Feeling anxious or nervous is a common emotion for all people. It's a normal reaction to stress, and it can help us handle strange or unknown problems. It also helps us avoid dangerous situations, as anxiety essentially prepares our bodies to face potential threats. We often feel anxious about new social interactions, frightening events, illness, and other personal fears or worries. Anxiety is beneficial in many situations, but excessive, long-term anxiety is overwhelming and can affect our well-being, social life, relationships and may cause other serious illnesses.

Recent data shows that about 10 to 20 percent of older adults suffer from some type of anxiety, although in many cases it is undiagnosed. The most common type of anxiety is a phobia, defined as the unexplained fear of certain things, events, or places. Anxiety is the most common type of mental health problem for women, and the second most common for men, after substance abuse.

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Unfortunately, many older adults suffering from anxiety go untreated. This happens for a variety of reasons:

- many seniors don't recognize or acknowledge their symptoms; if they do, they don't want to discuss it with a doctor or with their family;

- other seniors may not want to seek treatment, even if they are aware of their problem;

- the diagnosis is often missed because the senior in question may suffer from other medical conditions;

- other mental health problems can be mistakenly diagnosed; for instance, chronic grief may be associated with depression or anxiety, but it may be mistakenly diagnosed.

If left untreated, anxiety can lead to serious cognitive impairment, poor physical health, poor quality of life, and long-term disability. Fortunately, anxiety can be easily treated with therapy and prescription drugs.

How is anxiety defined?

Anxiety is a mental health condition defined by feelings of worry, fear, apprehension, or dread. These feelings are usually excessive or disproportional to actual situations or problems. There are multiple types of anxiety disorders:

- phobias – this is an intense, irrational fear of a thing, event, or place, which actually poses no threat; common types of phobias are associated with heights, tunnels, open or closed spaces, flying, and spiders; phobias affect seniors and may cause serious symptoms, like heart palpitations, chest pain, dizziness, nausea or shortness of breath;

- social phobia – this is usually known as an anxiety disorder – this is when an individual feels extremely uncomfortable in simple social situations; seniors may often feel fearful about being judged by others, leading to feelings of embarrassment or shame; social phobias make it hard to keep and maintain friendships; in extreme cases, seniors may feel isolated and depressed;

- general anxiety – those with general anxiety feel overly concerned about unimportant health issues, money or family problems, but also about possible natural disasters; seniors suffering from general anxiety understand their problem but find it very difficult to relax or sleep;

- post-traumatic stress disorder – known as PTSD, this condition develops after a traumatic event that involved physical or psychological harm; it can be caused by traumatic events like rape, mugging, car accidents, natural disasters, or war; symptoms can last for decades, even with therapy;

- obsessive-compulsive disorder – although not common among seniors, it does occur in certain individuals; people suffering from OCD follow specific rituals, like checking or counting things; these problems may cause stressful situations for the senior and the family;

- panic disorders – seniors suffering from panic disorders may have sudden attacks of terror, chest pain, weakness, sweatiness, nausea, dizziness, or faintness; panic attacks can occur at any time, and they last 10 minutes or more;

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What leads to anxiety disorders?

There are a variety of factors that may contribute to an anxiety disorder:

- extreme trauma or stressful situations
- chronic grief or extreme bereavement
- excessive consumption of caffeine, alcohol, or drugs (both legal or illegal)
- a family history prone to anxiety
- other mental illnesses or chronic conditions
- neurodegenerative conditions, like dementia or Alzheimer's disease

There are other factors that may lead to anxiety. For instance, the risk of anxiety can increase as a person ages and becomes physically impaired. Poor health, memory problems, and physical disabilities can also cause anxiety. Seniors are often fearful about falling, being unable to afford living expenses, being dependent on others, being alone, or being victimized.

Both seniors and their families should be aware that these health changes can bring on anxiety. They occur in conjunction with other disorders, including substance or drug abuse, which can hide the symptoms.

Signs and symptoms of anxiety disorder

- excessive fears and worries
- poor sleep
- hoarding or collecting various items
- overly concerned about the safety
- refusing to do routine activities or overly preoccupied with routine activities
- racing heart, trembling, sweating, nausea, and shallow breathing
- depression
- muscle tension, feeling shaky and weak
- self-medication with various drugs or alcohol

Signs and symptoms of depression

These symptoms usually last for more than two weeks:

- perturbed sleep patterns
- physical aches, pains, and lack of energy
- irritability and intolerance
- changes in appetite – either excessive eating or no eating
- loss of interest and pleasure
- changed sex drive
- noticeable difficulties with concentration and decision-making
- a feeling of guilt and worthlessness

The treatment options for seniors

Seniors who think they may be suffering from anxiety or depression should express their concerns with their primary care physicians. The doctor will be able to determine whether these symptoms are relevant and refer the patient to a psychiatrist. This is when the actual therapy and treatment will start.

Treatment may involve medication, stress reduction, coping skills, and therapy. Depending on the mental health issue, the doctor will determine whether any other conditions are present, like dementia, substance abuse, depression, or grief.

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