Anxiety in Older Adults: What You Need to Know

Feeling stressed and overwhelmed can have a major impact on your health. Here's what happens when you're under pressure - and how you can find more peace.

Worry and fear are part of the human experience. Transitioning into a new home; learning you have a new medical condition; dealing with the loss of a close friend - all can make you feel maxed out. And that's completely to be expected.

What's outside the norm, however, is a stubborn stress that you just can't shake. Such feelings of prolonged stress can lead to a mental-health condition known as anxiety. According to the Mayo Clinic, people with anxiety disorders often have intense and persistent worry and fear about everyday situations.

When stress starts to have a negative effect on your daily life, that’s when it has likely tipped into anxiety, according to the Geriatric Mental Health Foundation (GMHF).

Learning more about the ways your body and mind react to stress can help you find your way to strategies that can prevent anxiety from taking root.

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Are stress and anxiety the same thing?

Stress and anxiety are connected, but they are not exactly the same. The American Psychological Society notes that stress is typically caused by an external trigger, such as a fight with a loved one, a financial problem, discrimination, or chronic illness.

Anxiety, on the other hand, is marked by persistent worries that don’t go away, even after the stressor does.

Even though they are different, stress and anxiety are alike in how they affect your body and mind. And they both respond similarly to treatment.

How common is anxiety among older adults?

Up to 20 percent of older adults are affected by anxiety, says the GMHF. But that number could be much higher, since many people don't receive a formal diagnosis.

Women tend to be more affected by anxiety than men, but it is possible women are just more likely to seek treatment.

If you've had anxiety for a long time - perhaps even a lifetime - it may feel like this is a normal part of your identity. But stress and anxiety can have a profound ripple effect on your health. That's why it's essential to address them and get them under control.

What are risk factors for developing anxiety?

There are several risk factors for anxiety. And you may have more than one, which could make you more likely to feel stressed and anxious.

You might develop anxiety after experiencing:

• A chronic medical condition, such as COPD, cardiovascular disease, thyroid disease, or diabetes
• Changes in your social life
• Sleep problems
• Side effects of medication, such as steroids or bronchodilators
• Alcohol or prescription-medication misuse
• Sedentary behavior or mobility problems
• Childhood trauma
• Preoccupation with physical-health symptoms
• Trauma such as physical harm, crime, or natural disasters
• A family history of anxiety disorders
• Neurogenerative disorders like dementia or Alzheimer’s disease
• The loss of a loved one

Having any of these risk factors doesn't mean you will automatically develop anxiety. Recognizing the physical and mental symptoms can help you decide if these factors might be affecting you in a negative way.

What are the physical symptoms of anxiety?

Worry or distress are common with anxiety. But there are also many physical changes that happen when we feel anxious or depressed. That’s because stress and anxiety can cause a cascade of reactions, including hormonal changes that affect your physical function.

You might experience:

• Gastrointestinal problems like abdominal pain, cramps, constipation, or diarrhea
• Chest pains and increased heart rate
• Panic attacks
• Shortness of breath
• Headaches
• Excessive sweating
• Fatigue
• Muscle weakness and trembling
• Persistent aches and pains

Anxiety has also been linked to lower cognitive function. That might show up as:

• Cloudy or unfocused thinking (also known as “brain fog”)
• Memory issues
• Language struggles, like not being able to recall certain words
• Difficulty making decisions
• Problems paying attention

Chronic stress and anxiety can harm your brain and body. That might worsen if you feel like you're trapped in a cycle of stress and can't find a way out of it.

What are the health risks related to stress and anxiety?

Everyone feels stress and anxiety to some degree. But if it's becoming a more chronic issue, you could be at higher risk for these problems:

• Increased blood pressure
• Higher heart rate
• Depression
• Loss of libido
• Migraines
• Irritable bowel syndrome
• Immune system difficulties
• Chronic obstructive pulmonary disease
• Insomnia
• Muscle tension and weakness
• Cognitive impairment

What helps alleviate stress and anxiety?

Regardless of how much you worry, you can find strategies that help boost feelings of calmness. Experiment with these to find out which ones will work best for you.

Identify your stressors and try to minimize them. One of the easiest ways to reduce stress is to eliminate the stressor. Try keeping a worry journal for a few days.

Take note of:

• When feelings of worry and fear come on
• What was happening right before you noticed the signs
• What your thoughts were in the moment
• Any physical sensations — such as sweating or headaches
• What you did or said to yourself to overcome the feeling
• You can also rate the moment on a scale of 1 (low anxiety) to 10 (high anxiety).

Once you start to find a pattern, brainstorm some proactive ways to counter the feeling. For example, if you're often worried about mixing up your medications, ask your pharmacist if they can label your bottles differently to prevent mishaps at home. Or ask a trusted friend or family member to help you organize your medications each week.

Exercise. Research shows that movement has a considerable benefit for mental health. According to the Mayo Clinic, virtually any type of exercise can help combat the effects of stress.

Moving more also boosts your physical health, too — along with lowering chronic disease risk. If you’re not sure where to start, a SilverSneakers Classic workout is just right for new exercisers.

Practice de-stressing techniques. Stress and anxiety can cause muscle tension. That can lead to fatigue, headaches, and lower back pain. If your body feels all wound up, try muscle-relaxation activities like massages and warm baths.

