When discussing anxiety, we rarely think about people with high functioning anxiety who can actually get pretty good at hiding their genuine emotions, especially if they are ashamed, embarrassed, or afraid to share their source. We are more likely to look for obvious signs of nervousness.
Moreover, the mass media focus tends to be put on younger generations. The weight of staying connected and living with the overwhelming amount of information in the fast-paced world naturally makes us believe that it’s mostly our youth who’s in danger of struggling with anxiety disorders. While it’s not untrue, many people seem to forget about the elders.
The quality of life, abilities, and worries significantly change as we get older. People get less and less independent, their physical and mental health only worsens, and they start to struggle with day-to-day tasks relating to personal hygiene, cleaning, or managing their finances. These certainly are things that can make one feel inadequate and anxious. Does your loved one need a therapist? Meds? Live-in care specialist? Or simply some emotional support?
In this article, we dive into the topic of anxiety in elderly people, trying to determine if there’s more to it than we see with our bare eyes – who is at risk, how to diagnose anxiety in elders, and how to support them on a daily basis.
What Is Anxiety?
Anxiety is an emotion that is triggered in response to some kind of stressor. It’s not fear, but you can think of it as a combination of apprehension and worry. In most cases, anxiety is an entirely normal response to stress. For example, if you are about to give a presentation at work and feel anxious about it, this is a perfectly natural reaction.
However, anxiety disorders are a bit different. Anxiety disorders can cause significant distress in day-to-day life and significantly impair a person’s ability to cope with stress. In other words, it can interfere with routine activities and make it difficult to carry out basic tasks.
GAD (generalised anxiety disorder) is one of the most familiar types. It’s characterised by worrying about everyday situations and events, sometimes to the point where it makes you feel physically ill. People suffering from GAD tend to be overly concerned with their health, safety, family, and finances. They experience intense fear without there being an actual threat present.
Anxiety can also come in the form of:
- Social or performance anxiety – fear of social situations or being judged by others;
- Phobias – an intense fear of something specific like spiders or heights;
- Panic disorder – sudden attacks of terror where you may even have trouble breathing;
- Obsessive-compulsive disorder (OCD) – repetitive, unwanted thoughts and/or behaviours;
- Post-traumatic stress disorder (PTSD) – feelings of severe anxiety arising from a past traumatic event;
- Separation anxiety – feeling anxious when separated from certain people.
Regardless of the type and severity, all anxiety disorders have very similar symptoms, which may or may not include (depending on a person):
- Sweating, fast heart rate, muscle tension;
- Trouble sleeping;
- Shaking, panic;
- Stomach problems;
- Prolonged fatigue;
- Changes in appetite and weight;
How Common is Anxiety in the Elderly?
Various anxiety disorders are relatively common as it is estimated that between 10% and 20% of all people struggle with one or more types. Sadly, many spend their lives undiagnosed and struggling.
According to NHS and YouGov research, roughly half of adults over 55 struggle with depression, and not many fewer with anxiety. The most common causes include the death of a loved one, illnesses, and financial problems. What’s exceptionally worrying is that over one-third say they don’t know where to look for help.
Anxiety doesn’t discriminate. Whether you are young or old, male or female, you can develop this debilitating condition. What many people don’t understand is that you don’t really need to go through significant trauma to develop an anxiety disorder. There are other factors that might contribute to it, and these include:
- Genetic predisposition;
- Traumatic event during youth;
- Family history;
- Lack of support;
- Chronic medical conditions;
- Limited social support;
- Substance abuse;
- Difficult financial situation;
- Severe pain;
- Chronic pain.
How to Diagnose Anxiety in Elders?
As one’s physical and mental health deteriorates and life is no longer what it used to be, it’s not surprising that they will become more anxious and depressed. However, they may not show their symptoms to others as it’s difficult, sometimes embarrassing, to admit to suffering. Moreover, many people fear judgement and lack of understanding; plus, as older people need more assistance with day-to-day tasks, they might not want to cause more worries to their close ones.
Anxiety disorders often go unnoticed by family members because it can take some time before symptoms develop into a full-blown illness. That’s why you need to stay attentive. If you feel like something is off, try to look for any of the symptoms mentioned above. This way, you will be prepared for the talk, first with your loved one, then with a mental health specialist, if there will be a need for your assistance.
A psychologist or a psychiatrist will take into account various things when diagnosing anxiety. They will ask questions about the patient’s behaviour and lifestyle and use diagnostic tools such as self-reported questionnaires or interviews with family members. As such, your attention might be vital to get the one suffering proper help.
There are several such diagnostic tools that can be used to determine if someone is suffering from anxiety, for example:
- Anxiety Disorders Interview Schedule (ADIS) – used by mental health professionals;
- Self-Report Anxiety Scale (SAS) – used by health providers;
- Anxiety Sensitivity Index (ASI) – used by researchers;
- CAGE – used by doctors trying to determine if someone should be referred for further assessment.
Further steps might include medications and therapy, but emotional support of those around them is vital for improvement.
How Can You Help?
It sounds simple, but the most important thing you can do is make sure your loved one feels heard and understood. Remember that living with anxiety is difficult; that’s why you need to learn more about the disorder and reduce the stigma surrounding it.
When in a fight, try to stay calm and speak clearly, but gently. If the person is particularly unreasonable or insensitive, it may be best to take a break from the situation. This will help you both calm down and avoid hurting one another.
When your loved one talks about their fears and worries, listen attentively and without judgement. Don’t brush it off or tell them to stop worrying. This will only make them feel worse. Let them know that you love them and want to be there for them, no matter what happens.
Encourage them to attend therapy and take meds; you might even accompany them to the therapist or support group if they agree to it. However, find the right balance not to become pushy or too controlling.
Anxiety is a complex and often misunderstood disorder. The stigma surrounding mental health issues and problems the elderly already struggle with might make it challenging to admit that they suffer and need help.
It’s said that those who are the most vulnerable in life are also the most resilient. So if you know an older person struggling with anxiety, make sure to show them your love and support. They will need it more than ever before.