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An Overview of Phobias in Older Adults

Information on Phobias in Older Adults

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Updated March 23, 2011

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Until recently, older adults were generally not included in research on phobias and other anxiety disorders. Therefore, what information is available is drawn largely from research performed on younger people. However, in recent years, a few studies have focused specifically on anxiety disorders in older people. Combining these results can provide a fairly accurate look at phobias in our aging population.

Prevalence

Research has shown that older people tend to under-report feelings of anxiety. However, careful questioning can minimize this tendency. Older people are also willing to discuss physical symptoms which, if not caused by a physical illness, may be signs of anxiety.

Analysis of the available data combined with educated guesswork shows that approximately 10.2% of older adults suffer from anxiety disorders. This is much lower than the estimated 18.1% of all adults who suffer from such disorders. It appears that as people age, their likelihood of anxiety disorders goes down. It is not yet clear why this happens.

Study results vary widely on the percentage of older adults who suffer from phobias, with rates reported at everywhere from 0-10%. However, studies do show that of the phobias, only agoraphobia is statistically likely to develop for the first time in older adults. Other phobias appear to be present almost exclusively in people who have already had them.

Differentiating Phobias From Other Disorders

It is sometimes difficult to determine the cause of phobic symptoms in older adults. Statistically, elderly people are more likely to suffer from physical conditions that can cause similar symptoms. They are also more likely to take medication regularly, which can also cause these symptoms.

Additionally, many older adults develop fears that may be life-limiting but are not irrational or inappropriate. For example, an older person who has had several falls may develop a severe fear of being alone in public. If the fear is of falling and being unable to reach help, then it is not necessarily a phobia.

Treatment

Treating phobias in older adults can be somewhat more difficult than treating them in younger people. Many popular medication options, such as SSRIs, must be used with more caution in elderly patients, particularly those with certain physical conditions. Medications may also interact with other prescriptions.

Therapy can be effective, if the client is both willing and able to receive it. Financial concerns may make it difficult for older people to seek therapy. They may also feel that a stigma is attached to mental disorders, which may cause them to refuse treatment.

How to Help

In our quest to assist an older relative, it is easy to become overbearing. Treating your loved one like a child can make her feel resistant toward your efforts or even indicate to her that she can no longer trust her own judgment. Be supportive but avoid giving directives. Express your concerns calmly and directly, and enlist her help in "making you feel better" by seeing a doctor. Maintain boundaries and avoid infringing on your loved one's independence as much as possible.

Seeking Treatment

If you or someone you love is an older person who may be suffering from a phobia, it is best to start with a visit to the family doctor. Since numerous physical conditions can cause phobic-like symptoms, a full physical exam is important.

If there is no physical cause for the symptoms, then therapy may be indicated. Look for a therapist who specializes in geriatric psychology. He or she will be familiar with the unique needs and concerns of older clients, and will become an important member of your treatment team.

Remember to tell all of your doctors about any new medication that is prescribed. Treating a phobia in an older adult can be tricky, but with a bit of perseverance can be quite effective.

Source:

Pontillo PhD, Deborah, Lang PhD, Ariel and Stein MD, Murray. Management and Treatment of Anxiety Disorders in the Older Patient. Journal of Clinical Geriatrics. October 2002. 10:10. February 18, 2008.

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