Anxiety in Older Adults

Anxiety disorders are very common in today’s world. More than 19% of all adults in the United States have an anxiety disorder, which equates to around 40 million people. These older adults are more likely to talk to their doctors about their symptoms and spend time in the hospital to get the treatment they need. Those who care for elderly people should learn more about anxiety disorders and how to identify them.

1. What is Anxiety in Older Adults?

Though anxiety disorders are common among adults, the disorders affect a lot of elderly people, too. Up to 20% of all elderly people in the US struggle with anxiety disorders. Generalized Anxiety Disorder or GAD is the most common, followed by panic disorders, Post Traumatic Stress Disorder (PTSD), and phobias. Anxiety disorders are psychological conditions that include anxious thoughts or feelings. Caretakers must know more about these disorders such as their symptoms and the most common types.

What are the Common Types of Anxiety Disorders?

People can suffer from some anxious thoughts without letting those thoughts interfere with their lives. Other people find that their thoughts and feelings affect them so much that they cannot leave the house. It’s important that caregivers learn about the common types of anxiety disorders.

1. GAD (Generalized Anxiety Disorder)

GAD is the most common anxiety disorder affecting the elderly today. It also causes hopeless feelings and intrusive thoughts. Many people also have thoughts that make them worry about their loved ones. People will GAD often need to use the restroom often and have issues with their concentration and sleep. In the elderly, the condition can cause trouble breathing and hot flashes, too.

2. PTSD

PTSD is a disorder caused by some type of trauma in the person’s past. Those who served in the military can suffer from PTSD caused by the things they saw and did during their enlistments. Elderly people may develop PTSD when an incident causes them to remember a past traumatic event. This condition can also occur soon after the traumatic incident.

3. Phobias

Many people have at least one phobia, which is something that fills them with dread. A younger person might have a fear of the dark or a certain animal. Elderly people often develop phobias that relate to them and their families. They might worry that a child will have a car accident or that the roof will cave in during a storm. Phobias are irrational fears that the sufferers usually can’t explain. They know they have these thoughts but don’t know why.

4. OCD (Obsessive Compulsive Disorder)

OCD brings intrusive thoughts that the individual does not want to think about or experience. It often causes them to repeat certain actions as a way to stop bad things from happening. They may need to wash their hands multiple times, keep all of their dishes and clothing in a certain order, and check the oven several times before they leave the house because they think that if they don’t do these things, something bad will occur.

5. Panic disorders

Panic disorders cause panic attacks, which can mimic the signs of a heart attack. When an elderly person has a panic attack, they will often feel intense dread and notice their heart racing. It can also cause chest pain and nausea or leave the person feeling dizzy or weak. While some care for their panic attacks at home, others seek medical help.

6. Social phobias

Social phobias and anxiety disorders cause patients to feel judged and watched by others. It can worsen to the point where the person can no longer leave their home. These disorders can also affect the way patients respond to social situations and make it difficult for them to work or attend school. Elderly sufferers may even refuse to spend time with their loved ones.

Anxiety vs. Depression: Which One You Have?

While the symptoms of depression and anxiety are often similar, they are two different conditions. It is also possible for an elderly person to have both. Some of the signs of depression include:

1. Changes in their sleep patterns such as sleeping too much or too little
2. Hopeless, sad, or anxious thoughts
3. Concentration problems
4. A lack of interest in hobbies and activities they love
5. Feeling down
6. Less energy
7. Mood swings
8. Changes in their appetite and/or weight

The two conditions are different because people with depression often feel sad, which is usually not a symptom of an anxiety disorder. They often have a hard time getting out of bed or leaving the house because they don’t have the energy those activities require.

People with depression also feel sad a lot of the time and lose interest in things they always loved. They want to avoid hanging out with their friends or seeing their families. Depression can also cause suicidal thoughts and feelings. An individual may try to harm themselves or attempt suicide. A caregiver who thinks an elderly person is suicidal should seek medical help as soon as possible.

