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Is it anxiety? Or are you just a worrywart?

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September 29th, 2017
Anxious-looking senior talking on the phone.

Anxious-looking senior talking on the phone.

 

Anxiety is a general term that encompasses several conditions. “Anxiety disorders include post-traumatic stress disorder, phobias, panic attacks, obsessive compulsive disorder, and generalized anxiety,” says Nicki Nance, Ph.D., associate professor of human services and psychology at Beacon College in Leesburg, Fla. 

For seniors, anxiety disorders are among the most prevalent mental health conditions, with up to 15% affected, according to the American Geriatrics Society. Generalized anxiety disorder (GAD) is the most common form.

Experts do not know the cause of GAD. It is thought to be related to genes, and stressful life experiences may also play a role. The main symptom is frequent worry for six months or more, even in the absence of a stressful cause. Other symptoms include difficulty concentrating, irritability, sleep disruptions, restlessness, fatigue, muscle tension, and stomach upset. “The symptoms of GAD are similar to depression, and the two conditions often coexist,” says Carolyn AlRoy, Psy.D., psychologist and performance coach in New York, N.Y.

Anxiety or just a worrier?

“If your friends and family call you a worrywart, there’s a chance you could have GAD,” Nance says. “People with this disorder worry constantly, and as one situation is resolved, they immediately begin to worry about another.”

If you are having surgery in a few weeks and find yourself worrying about it, that doesn’t mean you have GAD. “Being anxious about a major event is called situational anxiety, which is a normal reaction to a stressful situation,” Nance says. 

Having situational anxiety can be beneficial. For example, if you are expecting a houseful of guests, being nervous about it may help you get all the preparations together in time.

Feeling less anxious

To reduce anxiety, whether you have a diagnosed condition, are in a stressful situation, or are worrying about something in the future, taking certain steps may help. “Cut your caffeine intake in half,” Nance advises, “and avoid alcohol. Even though it seems to relax you, alcohol has a rebounding effect that can make anxiety worse the day after you drink.”

Prioritize your obligations. “Say no to nonessential activities,” Nance says. “Overextending yourself can exacerbate symptoms.”

Sleeping well can be difficult when you feel agitated about something, but practicing good sleep hygiene (see sidebar) is very important. After all, your brain is working overtime. “You are less likely to feel anxious if you are well-rested,” Nance says. 

Try yoga, tai chi, or any form of activity, for that matter. “Exercise serves two main functions,” AlRoy says. “It helps muscle condition so people can be as independent as possible for as long as possible, and the endorphins from exercising can stave off symptoms of GAD. For those who can’t exercise, meditation can be a great option.” 

During especially stressful moments, breathing exercises may ease the worry. “Slow your breathing,” Nance says. “Count to four as you inhale, then count to four as you exhale.”

Getting help

Research consistently shows that a combination of medication and counseling can help people deal with GAD. Support groups help some people, but if that’s not your preference, at least go out and interact with other people. “Anxiety can be worse if you live alone and are socially isolated,” AlRoy says. “Being isolated is a risk factor for many other conditions including Alzheimer’s disease.” 

One of the top stressors facing older adults is the possibility of serious illness or a hospitalization. According to the Centers for Disease Control and Prevention, heart and lung disorders commonly lead to anxiety. For example, about 40% of people with chronic obstructive pulmonary disease (COPD) have anxiety. 

Being overly distressed about health care matters can lead to poorer outcomes. Some older adults may have a family member or friend who can help them through an episode of serious illness, hospitalization, or even a pile of insurance paperwork. But some don’t. 

Hence the fast-growing field of patient advocacy. Private professional health advocates (PPHAs) are experienced registered nurses or other health professionals who can help you navigate through the health care system. “Patients need someone knowledgeable looking out solely for their interests,” says Teri Dreher, R.N., C.C.R.N., iR.N.P.A., founder of NShore Patient Advocates, L.L.C., in Chicago, Ill., and author of Patient Advocacy Matters (2016, NShore Publishing).  “The health care system has become so complex and profit driven, patients can get lost in the shuffle.”

PPHAs can lessen your anxiety by looking out for your interests while you are hospitalized; educating you about medical conditions; researching your treatment options; investigating the quality of doctors, hospitals, or nursing homes; asking doctors questions a layperson wouldn’t know to ask; and even helping get your insurance claims paid. 

The main message is that you can feel better. “Good treatment outcomes are always profound to someone with GAD,” Nance says. “I have seen many people become better able to keep a job, improve relationships, deal with stressful events, and find enjoyment in their daily lives.”  


Feel less anxious at bedtime

Develop a relaxing prebedtime routine. Try reading or taking a warm bath.

Turn down the temperature. It’s easier to fall asleep in a cool environment.

Have a light snack. Large meals can keep you awake, but eating cheese, crackers, fruit, or a cup of soup can help you fall asleep and stay asleep.

Do not watch TV or use electronic devices. Studies show that the light emitted from electronic devices tricks your brain into thinking it is daytime.

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