We all experience anxiety. After all, worrying about the future is part of being human and helps us plan ahead and make better decisions. Some anxiety is normal and even productive. However, when anxiety becomes disruptive and disabling to a person’s life, it is considered an unhealthy psychiatric disorder.
Anxiety is the most common mental health problem in the U.S. today. However, despite its prevalence, the problem remains persistently under-recognized in the aging population. Studies show that nearly 15% of those over age 65 are coping with at least one anxiety disorder, most commonly Generalized Anxiety Disorder (GAD). Seniors may experience more troublesome anxiety than other age groups for several reasons: they experience more losses, suffer from more pain and chronic conditions, are often on multiple medications that might exacerbate anxiety.
I recall a former patient, who I will refer to as “Mr. R.” He was known to be a very strong, intelligent man who lost his wife few years ago. He was supported and visited by his two children frequently, living alone and able to take care himself until four months ago when his children noticed he lost weight. His neighbors said he had a few falls while walking outside of the house. In two months Mr. R was admitted with severe dehydration and malnutrition and was constantly anxious. He was found to have a generalized anxiety disorder, depression and mild dementia .
After hospitalization Mr. R and his family were advised to arrange help either at home or consider moving to an assisted living facility. His daughter agreed to move in with Mr. R, and they also decided to hire an assistant to come on a daily basis while his family members were at work.
This noticeably helped his anxiety, but still many times his family stated that he said, “I worry so much. I can’t control it. I am happy that you’re with me, but since Mother died I always felt like part of me died as well. I am feeling down most of the time.”
He was seen by his doctor who started him on Zoloft. Mr. R started to participate in swimming classes, gardening, and he followed up regularly with a counselor. His mood and appetite improved, as well as his quality of life.
Elderly anxiety disorders and depression usually respond well to a combination of talk therapy and medication. While prescription drugs should be used with caution in the elderly as many antidepressants can cause worsening of cognitive impairment, but at lower doses there are now some particularly effective medications that a physician can prescribe . Numerous studies have indicated that for a medication to be most effective, the patient should also be meeting on a regular basis with a skilled counselor, psychologist, or social worker.
Talk to your physician about available options for you.
Posting by Dr. Natalie Mykytsey, MD, Palliative Medicine Specialist
