In general, anxiety disorders are fairly rare in the elderly. Most elderly adults with anxiety disorders have suffered from the same disorder for many years. However, new phobias are seen regularly in older adults. The most common of these new-onset phobias in the elderly is agoraphobia.
Causes of Agoraphobia in the Elderly
In younger people, agoraphobia is frequently linked with panic disorder. The sufferer experiences one or more panic attacks, and then gradually becomes afraid of being in situations where the panic attacks may recur.
In older adults, however, new-onset agoraphobia is not usually linked to panic disorder. Instead, it generally develops from legitimate fears that spiral out of control.
Fears Associated With Aging
Aging causes a number of physiological changes. Reflexes are not as sharp. Illnesses are more frequent and more severe. Bones become brittle and more easily fractured. Both the natural process of aging and the effects of medications can cause reaction times to slow and mental processes to dull.
Under these conditions, it is easy to see that the world is a scarier place to many older adults. Becoming more cautious is a sensible move.
From Fear to Agoraphobia
Agoraphobia is often insidious. What begins as a normal, self-protective move by an older person, such as ceasing to drive at night, can gradually turn into an irrational and unhealthy phobia, such as a fear of driving at all.
It can be difficult for friends and relatives to determine whether an older person has crossed the line from fear to phobia. Younger people, who typically feel in control of their world, may not be able to fully understand the concerns of the elderly. They may suspect a phobia in an older person who is simply being prudent.
Of course, the opposite can happen as well. Many younger relatives and friends feel overly protective of the elderly. It is easy to accidentally encourage a phobia through well-meaning offers and suggestions.
Diagnosing Agoraphobia in the Elderly
The only way to tell if an older adult is experiencing agoraphobia is to confer with a licensed mental health professional. It is best to speak with a professional who is familiar with geriatric psychology to be sure that he or she is knowledgeable about the unique needs and concerns of the elderly. He or she will also be able to rule out other physical and mental disorders that can cause similar symptoms.
Treating Agoraphobia in the Elderly
Treatment of agoraphobia is no different in the elderly than it is in younger adults. Some professionals prefer to try non-medication based treatments first, due to the risk of side effects and interactions with other medications. Others find that medications work best. Your mental health professional will work up an individualized treatment plan that is right for you or your loved one.
Source:Flint, Alastair. “Anxiety Disorders”. Clinical Geriatrics. October 2001. 9:10. pp. 21-30. March 15, 2008.
