Generalized Anxiety Disorder (GAD) in the Elderly

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Donna Mae Scheib

Generalized Anxiety Disorder (GAD) in the Elderly

Posted by Donna Mae Scheib on June 12, 2018

Generalized Anxiety Disorder (GAD) in the Elderly

Recent research reports that generalized anxiety disorder (a feeling of excessive, unrealistic worry and tension with little or no reason) is the most common mental disorder among the elderly, affecting twice as many elderly who suffer from depression.  Generalized Anxiety Disorder can seriously affect the senior’s quality of life and lead to other complications, most notably obsessive-compulsive disorder, panic disorder, other phobias, and depression.

What are some common symptoms and characteristics of GAD?

  • Agitation
  • Cold, numbness / sweaty, tingly hands or feet
  • Dizziness
  • Dry mouth
  • Heart palpitations
  • Lack of involvement and interest in daily activities and social situations
  • Nausea
  • Panic, fear, and uneasiness
  • Shortness of breath
  • Sleep problems
  • Tense muscles

Quite simply, seniors typically encounter many specific stresses for their aging population: significant emotional loss, increased cognitive impairment, chronic physical problems, and financial concerns. As a result, separating these stresses and their symptoms from those of an anxiety disorder is often difficult.

However, one common characteristic of seniors who have GAD is that they worry excessively about routine activities and events over an extended period of time (e.g., six months or more). This typically causes distress that keeps them from carrying on with their normal life.

Causes of GAD

Medical professionals cannot pinpoint an exact cause for this mental illness, however, a person’s genes, exposure to environmental stress, and changes in their brain are contributing factors to GAD.

How to Assess for GAD

To help assess a loved one’s anxiety, you can talk to them to determine:

  • Do they have any worries or concerns? (Note if you feel these worries or concerns have increased in number and/or severity.)
  • Do they feel threatened or unsafe?
  • Is something bothering them in their lives?
  • What do they spend their time thinking about?
  • How do they feel overall?
  • What routine activities are they involved in and are they refusing or avoiding those they used to enjoy?

If the senior express any physical “problems”, you should ask further questions:

  • When you noticed the _____ pain, what were you doing?
  • When _____ happened, what were you thinking about?
  • What are you thinking about when you can’t sleep?

How can GAD be treated?

It is best to start with the primary care physician or geriatric specialist as many older individuals often feel more comfortable with doctors who they have developed a relationship with over the years. Hence, they are more willing to engage in conversation with these more familiar professionals and even are more accepting of any prescribed treatment or possible referrals to a mental health professional from them, if that is the recommended course of action.

First, the doctor will provide a routine physical examination and then review the patient’s medical history. Certain tests are often administered to rule out medical illnesses that might be causing the symptoms. However, there isn’t a test that can specifically diagnose an anxiety disorder which is another reason why this disorder is difficult to diagnose.

If there isn’t a medical reason for the ongoing symptoms, then the doctor may refer the patient to a mental health specialist so they can ask further questions and use various tools and tests to find out if there is indeed an anxiety disorder. An important consideration is how long and how intense the symptoms are throughout the diagnosis and if the symptoms persist when the individual is carrying out routine activities or are manifested in typical social situations.

The most successful treatment plan involves the patient, family, and doctor with everyone supporting the prescribed treatment plan until “normal functioning” returns.

Medicines may be prescribed to deal with GAD. If side effects are seen, they should be dealt with immediately.

In addition, cognitive behavioral therapy (CBT) is often recommended. This may involve a combination of relaxation training, cognitive restructuring (replacing anxiety-producing thoughts with more realistic ones), and exposure (systematic encounters with feared objects or situations). Generally, cognitive behavioral therapy has no side effects and it may take several months to see any results. 

There are also several recommended suggestions to help lessen and control the symptoms which include cutting down on foods and drinks that have caffeine, eating a well-balanced nutritional diet, engaging in daily exercise and activity, and getting better sleep through a relaxing bedtime routine. 

In Conclusion

Generalized anxiety disorder is a common mental illness among the elderly, however, there is treatment available to help. Keen observation of various symptoms and good medical attention can help ease the illness so the senior’s quality of life is resumed.

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