People with anxiety generally do not think about hurting themselves or their loved ones. Though they will also go to great lengths to avoid gatherings, they do so because they worry that something bad can happen at the event or that a loved one might get hurt on the way there.

Anxiety causes the patient to worry about things, people, places, and situations they cannot control. An individual can have both an anxiety disorder and depression, which will often worsen the symptoms of both. Stress or trauma can lead to one or both of these conditions.

2. What are the Signs of Anxiety in Older Adults?

The signs of anxiety disorders are diverse and can range based on the type of disorder. All of these disorders cause patients to experience anxious thoughts such as fear and panic or general uneasiness. Some of the other common signs of anxiety disorders include:

1. Thoughts of doom or dread
2. Hyperventilating
3. Trouble sleeping such as insomnia
4. Racing heart
5. Restlessness
6. Dry mouth
7. Tingling and/or numbness in the hands and feet
8. Nausea
9. Trouble catching their breath
10. Constant thoughts about a specific event

In many cases, a doctor will not diagnose a patient with an anxiety disorder unless the individual exhibited several of these symptoms for six months or longer. Caregivers should look for these symptoms and write down any they see before they speak to a doctor. While elderly people often exhibit the same symptoms, anxiety disorders affect them in different ways.

Elderly people dealing with anxiety disorders often feel on edge as if something bad will happen at any moment. They can feel nervous or restless, too. The disorder often causes them to feel weak or tired. They spend so much time worrying about what might happen that they don’t have enough energy to get through the day. They also suffer from irritability which makes it hard for them to be around certain people or in certain situations. An older adult with an anxiety disorder can also have trouble sleeping and sleeping through the night.

One of the hardest things about identifying anxiety disorders among the elderly is that they often have symptoms that are milder than younger people have. The Journal of Psychopathology and Behavioral Assessment published a study in 2008 that found older patients rate their symptoms differently than younger patients did. Even if they had the same symptoms, the elderly person would say that it was less of a problem and had less of an impact on their life.

Older people are more likely to experience insomnia caused by their disorder than younger people, too. Insomnia can prevent them from getting the sleep they need every night.

What are the Physical Signs?

In addition to the symptoms listed above, anxiety disorders can also present with some physical signs such as a rapid heart rate. Heart palpitations are quite common as are tense muscles. An elderly person dealing with worrying thoughts can tense their muscles without noticing it until they attempt to stand up or walk. Other physical signs to watch for include:

1. Muscle aches and pains
2. Feeling dizzy
3. Shaking
4. Weakness
5. Dry mouth
6. Sleepiness
7. Headaches

Caretakers should also listen to elderly people who complain about feeling sick. The physical symptoms of anxiety disorders often include stomach pain and shortness of breath . A caregiver might assume that the person has a cold or a virus when those symptoms indicate a mental disorder.

3. What are the Causes of Anxiety in Older Adults?

1. Losing a spouse

The National Council on Aging (NOCA) found that there are risk factors that increase the risk of an elderly person developing an anxiety disorder such as losing their spouse. Losing a spouse or partner is a traumatic event that has long-term effects. While some exhibit these symptoms right away, others begin showing symptoms a year or more after the death. The death of a spouse changes the daily life of the widow/widower. They need to learn how to do the things their spouse did and take care of things around the house. Widows and widowers often need to deal with things they never thought about before such as taking a spouse’s name off the deed or putting their vehicles in their name. They also need to follow the probate laws in their state.

2. Loss of Independence

NOCA found that the loss of mobility or independence can cause an anxiety disorder. As a person ages, their body changes and limits what they can do. They may need to give up on hobbies they loved such as working outside in their garden or taking long road trips because of their limited mobility. Elderly people also lose some of their independence. They often need to have a loved one move in who can take care of them or move to a nursery home. Older adults often feel anxious because of how their lives change.

3. Health Conditions

Financial insecurity and health conditions go along with anxiety disorders, too. Diabetes is a common condition among the elderly that changes the way their bodies process sugar. They may need to make some serious changes to their diet and find ways to get more exercise as well as take new medications.

