Anxiety

Care & Treatment

Most anxiety disorders can be treated with psychotherapy, medications (also known as “talk therapy”) or both.  Deciding on treatment depends on how severe the symptoms are, how much disruption the symptoms are causing to daily life, and on the older person's preference.

Psychotherapy

Psychotherapy involves talking and working with a mental health professional to understand what is causing your the anxiety disorder and what to do about it. These professionals can be psychiatrists, psychologists, or trained social workers.

Studies suggest that a type of psychotherapy called cognitive-behavioral therapy can be particularly helpful in treating a number of anxiety disorders, including generalized anxiety disorder, obsessive-compulsive disorder, panic disorder, and certain phobias. This therapy helps people better cope with anxiety, learn relaxation techniques, understand what is contributing to their anxiety, and helps them learn to change how they behave or respond to things that make them anxious.

Drug treatment

Two categories of drugs are often prescribed for anxiety disorders in older adults. There are antidepressants and benzodiazepines. There are several different types of these drugs. They work in different ways and can cause different side effects.

Your provider may prescribe an antidepressant, even if the anxiety is unrelated to depression. (The type of antidepressant is usually an SSRI, which stands for "selective serotonin reuptake inhibitor.") Another group of medications called SNRI’s may also be used. (SNRI’s stand for "serotonin-norepinephrine reuptake inhibitors.") Benzodiazapines can also be prescribed for anxiety disorders, but they should be used with extreme caution in older adults. Benzodiazepines, like any sedatives, may have more risk than benefit for older adults. Benzodiazapines are also associated with an increased risk of falling and can contribute to cognitive impairment.

If medications are prescribed, your healthcare provider should monitor you for side effects. Older adults are more likely to have side effects from anti-anxiety drugs than younger people. This is because certain health problems that are increasingly common with age increase the chances of side effects. It’s also because older adults generally take more medications than younger people and drugs can interact in ways that cause side effects.

If your healthcare provider prescribes an anti-anxiety drug, take it as recommended. If the drug is causing serious side effects, doesn’t seem to be working, or works at first but then stops working, tell your provider immediately. They may change the dose, or tell you how to stop taking the medication and prescribe a new one. You should always follow your healthcare provider’s advice for stopping a drug. If it is recommended to slowly taper off a drug, for example, never stop cold turkey.

Never stop taking a medication without first talking to your healthcare provider.

Remember: Just because one anti-anxiety drug doesn’t work for you doesn’t mean others won’t work. Once you’ve found a medication that does work, continue to take it as prescribed for as long as your healthcare provider recommends. If you stop as soon as your anxiety goes away, the anxiety may return and you could become more anxious than you were before you started taking the medication. Some people need to take medication for anxiety for a long time. If you or your provider think you no longer need a medication, you can work together on how to stop taking it so your body can adjust.

Last Updated November 2020