Clinical anxiety occurs when worry outstrips the actual threat — either it lingers long after a threat has passed or occurs when our minds conjure “what if…” scenarios. It’s marked by “a pervasive sense of worry [that leaves us] stuck with this ongoing, significant discomfort,” says Corina Laudate, a clinical social worker who works with older adults at McLean Hospital in Belmont, Massachusetts. Clinical anxiety that lasts at least 6 months and interferes with day-to-day functioning may be diagnosed as an anxiety disorder. Some 30 percent of adults experience one of several types of anxiety disorders at some point in life.
Treatment options
Try counseling. The first line of treatment for all types of anxiety is cognitive-behavioral therapy, or CBT, Hudak says. Backed by dozens of studies, CBT involves working with a therapist to examine and gradually shift your thought patterns and your behaviors. A skilled therapist can help with checking your thoughts against reality.
“The behavioral piece is one of the easiest places to intervene,” Laudate says. Something as simple as going for a walk can do amazing things, she notes. In fact, aerobic exercise has been found to help ease symptoms of anxiety as well as depression.
Tackle avoidance. Grappling with avoidance, a key component of anxiety disorders, is an important part of treatment. If a friend invites you to meet her at a park but you feel anxiety about dogs you may encounter, “The worst thing you can do … is not go to the park, even though you want to,” Hudak says. Tackling avoidance doesn’t happen overnight — it’s a process — but in CBT you work to name, recognize and gradually face your fears.
Consider medications. Medications such as SSRIs and SNRIs, also used for depression, can be useful for anxiety disorders, too, especially when combined with therapy.
“It’s rare that someone should be treated with medications alone,” Hudak says. While fast-acting medications like benzodiazepines are sometimes prescribed for acute anxiety, they can be addictive and can affect balance and cognition in older adults.
Talk it out. Practicing self-compassion is invaluable, says Laudate, and social support — in the form of group therapy or connections with friends and family — can counter isolation that can fuel anxiety and provide perspective. “You say out loud what’s been bothering you and let a little sunshine in to disinfect the worry,” she says.
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