By Meredith Kimple
In a previous blog post, we discussed the importance of monitoring and supporting our older loved ones’ emotional health. Depression is more prevalent in the elderly population than we might think, and yet, it is frequently overshadowed and unconsciously dismissed in the face of more prominent physical and cognitive illnesses. Without undermining the enormous impact diseases like Alzheimer’s and cancer have on an older body, I would like to once again emphasize the importance of, and acknowledge the challenge in, promoting senior mental health.
We all have our fair share of worries. Giving a presentation in front of an assembly, paying our children’s college tuition bills, watching the Heels play Duke, mulling over the state of the world – any of these things can cause us to break into a sweat. Though very unpleasant, worrying is perfectly normal, and in fact, fear can prove to be a powerful motivator when it comes to thoroughly preparing for the future.
But there’s a big difference between the occasional worry and an anxiety disorder.
An individual who has an anxiety disorder lives in a state of excessive, prolonged anxiety, to such an extent that it impedes their ability to function. Though they tend to appear most strongly in the years between adolescence and middle adulthood, anxiety disorders can develop at any time.
It is estimated that anxiety disorders affect about 15% of older adults every year. In the past, research seemed to indicate a decline in anxiety disorders with age, but in recent years, there has been greater recognition of the condition’s occurrence in the elderly.
So what causes anxiety disorders in older people?
There are several factors that can leave our older loved ones susceptible to an anxiety disorder. Though the majority of older people who have an anxiety disorder have had it since their youth, certain aspects of the aging process can worsen or even cause this condition. Many of the illnesses and diseases that affect the elderly population, like heart disease and diabetes, can aggravate an anxiety disorder; even some medications can cause older adults to experience chronic anxiety.
Anxiety disorders frequently occur alongside other psychiatric illnesses, particularly depression. As they age, seniors undergo countless physical changes, suffer the loss of friends and family, sacrifice their independence, and experience feelings of loneliness and uncertainty. These events and adjustments are emotionally taxing, leaving many older people vulnerable to both depression and anxiety.
While anxiety disorders are not fatal, they can exacerbate other physical and psychiatric illnesses, increasing the likelihood of hospitalization and decline. Compromised mental health can, at its best, lower an older adult’s quality of life and harm their self-confidence.
Anxiety disorders can be difficult to spot in older individuals, in part because seniors are often reluctant to vocalize their symptoms. This may come either from ignorance or from a fear of being labeled “mentally ill”; for centuries, mental illness has been unfairly stigmatized, and your older loved one may be afraid to admit their anxiety, even if they suspect they are suffering from that condition.
To further complicate matters, other medical conditions may mask the usual physical symptoms of anxiety; headaches, muscle tension, and pain can be misidentified as part of a pre-existing problem. Cognitive impairment can make identification all the more difficult; a person with Alzheimer’s disease or dementia may exhibit behaviors that could easily be mistaken for the symptoms of an anxiety disorder, and they may be unable to communicate or understand their feelings.
As their loved ones, how can we determine if they actually have an anxiety disorder?
Different disorders present different symptoms, but Generalized Anxiety Disorder (GAD) is the dominant variation among older adults. If your senior loved one has trouble sleeping, is restless, tired, and tense, and has spent at least six months worrying about everything from their relationships to their finances, they might have GAD. It is important to note that these behaviors must impede their normal day-to-day functioning, and their worrying must be uncontrollable. Things happen that cause all of us to worry, but an individual with an anxiety disorder experiences excessive, often irrational worry for a prolonged period of time.
If you suspect that a senior loved one is suffering from an anxiety disorder, it is very important that you act as soon as possible. First, try talking with them about any recent changes in their lives, and ask them about their feelings; having your support may help them to honestly share their concerns with you. However, they may be more willing to speak to a doctor they know and trust. Calling your older loved one’s primary physician can help to rule out other health issues; as mentioned above, anxiety can be aggravated by certain diseases, conditions, and medications. Anxiety disorders are treatable, both with medication and cognitive behavioral therapy.
Crippling anxiety may not be life-threatening in and of itself, but it can keep our older loved ones from living their lives to the fullest. Fear is powerful, and it is, above all, incredibly isolating. Age brings a plethora of rich experiences, some of which are wonderful and uplifting, and some of which serve to reinforce negative thought patterns. If there is nothing to counter these doubts and fears, our loved ones are in danger of losing their resolve to live and participate actively in the world around them.
You might think that at the end of our lives, many of our daily worries would abate. But the lives of our senior loved ones are often far from carefree, and they may have fewer coping strategies. Anxiety disorders cannot be managed without professional intervention, and we must be there to encourage them to seek help. In supporting and caring for their mental health, we are bolstering both their physical wellness and self-esteem through times of tremendous change.