Anxiety Disorders

Risk Factors and Diagnosis

Although the research is limited, some studies have found that specific phobias and generalized anxiety disorder (GAD) are the most common anxiety disorders among older adults. Obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) appear to be the least common, but there is little research on the prevalence of these illnesses in older populations.

Anxiety disorders are less common among older adults than younger adults. Anxiety disorders typically start in early life. However, anyone can develop an anxiety disorder at any time.

Risk Factors

Some factors that appear to be associated with an increased risk for an anxiety disorder in late life include

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.

Having depression also increases a person's risk for an anxiety disorder in all age groups, although it is not clear which illness usually comes first. Other medical problems associated with anxiety include

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.

Other Illnesses Can Complicate Diagnosis

There are a number of reasons why it can be difficult to accurately diagnose an anxiety disorder in older adults.

Anxiety disorders among older adults frequently occur at the same time as other illnesses such as depression, diabetes, heart disease, or a number of other medical illnesses. Problems with cognition (thinking) and changes in life circumstances can also complicate matters.

Sometimes the physical signs of these illnesses can get mixed up with the symptoms of anxiety, making it difficult to determine if a person has a true anxiety disorder. For instance, a person with heart disease sometimes has chest pain, which can also be a symptom of a panic disorder.

Sometimes the worrying symptoms of a medical illness can lead to an anxiety disorder. Or, sometimes the side effects of medication can cause anxiety. Also, a disability or a change in lifestyle caused by a medical illness may lead to an anxiety disorder. Muscle tightness, feeling very tense all the time, and difficulty sleeping can also be symptoms of a physical illness or an anxiety disorder, complicating diagnosis.

Other Reasons a Diagnosis May Be Missed

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.

Also, older adults may express their anxiety with a doctor differently than younger adults. For example, they may express anxiety in physical terms such as feeling dizzy or shaky, while younger adults may express it in more psychological terms.

Older adults may also have more difficulty answering complex screening questionnaires if they have diminished cognitive abilities or memory problems. As a result of these complications, doctors may miss the anxiety disorder.

Might 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.

If an anxiety disorder is diagnosed, the next step is usually seeing a mental health professional. The practitioners who are most helpful with anxiety disorders are those who have training in cognitive behavioral therapy and/or behavioral therapy, and who are open to using medication if it is needed.

You should feel comfortable talking with the mental health professional you choose. If you do not, seek help elsewhere. Once you find a mental health professional with whom you are comfortable, the two of you should work as a team and make a plan to treat your anxiety disorder together.