Anxiety vs. Depression Among Older People: Causes, Signs, And Treatment Options

Depression and anxiety could be affecting older people more than you can imagine. For example, most older people living in long-term care facilities are prone to depression or anxiety disorders for various reasons. These include deterioration of physical health, loss of networks and friends, and moving to a new environment.

In fact, one doesn't need to be in a long-term care facility for them to develop anxiety and depression. Recent research shows that more than 40% of adults above 65 years are likely to develop such complications.

Anxiety may appear unexpectedly or gradually over hours, days, months, or years. Prolonged pressure is associated with anxiety disorders in the elderly. These disorders include Separation Anxiety Disorder (SAD), Specific Phobia, Panic Disorder, Generalized Anxiety Disorder, and others. Generalized Anxiety Disorder is the most prevalent among people aged above 65 years. The presence of any three linked symptoms like insomnia, exhaustion, lack of concentration, irritability, restlessness, and muscle tension are the diagnostic criteria for anxiety.

Meanwhile, depression is a widespread psychological condition that appears simultaneously with anxiety. It manifests as lack of concentration, loss of locomotory energy, psychomotor agitation, lack of sleep, and weight gain or loss.

Generally, anxiety and depression are closely related but with slight differences. Whereas anxiety causes feelings of fear, worry, and restlessness, depression is characterized by decreased energy, hopelessness, and feelings of sadness. This post will help you understand the symptoms, causes, treatment, and preventive measures against anxiety and depression in old age. Keep on reading to learn more.

How Does Anxiety and Depression Differ In Young Adults From The Elderly

Older folks experience anxiety or depression differently from youth and young adults. For example, they don't express typical depression symptoms compared to young adults. Depression and anxiety frequently co-occur with different medical conditions in older adults and last longer.

At 65 and above, you may develop depression or anxiety if you have diabetes or heart-related illnesses. Moreover, anxiety reduces your capacity to heal, especially if you have underlying medical conditions.

According to research on nursing home residents with physical ailments, depression significantly raises the risk of death from those conditions. Additionally, anxiety and depression are connected to a higher risk of death following a heart attack. Therefore, it's crucial to ensure the older adult you're worried about gets depression and anxiety counseling even if the symptoms are mild.

Signs And Symptoms Of Anxiety And Depression In The Elderly

To reiterate, anxiety and depression slightly differ from one another. In the same sense, this section highlights the signs and symptoms of each condition separately:

A. Depression In Older People

As you age, depression may affect you irrespective of your accomplishments or experiences. And all symptoms associated with depression in old age may influence your life, thus affecting your relationships, hobbies, interest in work, sleep, appetite, and energy. Regrettably, many adults don't realize the symptoms of depression and therefore fail to seek help.

At 65 years and above, you could be depressed if you've lost interest in your daily endeavors for the last month, you feel unhappy or low, and experience general sadness. Remember, you may experience these symptoms from time to time, but it doesn't mean you're depressed. It can only indicate depression if the symptoms have existed for a while.

Moreover, older adults suffering from depression may show symptoms related to their physical well-being compared to other symptoms. If you're 65 and above, you're likely to complain about your physical health complications like arthritis or lousy sleeping posture instead of feeling gloomy and miserable.

The signs and symptoms of depression in adults are put into various categories, including:

1. Physical symptoms

These are symptoms associated with their physical wellbeing, such as:

• Significant weight loss;
• Change or loss of appetite;
• Pacing, hand wringing, or agitation;
• Changes in bowel habits, nausea, and digestive upsets;
• Loss of memory;
• Sluggish movement;
• General body tiredness; and
• Sleeping more than usual.

2. Feelings

Symptoms include:

• Feeling guilty or worthless;
• Feeling overwhelmed;
• Having the feeling of emptiness, hopelessness, and sadness; and
• Having short temper, irritability, and moodiness.

