. Fatigue, headaches, tense, aching muscles, headaches, shaking, twitching, difficulty swallowing, sweating, nausea, lightheadedness, frequent toilet breaks, hot flashes, and headaches are some of the symptoms.
PTSD, or post-traumatic stress disorder
A traumatic event involving physical pain or the prospect of physical danger to oneself, a loved one, or even strangers can result in PTSD. In addition to being brought on by experiences of war, PTSD can also be brought on by traumatic events like muggings, rapes, abuses, vehicle crashes, or natural catastrophes like earthquakes or floods. Months or years after the incident, symptoms could appear. Thirty years or more after an occurrence, some older persons may repeat a trauma because they feel powerless owing to a new condition (like being confined to a wheelchair) or certain triggers that bring back memories (like news reports about ongoing wars).
A person with PTSD may lose interest in things they used to enjoy, be emotionally numb among individuals they used to be close to, be easily startled, and struggle to feel affection. People with PTSD may act violently, aggressively, or irritably. When someone with PTSD has flashbacks, they may have nightmares while they sleep or vivid memories of the tragedy throughout the day. A person may think the traumatic incident is reoccurring during a flashback.
OCD, or obsessive-compulsive disorder
While obsessive-compulsive disorder is uncommon in older adults, some do have distressing, recurring thoughts that they manage through routines like counting, touching, or checking objects repeatedly. Potential violence and harm to loved ones are among the most prevalent anxieties. Some OCD sufferers hoard unnecessary things, while others are obsessed with symmetry and order.
Anxiety disorders
A hammering heart, chest pain, sweatiness, weakness, fainting, dizziness, or nausea are common symptoms of panic disorder, along with unexpected episodes of terror. Even while you’re asleep, panic attacks can happen at any time. Although some symptoms may persist for much longer, an attack typically peaks within ten minutes. Although older persons may not often suffer from panic disorder, those who do may refuse to be left alone. When an elderly person has a panic attack, they can believe they are having a heart attack or stroke.
Why is anxiety a worry for an older adult?
Anxiety and depression frequently coexist in older persons, and both conditions can be crippling, lowering general health and quality of life. Understanding the symptoms of anxiety and depression is crucial, as is discussing any worries with a doctor. Anxiety and memory are closely related. Anxiety can cause memory problems, and severe anxiety might exacerbate amnesia or trigger traumatic event flashbacks.
How can an anxiety disorder develop?
Anxiety disorders can be caused by a variety of factors:
Severe stress or trauma
Loss and complex or ongoing grieving
Caffeine, alcohol, and illegal, over-the-counter, and prescription drugs
Anxiety problems in the family
Neurodegenerative diseases (such as Alzheimer’s or other dementias) or other physical or mental ailments.
Anxiety disorders can be brought on by the stressors and changes that occasionally accompany aging, such as loss, memory issues, and poor health. Anxiety can result from common worries about getting older. Many elderly people fear falling, not having enough money for living expenses and prescription drugs, being harmed, becoming dependent on others, being abandoned, and dying.
It is important for older persons and their families to understand that anxiety can sometimes be triggered by changes in their health. Anxiety disorders can coexist with other mental or physical conditions, such as substance or alcohol misuse, which can mask or exacerbate the symptoms.
It’s also crucial to remember that many older adults who suffer from anxiety had an anxiety condition as children, sometimes going misdiagnosed and untreated.
Anxiety that lasts at least six months might worsen if left untreated, but mild, transient anxiety can be brought on by a stressful event, like the death of a loved one.
Anxiety and Depression
Anxiety and depression frequently coexist in elderly persons. Elderly people should inform their doctors if they are exhibiting either of these symptoms.
Who is able to assist?
Seniors should talk to their primary care providers about their worries if they believe they may be experiencing anxiety. A doctor can assist in determining if the symptoms are caused by a medical problem, anxiety disorder, or both. Seeing a mental health care provider is the next step if the doctor determines that the patient has an anxiety issue. To develop a treatment plan for the anxiety disorder, the patient and the provider should collaborate.
Which treatments are available?
Medication, counseling, coping mechanisms, stress management, and family or other social support are all possible components of treatment.
The patient’s kind of disorder or mix of disorders, as well as the presence of other conditions including dementia, substance misuse, depression, or sorrow, can be determined by a mental health care practitioner.
People who have previously received therapy for an anxiety illness have to disclose this information to their healthcare provider. If they were given medication, they must disclose the type, dose, adverse effects, and effectiveness of the treatment. The patient should explain the kind of therapy, the number of sessions, and whether it was beneficial if they went. Before they discover the treatment that works best for them, people may need to try a number of various approaches or combinations of approaches.
Drugs
While it won’t treat anxiety disorders, medication can help manage them while therapy is being received. Doctors, usually psychiatrists or geriatric psychiatrists, who can also provide therapy or collaborate with psychologists, social workers, or counselors who offer therapy, are required to prescribe medication.
Beta-blockers, which reduce some of the physical symptoms, antidepressants, and anxiety medicines are the main treatments for anxiety disorders.
Antidepressants
For the majority of anxiety problems, antidepressants are usually recommended. They function by changing the chemistry of the brain. Antidepressants should be taken long enough to work because symptoms often begin to subside after 4-6 weeks. Tricyclics, monoamine oxidase inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs), and serotonin and norepinephrine reuptake inhibitors (SNRIs) are examples of antidepressants.
Anti-anxiety medications
Anxiolytics, another name for anti-anxiety medications, are occasionally used when a short-term, fast-acting medicine is required. It has been demonstrated that the anti-anxiety medication buspirone works well for senior citizens. Another useful anti-anxiety medication is benzodiazepines, which should be taken with caution by older persons due to the risk of memory loss, shakiness, and falls. Benzodiazepines are typically prescribed for brief durations of time. If they stop taking them suddenly rather than weaning off, some people get withdrawal symptoms. Benzodiazepines are usually not addictive; however, they might be when taken often over an extended period of time.
Beta-blockers
By stopping the physical manifestations of some anxiety disorders, beta-blockers can help reduce anxiety.
Taking Drugs
Find out about the effects and side effects, such as when and how it should start to assist.
Inform your physician of any additional medications you are taking, including over-the-counter and prescription medications, herbal supplements, and complementary and alternative therapies.
Learn how and when to stop taking the drug. Some need to be tapered down under a doctor’s supervision because they cannot be stopped suddenly.
Regular use is necessary for the effectiveness of certain drugs.
Counseling
In order to determine the source of the anxiety condition and how to manage its symptoms, therapy or psychotherapy entails speaking with a qualified mental health practitioner, such as a psychiatrist, psychologist, social worker, or counselor.
Therapists who use cognitive-behavioral therapy assist patients in altering the thought processes that fuel their anxieties and the responses they have to circumstances that cause them to feel anxious. A therapist can assist in resolving anxiety-inducing issues and teach new coping and relaxing techniques. A therapist can offer exposure strategies to help a patient become less sensitive to the conditions that make them feel uncomfortable when they are ready to confront their anxieties. In order to reduce anxiety, therapists also instruct patients in deep breathing and other relaxation methods. Behavioral therapy is therapy that lasts 12 sessions or less.