Anxiety

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)

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.. Their ongoing anxiety makes it hard for them to relax. They may realize that their circumstances don’t call for this kind of worry, but they still cannot stop ruminating (over-thinking about situations).

Symptoms of GAD include:

  • being overly anxious
  • being easily startled
  • difficulty relaxing
  • trouble concentrating
  • difficulty falling and staying asleep
  • irritability
  • restlessness
  • feeling “on edge” or tense
  • shortness of breath
  • rapid heart rate
  • sweating
  • dry mouth
  • dizziness
  • nausea
  • frequent bowel movements or urination
  • headaches
  • depression

Panic Disorder

People with panic disorder have panic attacks, which are episodes of overwhelming anxiety.  During these attacks, they may feel as though they are about to lose control, have a heart attack, lose their mind, or die.

In some cases, the person has attacks in response to certain “triggers” that frighten them. 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
  • dizziness
  • faintness
  • weakness
  • trembling
  • tingling or numb hands
  • sweating
  • nausea
  • stomach pain
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.

Phobias

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. A common phobia is agoraphobia, which an extreme fear of public places. 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 an 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 other people and have difficulty talking with them. 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, certain rituals or behaviors over and over. These 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 handwashing is a common compulsion. A person with OCD may spend more than an hour washing their hands after shaking hands with a stranger. In this case, the obsessive thought that drives this compulsion is the worry that about being exposed to a serious disease carried by the stranger. Another common compulsion is checking doors and windows over and over again to make sure that they are locked. 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. For example, a person who has started to have difficulty remembering to pay bills on time may become obsessive about checking the date on the calendar and comparing it with the date payments are due. 

Hoarding disorder

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 three times as common in older adults than in younger people.

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 crashes, 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, anxious, and vigilant. 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, a Holocaust survivor may experience PTSD for the first time late in life. Or the new onset of PTSD in later life may be related to the loss of social supports as a person ages (for example, the death of a spouse or sibling).

Symptoms of PTSD can make it difficult for people to manage daily activities and enjoy life. These include:

  • 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
  • irritability
  • anxiety
  • loss of interest in activities that were enjoyable in the past
  • depression
  • 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, thyroid problems, neurological disorders like Parkinson’s, and lung diseases such as chronic obstructive pulmonary disorder (COPD).  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.

 

Last updated August 2020