3. Thoughts

Through thoughts a depressed older person may feel:

• A perceived change of family status;
• Immeasurable financial concerns;
• Pessimistic comments like 'life's not worth living' or 'it's my fault;’
• Frequent suicidal thoughts; and
•  

4. Behaviors

Check out the following behavioral characteristics:

• Defense mechanisms where you deny your feelings of depression;
• Behaving out of character;
• Lack of motivation in the morning;
• You don't derive fun from any activity;
• Feeling confused and losing your ability to work;
• Withdrawing from friends and family; and
• Restlessness and general body weakness.

B. Anxiety In Older People

The signs of anxiety in the elderly aren't always evident because they develop slowly. And everyone can experience anxiety at particular points in life, and it's difficult to know how frequent anxiety disorders may occur. However, you can seek medical help if you're experiencing symptoms from the following categories:

1. Physical Symptoms

These include:

• Cold of hot flushes;
• A tingling or numb feeling;
• Frequent fainting, lightheadedness, or dizziness;
• Shaking while sweating;
• Insomnia;
• Self-detachment or feeling detached from your physical environment;
• Muscle pain and tension;
• Pain in the stomach, nausea, and vomiting; and
• Increased heart rate.

2. Thoughts

These include:

• Intrusive or unwanted thoughts;
• Finding it difficult to stop worrying;
• Thoughts like:
  • "People are judging me."
  • "I'm about to die."
  • "I can't control myself."
  • "I'm going crazy."

3. Feelings

These include:

• Uncontrolled or overwhelming panic;
• Persistent nervousness and tension;
• Fear (for example, worrying that bad things will happen);
• Worrying about your physical symptoms;
• Panic (especially during some particular events, situations, or objects); and
• Feeling overwhelmed.

4. Behavioral

These include:

• Easily startled;
• Difficulty in making decisions;
• Lack of assertiveness ( for instance, you may avoid eye contact);
• An uncontrollable urge to undergo rituals to alleviate your anxiety; and
• Keeping off conditions or objects that may cause anxiety.

Causes Of Depression And Anxiety In Older Adults

For adults, anxiety and depression may appear concurrently, weakening your body and decreasing your overall health and living standards. It's good to understand the various causes of depression and anxiety and express your concerns to your healthcare provider. Get to learn the different causes of anxiety and depression below:

A. Depression

As you grow old, you may face significant life changes predisposing you to depression. The changes may include:

Recent bereavement

At 65 years and above, you may have witnessed the passing on of other people; however, the loss of a partner, spouse, pet, family member, friend, or any other loved one can negatively affect you. As a result, you may develop depression.

Worries

At old age, you may fear dying because you feel unaccomplished, or you may worry about your medical and financial problems.

Lack of a sense of purpose

Accidents and physical problems can limit you from engaging in activities you once enjoyed, thus losing your sense of purpose. Moreover, after retirement, most people tend to lose their financial security, self-esteem, rank, and identity, increasing their risk for depression.

Isolation and loneliness

Most older people aren't allowed to drive and some are immobile due to physical health problems. Their social circles may reduce due to relocation or death, and in some cases, they live alone. These experiences make the elderly feel isolated or lonely, causing depression.

Health problems

As you grow old, sickness, or surgery can damage your image, and you may experience memory loss and severe or chronic pain due to an illness or disability. All these can trigger depression in your old age.

Medical conditions

Various health conditions can lead to depression in old age either directly or through a subconscious response to the situation. Any chronic disease, especially life-threatening, disabling, or painful, can cause depression or worsen the symptoms.

B. Anxiety

Anxiety in old age is common in people above 65 years old. The various types of anxiety disorders include; Separation Anxiety Disorder (SAP), Specific Phobia, Panic Disorder, Generalized Anxiety Disorder (GAD), and others. Although these anxiety disorders vary in their symptoms, they have typical causes; however, researchers aren't sure why some folks suffer from excessive anxiety.

