In part two of the series Overcoming Worry and Fear: Anxiety in Older Adults, I will discuss some of the more common anxiety disorders. An anxiety disorder causes feelings of fear, worry, apprehension, or dread that are excessive or disproportional to the problems or situations that are feared. There are several types of anxiety disorders:
Specific Phobias: A specific phobia is an intense, irrational fear of a place, thing or event that actually poses little or no threat. Some common specific phobias are heights, escalators, tunnels, highway driving, closed-in spaces, flying and spiders. Agoraphobia is a fear of public places, leaving one’s home, or being alone. Phobias more common to older adults include fear of death, disaster to family, and dental procedures. Facing, or thinking about, these situations or things can bring on severe anxiety or a panic attack (chest pain, heart palpitations, shortness of breath, dizziness, or nausea).
Social Phobia (also called Social Anxiety Disorder): Social phobia is when an individual feels overwhelmingly anxious and self-conscious in everyday social situations. An older adult might feel intense, persistent, and chronic fear of being judged by others and of doing things that will cause embarrassment. Some older persons suffer social phobia because they are embarrassed about being unable to remember names or are ashamed of their appearance due to illness. A social anxiety disorder makes it hard to make and keep friends. Some with social phobia can be around others, but are anxious beforehand, very uncomfortable throughout the encounter, and afterwards, worry about how they were judged. Physical symptoms can include blushing, heavy sweating, trembling, nausea, and difficulty talking.
Generalized Anxiety Disorder (GAD): Those with GAD suffer constant worries, and there may be nothing to cause these worries. Those with GAD are overly concerned about health issues, money, family problems, or possible disaster. Those with GAD usually understand that they worry more than necessary. Older adults with GAD have difficulty relaxing, sleeping and concentrating, and startle easily. Symptoms include fatigue, chest pains, headaches, muscle tension, muscle aches, difficulty swallowing, trembling, twitching, irritability, sweating, nausea, lightheartedness, having to go to the bathroom frequently, feeling out of breath, and hot flashes.
Post -Traumatic Stress Disorder (PTSD): PTSD develops after a traumatic event that involved physical harm or a threat of physical to the individual, a loved one, or even strangers. PTSD can result from traumatic incidents, such as a mugging, rape, abuse, car accidents, or natural disasters such as floods or earthquakes, in addition to resulting experiences of war. Symptoms may emerge months or years after the event. Some older adults may relive a trauma 30 years or more after an event due to feeling helpless because of a new disability (for example, being confined to a wheel chair) or specific triggers that revive old memories (for example, news coverage of current wars).
A person with PTSD may startle easily, be emotionally numb with people with whom they were once close, having difficulty feeling affection, and lose interest in things they once enjoyed. Those suffering from PTSD may be irritable, aggressive or violent. A person with PTSD can experience flashbacks, in which vivid thoughts of the trauma occur during the day or in nightmares during sleep. During a flashback, a person may believe the traumatic event is happening again.
Obsessive-Compulsive Disorder (OCD): While OCD is not common among older adults, some older people due suffer from persistent, upsetting thoughts that they control by performing certain rituals, such as repeatedly checking things, touching things in a particular order, or counting things. Some common fears include possible violence and harm to loved ones. Some with OCD are preoccupied with order and symmetry; others accumulate or hoard unneeded items.
Panic Disorder: Those with panic disorder have sudden attacks of terror, and usually a pounding hear, chest pain, sweatiness, weakness, faintness, dizziness, or nausea. Panic attacks can occur at any time, even during sleep. An attack usually peaks within 10 minutes, but some symptoms may last much longer. Panic disorder is not common among older adults, however, an older adult with the disorder may refuse to be left alone. An older person experiencing a panic attack may think he or she is having a heart attack or a stroke.
Tomorrow in the final post in this series, I will discuss what leads to an anxiety disorder and some of the treatment options.
Elayne Forgie has been a professional geriatric care manager for over 20 years and was a founding Board Member of the Florida Geriatric Care Managers Association. She is the President/CEO of ElderCare at Home, Inc. and The Alzheimer's Care Resource Center. Information on this website or contained in this article is not intended to replace the medical advice of your doctor or health care provider.
