A little anxiety can be a good thing — motivating you to act quickly in the face of danger, for example, or inspiring caution with your finances. But when you can’t control your worries, they can harm your health, particularly if you’re 50 or older.
Anxiety disorders, marked by oppressive and unrelenting worry, were once thought to be uncommon among older people. But new research shows that about 15 to 20 percent of seniors suffer from them, says Rajesh Tampi, a professor of psychiatry at Case Western Reserve University School of Medicine in Cleveland. That’s almost double previous estimates.
Sometimes people who were anxious when young see it recur later in life — triggered by, say, the loss of a family member or an unexpected medical diagnosis. Or it can emerge late in life, caused by health problems such as thyroid or heart conditions, or by drugs, including asthma medication, decongestants and steroids.
Here’s how to recognize anxiety and how to treat it.
Generalized anxiety disorder, the most common type in older adults, causes overwhelming worry with swirling, repetitive thoughts of dread. Sufferers say they’re “miserable, anxious and aroused — they can’t relax and have trouble focusing,” says Richard A. Friedman, director of the psychopharmacology clinic at Weill Cornell Medical College in New York. They may also experience fatigue, irritability, muscle tension and insomnia.
Anxiety also can emerge as a panic disorder, a sudden onset of terror that produces heart-pounding panic attacks without warning.
If you experience anxiety regularly but it doesn’t substantially limit your ability to function normally, consider such measures as meditation, tai chi, yoga, slow and deep breathing, and prayer. They can help people manage stress and anxiety, research suggests.
Aerobic exercise may help, too. It can spark the production of anxiety-reducing chemicals in the brain. “Anything that gives you more sense of control over your own body and your thinking would be beneficial,” Tampi says.
If excessive worry interferes with your daily life on most days for six months or longer, talk with a doctor. He or she can rule out physical causes such as medication and can ask questions to diagnose the condition and recommend appropriate counseling or therapy, which can sometimes ease or cure anxiety without the need for medication.
Cognitive behavioral therapy (CBT), the most common type used for anxiety disorders, involves learning to observe anxious feelings and what triggers them, and developing coping skills.
If CBT or other therapy doesn’t provide enough relief, you may need medication, usually in addition to therapy. Some studies show that about 60 percent of people taking antidepressants such as citalopram (Celexa and generic) and sertraline (Zoloft and generic) improve, compared with about 40 percent of those taking a placebo.
But those drugs can take several weeks to work, and they can cause such side effects as sexual dysfunction, nausea, diarrhea and insomnia. So work with your doctor to find one that helps you but has the mildest side effects.
Be wary if your doctor recommends benzodiazepines, such as alprazolam (Xanax), diazepam (Valium) and lorazepam (Ativan). They can work fast but have strong effects that can increase the risk of falls and fractures, worsen memory, cause confusion and sedation, and lead to drug interactions, addiction and overdoses, especially in older adults.
Those drugs should be used only short term for severe anxiety, and only until psychotherapy and antidepressants kick in. Even more worrisome are antipsychotic medications such as quetiapine (Seroquel and generic), which are sometimes used to reduce anxiety in residents of nursing homes. They pose many risks and should be used only as a last resort.
For further guidance, go to www.ConsumerReports.org/Health, where more detailed information, including CR’s ratings of prescription drugs, treatments, hospitals and healthy-living products, is available to subscribers.