July 6, 2015

Anxiety disorders are just as common in the elderly population as in younger people, and depression and anxiety are often suffered together.

According to, a web site devoted to mental health, nearly half of those with clinical depression also meet the criteria for anxiety disorder, and about a quarter of those diagnosed with anxiety disorder also suffer depression.

Unfortunately, many people have the false belief that anxiety lessens with age, but the truth is, many older adults with an anxiety disorder had one when they were younger, and others develop life-affecting anxiety from the stresses they face from chronic illness, changing conditions, cognitive impairment and significant emotional losses.

Difficulties Recognizing Anxiety in the Aging

David Forman, president of Visiting Angels of Sussex, DE a home care company that provides experienced compassionate caregivers says, “It’s important to distinguish between a normal short-term response to stress and life-altering anxiety issues.”

Realistic concern about physical problems and illness, serious life circumstances, and prescription medications all make it difficult to separate a normal level of anxiety or adverse symptoms of medication from a treatable issue or disorder.

Forman says many common illnesses like dementia and Parkinson’s create symptoms like agitation that mimics anxiety, and some medications, their interactions, or incorrect dosing can cause changes in breathing and heart-rate, that can also be mistaken for anxiety.

Similarly, some illnesses like a stroke may cause personality changes that may seem like depression; and medications of virtually every type also may cause depression.

With so many possible causes of anxiety and depression, where do you start to look for solutions?

Diagnosis and Treatment of Anxiety and Depression

While diagnosis and treatment in most cases should start with the primary care physician, individuals or their loved ones can consider the following first:

  • Life circumstances - The loss of a life-long partner, spouse, family member or friend brings with it a normal process of grief. Situational depression is a horrible part of life as a human being. The same brain dealing with loss or other “depressing” situations mentally, is also the control center for the body’s physical responses. Situational depression and anxiety is completely normal.

Grief share meetings, or spiritual counseling is available at most houses of worship throughout Sussex County.  If you haven’t been active in a church or synagogue, now may be the time God is calling you to join with a body of believers to minister to your needs.

Your family physician can also order a short-term course of anti-anxiety medication.  However, be aware that long-term use of short acting anti-anxiety medications may eventually add to depression!

  • Medications - Sudden or unexplained anxiety or depression without a cause is very likely a result of prescription medication, over-the-counter products, or a combination of both.

Since anxiety and depression are caused by chemical imbalances, the chemistry of medication is going to be the number one culprit.  Medication-induced anxiety or depression can be caused by incorrect dosing, drug interactions, or may simply be your body’s normal response to a particular medication.  While your doctor or pharmacist can tell you what side effects you may experience, remember that their information is based on studies of a whole lot of people that are not you!, a health information web site written by medical experts, lists worsening depression as the side effect of many short-acting anti-anxiety medications.

Some common culprits: Xanax, Ativan, or other short acting anti-anxiety medications (usually benzodiazepines), are great are great for “as needed” situations, but should not be used as a sleep aid unless the cause of insomnia is anxiety.  After just a few consecutive days of use of these drugs when used exclusively for sleep, people report a “feeling of doom” or similar symptoms of depression.  Speak to your doctor about removing these meds from your daily routine, using them only “PRN” (as necessary).

Similarly, nighttime pain meds such as Tylenol PM or Advil PM when used just for the purpose of helping you get to sleep, are notorious for causing morning depression, irritability and even confusion the following day. Long-term use causes kidney damage.  Forman suggests asking your doctor about nighttime sleep aids that are designed specifically for sleep, or trying sublingual melatonin, which is available at any drug store and is generally a safe, effective sleep aid.

Several of today’s anti-depressant medications also effectively treat general anxiety disorder and can truly raise a person’s quality of life, helping, rather than worsening these symptoms.

When reviewing your medication routine, Forman suggests that your goal should be to reduce the overall number of different meds, and be 100% sure that your remaining medication’s dosage is correct for your personal needs.

Nobody should have to face anxiety or depression alone. From a few hours a week, to 24/7 care, Visiting Angels compassionate caregivers can help. They offer help with personal hygiene, meal preparation, light housekeeping, shopping, errands and appointments, and joyful companionship. Call (302) 329-9475 or visit