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How is an anxiety disorder different from just feeling anxious or worried? How common are anxiety disorders among older adults? What other illnesses can coexist with an anxiety disorder? What are the different types of anxiety disorders? What is generalized anxiety disorder (GAD)? What is social phobia? What is panic disorder? What is post-traumatic stress disorder (PTSD)? What is obsessive-compulsive disorder (OCD)? What is a phobia? Which anxiety disorders are most and least common among older adults? Does an anxiety disorder look different in an older adult compared to a young adult? Is it difficult to diagnose an anxiety disorder in older adults? What should I do if I think I have an anxiety disorder? What increases my risk for developing an anxiety disorder? What are the symptoms of generalized anxiety disorder (GAD)? What are the symptoms of social phobia? What are the symptoms of panic disorder? What are the symptoms of post-traumatic stress disorder (PTSD)? What are the symptoms of obsessive-compulsive disorder (OCD)? What are the symptoms of a specific phobia? How are anxiety disorders typically treated? What are the most common types of antidepressants used to treat anxiety disorders? What other types of antidepressants can help anxiety disorders? How should antidepressants be taken? What types of anti-anxiety medications are used to treat anxiety disorders? How should anti-anxiety medications be taken? Will psychotherapy help me? How can cognitive behavioral therapy help with obsessive-compulsive disorder? How can cognitive behavior therapy help with social phobia? How can cognitive behavioral therapy help with post-traumatic stress disorder (PTSD)? How is exposure-based behavioral therapy used? What is being done to improve understanding and treatment of anxiety disorders in older adults? How is an anxiety disorder different from just feeling anxious or worried? If you have an anxiety disorder, worry or fear becomes long-term and may get worse instead of better as time goes on. Doctors and older adults tend to view anxiety and fear as normal given the circumstances of aging. But developing an anxiety disorder late in life is not a normal part of aging. How common are anxiety disorders among older adults? A woman looks worriedly out a window. Studies estimate that anxiety disorders affect between 3 and 14 percent of older adults in a given year. More women than men experience anxiety disorders. They tend to be less common among older adults than younger adults. What other illnesses can coexist with an anxiety disorder? In older adults, anxiety disorders often occur at the same time as depression, heart disease, diabetes, and other medical problems. In some cases, these other illnesses need to be treated before a person will respond to treatment for the anxiety disorder. What are the different types of anxiety disorders? Anxiety disorders are a collection of disorders that include generalized anxiety disorder (GAD), social phobia panic disorder, post-traumatic stress disorder (PTSD), obsessive- compulsive disorder (OCD), and specific phobias. What is generalized anxiety disorder (GAD)? A man worrying. In generalized anxiety disorder (GAD), a person becomes very worried about things like health, money, and family problems, even if everything is OK. A person may be very anxious about just getting through the day. What is social phobia? In social phobia a person fears being judged by others or of being embarrassed. This fear can get in the way of doing everyday things such as going to work, running errands or meeting with friends. People who have social phobia often know that they shouldn't be so afraid, but they can't control their fear. What is panic disorder? In panic disorder, a person has sudden, unexplained attacks of terror, and often feels his or her heart pounding. During a panic attack, a person feels a sense of unreality, a fear of impending doom, or a fear of losing control. Panic attacks can occur at any time What is post-traumatic stress disorder (PTSD)? Post-traumatic stress disorder (PTSD) develops after undergoing a terrifying ordeal like an accident or an act of violence. A person who develops PTSD may have been the one who was harmed, or have a loved one who was harmed, or have witnessed a harmful event. What is obsessive-compulsive disorder (OCD)? People with obsessive-compulsive disorder (OCD) feel the uncontrollable need to check things over and over, or they may have certain thoughts or perform certain routines over and over. The thoughts and rituals of OCD cause distress and get in the way of daily life. The repeated, upsetting thoughts of OCD are called obsessions. To try to control them, people with OCD repeat rituals or behaviors, which are called compulsions. People with OCD can't control these thoughts and rituals. What is a phobia? A specific phobia is an intense, extreme fear of something that poses little or no actual danger. Some of the more common specific phobias involve closed-in places, heights, escalators, tunnels, highway driving, water, flying, dogs, and the sight of blood. Which anxiety disorders are most and least common among older adults? Although the research is limited, some studies have found that specific phobias and GAD are the most common anxiety disorders among older adults. OCD and PTSD appear to be the least common, but there is little research on the prevalence of these illnesses in older populations. Does an anxiety disorder look different in an older adult compared to a young adult? Sometimes, yes. Brain studies have shown that older adults tend to experience and process emotions differently than younger adults. They also have different concerns. For example, they may worry more about health and disability, and have fewer concerns about work, finances, and family compared to younger adults. Is it difficult to diagnose an anxiety disorder in older adults? Because anxiety disorders may look different in older adults compared to younger adults, they can be difficult to detect and diagnose. Doctors can have difficulty distinguishing between anxiety caused by adapting to difficult life changes, and a true anxiety disorder. For example, if you fell and broke a hip, you may be justifiably fearful of going out for a while. But that would not mean you have developed an anxiety disorder. What should I do if I think I have an anxiety disorder? If you think you have an anxiety disorder, the first person you should see is your family doctor. A physician can determine whether the symptoms that alarm you are due to an anxiety disorder, another medical