4. Financial insecurity

Financial insecurity refers to the worries they have about their future. Many older people worry about whether they have enough money to pay for everything they need and if they can keep their homes. Other causes of anxiety disorders in the elderly include trauma, misuse of medications or other substances, and medication side effects.

4. What are the Treatment Options?

1. Psychotherapy

Psychotherapy is just one of the therapy treatments for older adults with anxiety disorders. Often called talk therapy, it gives the patient a safe place to talk about their past and current experiences. The therapist will help the patient identify the anxious thoughts they have and discover what caused them.

2. Acceptance and Commitment Therapy

ACT is a type of therapy that works well for some older adults. It teaches them how to manage their stress, which may help with their anxious thoughts. The patient sets goals and looks at how to reach those goals. If the older adult feels anxious in public, they might spend a little time outside in their yard and then at a park. They slowly work on achieving a set goal. ACT also teaches patients healthy ways to deal with their intrusive thoughts.

3. Cognitive Behavioral Therapy

Also known as CBT. This is a type of psychotherapy that can help people with anxious thoughts and feelings. It helps them identify their fears and learn what to do about them. Older adults essentially learn how to disassociate their thoughts and feelings with specific actions or responses.

4. Antidepressants

Antidepressants are a popular treatment option for some patients. They must look over the side effects as these medications can change their sleep pattern or appetite and cause sexual dysfunction. Antidepressants can also cause suicidal thoughts in some patients, which is why their caregivers need to keep an eye on them

5. Exposure Therapy

Though it doesn’t work well for everyone, exposure therapy can help some elderly patients. They take small steps towards a goal that goes along with their anxiety. For example, a patient might worry that their house will burn down if they don’t follow the same steps every morning before they leave. With exposure therapy, they slowly cut down on the number of actions they take. They learn that nothing bad will happen.

6. Anti-anxiety medications

Anti-anxiety medications are another treatment option. Patients can take the medication every day or when they are in stressful situations or feel they may have a panic attack. They are usually only a short-term treatment though that should go along with therapy.

5. What are Natural Remedies to Help with Anxiety?

1. Increase vitamins and minerals

Several studies found that different vitamins and minerals can help those struggling with anxiety disorders. Patients who consume more magnesium and Vitamin D can reduce some of their symptoms. Dark chocolate, whole wheat, and almonds are just some of the foods with high levels of natural magnesium. Vitamin D is common in fatty types of fish such as salmon.

2. Exercise

A study from 2013 found that regular exercise can decrease the symptoms of anxiety. Participants completed 30 minutes of moderate or high-intensity workouts five times a week. Exercise can also help a sufferer get more sleep at night and boost their serotonin levels.

3. Get an animal

Older adults often feel lonely because they don’t have as many friends or close family members as they once did. Getting a pet can help them avoid some of the anxious thoughts that threaten to take over their lives. A pet gives them an excuse to get out of the house and gives them a loving companion.

4. Avoid alcohol

Using or abusing alcohol can increase an individual’s risk of having anxious thoughts and lead to other mental disorders. Doctors recommend that their patients cut back on their alcohol intake.

5. Practice meditation

Meditation allows a person to focus their mind, body, and spirit and form a connection between the three. It doesn’t require a lot of fancy equipment or a lot of time either. Meditation can reduce the symptoms of most anxiety disorders, too.

6. Reduce caffeine

Excessive caffeine consumption can lead to heart palpitations and cause anxiety disorders. Patients struggling with anxiety should limit their caffeine consumption to just 400 milligrams per day.

7. Keep a journal

A study from 2016 found that people who engaged in creative writing exercises could better manage their stress. Older adults can try writing exercises that give them a writing prompt or keep a journal of their thoughts and feelings.

8. Get more sleep

Adults need a minimum of seven hours of sleep a night, but some older adults may need as much as 10 hours or more. Though getting enough sleep is difficult, patients can try to work out later in the day and cut down on the activities they do in bed. Keeping the bedroom cool and dark can also help.

9. Try aromatherapy

Not only does aromatherapy smell good, but it can help with anxiety. One study from 2012 asked more than 60 women over the age of 45 to try using lavender. Many of the participants had an easier time falling asleep and kept their anxiety symptoms under control.

