Aging & Health A to Z
Causes & Symptoms
Several different anxiety disorders have different causes and symptoms. But some symptoms, including fear and worry, are common to all anxiety disorders.
Common Anxiety Disorders
Generalized anxiety disorder (GAD)
Many older adults with GAD experience symptoms for the first time later in life. People with GAD worry excessively, day in and day out, about many things. They may be anxious about their health, members of their family, their jobs, and money—even when there is no real reason to worry about these things. Or they may feel anxious even when there’s no worry to focus on. Their ongoing anxiety makes it hard for them to relax. They may realize that their circumstances don’t warrant this kind of worry, but they still can’t stop.
Symptoms of GAD include:
- being overly anxious
- being easily startled
- difficulty relaxing
- trouble concentrating
- difficulty falling and staying asleep
- feeling “on edge” or tense
- shortness of breath
- rapid heart rate
- dry mouth
- frequent bowel movements or urination
People with panic disorder have panic “attacks,” which are episodes of terrifying anxiety. During these attacks, they may feel as though they are about to lose control, have a heart attack, or lose their mind, or die.
In some cases, the person has attacks in response to certain “triggers” that frighten him or her. Common triggers include being caught in a crowd, or being trapped in a public place.
Panic attacks usually last between a few minutes to half an hour. Symptoms may include:
- rapid, “pounding” heartbeat
- shortness of breath
- chest pain
- tingling or numb hands
Some of the above symptoms can be signs of a heart attack, particularly in older women.
If these symptoms don’t go away, or if you experience severe chest pressure or pain, call 911.
It’s unusual for someone to begin having panic attacks in later life. Panic attacks that do begin later in life are usually milder and have a more gradual onset than those that begin earlier in life.
A phobia is an extreme fear of something that usually poses little or no danger. When people with a phobia see or encounter the thing they fear they can be flooded with anxiety, just like a person having a panic attack. Simply anticipating the feared thing can make a person with a phobia extremely anxious. If you have a phobia you may go to extremes to avoid the thing you fear. Agoraphobia, an extreme fear of public places, is a common phobia. People with this phobia try to avoid public places, and, as a result, may rarely leave home and can become very isolated. In older adults, agoraphobia may be associated with a fear of falling.
People with phobias may recognize that their fears are irrational but are still unable to overcome them. This can lead you to feel out of control and hopeless.
There are two general categories of phobias:
- Specific phobias are extreme fear of a specific person, animal, place, object, event, or situation. Common specific phobias include fears of certain animals (such as snakes or spiders), enclosed spaces, flying, and heights. Some phobias are more common at certain ages than others. A phobia of becoming a victim of a crime, for example, is more common in later adulthood than early adulthood. Fear of falling is a specific phobia that is increasingly recognized to often start later in life.
- Social phobias are a fear of behaving inappropriately or feeling incompetent or embarrassed in social situations or in public. People with social phobias may fear speaking in public, going on dates, or simply socializing with others. They may feel extremely self-conscious around and have difficulty talking with others. They may worry, for days or weeks, about an upcoming event during which they will meet people.
Obsessive-compulsive disorder (OCD)
People with obsessive-compulsive disorder (OCD) have recurring thoughts that cause anxiety. These thoughts are called “obsessions.” To try to ease their anxiety, people with OCD repeat, over and over, certain rituals or behaviors that are called “compulsions.” People with this anxiety disorder can’t control their anxiety-causing thoughts or stop engaging in their compulsive behavior. Their disruptive thoughts and rituals can make it difficult for them to function and can cause a great deal of distress.
Repeated hand washing is a common compulsion. A person with OCD may spend more than an hour washing her hands after shaking hands with a stranger. In this case, the obsessive thought that drives this compulsion is the worry that she has been exposed to a serious disease carried by the stranger.. Checking doors and windows over and over again to make sure that they are locked is another common compulsion. OCD can be disabling, interfere with work, and disrupt family relationships.
In older adults, depression or dementia can play a role in the development of OCD. A person who has begun having difficulty remembering to pay her bills on time, for example, may become obsessive about checking the date on the calendar and comparing it with the date particular payments are due.
The key feature of hoarding disorder is the persistent difficulty in throwing away or parting with possessions, regardless of their actual value. The hoarding is often compulsive. The collected items may clutter living space, making it difficult to use some rooms. In older adults, this syndrome is often accompanied by extreme self-neglect. Hoarding is believed to be 3 times as common in older adults.
Post-traumatic stress disorder (PTSD)
People who have seen or have been the victim of a traumatic event may develop post-traumatic stress disorder (PTSD). Traumatic events that can lead to PTSD include events that have or nearly caused serious injury or death—such as wars, car accidents, natural disasters, long-term abuse, and violent crimes. Some people develop PTSD after a family member or friend is the victim of a traumatic event or dies suddenly and unexpectedly.
During a traumatic event it’s normal to be extremely frightened and vigilant, and to have a rapid heartbeat and related symptoms. But for people with PTSD, these symptoms continue long after the event. Sometimes symptoms of PTSD don’t occur immediately after the event. Instead, the person seems fine for a few weeks or months right after the event, and then begins to experience PTSD. In older adults, the onset can be delayed even for years. For example, it may appear for the first time late in life for a Holocaust survivor. Or the new onset of PTSD in later life may be related to the loss of social supports (for example, death of a spouse or sibling) as a person ages.
Symptoms of PTSD can make it difficult for people to manage daily activities and enjoy life. These include:
- either having “flashbacks” in which the person “relives” the event; or not being able to remember the event at all
- nightmares about the event
- frightening thoughts
- a need to avoid places and situations that remind the person of the event
- feeling emotionally numb
- guilt, if others died or were more badly hurt in the event
- loss of interest in activities that were enjoyable in the past
- being tense or “on edge”
- being easily startled
Anxiety and Other Health Problems in Later Life
Older adults with anxiety disorders often have other health problems that can contribute to anxiety. These include coronary artery disease, diabetes, lung diseases such as chronic obstructive pulmonary disorder (COPD), neurological disorders like Parkinson’s, and thyroid problems. Older people with dementia and delirium may also suffer from anxiety disorders. People with anxiety often have depression as well. In addition, anxiety can be a side effect of certain medications.
Updated: November 2016
Posted: March 2012