What is Anxiety?

Anxiety is a mental health condition characterized by excessive and persistent feelings of fear, worry, or unease. Anxiety disorders encompass a wide range of conditions, including generalized anxiety disorder, panic disorder, social anxiety disorder, and specific phobias. These disorders are typically associated with significant distress and impairment in daily functioning.

Individuals with anxiety disorders often experience symptoms such as excessive worrying, restlessness, irritability, difficulty concentrating, muscle tension, and sleep disturbances. Anxiety can manifest physically as well, leading to symptoms like rapid heartbeat, shortness of breath, sweating, trembling, and gastrointestinal discomfort.

Anxiety disorders can also be caused by a combination of genetic, environmental, and neurological factors. Imbalances in certain neurotransmitters, such as serotonin and gamma-aminobutyric acid (GABA), are thought to play a role in the development of anxiety disorders. Additionally, factors such as trauma, chronic stress, and family history of anxiety can contribute to their onset.

To diagnose anxiety disorders, healthcare professionals rely on thorough assessments, including clinical interviews, self-report questionnaires, and observation of symptoms. It is crucial to rule out other medical conditions that may mimic anxiety symptoms, such as thyroid disorders or cardiovascular problems.

Anxiety in older adults

Older patients who experience major depression also meet the criteria for generalized anxiety disorder (GAD) in more than 50% of the cases. In addition, some older persons meet the criteria for panic disorder.

Anxiety symptoms may be secondary to appropriate fear in threatening situations.

Older adults living in urban settings often fear being attacked as they walk the streets.
Those with memory loss who live alone may fear that they will get lost driving to the doctor’s office.
Individuals who have lost the acuteness of their reflexes fear driving on busy, crowded highways.

Medical causes of anxiety in older adults

Hyperthyroidism
Cardiac arrhythmia
Pulmonary emboli
Hypoglycemia
Medications
Caffeine
Over-the-counter sympathomimetic drugs
Anticholinergic agents
Withdrawal from anti-anxiety medications

People with anxiety can also experience panic attacks. This is a discrete period of intense fear or discomfort, in which four (or more) of the following symptoms developed abruptly and reached a peak within 10 minutes:

Heart:

Palpitations
Chest Pain
Nausea

Breath:

Shortness of Breath
Choking
Dizziness
Parasthesias (numbness/tingling)
Hot/cold waves

Fear:

of Dying
of Going Crazy
Sweating
Shaking
Derealization/Depersonalization

Psychedelic-assisted therapy

Depression and anxiety can affect everyone and may manifest in addiction disorders to alcohol, drugs or prescription medications. Dr. Keith Heinzerling is an addiction medicine specialist who treats adults of all ages. Patients with depression, anxiety, PTSD, end-of-life distress, chronic pain, drug/alcohol problems, and other conditions may be eligible for psychedelic-assisted therapy with ketamine.

Resources

Anxiety & Depression Association of America

Our geriatric psychiatrist, Dr. David Merrill, offers kind, compassionate, thorough clinical evaluations and follows depression treatment guidelines, helping the patient to stay connected with the activities and people who matter to them. Contact us at 310-582-7641 to schedule a consultation.

If you or someone you know is in crisis, call the National Suicide Prevention Lifeline (Lifeline) at 1-800-273-TALK (8255), or text the Crisis Text Line (text HELLO to 741741). Both services are free and available 24 hours a day, seven days a week. The deaf and hard of hearing can contact the Lifeline via TTY at 1-800-799-4889. All calls are confidential. Contact social media outlets directly if you are concerned about a friend’s social media updates or dial 911 in an emergency. Learn more on the Lifeline’s website or the Crisis Text Line’s website.