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Anxiety disorders are actually the most common mental illness in the U.S., affecting 40 million adults in the United States age 18 and older, or 18.1% of the population every year. Some people suffer with anxiety throughout their lives, while others develop symptoms later in life. Some may be surprised to learn that elderly anxiety disorders are actually more prevalent than depression in seniors. Anxiety is a common illness among older adults, affecting as many as 10-20 percent of the older population, though it is often undiagnosed.
According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), anxiety disorders include disorders that share features of excessive fear and anxiety and related behavioral disturbances. An anxiety disorder can cause fear, worry, apprehension or dread that are excessive or disproportionate to the presenting stressor. Usually there is persistent worry that that a person can’t “shake” despite their attempts. An anxiety disorder is a clinical diagnosis made based upon the presence of certain symptoms. There are actually many different types of anxiety disorders. This is why it’s so important to consult with a licensed professional who understands the different presentations of anxiety disorders so that appropriate interventions can be tailored to the person.
Below is a list of some of the most common symptoms of anxiety. The number, duration and frequency of each of the symptoms needs to be taken into account when understanding what type of Anxiety Disorder a person has.
• Excessive worry about a variety of events and situations
• Significant difficulty in controlling the anxiety and worry
• Feeling wound-up, tense, or restless
• Anger and/or irritability
• Problems with concentration
• Recurrent unwanted thoughts
• Obsessive rituals, such as hand washing, cleaning or checking
• Difficulty with sleeping and/or nightmares
• Numb emotions
• Startling easily
• Significant tension in muscles
• Somatic complaints/ physical aches and pains
• Recurring thoughts of death or suicide
• Avoiding social situations or the outside world
• Chest pain or heart palpitations
Experiencing one of these symptoms alone does not constitute an anxiety disorder. However, when a person presents with multiple symptoms, causing significant distress, they very well may have an illness that can be treatable.
It is important to note that the behavioral and psychological symptoms of anxiety in seniors are often combined with physical symptoms and are complicated by medical issues. People may feel nauseous or have abdominal discomfort due to a medical condition, which impacts their appetite, sleep, mood and behavior. They may be overly fatigued or have trouble sleeping. In addition, when a senior has incontinence issues, that impacts sleep, it can increase anger, irritability and difficulty performing daily life tasks.
There is not necessarily one single “thing” that 100% causes anxiety for everyone. People have different protective factors, strengths, coping skills and support systems that can help to navigate stressors. What causes deep anxiety for one person, may be viewed as a minor bump in the road for another. When somebody has an anxiety disorder, usually there are a number of factors in play. The more risk factors present, the higher the likelihood a person will suffer from anxiety and not be able to manage stressors efficiently or effectively.
• Personal and/or family history of anxiety disorders
• Bereavement, loss of a loved one (including spouses, children and pets)
• Trauma or abuse
• Medical diagnoses/issues (especially Parkinson’s and other neurodegenerative disorders)
• Chronic illness/ Chronic pain (About 90 percent of elderly people suffer from at least one chronic illness)
• Financial insecurity
• Loss of vision, hearing and/or mobility
• Incontinence (urine and/or bowel)
• Medication mismanagement
• Alcohol and/or substance abuse
• Loss of driver’s license, transportation, sense of freedom
• Feeling forced to move out of their homes into congregate living
• History of falls/ Fear of future falls
• Social isolation
Unfortunately, a variety of negative life events and losses can happen at the same time a senior is experiencing physical and cognitive decline. All these elements combined can lead to truly devastating results, including death. For the clients with Blue Moon Senior Counseling, most of our seniors had pleasant expectations for their “golden years” and were simply not prepared for the sheer number of losses that came to be.
There are different types of anxiety disorders. Each has distinct symptoms.
Brief description of Anxiety disorders in seniors:
• Specific phobias – Powerful, irrational fears of non-threatening places, people, events or things
• Social anxiety – Overwhelming self-consciousness and worry around other people
• Generalized anxiety disorder – Constant worry that doesn’t seem to have a particular reason or trigger. This is the most common anxiety disorder in the elderly population.
• Post-traumatic stress disorder – Difficulty coping for a long-term period after a life-threatening, terrifying or intensely emotional event.
• Panic attacks – Sudden and forceful fear and dread
• Obsessive-compulsive disorder – Intrusive thoughts that cause anxiety and make people feel as though they have to complete a certain activity or ritual to ease the worry
Some common phobias for older adults are fear of death, worry that family members will be hurt and medical or dental procedures. Social anxiety may occur because seniors are embarrassed about their memory loss or appearance. People with generalized anxiety disorder may worry about illness, finances and possible disasters. Post-traumatic stress disorder can develop from recent distressing incidents or past traumas that are re-triggered due to disability or another experience.
Seniors may not seek treatment for their mental health struggles. They may worry that there is a stigma associated with psychological disorders. They may think it would be showing weakness to ask for help. They might also believe that it’s normal to experience worry as they age. If they’ve dealt with anxiety throughout their lives, seniors may believe that their suffering is normal and nothing can help.
Family members may not notice or be aware of anxiety disorders in seniors, either. Many loved ones see their older relatives becoming more irritable and worried, but they chalk it up to age, dementia or part of a medical issue.
The good news is that there are treatment options for anxiety disorders. Treatment can involve medication, therapy, stress reduction, coping skills, and family or other social support. Medication can often be helpful but does not “cure” anxiety disorders outright. Medications are prescribed by physicians and/or psychiatrists. Whenever medication is prescribed, the professional standard is for the client/patient to also have therapy/psychotherapy during the same period. The Licensed therapists at Blue Moon Senior Counseling do not prescribe medication but we do work with clients who have been prescribed medication by their own physicians.
The Licensed therapists with Blue Moon provide one-on-one individual therapy to seniors in their own homes. The initial focus of therapy is to understand the presenting problems/symptoms, understand causal and contributing factors and work to reduce and/or manage symptoms. We develop agreed upon therapeutic goals and use different interventions to find what works best. Our therapists are keenly aware of the new and complicated issues seniors face as they age as well as understand resources and options that exist that are not usually commonly known. We consider ourselves to be professional allies to our clients and strive to help them feel heard, respected, cared for and ultimately for them to feel better.
Contact us if you’re concerned about elderly anxiety. Our Licensed mobile therapists make treatment more convenient and comfortable by seeing patients in their own residences. We accept self, family and professional referrals. Individual counseling can help reduce anxiety and is a Medicare covered service that seniors deserve to benefit from!