What Causes Anxiety in the Elderly?
Loss of a Spouse
Companionship is an essential part of a fulfilling life. When a spouse dies, the loved one left behind loses more than a life partner. Family roles become redefined, daily routines are interrupted by the absence of a primary member. While life continues at the same hectic pace, a grieving spouse may feel less of a sense of purpose and drive. According to Knoxville, Tennessee gerontology psychiatrist Dr. Melanie Hunt, “When a person loses someone they have shared a life-long connection with, they feel as if a part of them has been amputated. This level of loss can cause psychological impacts that can greatly hinder physical health.” Loss of interest in normal activities, a decrease in appetite, and an increase of feelings of despair can cause an imbalance in brain function and trigger a panic response.
The bereaved may also feel a sense of fear, regret, or guilt from unfinished tasks or unmended fences. Additionally, research shows that how a loved one passes away poses another dimension in the grief of the widowed spouse. For example, if a spouse had a long battle with a terminal illness, the caretaking spouse may feel a sense of failure, as if there was not enough done to prevent the death from happening at the moment it occurred. Such thoughts can lead to mental and emotional obsessions, causing sleeplessness, anxiety, and panic.
The contemplation of one’s mortality is natural in the process of understanding death and dying. When one loses a partner during their golden years, such a loss can amplify the fear of one’s death. For some older adults, the loss of a spouse can result in stress-related cardiomyopathy, also known as “broken heart syndrome.”
When older adults experience age-related health issues, it is normal to experience feelings of fear and uncertainty. Some chronic medical conditions may cause anxiety and can be linked to risk factors in mental health. A person with comorbidity (one or more co-occurring health issues) can experience an increase in anxiety as other symptoms arise. Illness such as heart disease and other cardiovascular conditions, COPD, insomnia, thyroid disease, and diabetes can cause increased anxiety and leave patients feeling poorly, overall. Diseases that cause cognitive declines such as Parkinson’s Disease, Alzheimer’s, and dementia can also cause a patient to have panic attacks, disorientation, agitation, and distress.
The combination of medication-related side effects can cause disruptions in metabolism and heartbeat, bringing on a panic attack. For example, a person diagnosed with COPD may take a bronchodilator/inhaler. Common side effects for this medication are rapid heartbeat, nervousness, and high blood pressure. The onset of these types of side effects combined with pre-existing illness-related symptoms can cause excessive worry. Physical limitations as a person ages can leave one feeling chronic pain, which can cause an older person to fear movement and stimulate obsessive thoughts of being pain-free. This can lead to a snowball effect of physical, emotional, and mental instability. Additionally, older adults who have chronic pain are often at risk for the misuse of prescription medications; chemical dependency is a major risk factor for anxiety, sudden mood, and personality changes.
According to Mayo Clinic online, late-life depression affects about 6 million Americans, ages 65 and older with only 10 percent receiving treatment. Depression in the elderly is frequently confused with the effects of multiple illnesses and the medicines used to treat them.
Many factors can contribute to the onset of elderly depression. Both depression and anxiety can feed into mood swings, physical exhaustion, and a lack of interest in activities of daily living. Transitions from independent living to assisted living can also bring about depressive episodes. These changes in mood or behavior can be a result of a “mourning period” in which elderly people long for their independence, memory, and physical capacity.
Reflections on the past are common later in life; elderly adults may experience memories of repressed past traumas that may not have been addressed. This can cause disruptive emotional upheaval, feelings of regret, hopelessness, and fear of one’s mortality. The loss of a supportive community due to health restrictions can result in consistent disappointment. With a decline in physical abilities and loss of friends and family, feelings of fear can cause feelings of isolation. When older adults experience late-life depression it is oftentimes a cumulative or gradual change. The longer symptoms go untreated, the harder it will be for them to rehabilitate, increasing the risk of death.
Stay tuned for next week and we will go over treatment options.