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Anxiety Attacks in Older People - Causes, Symptoms and Treatment

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Anxiety attacks go underdiagnosed in individuals mostly among older people. Read about its symptoms, causes, and treatment options.

Medically reviewed by

Dr. Siva Anoop Yella

Published At July 4, 2023
Reviewed AtFebruary 8, 2024

Introduction

When a person ages, the functions of many systems in the body start to deteriorate gradually. As a result, many conditions started developing. One such condition is an anxiety disorder. The prevalence and understanding of anxiety are common in younger adults. However, many mental conditions, including anxiety, go underdiagnosed in older people. There is a misconception that during old age, the severity of anxiety decreases compared to young age. This can be true in some cases. But the number of older people with an anxiety disorder is not less. Studies suggest that 10 to 20 percent of older people suffer from anxiety.

What Are the Causes of Severe Anxiety?

  1. Phobias: Phobia is defined as a persistent fear of an object or situation. There are many types of phobias, including a phobia of height, insects, flying, and closed spaces. In older people, common phobias are fear of death, abandonment, family danger, and so on. A person may experience shortness of breath, dizziness, sweating, vertigo, and so on, while experiencing phobia.

  2. Panic Disorder: It is characterized by sudden feelings of terror that come frequently without any warning signs. Symptoms of panic disorder include heart palpitations, shortness of breath, dizziness, chest pain, fear of dying, and abdominal discomfort.

  3. Generalized Anxiety Disorder (GAD): A person with GAD experiences continuous worries which may or may not arise without any specific cause. Older people with GAD commonly present with symptoms like restlessness, panic attacks, digestive problems, and so on.

  4. Obsessive Compulsive Disorder (OCD): OCD is characterized by symptoms such as unwanted thoughts and compulsive rituals or behaviors. As a part of controlling or preventing thoughts, the person with OCD may engage in rituals like hand washing, cleaning, counting, and so on.

  5. Post-traumatic Stress Disorder (PTSD): It is a group of symptoms that occurs following a traumatic experience, like violence, abuse, and natural disasters. In some cases, the symptoms of PTSD may appear in a few months or a year. In older people, a new disability can trigger the symptoms of PTSD.

What Are the Risk Factors for Anxiety Attacks in Older People?

  • Long-term medical conditions like diabetes, hypertension, arrhythmias, angina.

  • Use of medications such as steroids, anti-psychotics, bronchodilators, stimulants.

  • Life events such as the death of a loved one or a close relative.

  • Poor physical health or limited physical mobility.

  • Excessive alcohol consumption.

  • Negative events during childhood.

  • Sleep disturbance.

What Are the Signs and Symptoms of Anxiety in Older People?

An older person with anxiety may present with the following signs and symptoms:

  • Excessive worrying, panicking and shaking.

  • Difficulty in breathing or shortness of breath.

  • Sweating.

  • Nausea and vomiting.

  • Chest pain.

  • Headaches and confusions.

  • Frequent urination.

  • Dry mouth.

  • Insomnia or difficulty falling asleep.

  • Heart palpitations.

  • Avoiding social situations, gatherings, activities, and other things that may trigger anxiety.

  • Taking extreme precautions every time to be safe.

  • Irrational thoughts.

  • Muscle tension.

  • Changes in eating habits and sleeping patterns.

How Is Anxiety Attack Diagnosed in Older People?

A psychiatrist diagnoses and treats anxiety disorders. He will take a detailed history of signs and symptoms experienced by patients. The exact cause of the anxiety will be diagnosed, and treatment will be based on the cause and symptoms.

If the patient has previously received any treatment for anxiety that has to be informed to the psychiatrist or mental health provider along with the medications taken. If the patient had attended any therapy sessions before, that also should be informed.

What Are the Treatment Options for Anxiety in Older People?

The psychiatrist may prescribe medications along with psychotherapy for the effective treatment of anxiety disorders in older people. The medications will be provided in low dosages to older adults to reduce the side effects of medications.

Medications: Although medications do not treat anxiety completely, they can reduce its severity and manage symptoms. Antidepressants, anti-anxiety, and beta-blockers are the medications that are used to manage anxiety symptoms.

  • Antidepressants: The commonly prescribed antidepressants to manage anxiety include selective serotonin reuptake inhibitors (SSRI), serotonin and norepinephrine reuptake inhibitors (SNRIs), tricyclics, and monoamine oxidase inhibitors (MAOIs). Symptoms start reducing after four to six weeks of taking antidepressants.

  • Anti-anxiety Drugs: Anti-anxiety drugs are usually prescribed for short term in older adults. Buspirone is an effective anti-anxiety medication for older people. Benzodiazepines are also used to cure anxiety disorders. But in older adults, it has to be given with care as high doses can sometimes result in memory loss and balance problems.

  • Beta-blockers: They are usually prescribed for hypertension and irregular heartbeat. However, they are also used in treating people who are diagnosed with anxiety disorder. Although beta blockers cannot alter the chemical imbalances or other problems that cause anxiety, they can manage the physical symptoms associated with it.

Psychotherapy: Some healthcare professionals claim that psychotherapy is not useful for the management of anxiety in older people. However, psychotherapies like cognitive behavioral therapy (CBT) along with medications successfully manage anxiety disorders in older people. It helps in identifying and managing negative thoughts.

How Can Older People Manage Anxiety Attacks?

Taking help from a medical professional should be the priority of older people suffering from an anxiety disorder. However, the following strategies can be helpful for older adults in coping with anxiety disorders:

  • Talk with a family member or friend. Sharing the feelings and anxiety experiences with a close friend or relative can relieve a few symptoms. Nowadays, there are many online support groups to help older people to manage different types of anxiety.

  • Stress management techniques like yoga, meditation, Tai chi, breathing exercises, and mindfulness are found to be effective in managing anxiety symptoms.

  • Avoid alcohol, caffeine, over-the-counter medications, and nicotine as these can act as stimulants for anxiety.

  • Regular exercise has many benefits. Studies found that regular exercise can enhance the secretion of dopamine and serotonin. These hormones have many mental benefits and can reduce the symptoms of anxiety.

  • Get plenty of sleep. As sleep deprivation is considered a cause of anxiety, it is important to get adequate sleep to prevent anxiety.

  • Avoid watching negative news or movies too much and focus on positive things.

Conclusion

Anxiety is common in both younger and older adults. Older people experience anxiety for many reasons, including chronic conditions and traumatic experiences. Many cases of anxiety in older adults go underdiagnosed due to a lack of awareness and a misconception that older adults do not suffer from anxiety. Severe anxiety can affect older adults' daily activities, making life miserable. With a proper diagnosis and treatment, and support from medical professionals and other older people can come out of anxiety and lead a happy life.

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Dr. Siva Anoop Yella
Dr. Siva Anoop Yella

Psychiatry

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anxiety
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