As many of my patients are over 50, I sometimes see anxiety-related – even obsessive-compulsive behavior – in them, particularly my female patients. They seem to worry more, have trouble sleeping, problems with concentration and may even develop certain fears – especially if they are newly living alone. Many of these symptoms can also accompany physical ‘change of life’ hormone issues and life stressors in both women and men. However, there may be other underlying physical or psychological conditions that may aggravate OCD-like behavior in older adults that may surprise you.
Anxiety or OCD?
Getting older can prompt feelings of anxiety that may manifest differently than in a younger person. Generally, it’s common for these feelings to start after major life changes – like the death of a spouse or parent. One patient of mine, I’ll call him Al, recently lost his wife of over 40 years, and developed a lot of anxiety and fear of driving and/or even going outside his home. In addition, chronic, stressful living situations brought about by an illness, job, loss of income, or caring for an elderly parent, can take its toll in creating a kind of generalized anxiety disorder. This anxiety can show up in ways that have psychological features of obsessive-compulsive disorder like:
- Repetitive behaviors – washing hands (especially if an illness, or care-taking situation is involved), checking locked doors (especially after death of a spouse, parent, personal injury, recent crime victim), straightening hair, changing clothes, etc.
- Hoarding – stockpiling food, water, or personal items to the point where the living space becomes too cramped to move. This behavior can stem from a fear of loss of income and not having enough money to take care of themselves; feeling a loss of identity from losing a job; holding onto memories through belongings after death of a loved one, or some other major life change that causes people to re-examine their life role now.
However, there are also physical conditions which can show up as OCD-anxiety-like symptoms:
- Diabetes. Blood sugar fluctuations can cause anxiety symptoms and sometimes irrational thoughts, fears, mood swings and depression.
- Hormone changes. Depression, irritability, mood changes, can accompany hormone shifts/decreases in both men and women in over-50 age groups. These can prompt anxiety and compulsive behaviors.
- Pre-Alzheimer disease. Undiagnosed Alzheimer, or pre-Alzheimer disease, or dementia that sometimes accompanies Parkinson disease may be at the root of some anxiety and OCD-like behaviors.
- Medication side effects – some drugs given for diabetes, Parkinson disease, and other conditions can have side effects that cause anxiety, agitation, even paranoia and hallucinations. If you take medications for these conditions, talk to your doctor about possible behavioral side effects.
True OCD is usually diagnosed earlier in life from the age of 12 through early adulthood. However, it is possible that a patient’s OCD has gone undiagnosed for years and their symptoms are more easily recognizable in their behavior with stresses of growing older.
What To Do About Symptoms
As I tell my patients who are affected by generalized anxiety, this most likely is a symptom of hormone and/or life change stressors they are experiencing at the same time. If OCD symptoms are present, they may have gone undiagnosed and have just become more pronounced with added stressors. Here are some things I recommend:
- Hormone testing. Unbalanced hormones in both men and women can cause physical and psychological distress and result in unusual thinking, behaviors. Hormone testing should be done to determine levels. Natural hormone replacement may be of benefit.
- Counseling. If life stressors seem to be a factor, I offer specific counseling with a grief counselor or a trained mental health therapist specializing in “senior issues” who can help work through these situations with them.
- Determine/treat. I want to rule out any undiagnosed conditions/illnesses that may be causing the symptoms. Cognitive behavioral therapy can be very helpful in treating anxiety-OCD disorders by changing thinking patterns that created certain fears and behaviors. Just venting concerns can be very helpful to most people. A short course of antidepressants or mild tranquilizers may help as well.
- Exercise. Regular outdoor exercise can do wonders for depression by increasing serotonin levels in the brain. It also helps burn off stress that fuels anxiety. Many of my patients with anxiety-OCD symptoms find their symptoms decrease significantly.
As I tell my patients, the life changes of getting older can provoke a lot of anxiety and unusual behavior in some people, especially if they have become newly alone, retired, or are living in a chronic, stressful situation. However, anxiety and OCD symptoms can be treated successfully and allow you to cope with any change, or life stressors you are dealing with in a more manageable way.
Mark Rosenberg, M.D.
Senior Anxiety, OCD and Hoarding, http://www.agingcare.com/Articles/senior-anxiety-hoarding-ocd-144712.htm
photo credit: studyhealth.com