65+ years

Anxiety disorders

Your risk of having an anxiety disorder when you are older is supposed to be much less than when you were younger. Between the ages of 16-54 over 20% of women have an anxiety disorder, however after the age of 65 the numbers drop to an average of 8% of women over a 12 month period. Of course this is not helpful if you are the one with the anxiety disorder!

Previous experiences with anxiety and depression, past trauma, lack of support all mean you are more likely to have an anxiety disorder at this time. Having an illness such as arthritis or cardiovascular disease also increases the risk of high anxiety. Loneliness, financial strain, repeated loss and your rapidly changing world add to the causes of fear and apprehension, which can overwhelm and distress you.

Is this you?

LEARN Consider the different stories and images below, listen to a podcast or watch the video. 

THINK Then, to understand more about what causes anxiety, you can explore the different social, psychological and physical things that can increase anxiety. In this section you will find questions to ask yourself about each cause to see if it affects you.

DO Once you have explored the causes of anxiety then it is time to do something. Go to the ‘Toolkit’ to find a range of different tools to help yourself try and reduce anxiety.

View the causes of Anxiety Disorders for 65+ years

Do you relate to these?

I often feel most uncomfortable in a crowded room. I can see everyone laughing and happy, but I cannot join in. Really, it is much easier to plead an excuse and not go.  

“Old age is like flying through a storm. Once you’re aboard there’s nothing you can do.”
Golda Meir 

“I cry a lot because I miss people. They die and I can’t stop them. They leave me and I love them more.”
Maurice Sendak

I can’t explain how painful it is to wait for something that never comes.

It feels like we carry these things inside us that no one else can see.

I’ve reached the stage that even a trip to the local store has become a challenge because I have to make so many arrangements and so many choices. I know it’s ridiculous but I can’t control the feelings.

I never said I wanted to be 'alone'. I said I wanted to be 'left alone'. There is a world of difference between the two.

It feels like we carry these things inside us that no one else can see.

Sometimes I get anxious about things and I don’t like to tell anyone that I feel nervous and unsure. I like to try and keep it private. Often it’s because I really don’t know why I feel this way, so I say I am fine and I smile but really I feel my heart will burst or I am going to be sick.

Causes of anxiety disorders for 65+ years

What happens

Some personalities are more prone to anxiety - you might be a perfectionist who becomes anxious when things aren’t done to your exacting standards, you might be the kind of person who over-analyses your every thought, or you might be rigid in your thinking and find uncertainty difficult to cope with or tolerate.

Questions to ask yourself

Is it in my make up to be anxious?

How much do I like things to be perfect?

How much do I over think things?

How much do I over analyse my every thought?

Do I find uncertainty difficult to cope with?

Do I get anxious that I am losing control because of all the changes that are happening in my life?

What happens

If you have had a diagnosis of anxiety or depression before in your life, you are more at risk of having a further episode.  

Questions to ask yourself

Have I been diagnosed with either anxiety or depression before in my life?

What happens

Distressing and faulty thinking such as

  • catastrophising - thinking the worst possible thing will happen
  • jumping to conclusions - thinking you can predict the future (and it is bad) 

create a negative cycle.

Distressing thoughts cause physical symptoms such as a racing heart, feeling sick causing you to want to run away. Your self-talk remains negative - “I am hopeless” and the whole cycle starts again. If you find it hard to challenge your thoughts or if you avoid situations that cause anxiety you don’t get the benefit of facing your fear and working through the anxiety – this can lead to anxiety disorders.

Questions to ask yourself

Think of a recent time when you felt anxiety and ask yourself – in what ways were my thoughts unhelpful or faulty?

For example, do I:

  • jump to conclusions about what people are thinking about me?
  • think something really bad is about to happen?

What is the evidence to support my thoughts?

What is the worst thing that could happen? How likely is this?

What happens

Sometimes you focus on all the things you can’t do and this can make you anxious. Having a fear of failure is paralysing and can overwhelm you. As you grow older there are things you can no longer do and these need to be replaced by things you can do and feel good about.

