• Anxiety and Older Adults
• Depression and Older Adults

Anxiety and Older Adults

Feelings of anxiousness or nervousness are common in both adults and children. But when those feelings start to be overwhelming and affect your daily life, you could have an anxiety disorder. Mood swings and debilitating worry are important signs to watch for.  

Anxiety disorders in older adults are fairly common, affecting 10% to 20% of people. However, anxiety disorders often go undiagnosed. Anxiety is found more often than depression and cognitive disorders in older adults.  

Generalized Anxiety Disorder (GAD) is the most common type of anxiety disorder diagnosed in older adults. Having more anxiety as you age is a common issue in older adults. The most common type of anxiety disorder: Generalized Anxiety Disorder. This type of anxiety causes racing thoughts, constant worrying, and a feeling of hopelessness. Older adults with anxiety aren’t able to sleep or concentrate as well. They also feel tired, irritable, and nauseous. They may also have to go to the bathroom often. Hot flashes and feeling out of breath are additional signs of generalized anxiety.  

Post-traumatic stress disorder (PTSD).  This type of anxiety is caused by a traumatic event. In some cases, symptoms of the trauma may not emerge until months or even years after the event. Older adults may be triggered by a previous traumatic event after feeling helpless because of a new disability.  

Symptoms of Anxiety in Older Adults of all ages will typically show one or more common symptoms that may include: Shakiness and panicky feeling,  Difficulty breathing, sweating, and nausea, Dizziness or feeling lightheaded, Digestion problems, Chest pain, Headaches and confusion, Eye and vision problems, Muscle tension, soreness, and fatigue, Irrational thoughts, Forgetfulness, Irritability, Avoidance of activities, places, people, Changes in weight, appetite, or eating habits, Inability to sleep, Not wanting to leave home, withdrawal, Obsessive thoughts and compulsive behavior.  

How to Manage Anxiety in Older Adults

Anxiety isn’t always caused by a specific trigger. It typically happens because of overwhelming environmental and situational factors. As older adults deal with frequent changes, they can become more anxious. Some common triggers for older adults include: Financial insecurity, Health problems, immobility, or chronic pain, Dementia, Loss of independence and isolation, End-of-life , Grief and loss.Being aware of these triggers can help identify when you or a loved one might need help. Here are some other ways to help manage anxiety in older adults:  

1. Understanding what triggers feelings of anxiety and how to cope will help you recognize when you feel out of control.  

2. Therapy can help you learn ways to cope with your anxiety. You’ll learn relaxation methods and how to handle other stressors.  

3. Create a social support network. Family, friends, and people nearby that you trust can be a helpful resource for you to turn to when you feel yourself losing control. They may also be able to help you identify stressful situations and know when to get you out of them. ‌  

4. Try to have a healthy, balanced life.  Getting enough sleep, eating well, and staying active are important ways to manage your stress levels. Creating an active, balanced lifestyle with social interaction and hobbies you love can reduce stress and anxiety.  

When to See Your Doctor  

If you feel like your anxiety and nervousness are uncontrollable, you should contact your doctor. Your doctor can help diagnose you with an anxiety disorder and determine the right treatment plan for you. Your doctor will refer you to a mental health professional. Your doctor may prescribe low dosages of medications for older adults to find the right dosage for your body. Psychotherapy may also be recommended to effectively manage anxiety.

Reference: WebMed – Medical Expert Editorial

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Depression and Older Adults  

Feeling down every once in a while is a normal part of life, but if these feelings last a few weeks or months, you may have depression.  The following topics regarding management of depression in older adults are reviewed:

1. What is depression?

2. What are risk factors of depression?  

3. What are signs and symptoms of depression?  

4. Supporting friends and family with depression.  

5. How is depression treated?  

What is depression? Depression is a serious mood disorder. It can affect the way you feel, act, and think. Depression is a common problem among older adults, but Clinical Depression is not a normal part of aging. In fact, studies show that most older adults feel satisfied with their lives, despite having more illnesses or physical problems than younger people.  

There are several types of depression that older adults may experience:  

1. ‍Major Depressive Disorder – includes symptoms lasting at least two weeks that interfere with a person’s ability to perform daily tasks.‍
2. Persistent Depressive Disorder (Dysthymia) – experiencing depressed mood that lasts more than two years, but the person may still be able to perform daily tasks.  ‍
3. Substance - Medication-Induced Depressive Disorder – depression related to the use of substances, like alcohol or pain medication.‍
4. Depressive Disorder Due to A Medical Condition – depression related to a separate illness, like heart disease or multiple sclerosis.  

