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Managing Anxiety in Seniors

Katherine O'Brien
By Katherine O'BrienSeptember 18, 2018

Last Updated: September 18, 2018

Anxiety and depression — which often go hand in hand — are a serious public health problem in older adults, with recent research suggesting that as many as 15% of seniors suffer from depression and 25%, from persistent feelings of sadness. Although mental health issues are not always easy to diagnose, if left untreated, they could leave older adults susceptible to disability, isolation and even premature death.

Although seniors may not talk readily about anxiety and depression because of perceived stigma, people in this age group can be at particular risk, given that they typically experience more losses and suffer from more pain and physical ailments than younger adults. People who lack a supportive social network or are single, divorced or widowed are especially prone to depression as are those recovering from a fall, major illness or surgery. The treatment of anxiety and depression can be challenging as older adults are often on multiple medications, some of which might exacerbate anxiety. In addition, if an elderly adult is cognitively impaired, this can complicate both the diagnosis and the treatment.

Recognizing the Signs of Anxiety

Agitation, insomnia, the inability to focus and sudden mood changes can suggest anxiety or depression as can an unkempt appearance or weight loss or weight gain.

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Isolation is another symptom, one that can be exacerbated in those who have fallen in the past, are hearing impaired or have mobility issues. It is not uncommon for seniors to limit outside activities in an effort to avoid falling.

On top of this, anxiety sometimes manifests itself physically (e.g., back pain, headaches, rapid heartbeat), which makes the diagnosis all the more complicated.

Ways to Manage Anxiety and Probe for More Information

If a senior opens up about anxiety or depression, try to zero in on what is triggering their feelings — if a financial or medical problem is weighing them down, for instance, a referral to a specialist might be in order.

If you suspect a senior is anxious or depressed and they are not forthcoming, try to find out if they have experienced any of the following:

  • An increase in the use of alcohol or other substances (legal or illegal)
  • Changes in food intake (missing meals or overeating)
  • Physical complaints, such as back or chest pain, headaches, or shortness of breath
  • Sleep disruptions
  • Waning interest in activities and social events

In a senior without a cognitive impairment, the Generalized Anxiety Disorder Assessment (GAD 7) Tool can be used to screen for anxiety.

Medication is one way to treat anxiety and depression, though it tends to be more effective when combined with counseling or therapy, such as cognitive behavioral therapy (CBT). Not every older adult can tolerate antidepressants, but they are often recommended — benzodiazepines are generally to be avoided as older adults sometimes develop serious side effects.

For the most part, it’s safer to start seniors with a low amount of medication, increasing the amount slowly.

Electroconvulsive therapy or other newer forms of brain stimulation, such as repetitive transcranial magnetic stimulation (TMS), can play a part in treating depression in elderly persons, especially if they can’t take antidepressants or if the depression is severe.

Seniors may also get some relief by confiding in family and friends, attending a support group or talking to clergy. For some, attending a place of worship or taking part in activities at a senior center may hasten recovery. Relaxation techniques, such as meditation or yoga can also be helpful.

Do you have any other suggestions for managing anxiety in seniors? Share your tips with us in the comments below.

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Katherine O'Brien
Katherine O'Brien
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