Press play to try a 3-Minute Midday Meditation led by SilverSneakers LIVE trainer Shannon Thigpen:

Many gentle forms of exercise are also great at helping you to reset and recharge. Two popular SilverSneakers classes that definitely count are Gentle Stretch (Express) and SilverSneakers Yoga.

Recommended reading: Mindfulness Meditation: The SilverSneakers Guide

Have a support system. Loneliness and isolation have been linked to stress and anxiety. That’s why it’s important to have people you can lean on. Maintain your social connections with your friends and family and seek out situations where you can meet new people to interact with. (Here are some tips to strengthen your friendships.)

Eat healthy. Stress can make you crave comforting foods that may likely be salty, fatty, or sugary. Eating junk food may give you a boost in the moment, but it doesn’t make your body or mind feel very good in the long run. That can lead to a vicious cycle of stress and anxiety.

Keep your favorite healthy snacks on hand — think prewashed fruit and veggies, whole grain crackers, and lean protein, like hard boiled eggs or edamame. That way, when you do reach for a bite when you’re feeling overwhelmed, the good stuff is what you’ll grab.

Get quality sleep. When you have sleep issues like trouble falling or staying asleep, it can make stress and anxiety worse, which can then worsen sleep problems. Like an unhealthy diet, poor sleep is a vicious cycle for anxiety too.

Focus on having a consistent nightly routine that helps you fall asleep and stay asleep. That may include leaving all electronic devices outside of your bedroom, reading to wind down, or a soothing nighttime skin-care routine.

When should I talk to my doctor about my stress and anxiety?

If you’ve tried to reduce your stress and anxiety on your own and it’s not improving or getting worse, you should consider talking to your doctor.

They will likely perform a general physical checkup that may include blood tests. Since some physical health conditions can cause mental distress, they'll want to rule out an underlying health problem.

They will also review your medications and supplements with you to see if there are any drug interactions that may be affecting your mood.

Ahead of your appointment, it's a good idea to keep track of your feelings of anxiety as soon as you have them. The notes from your worry journal (see above) will be good to share with your doctor. Together you can look for any patterns. For instance, your anxiety may surge just before or after you eat - which means it could be related to a blood-sugar problem.

How are anxiety disorders diagnosed?

If your doctor doesn't find a physical cause of your symptoms, they may suggest a mental health screening. This involves answering some questions to better understand your specific symptoms and how they affect your life.

Not all primary care doctors are trained to fully diagnose and treat mental health conditions, which is why they may refer you to a mental health specialist after ruling out other potential health conditions.

Mental health experts, such as psychiatrists, counselors, or clinical social workers, use standardized screening tools to figure out whether your symptoms match up with the criteria for an anxiety disorder.

Anxiety disorders exist on a spectrum. That means you might have several symptoms but still not technically meet the criteria for a specific diagnosis.

That doesn't mean your symptoms should be brushed off. It just points them to different treatment methods to come up with a plan that's right for you.

How is anxiety treated?

In addition to the lifestyle strategies mentioned earlier, your doctor or mental health specialist may recommend talk therapy (psychotherapy) and/or medication (see below).

One of the most common - and effective - types of talk therapy is cognitive-behavioral therapy, or CBT. Research shows that CBT can help ease anxiety disorders, depression, and other mental health conditions.

The goal of CBT is to show you that you have the power to shift your thoughts and actions. You'll learn to spot negative self-talk and other unhealthy behavioral patterns. At the same time, you'll practice different ways to challenge these patterns and behaviors.

CBT can be done in-person with a trained therapist or through online resources. Your health care providers or health plan can connect you with online resources.

What medications treat anxiety?

If your anxiety isn't improving with lifestyle changes, your doctor might also recommend medication to treat it. One class of drugs prescribed for anxiety are called anxiolytics, which help reduce the symptoms of anxiety, such as panic attacks or extreme worry.

The most common anxiolytics are benzodiazepines, which may be prescribed on their own or with antidepressants. The three most prescribed are:

• Clonazepam (Klonopin®)
• Alprazolam (Xanax®)
• Lorazepam (Ativan®)

According to the National Institute of Mental Health, benzodiazepines tend to take effect more quickly than antidepressants. Doctors usually prescribe them for short periods of time, especially for older adults, so they don't become dependent. People can build up tolerance over time, so your dosage may change if you've been taking the medication for a while.

Whether your doctor suggests an anti-anxiety medicine or not, also consider asking for referrals to other health professionals who can be helpful. You may benefit from meeting with a physical therapist, dietitian, social worker, or therapist. Since there are many aspects to stress and anxiety, addressing them with a range of approaches can often work better than just trying one tactic on its own.

See our sources:

• Anxiety disorders symptoms and causes: Mayo Clinic
• Prevalence of anxiety in older adults: Geriatric Mental Health Foundation
• The difference between stress and anxiety: American Psychological Association
• Risk factors/signs/effects of stress and anxiety: Mental Health America/National Council on Aging; Yale Medicine; and Mayo Clinic
• Tips for handling stress and anxiety: American Psychological Association
• Exercise and managing stress: Mayo Clinic
• About cognitive behavioral therapy (CBT): American Psychological Association
• Anti-anxiety medication: National Institute of Mental Health

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