There are lots of outside negative influences on our lives today. Effects of negative presidential campaign advertising have been studied but most refer to the impact of this type of campaigning on the voter turnout but not on emotions. To see more about negative campaign ads in this 2008 presidential campaign and the emotional responses they reap, read my blogs here and here.

But today, we deal not only with fear inducing negative campaigning but also extensive media coverage of a rapidly declining economy that has reached world wide proportions. This can lead to anxiety and even depression. Today, I thought I would reprint an article that appeared in the EricksonTribune, a free monthly periodical that has over 3.5 million subscribers to boomers and above. If you want to suscribe at http://www.ericksontribune.com. The article is on anxiety.

Control your anxiety, not vice versa:  “Everyone experiences anxiety periodically. It can even be good, a driving force that helps us accomplish something,” says Deborah Schiavone, Ph.D., a mental health specialist and assistant professor of nursing at Georgetown University in Washington, D.C. But untreated, long-term anxiety can have devastating effects.

“Chronic (long-term) anxiety can lead to weight loss, inability to sleep, poor concentration, and irritability,” says Linda Carpio, L.C.S.W., a social worker specializing in senior mental health issues at Peninsula Counseling Center in Woodmere, N.Y. “Uncontrolled, anxiety can lead to feelings of hopelessness and depression.” The good news is even if you’ve been living with your anxiety for decades, there are ways to change your responses and take control.

Defining anxiety:  Anxiety is a catch-all term for several different types of disorders. It is estimated that one in ten older adults suffers from some form of anxiety disorder. Anxiety has the same elements as fear. “There’s a physical element, like increased heart rates and blood pressure. There’s an emotional element; it’s uncomfortable and distresses you. And there’s a cognitive element; you are aware of it,” says Gary Kennedy, M.D., director of the division of geriatric psychiatry at Montefiore Medical Center in Bronx, N.Y.

But fear usually has a specific cause, like an attack dog barking at you. Once the fear-producer is gone, your responses (like heightened blood pressure) dissipate. Anxiety, by contrast, often has no identifiable cause. This is the most common form of anxiety: generalized anxiety disorder (GAD).
Your anxiety might originally spring from a specific cause, like a bad fall you had. It’s when that fear of falling, even without any immediate danger, stays present that you have GAD. It’s this kind of anxiety that leaves many older adults housebound.

Other anxiety disorders include phobias, seemingly unreasonable fears (like terror of elevators), and panic attacks, in which you feel a sudden, uncontrolled terror. Panic attacks often come with physical symptoms, like shortness of breath and heart palpitations.

Recognizing the stressors:“Older adults face many of what I call ‘lifestyle adjustments.’ These adjustments include retiring, moving to a new environment, loss of family or friends, multiple medical conditions, and/or financial worries,” says Roberta Feldhausen, A.P.R.N.-P.M.H., Erickson Health’s director of mental health services. “They are also caring for many more people—their grandchildren, their adult children, and even still caring for parents,” Carpio adds.

Experts agree that it’s never too late to start fighting anxiety. The first step is proper diagnosis, usually through your primary care physician (PCP). “You have to be sure your jumpiness is truly from anxiety, and not from a physical problem like hypothyroidism,” Kennedy says. The latter leads to mental and physical sluggishness, due to under-production of a thyroid hormone.

Getting a diagnosis: “Primary care doctors really have to look for anxiety. That means taking time with our patients, getting a complete history, finding out what’s going on in their lives,” says Leslie Rigali, D.O., Erickson Health medical director at Brooksby Village, an Erickson-built and -managed community in Peabody, Mass.

“Another problem regarding anxiety in older adults is many of them are seeing multiple doctors, and each doctor may be getting a different part of the story,” Carpio says. Erickson Health professionals consult weekly and that makes it more likely for someone to have noticed if “Mrs. Smith” seems to be anxious in some way.

The old-fashioned treatment option: Drugs used to be the one recognized treatment for fighting anxiety. Medications can help, but finding the right one, in the right dose, takes patience. “In a lot of ways, nothing beats the old class of drugs called benzodiazepines, like Valium. However, in older adults, these can slow thinking and reflexes,” says Kennedy. “Some of these drugs tend to be sedating, causing balance problems. If you take them before bedtime and have to get up during the night, you’re more likely to fall,” Rigali says. Kennedy’s first choice with older patients is antidepressants, a group called SSRIs (selective serotonin reuptake inhibitors), like Prozac and Zoloft.
More than pills alone.

“Medication is effective, but it’s combining medicine with lifestyle and attitude changes that conquers anxiety,” Feldhausen says. “Anxiety is very responsive to behavioral changes, like learning relaxation techniques,” Schiavone says.“We teach breathing exercises; thought stopping (recognizing the anxious thought and stopping it); keeping a journal; and replacing negative with positive thoughts,” Carpio says. “Maintain a regular sleep/wake cycle. Find some form of physical activity to keep your mind off anxious thoughts,” Kennedy adds. “Both caffeine and nicotine produce anxiety and both can be difficult to give up,” Schiavone says. “You have to believe in the long-term benefits.”

Finding help:“The number of older adults with mental health issues is growing, so we need a new culture of care providing the right mental health support for them,” says Kennedy. Feldhausen points to advanced practice psychiatric nurses. “They combine both counseling skills (like social workers) and health skills (like nurses),” she says.. To find your best counselor, Feldhausen says, “I’d start with a referral from your PCP, preferably to someone with geriatric mental health skills.” She also recommends checking with your local mental health association or department of aging.