When is anxiety something to worry about?

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You ve been troubled about your health, family, or finances. You ve had heart palpitations, an upset stomach, and difficulty sleeping. Could you be one of the 40 million Americans who has an anxiety disorder? All of us have lost a night or two of sleep worrying about something in our lives, says Gary Kennedy, M.D., director of the division of geriatric psychiatry at Montefiore Medical Center, Bronx, N.Y. But excessive worry that affects your social functioning is a sign of an anxiety disorder. How do you know if you are worrying too much? Persistent worry is when something is no longer in the back of your mind but is intruding on your other thoughts, Kennedy explains. Panic disorders, post-traumatic stress disorder, obsessive compulsive disorder, and phobias are all examples of anxiety disorders. But the most common in seniors is generalized anxiety disorder (GAD), in which you become excessively concerned about things such as health, money, family problems, or even just how you re going to get through the day.

Why it happens

Anxiety can occur along with medical conditions such as depression, heart disease, diabetes, fractures, or Alzheimer s disease, Kennedy says. Symptoms of anxiety and depression in particular can overlap making the diagnosis a challenge. A coexisting major illness might need to be treated first before anxiety can be dealt with effectively. Sometimes people attribute anxiety symptoms to something else such as a heart problem if they notice palpitations, for instance, says Roberta Feldhausen, P.M.H.C.N.S., B.C., director of mental health services at Riderwood, an Erickson Living community in Silver Spring, Md. Agoraphobia, specifically a fear of leaving your home, may occur after you ve had a fall. You may initially be experiencing a fear of falling, which can mushroom into a crippling anxiety disorder, Kennedy explains. Some people with breathing problems are afraid to go out for fear of having an episode of shortness of breath, Feldhausen adds. Other warning signs to look for? Not looking forward to things you ve always enjoyed, such as spending time with your children or grandchildren, or going to church, Kennedy says. When worrying persists, or your physical functioning is impaired with symptoms of panic attacks such as a racing heart, sweating, or shortness of breath not related to a medical disorder, then you should get professional help, he advises.

Will treatment work?

Anxiety treatment is as effective for older adults as for younger ones, Kennedy says. There have been major advances in treatment and counseling techniques. Medications of choice have changed over the years too, he continues. Certain antidepressants can be prescribed that are very effective, have fewer side effects, and are safer than benzodiazepines [Valium/diazepam, Xanax/alprazolam] that were widely prescribed as a first line of treatment in the past. Medications tend to help the problem initially and then counseling helps you manage your anxiety over time, Feldhausen explains. Research shows that individualized treatment works best. Therapy for anxiety disorders emphasizes healthy behaviors and stress reduction with a good diet and adequate sleep. But the best therapy out there is exercise, Kennedy says. I can t say enough about its benefits. It provides distraction, reduces muscle tension, re-routes your brain s circuitry, improves your resilience, and lifts your mood. Just take a good 30-minute walk every day. It s even better if you have someone to walk and talk with. Some people with anxiety feel restless, and exercise is a great outlet for that, Feldhausen adds. Anxiety disorders tend to be less common among older adults than younger ones. Older adults are by and large a mentally healthy group, Kennedy says. You don t have to give in to anxiety; it s very manageable. This is one case in which you can help by coping actively and pulling yourself up by your bootstraps.

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Roberta Feldhausen, A.P.R.N.-M.H.

Erickson health and wellness experts can be found at Erickson-built communities all over the U.S. This month's expert is Roberta Feldhausen, A.P.R.N.-M.H., Director of Mental Health Services at Riderwood in Silver...

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