condition, or both. What increases my risk for developing an anxiety disorder? Some factors that appear to be associated with an increased risk for an anxiety disorder in late life include being female; having several chronic medical conditions; being single, divorced or separated; and having less education. Experiencing stressful life events, being physically limited in daily activities, and having had difficult childhood experiences also increase a person's risk for developing an anxiety disorder. What are the symptoms of generalized anxiety disorder (GAD)? People with GAD often worry about everything, even if there is no reason to worry. They can't control their worries and can't relax. They may be easily startled, and have trouble falling or staying asleep. What are the symptoms of social phobia? People with social phobia are very anxious about being with other people. They feel very self-conscious around other people, have a hard time talking to others, and worry about being embarrassed. What are the symptoms of panic disorder? People with panic disorder experience marked attacks of fear. During an attack, they may sweat a lot, feel weak or faint, or feel dizzy. They may feel flush or chilled, and their hands may tingle or feel numb. They may also feel nauseous, have chest pain, or have difficulty breathing. What are the symptoms of post-traumatic stress disorder (PTSD)? People with post-traumatic stress disorder (PTSD) constantly re-live the trauma they experienced while awake, and in nightmares while asleep. These are called flashbacks and may include images, sounds, smells, or feelings. They may be triggered by ordinary events, such as a door slamming or a car backfiring. What are the symptoms of obsessive-compulsive disorder (OCD)? People with obsessive-compulsive disorder (OCD) have repeated and unwanted thoughts or images about things such as fear of germs, dirt, or intruders; violent or sexual acts; hurting loved ones; or being overly tidy. What are the symptoms of a specific phobia? People with a specific phobia have an irrational, extreme fear of a particular thing. Although they may realize the fear is irrational, they often find that facing, or even thinking about facing, the feared object or situation brings on a panic attack or severe anxiety. How are anxiety disorders typically treated? Most disorders can be treated with medication or psychotherapy. For some, a combination of medication and psychotherapy may be the best treatment approach. What are the most common types of antidepressants used to treat anxiety disorders? Antidepressants are increasingly recommended to treat anxiety disorders in older adults. They are most commonly prescribed to treat generalized anxiety disorder (GAD) and panic disorder. What other types of antidepressants can help anxiety disorders? For some people, older classes of antidepressants such as tricyclics and monoamine oxidase inhibitors (MAOIs) may be a better choice. People taking MAOIs must follow strict food and medicine guidelines to avoid potentially serious interactions. They must avoid substances that contain high levels of the chemical tyramine which is found in many cheeses, wines, and pickles and in some medications including decongestants. How should antidepressants be taken? For all types of antidepressants, patients must take regular doses for at least three to four weeks, sometimes longer, before they are likely to feel the full benefit. They should continue taking the medication for an amount of time specified by their doctor, even if they are feeling better, to prevent the anxiety from returning. What types of anti-anxiety medications are used to treat anxiety disorders? Pill bottles. Benzodiazepines are a type of anti-anxiety medication sometimes used to treat anxiety disorders in older adults. Benzodiazepines include clonazepam (Klonopin), which is used for social phobia and generalized anxiety disorder (GAD); lorazepam (Ativan), which is used for panic disorder; and alprazolam (Xanax), which is used for panic disorder and GAD. How should anti-anxiety medications be taken? Benzodiazepines can be habit-forming, so they should be taken with caution. Also, they tend to stay in an older adult's system longer than in younger adults, because older adults tend to have slower metabolisms. As a result, they can accumulate in the body faster than in younger adults. Therefore, benzodiazepines should only be used for a limited amount of time. Will psychotherapy help me? A man talking with his doctor. - Click to enlarge in new window. A type of psychotherapy called cognitive-behavioral therapy (CBT) is very useful in treating anxiety disorders. The cognitive part helps people change the thinking patterns that support their fears, and the behavioral part helps people change the way they react to anxiety-provoking situations. How can cognitive behavioral therapy help with obsessive-compulsive disorder? People with obsessive-compulsive disorder (OCD) who fear dirt and germs are encouraged to get their hands dirty and wait increasing amounts of time before washing them. The therapist helps the person cope with the anxiety that waiting produces. After the exercise has been repeated a number of times, the anxiety may lessen. How can cognitive behavior therapy help with social phobia? Cognitive behavioral therapy can help people with social phobia learn how to overcome the belief that others are always watching and judging them. When people are ready to confront their fears, they are shown how to use exposure techniques to desensitize themselves to situations that trigger their anxieties. How can cognitive behavioral therapy help with post-traumatic stress disorder (PTSD)? People with post traumatic stress disorder (PTSD) may be helped by recalling their traumatic event in a safe environment, which helps reduce the fear it produces. Cognitive behavioral therapists also teach deep breathing and other types of exercises to relieve anxiety and encourage relaxation. How is exposure-based behavioral therapy used? Exposure-based behavioral therapy is used to treat specific phobias. The person gradually encounters the object or situation that is feared, perhaps at first only through pictures or tapes, then later face-to-face. Often the therapist will accompany the person to a feared situation to provide support and guidance. What is being done to improve understanding and treatment of anxiety disorders in older adults? The research on treating anxiety disorders in older adults lags behind other fields. Many studies of anxiety treatments limit their enrollment to participants younger than 65, thereby excluding older adults. |