Questions to ask yourself

How much do I value myself?

How much do I believe I am a valuable person?

How much do I focus on the things I don’t do well?

Do I avoid things if I think I will fail?

What happens

If you define yourself by how you look, then the impact of aging can cause anxiety that interferes with your daily life. There are so many changes to your body with aging and if this is very distressing it can cause you to become fixated and focused on these changes.

Questions to ask yourself

How anxious am I about how my body looks?

Does anxiety about my body affect my daily life?

How anxious am I about the changes that are happening to how I look?

What happens

Physical, emotional, mental and sexual abuse can significantly affect your mental and emotional health. Ever having felt neglected, threatened or that you may be harmed in some way increases the risk of you experiencing an anxiety disorder. With maltreatment you learn you can’t trust that people will do the right thing by you – even sometimes those you thought loved and cared about you. Even though these events may have happened a long time ago the psychological effects can be long lasting.

Questions to ask yourself

Have I felt:

  • neglected?
  • threatened?
  • that I might be harmed at any time during my life?

Has abuse put me more at risk of anxiety?

How much can I trust others?

How safe do I feel?

What happens

Having roles that give you meaning and a sense of purpose are important to your mental and emotional health. You might be a best friend, a mother, grandmother, artist, volunteer… there are many roles you may have and as you age these may be changing. Sometimes these roles are given to you and at other times you choose the roles you have. If you feel good about your roles, feel a sense of purpose and that you have a place in the world you are more likely to have the confidence to deal with your anxiety.

Questions to ask yourself

What roles do I have?

How anxious am I about the roles I have?

How anxious am I about the roles I might have lost ?

Social causes →
What happens

Family dysfunction can include lots of things like blame, guilt, hostility or lack of thoughtfulness that create tensions within a family. It might be your parents are more reliant on you, or you have lost a parent, or both parents. Perhaps your children are busy with their own lives or live a long way away. Perhaps you don’t have children and rely on others for support. Not having a family around or living alone  at this time can be unsettling and make you highly anxious about the future.

Questions to ask yourself

Are there family problems which cause me to be anxious?

Have there been changes to my family which I am anxious about? If so, what are they?

How anxious am I about who I can rely on for support?

What happens

Sometimes change is stressful. You might be anxious about changes to your independence, thinking about whether you can continue to live alone, or where you should you live if you need support. Events such as serious illness or the death of someone you love can challenge your sense of hope and coping skills all of which can make you very anxious.

Questions to ask yourself

How anxious am I about losing some of my independence?

Have I experienced any stressful or difficult events recently? If so, what are they?

How do I cope with change?

What happens

Sometimes the trauma from a past event comes up again when you are older and you find yourself reliving the anxiety you had at the time, possibly having distressing memories. This may be a condition called Post Traumatic Stress Disorder (PTSD) and around 5% of older women have PTSD.

Questions to ask yourself

Are my anxious feelings and thoughts associated with an event that happened in the past?

Could I have PTSD? (get information on PTSD here)

What happens

How much anxiety you feel about money depends to some extent on your assets and financial situation. There is often a fear of not having enough money to last you and not being a burden to others or a fear that others may not be being careful with your money. These things can make you frightend about your future and cause general anxiety about everything.

Questions to ask yourself

How anxious am I about money?

How anxious am I about being a financial burden to others?

How much does anxiety about money interfere with my thoughts every day?

What happens

Friends can be important protectors of your emotional wellbeing. Friends can accept you for all that you are and sometimes they can reject you. This happens at every age and stage of your life. As you get older friends may change and you may be anxious about losing old friends.

Questions to ask yourself

Do I feel accepted by my friends?

Who accepts and does not accept me?

How anxious am I about losing friends?

How anxious am I about making new friends?

What happens

Having people to talk to when you need support is one of the most important ways to feel good about yourself. This might be friends, family, people in community groups you belong to, or the people you mix with where you live. As you grow older the supports you may have relied on may change, perhaps because you have moved to a new community, perhaps through illness and death. Feeling alone and grieving for support networks you have lost can negatively affect your mental and emotional health. You may become very distressed by a fear of being left alone.