Probably, anxiety may be a result of several environmental and situational conditions such as:

• Childhood trauma;
• Drug abuse (for example, alcoholism) or misuse of prescription drugs;
• Side effects of medications. Blood pressure drugs, sleeping pills, steroids, tranquilizers, and ulcer medications can predispose you to anxiety disorders;
• Chronic health conditions such as dementia, diabetes, and high blood pressure;
• Sleep disturbances such as insomnia;
• Financial insecurity;
• Loss of independence;
• Limited physical mobility; and
• Painful life events like the loss of a loved one.

How To Diagnose Depression or Anxiety

If you're an older adult with symptoms of anxiety and depression that have lasted for more than one month, your healthcare provider may help you diagnose your condition.

But before your healthcare provider comes up with a diagnosis, you may need to provide your medical records that may help determine whether underlying health problems caused your condition. The medical records may also help your doctor know whether your situation is due to side effects of medical drugs used in the past.

Additionally, your doctor may use a geriatric depression and anxiety scale to ask you questions that determine how long your symptoms have existed. In addition, you'll undergo a physical exam and blood tests to rule out any primary cause before prescribing treatment.

A quick and more straightforward way to determine if you're undergoing depression or an anxiety disorder is to perform a personal screening. Remember, this isn't a diagnosis but a means of determining whether your symptoms qualify for seeking medical help. There are various online platforms where you can do a personal screening.

Treating Anxiety and Depression In The Elderly

Anxiety and depression in old age are common but treatable and you can manage the symptoms well if discovered early. Treatment may involve drugs, psychotherapy, social support, coping mechanisms, and stress reduction.

It's important to tell your doctor if you've received treatment before. It'll prompt your doctor to check your medical records to determine the medication used, dosage, side effects, and effectiveness. The documents may also help the doctor determine the therapy sessions you underwent, the number of sessions, the type of therapy, and if it helped. Occasionally, some people must explore various treatment options before finding one that works.

There are various ways that anxiety and depression in old age can be treated or managed by healthcare providers; these include:

Psychotherapy

Psychotherapy is suitable for older people who have experienced significant life stressors (like health problems, home relocations, loss of family or friends) or those who have mild symptoms and may not want to take medication. Also, it may be good for you if you may react to the available drugs.

Research proves that psychotherapy can decrease anxiety and depression symptoms in old age. It's commonly called talk therapy or counseling. It includes cognitive and interpersonal therapy treatment sessions where affected people are taught new behavioral and thinking ways, thus avoiding habits that can cause anxiety and depression.

Anti-anxiety drugs

They're also known as anxiolytics and are usually given when a quick solution is required. Benzodiazepines and Buspirone are the most common anti-anxiety drugs for adults above 65 years; however, use them carefully since they may cause dizziness, falls, instability, and memory impairment.

Antidepressants

Antidepressants are commonly prescribed in most depressed older adults. They alter the brain's chemistry and should be taken for more than a month for them to work. Examples of antidepressants include monoamine oxidase inhibitors, tricyclics, serotonin reuptake inhibitors, and selective serotonin reuptake inhibitors.  

Electro-compulsive therapy (ECT)

It's the safest way of treating depression in older people. It's a type of brain stimulation that uses electric current to stimulate the brain and cure depression. A healthcare provider may recommend ECT in cases of severe depression and if the depression doesn't improve through psychotherapy or medication.

Other Means Of Relieving Depression And Anxiety

You can reduce the symptoms and effects of depression and anxiety by following the tips enumerated below:

• Exercising regularly;
• Enrolling in a good assisted living facility for the elderly within your state;
• Avoiding substances which increase symptoms, including alcohol, certain herbal supplements, overeating, smoking, and caffeine;
• Using stress management skills; and
• Confiding in your spiritual leaders or family members.

Conclusion

Anxiety or depression affects all age groups though it's prevalent in older people. As you age, depression may affect you no matter how well you've lived before. Regrettably, many adults don't realize the signs of anxiety or depression and fail to seek help. If you're affected or have an acquaintance suffering from depression or anxiety, worry not; there's a solution. Try to share it with your family, then visit your doctor if your depression or anxiety is uncontrollable. Your healthcare provider will diagnose your problem and offer relevant prescriptions.