Q: I have noticed my father growing more anxious since he retired. Is anxiety a physical or a mental issue, and what I can do to help without making him more anxious?
Novelist Jodi Picoult said, “Anxiety is like a rocking chair. It gives you something to do, but it doesn’t get you very far.” This quote likely brought to mind your retired dad rocking on his porch, contemplating his fate and worrying about his future.
Anxiety in older adults is usually a mental disorder, but may have some physical components as well. In fact, oftentimes the older adult is anxious about growing older and the physical limitations that may come along with the aging process. There are also certain medical conditions that can increase anxiety, such as an overactive thyroid or certain rare adrenal tumors. Even certain medications can be part of the problem.
It used to be thought that anxiety disorders decline with age. But this was because more elderly patients were emphasizing their physical complaints to the doctor and less likely to report psychiatric symptoms. I see elderly patients all the time who come to my office with complaints of dizziness, heart palpitations and insomnia, and an extensive medical work-up reveals an anxiety disorder as the cause of the physical complaints.
Experts now realize that aging and anxiety are not mutually exclusive, and that anxiety is as common among the old as among the young. Oftentimes, the elderly patient with anxiety had some form of it when they were younger. Also, in this age group, the older patient’s anxiety is frequently associated with traumatic events, such as a fall or acute illness.
There are many things you can do to help your dad if you notice he is more anxious. First, make sure your dad has seen his primary care doctor for a full general medical evaluation. If nothing bad turns up, you can talk to your dad about ways to improve his mood and quality of life. These include regular exercise, eating a well-balanced diet, getting enough sleep, and limiting alcohol and caffeine. If he takes you up on these things, you can continue to suggest other non-pharmacologic modalities to help, such as meditation, yoga and deep breathing exercises. In addition, if your dad is just pacing in his home, see if you can get him to volunteer or be more active in the community, which would provide a support network for him and help relieve everyday stress.
If all else fails and his symptoms are severe and impairing his quality of life, please take him to see a geriatric psychiatrist to consider medications to help him. Sometimes medicines like Valium and Xanax are prescribed for this condition, but these can have many adverse effects in older patients, like dizziness and gait instability. If your dad allows it, go to the doctor with him so you can understand what exactly is being prescribed and what to watch
out for.
Just caring enough to write this question and showing your dad that you care is a great reflection of him as a parent. Spending time with him and telling him how much you care may make the most difference of all.
Palisadian Damon Raskin, MD, is a board-certified internist who offers preventative medicine, concierge services and addiction medicine to patients in and around the Palisades. Contact: 310-459-4333. To submit your medical questions, email john@palipost.com.
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