Questions to ask yourself

Do I have good friends, family or people I trust who can be there for me?

Who can I turn to for support or talk to if I need?

Have people who I turn to for support moved on, or are no longer there for me?

How anxious am I about being alone?

Community causes →
What happens

The community in which you live is important to your mental health. Feeling safe, that there are places to go, ways to get there and things to do can help you to feel connected to your community and that you belong somewhere. If you move to a new community you may get anxious about finding your way around, and finding the same type of services you are used to. You may feel you don’t belong anywhere anymore.

Questions to ask yourself

How do I feel about the community where I live?

How connected do I feel and do I feel that I belong in my community?

What are the services available to me in the community where I live?

What happens

Feeling safe is a basic human right. When you are older you can feel more vulnerable and less safe. This might be physically, such as feeling more vulnerable to a physical attack – or it can be emotionally, where you feel more vulnerable to being exploited, or cheated financially.

Questions to ask yourself

How safe do I feel in my community?

How nervous and fearful am I about being physically attacked?

How anxious am I about falling over when I am out and about?

How anxious am I that I could be cheated financially or exploited to the point I no longer trust or want to talk to people?

Physical causes →
What happens

Having an illness or a severe and ongoing health condition such as arthritis makes you more likely to have anxiety. It may be the result of the physical pain that comes with arthritis, but it can also be because of the limitations it places on your life. If what you can do or where you can go means you can do less of the activities that used to give you pleasure, this can create space for anxiety.

Questions to ask yourself

How anxious am I about getting sick in the future?

How anxious am I about my illness? (if relevant)

Have I a serious illness which has caused my anxiety disorder?

Is my anxiety disorder made worse by the symptoms of my illness?

What happens

46% of 70-85 year old women fear they may fall. The risk of falling is increased if you:

  • live alone
  • are overweight
  • are forgetful
  • have depression
  • have problems with your balance
Questions to ask yourself

How frightened am I of falling?

Am I at increased risk of falling?

What happens

Excessive drinking (defined as more than two standard drinks on any day and with no alcohol free days in a week) can:

  • make you anxious
  • be a sign you are trying to cover up or numb your feelings of anxiety
Questions to ask yourself

How much am I drinking?

How anxious am I about how much I drink?

Am I drinking to make the anxiety go away?

What happens

The tiredness created by a lack of good quality sleep can cause anxious thoughts and feelings which can severely impact on your daily life. Interrupted sleep and irregular sleep patterns such as going to bed and waking at very different times each day are particularly bad and make the anxiety worse. 

Questions to ask yourself

How much sleep do I get per night?

Do I have a lot of trouble going to sleep or getting back to sleep after I wake up?

How interrupted is my sleep?

Are my sleep patterns irregular?

What happens

A diet with too much processed or take away food combined with too little exercise = more negative moods = more worry and anxiety. Missing meals or not including a range of healthy foods can make you more prone to under-nutrition or anaemia for example. If you already have an anxiety disorder, your anxiety symptoms may stop you from reaching for the healthier food options and getting the activity you need and this creates a vicious cycle for you.

Questions to ask yourself

How healthy are the foods I eat?

Do I get a range of nutritious foods into my diet?

Am I physically active at least 3-4 times per week?

How much do my anxiety symptoms affect my diet and stop me eating healthy foods?

How much do my anxiety symptoms stop me from exercising?

Created on 18/08/2013 | Updated on 02/08/2016
References for this page

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Jean Hailes is Australia’s leading and most trusted women’s health organisation. We believe in physical and emotional health and wellbeing in all its dimensions for all women in Australia throughout their lives.

We offer a range of free resources and easy to understand information on women’s health and wellbeing. Appointments at our specialist women’s health clinics can be made in person (East Melbourne and Clayton, VIC) or across Australia via our Telehealth consultation service. www.jeanhailes.org.au

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