10. Follow a healthy diet

A healthy diet is one filled with lean proteins and fresh fruits and vegetables. Sticking to a healthy and balanced diet can help someone cut down on their anxious thoughts and experience fewer symptoms of their disorder.

6. How Can You Help Your Aging Parents with Anxiety?

1. Talk to a physician

Before they do anything else, the child of an aging parent with anxiety should speak to the parent’s primary care physician. They need to let them know about the symptoms they witnessed and any changes they noticed. The doctor can weed out the medical causes of the anxiety and provide referrals to specialists.

2. Get them out of the house

Some elderly people experience anxiety because they spend so much time cooped up inside. It’s important that their children and caregivers get them outside as often as possible. Whether they go to the park and watch kids playing or have lunch at their favorite restaurant, it shows them they can still do things.

3. Talk to them

When an aging parent has irrational or delusional thoughts, their children might assume it’s time for them to enter a nursing home. Their children should both listen to them and support them. They can let their parents know that they understand their feelings and make sure that they know help is available when they make the choice to get help.

4. Follow a routine

Elderly people dealing with anxiety often feel some relief when they follow a set routine. It lets them know that things will stay the same and helps them keep track of what they need to do. A daily routine can include waking up at the same time every morning and having meals at the same time as well as doing things around the house like watching a favorite TV show or doing some work outside. Weekly routines can also help because it gives them things to look forward to every week. A weekly routine can include grocery shopping on Saturday, prepping meals for the week on Sunday, and visiting with loved ones on Monday.

5. Increase their social interaction

Elderly people can feel anxious because they are lonely or feel lonely because they are anxious. For example, someone who worries about what would happen if they left the house will miss out on interacting with people in public. Someone who is already lonely might feel anxious when they spend time with other people. Many cities have clubs and organizations that let elderly people get together in a safe environment. Some organizations even plan dances and trips.

6. Help them with their hobbies

Children can also help their parents find some hobbies they love that they can easily do. If they have a parent who loves flowers and plants, they might help them plan a new garden. They can help their parent pick out new plants online or buy them from a local shop and assist. Someone who loves drawing or painting might appreciate a new easel and some paint or charcoal. Elderly people may also enjoy putting together a family history and doing some genealogy work or trying new recipes.

FAQ

1. Does Medicare Pay for Anxiety?

Medicare does pay for anxiety, but it depends on the plan the person has. Those with Medicare Part A will get their hospital stay covered. Their plans also pay for any special care they need as well as their meals and rooms. Medicare Part B pays for most treatments offered outside of a hospital setting such as therapy sessions and appointments with doctors. It can also cover some or all of the costs associated with inpatient care. Medicare Part D pays for any of the medications that the covered patient needs to treat their anxiety. Older adults can have two different Medicare parts.

2. What Causes Panic Attacks in the Elderly?

A panic attack matches the signs of a heart attack so closely that many people visit the ER when they have their first one. Anxiety is one of the leading causes of panic attacks as the individual has a flight or fight response. This type of response happens when a person is in a situation that leaves them feeling as though they only have two options: run away or stay and fight. Some of the other causes of panic attacks in the elderly include:

• The loss of a spouse or another loved one
• Failing health
• Caffeine consumption
• Stress
• A change in the environment

3. Is Anxiety Common in the Elderly?

Not only is anxiety common among the elderly, but it’s also one of the most common psychological conditions they face. The Centers for Disease Control and Prevention (CDC) found that 7.6% of people between the ages of 50 and 64 suffered from an anxiety disorder as did 12.7% of those over the age of 65. Anxiety is fairly common across all age groups, but it affects the elderly in a few different ways.

4. Who/Which Doctors Treat Anxiety?

The doctors who treat anxiety are the same ones who treat other psychological disorders. Patients usually see their physician first and then a specialist. They can work with a psychiatrist, psychologist, or a psychiatric nurse practitioner. In most cases, the patient needs to get a referral from their doctor before they can see one of these specialists.