Anxiety in Older Adults

Have you ever suffered from excessive nervousness, fear or worrying? Do you sometimes experience chest pains, headaches, sweating, or gastrointestinal problems? You may be experiencing symptoms of anxiety.

Excessive anxiety that causes distress or that interferes with daily activities is not  a normal part of aging, and can lead to a variety of health problems and decreased functioning in everyday life. Between 3% and 14% of older adults meet the criteria for a diagnosable anxiety disorder, and a recent study from the International Journal of Geriatric Psychiatry found that more than 27% of older adults under the care of an aging service provider have symptoms of anxiety that may not amount to diagnosis of a disorder, but significantly impact their functioning.

The most common anxiety disorders include specific phobias and generalized anxiety disorder. Social phobia, obsessive-compulsive disorder, panic disorder, and post- traumatic stress disorder (PTSD) are less common.

Common Types of Anxiety Disorders and Their Symptoms

Panic Disorder: Characterized by panic attacks, or sudden feelings of terror that strike repeatedly and without warning. Physical symptoms include chest pain, heart palpitations, shortness of breath, dizziness, abdominal discomfort, and fear of dying.

Obsessive-Compulsive Disorder: People with obsessive-compulsive disorder (OCD) suffer from recurrent unwanted thoughts (obsessions) or rituals (compulsions), which they feel they cannot control. Rituals, such as hand washing, counting, checking or cleaning, are often performed in hope of preventing obsessive thoughts or making them go away.

Post-Traumatic Stress Disorder: PTSD is characterized by persistent symptoms that occur after experiencing a traumatic event such as violence, abuse, natural disasters, or some other threat to a person’s sense of survival or safety. Common symptoms include nightmares, flashbacks, numbing of emotions, depression, being easily startled, and feeling angry, irritable or distracted.

Phobia: An extreme, disabling and irrational fear of something that really poses little or no actual danger; the fear leads to avoidance of objects or situations and can cause people to limit their lives. Common phobias include agoraphobia (fear of the outside world); social phobia; fear of certain animals; driving a car; heights, tunnels or bridges; thunderstorms; and flying.

Generalized Anxiety Disorder: Chronic, exaggerated worry about everyday routine life events and activities, lasting at least six months; almost always anticipating the worst even though there is little reason to expect it. Accompanied by physical symptoms, such as fatigue, trembling, muscle tension, headache, or nausea.

Identifying Risk Factors for Anxiety

Like depression, anxiety disorders are often unrecognized and undertreated in older adults. Anxiety can worsen an older adult’s physical health, decrease their ability to perform daily activities, and decrease feelings of well-being.

Check for Risk Factors

Anxiety in older adults may be linked to several important risk factors. These include, among others:

• Chronic medical conditions (especially chronic obstructive pulmonary disease [COPD], cardiovascular disease including arrhythmias and angina, thyroid disease, and diabetes)
• Overall feelings of poor health
• Sleep disturbance
• Side effects of medications (i.e. steroids, antidepressants, stimulants, bronchodilators/inhalers, etc)
• Alcohol or prescription medication misuse or abuse
• Physical limitations in daily activities
• Stressful life events
• Negative or difficult events in childhood
• Excessive worry or preoccupation with physical health symptoms

Screening for Anxiety

A quick, easy and confidential way to determine if you may be experiencing an anxiety disorder is to take a mental health screening.  A screening is not a diagnosis, but a way of understanding if your symptoms are having enough of an impact that you should seek help from a doctor or other professional. Visit www.mhascreening.org to take an anxiety screening.  If you don’t have internet access, you can ask your primary care doctor to do a screening at your next visit.

Anxiety is common and treatable, and the earlier it is identified and addressed, the easier it is to reverse the symptoms.

Depression and Anxiety

Older adults with mixed anxiety and depression often have more severe symptoms of both depression and anxiety. Learn more about the symptoms of depression by reading the “Depression in Older Adults” fact sheet.

Treatment Options

The most common and effective treatment for anxiety is a combination of therapy and medication, but some people may benefit from just one form of treatment.

If you or someone you know is experiencing symptoms of any form of anxiety, you should seek professional help immediately.

If you or someone you know is in crisis and would like to talk to a crisis counselor, call the free and confidential National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255).

Medicare Helps Cover Mental Health Services

Worrying about health insurance costs should never be a barrier to treatment. Visit the Medicare QuickCheck® on MyMedicareMatters.org to learn more about all of the mental health services available to you through Medicare.

Medicare Part A

Medicare Part A (hospital insurance) helps cover mental health care if you’re a hospital inpatient. Part A covers your room, meals, nursing care, and other related services and supplies.

Medicare Part B

Medicare Part B (medical insurance) helps cover mental health services that you would get from a doctor as well as services that you generally would get outside of a hospital, like visits with
a psychiatrist, clinical psychologist or clinical social worker, and lab tests ordered by your doctor. Part B may also pay for partial hospitalization services if you need intensive coordinated outpatient care.

Medicare Part D

Medicare Part D (prescription drug coverage) helps cover drugs you may need to treat a mental health condition.

Need help figuring out mental health coverage through Medicare? Use the Medicare QuickCheck® to get a personalized report on the best options for your situation.

Works Cited

1. U.S. Administration on Aging/Substance Abuse and Mental Health Services Administration. Older Americans behavioral health issue brief 6: Depression and anxiety: Screening and intervention. (2013). Retrieved April 2, 2015,    from    http://www.ncoa.org/improve-health/center-for-healthy-aging/content-library/IssueBrief_6_ DepressionAnxiety_Color.pdf
2. Medicare & Your Mental Health Benefits. (2014). Baltimore: Centers for Medicare and Medicaid Services. Retrieved April  2,  2015, from http://www.medicare.gov/publications/pubs/pdf/10184.pdf
3. Anxiety Disorders. (n.d.). Retrieved April 5, 2015, from http://www.mentalhealthamerica.net/conditions/anxiety- disorders#anxiety  disorders