Social phobia, GAD and other senior anxiety disorders

Sunrise Senior Living  |  July 25, 2017

Anxiety disorders are common, but often misunderstood, mental health issues. 

While we all feel worried or overwhelmed at times, anxiety disorders go above and beyond a typical case of stress. According to the American Psychiatric Association, anxiety disorders cause disproportionate levels of fear and nervousness, to the point that it interferes with people's everyday lives. People with one of these conditions may react with extreme stress to common situations, or become so fearful that something will go wrong that they avoid common situations, no matter how unrealistic their concerns may be.

Though about 30 percent of all adults in the U.S. experience some form of anxiety disorder in their lifetimes, making it the most common of all mental disorders, they are still believed to be under diagnosed in senior populations. In order to provide your loved one with the best comfort and support, caregivers should look for signs of anxiety disorder and know how to approach getting treatment.

Rates of anxiety in seniors
The Anxiety and Depression Association of America states that it was a common misconception in the medical community to think that anxiety disorders decrease with age. In actuality, cases of anxiety may have just been going undiagnosed because older adults are less likely to seek treatment for mental health issues. Mental Health America added that as much as 14 percent of seniors may meet the requirements for an official anxiety disorder diagnosis. Additionally, another 27 percent may not have a diagnosable disorder, but live with enough anxiety symptoms that interrupt their ability to function normally.

"Anxiety disorders are frequently comorbid with chronic depression."

Anxiety disorders are frequently comorbid with chronic depression, another mental health issue that afflicts many adults as they age. Growing older brings about a lot of life changes, from adapting to new limitations to their health to losing friends and loved ones to adjusting to new schedules and habits. These changes can trigger depressive episodes. Seniors may also begin to feel stress and worry about the new direction their lives are going in, adding to anxiety disorders as well.

Medications may lead to these developments through side effects or potential misuse. Other substances, like alcohol, can worsen symptoms, too. 

Not all anxiety disorders experienced by seniors are the result of aging, however. Many of them may have been living with these conditions, untreated, for years.

Seniors may develop anxiety disorders as they age and face drastic life changes. Seniors may develop anxiety disorders as they age and face drastic life changes.

The different types of anxiety disorder
Recognizing the warning signs for an anxiety disorder in an older loved one can be tricky, as not all conditions manifest in the same way. According to the Geriatric Mental Health Foundation, some of the most common disorders include:

  • Panic Disorder. People who have panic disorder feel intense physical symptoms of stress and fear called panic attacks. These can be triggered as an extreme response to normal stressors, such as a preparing to undergo a medical procedure, or they can manifest randomly from seemingly unknown reasons. It's possible for people to have an occasional panic attack in highly stressful, unique situations without having panic disorder. The American Psychological Association states that experiencing four or more panic attacks may be a sign of a chronic disorder. Panic attacks can feel like a heart attack or stroke to someone who has not experienced them before. They can include shortness of breath, rapid heart beat, chest pain, weakness, dizziness, nausea, sweating and shaking.
  • Social Anxiety Disorder. This condition is specifically tied to social situations. Typically, a person with social anxiety experiences intense stress and worry when they socialize, or even thinks about having to socialize, with other people, fearing they may be embarrassed or judged by others. This can affect a person's life in a fairly minimal way, just causing them temporary stress before or during social engagements. In more extreme cases, however, people may be unable to appropriately interact with others and will do whatever they can to stop socializing in any way. 
  • Generalized Anxiety Disorder. Seniors living with GAD feel significant, constant worries. These worries can stem from overreactions to common life events, such as deeply fearing an accident every time they have to get in a car, or they may feel anxious and stressed for no discernable reason at all. They feel as if they are on high alert at all times. They often have trouble relaxing and concentrating and will startle easily. It can include physical symptoms, such as headaches, fatigue, hot flashes and muscle aches. People with GAD are usually aware that they are panicking for no reason, but cannot get their bodies to stop having a panic response. 

While you may not be able to tell on your own what kind of anxiety disorder your loved one is living with, if you notice a pattern of panic, fear and worry that interrupts their ability to function normally you should consider advising them to speak to their doctor. Look for signs that they are avoiding activities or social settings they used to enjoy, or stress reactions that are disproportionate to the issue they are facing. Ask guiding questions about their levels of anxiety and try to help them identify possible triggers for these feelings.

Breathing exercises, medication and physical activity may help seniors battling anxiety disorder.Breathing exercises, medication and physical activity may help seniors battling anxiety disorder.

Treating anxiety disorder
Consulting your loved one's medical provider is the only way to get an accurate diagnosis and begin a path toward recovery. Treatment options may include daily medications, drugs that are only needed when facing a direct panic attack, support groups or individual therapy. 

You can also help your loved one work on personal coping strategies at home outside of their therapy sessions. They may need to adjust other prescriptions they're on, or avoid caffeine and alcohol, which can increase anxiety. Breathing exercises and meditation may help in some cases, as can working out. Go for walks with your loved one to help them get fresh air and increase the mood-boosting chemicals released during physical activity.

Above all else, be patient, calm and compassionate when interacting with your loved one. If they feel like they're being a problem for you, it can increase their anxiety. Ask them how you can help make them feel better and reassure them often. Anxiety disorders are treatable, as long as your loved one has the support and resources they need to combat them.