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Anxiety Disorders

In our day-to-day life, we often encounter situations that cause us to feel uncomfortable, irritable, or overwhelmed. Sometimes our minds go to THAT place- “I can’t do this”, “this is too much for me to handle”, or “if I don’t think about it, it will go away.” For most of us, we are able to work through these issues and continue with our lives. Sometimes, however, these feelings become overwhelming, relentless, and debilitating—effecting our daily lives in negative ways. Unfortunately for 1 out of 10 older adults, these feelings are very real and can impact their quality of life.

Anxiety is defined as a constant distressing worry that a person finds difficult to control. Sometimes there is an identified stressor, such as finances or relationships, but this may not always be the case. Particularly in older adults, they may speak of their “nerves being all torn up”, yet be unable to state any specific thing they are nervous about. Anxiety disorders often present with physical symptoms—upset stomach, pounding heartbeat, sweaty palms, muscle tension, chest pains—and in extreme cases, such as with panic attacks, people think they are experiencing a heart attack. Other symptoms include intrusive and relentless feelings of worry or fear, restlessness, pacing, hand-wringing, irritability, difficulty concentrating, low energy, and fear of social situations.

Feelings of anxiety and stress stem from adaptive biological processes which help humans anticipate, plan, and prepare. In fact, some anxious feelings can serve a positive role, helping us to recognize potentially dangerous situations and react accordingly. Many people recognize that “butterflies-in–your-stomach” feeling as we plan and rehearse for a speech, travel to an unfamiliar area, or begin a new unfamiliar work task. However, if these feelings become overwhelming, distressing, or prevent a person from completing the task, it may represent symptoms of a more serious anxiety disorder.

Anxiety disorders should only be diagnosed by a physician or psychiatrist. A comprehensive medical exam is often necessary, especially in light of the physical symptoms mentioned above. Additionally, there are certain medications and treatments, such as steroids, OTC allergy medications, and thyroid medications which can mimic the symptoms of anxiety. EVERYONE experiencing symptoms of an anxiety disorder should have a medical evaluation to determine the basis of those symptoms.

Medications can help address the symptoms of anxiety, but these often have potentially dangerous side effects in older adults. Benzodiazepines such as Ativan, Valium, Klonopin, and Xanax are often prescribed, but should be closely monitored by a physician for signs of addiction, dependence, tolerance, and withdrawal. These medications can also cause drowsiness, dizziness, and confusion, greatly increasing the risk of falls in older adults. Anti-depressant medications such as Paxil, Prozac, Celexa, and Lexapro are preferred over benzodiazepines for treatment in the elderly, as these generally do not cause these serious side effects. The preferred treatment for anxiety disorders is a combination of medical and psychological interventions—relaxation therapy, counselling, and de-sensitization therapies. Dietary changes such as the elimination of caffeine, nicotine, and sugar may also help address symptoms.

What Can We Do To Help?

1. Educate yourself about the symptoms of anxiety disorders in order to recognize it in the people we support.

2. Make referrals for a medical and/or mental health evaluation.

3. Be supportive. Remember no matter how petty a concern may seem to you, it is very real to the person experiencing symptoms of anxiety.

4. Ask questions in a non-threatening manner:

Are you worried about something?

Are you having a hard time sleeping?

Do you have a hard time putting things out of your mind?

What can I do to help you feel more safe or comfortable?

5. Encourage people to used self-soothing skills learned in therapy (breathing techniques, relaxation therapies, etc.)

6. Provide a positive environment where individuals are set up to succeed and achieve life goals, as feelings of inadequacy and fears of failure or rejection by others are often underlying factors of anxiety disorders.

Julie Foster, BA, QP

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