Anxiety and Depression in Seniors

It wasn’t that long ago that scientists believed anxiety and depression waned as people became older. But it may be that seniors are more likely to focus on physical ailments than mental and emotional ones. It is such a vital issue that May 2-8 has been designated Anxiety and Depression Awareness Week.

The Anxiety and Depression Association of America notes that recognizing anxiety disorders in older adults can be challenging, especially since some of the symptoms—headaches, back pain and a rapid heartbeat—could be indications of other medical conditions.

Adding to the complications: many older adults grew up in a time when mental illness was stigmatized and may be unwilling to talk about their feelings.

There are significant reasons to take anxiety seriously. Older adults with anxiety disorders have more difficulty managing day-to-day living than other older adults. They also are at greater risk of illness, falls, disability, social isolation and placement in institutions.

Anxiety disorders take on many forms, but generalized anxiety disorder (GAD) is the most common among older adults. Most anxiety issues—if not diagnosed when younger—are associated with traumatic events such as an acute illness, a fall or death and grief.

According to the New York Times, seniors showed positive responses to a selective serotonin reuptake inhibitor (SSRI), though the drugs may take longer to begin working than in younger people. The article reported that SSRIs tend to begin showing positive effects within four weeks for most adults, but up to 12 weeks for the elderly.

A number of natural and herbal remedies are available, too—including lavender, chamomile and passionflower. But given the possibility for interaction with medication, seniors should discuss natural remedies with their physicians before proceeding.

To make sure the senior is more comfortable, diagnosis and treatment typically begins with the primary care physician, who has an established relationship. This physician may provide a referral to a mental health professional.

Depression is equally serious for seniors. Older adults with depression are at risk for suicide; white men age 85 and older have the highest suicide rate in the United States.

While depression is common, it is not a normal part of aging. It may be difficult to diagnose because of an unwillingness to talk about sadness. But research shows that about 2 million of those over age 65 suffer from some form of depression. Like anxiety, it can be triggered by a chronic illness, such as Alzheimer’s disease, Parkinson’s disease, heart disease, cancer or arthritis.

Widowhood may bring on depression, with one-third of widows/widowers meeting the definition of depression within the first month after a spouse’s death. Half of these remain clinically depressed for one year.

A senior with clinical depression may be treated with antidepressants and/or psychotherapy.

Depression and anxiety disorders are nothing to be ashamed of and are, in fact, quite common. Historians believe Abraham Lincoln may have suffered from depression during his presidency. Oprah Winfrey has discussed having panic attacks, a form of anxiety disorder, as has baseball player Joey Votto. Howie Mandel, comedian and judge on America’s Got Talent, has discussed his germaphobia and the lifestyle changes he has made, including shaving his head to feel cleaner. Tipper Gore, wife of vice president Al Gore, discussed her battles with depression. Harry Potter author JK Rowling struggled with depression, using her suicidal thoughts as fodder for the Dementors, which exist to steal happiness.

Depression and anxiety are both extremely treatable—but carry significant risks if left untreated.

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Sources:
National Institutes of Health http://nihseniorhealth.gov/depression/aboutdepression/01.html
Anxiety and Depression Association of America http://www.adaa.org/living-with-anxiety/older-adults/symptoms
Mental Health America http://www.mentalhealthamerica.net/conditions/depression-older-adults-more-facts
Aging Well http://www.todaysgeriatricmedicine.com/archive/050712p14.shtml