Risk Factors of Depression

There are many things that may be risk factors of depression. For some people, changes in the brain can affect mood and result in depression. Others may experience depression after a major life event, like a medical diagnosis or a loved one’s death. Sometimes, those under a lot of stress — especially people who care for loved ones with a serious illness or disability — can feel depressed. Others may become depressed for no clear reason.  Possible Risk Factors:

1. ‍Medical Conditions, such as stroke or cancer  ‍
2. Genes – people who have a family history of depression may be at higher risk  ‍
3. Stress - including caregiver stress  ‍
4. Social isolation and loneliness - Studies show that loneliness and social isolation are associated with higher rates of depression.‍
5. Lack of exercise or physical activity *  ‍
6. Functional limitations that make engaging in activities of daily living difficult.‍
7. Addiction and/or alcoholism

Note:  Research has shown that these factors are related to the risk of depression, but do not necessarily cause depression:  

What are signs and symptoms of depression?  

1. ‍Persistent sad, anxious, or "empty" mood *
2. Feelings of hopelessness, guilt, worthlessness, or helplessness
3. Irritability, restlessness, or having trouble sitting still  
4. Loss of interest in once pleasurable activities, including sex
5. Decreased energy or fatigue  
6. Moving or talking more slowly  
7. Difficulty concentrating, remembering, or making decisions
8. Difficulty sleeping, waking up too early in the morning, or oversleeping  
9. Eating more or less than usual, usually with unplanned weight gain or loss  
10. Thoughts of death or suicide, or suicide attempts

Note: If you have several of these signs and symptoms and they last for more than two weeks, talk with your doctor. These could be signs of depression or another health condition. Don’t ignore the warning signs. If you are a family member or friend, watch for clues. Listen carefully if someone of any age says they feel depressed, sad, or empty for long periods of time. That person may really be asking for help.  

Depression can look different depending on a person’s cultural background Signs and symptoms of depression can look different depending on the person and their cultural background. People from different cultures may express emotions, moods, and mood disorders — including depression — in different ways. In some cultures, depression may be displayed as physical symptoms, such as aches or pains, headaches, cramps, or digestive problems. Depression is a medical condition that requires treatment from a doctor. While family and friends can help by offering support in finding treatment, they cannot treat a person’s depression.  

How is depression treated?

Depression, even severe depression, can be treated. It’s important to seek treatment as soon as you begin noticing signs. If you think you may have depression, start by making an appointment to see your doctor or health care provider.  Certain medications or medical conditions can sometimes cause the same symptoms as depression. A doctor can rule out these possibilities through a physical exam, learning about your health and personal history, and lab tests. If a doctor finds there is no medical condition that is causing the depression, he or she may suggest a psychological evaluation and refer you to a mental health professional such as a psychologist to perform this test. This evaluation will help determine a diagnosis and a treatment plan.  

Common forms of treatment for depression include:  

Psychotherapy , counseling, or “talk therapy” that can help a person identify and change troubling emotions, thoughts, and behavior. It may be done with a psychologist, licensed clinical social worker (LCSW), psychiatrist, or other licensed mental health care professional. Examples of approaches specific to the treatment of depression include cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT).  

Medications for depression that balance hormones that affect mood, such as serotonin. There are many different types of commonly used antidepressant medications. Selective serotonin reuptake inhibitors (SSRIs) are antidepressants commonly prescribed to older adults. A psychiatrist, mental health nurse practitioner, or primary care physician can prescribe and help monitor medications and potential side effects.  

Treatment, particularly a combination of psychotherapy and medications, has been shown to be effective for older adults. Treatment choices differ for each person, and sometimes multiple treatments must be tried in order to find one that works. It is important to tell your doctor if your current treatment plan isn’t working and to keep trying to find something that does.  

Talk with your doctor about what treatment(s) might be good to try. Don’t avoid getting help because you don’t know how much treatment will cost. Treatment for depression is usually government health plans.  Although most cases of depression cannot be prevented, healthy lifestyle changes can have long-term benefits to your mental health. Here are a few steps you can take:  

1. ‍Be physically active and eat a healthy, balanced diet. This may help avoid illnesses that can bring on disability or depression.
2. Get 7-9 hours of sleep each night.
3. Stay in touch with friends and family.  
4. Participate in activities you enjoy.

Reference: National Institute on Aging (NIA) – USA National Institutes of Health (NIH)