Anxiety and Alzheimer’s Disease
What is anxiety?
Feeling anxious or nervous is a common emotion for people of all ages and a normal reaction to stress. In some situations, feeling anxious can be a good thing. Think about situations where a bit of anxiety serves to make you more attentive to a stressful situation or avoid danger. It is normal to feel anxious about illness, new social interactions, and frightening events. However, when a person frequently feels anxious and the anxiety is overwhelming and affects daily tasks, social life, and relationships, that is when the emotion of anxiety crosses the line to being an illness.
A so-called “anxiety disorder” or illness causes feelings of fear, worry, apprehension or dread that are excessive or disproportional to the problems or situations that are feared. The different types of anxiety disorders include phobias, social anxiety disorder, generalized anxiety disorder, post-traumatic stress disorder, obsessive compulsive disorder, and panic disorder.
For people with Alzheimer’s disease, anxiety can complicate their course and significantly reduce their quality of life and interpersonal relationships. An instance of forgetting, losing an item, or having a word-finding lapse can trigger an anxious feeling. Or they may be less able to identify a specific trigger and/or not even recognize the change, but their family caregivers see increased levels of generalized anxiety and uneasiness with even mundane day to day tasks.
Untreated, anxiety can lead to additional problems with memory and in some cases, it appears to hasten the progression of Alzheimer’s disease. In most cases, anxiety is treatable, though in people with Alzheimer’s disease the desire to avoid sedating medications does limit the pharmacologic options. While treatment can involve prescription medications, non-pharmacologic therapy will likely be beneficial as well and can include stress reduction strategies, developing coping skills, and family or other social support.
What causes anxiety disorders?
The following can contribute to anxiety disorders:
Extreme stress or trauma
Bereavement and grief
Alcohol, caffeine, drugs (prescription, over-the-counter, and illegal)
A family history of anxiety disorders
Other medical or mental illnesses
Neurodegenerative disorders (like Alzheimer’s or other dementias).
Signs of an anxiety disorder
Excessive worry or fear
Refusing to do routine activities or being overly occupied with routine
Avoiding social situations
Overly concerned about safety
Racing heart, shallow breathing, trembling, nausea, and sweating
Poor sleep
Muscle tension, feeling weak and shaky
Hoarding/collecting
Depression
Self-medication with alcohol or other central nervous system depressants
Strategies for Family Caregivers
If you suspect your loved one may have anxiety, you may notice the following and ask about changes in:
Mood. Is your loved one more tearful or not feeling right?
Daily routines and activities: Is your loved one avoiding activities and social situations?
Worries: Does he/she appear to worry excessively?
Medication. Is he/she taking a new medicine? Or has the dosage changed?
Alcohol use: Is he/she drinking more than usual?
Physical health: Are there signs or symptoms of an infection or illness?
Get help! Start by talking with your loved one's physician. A physician can help determine if the symptoms are due to a medical condition, anxiety, or both.
Communicating with your loved one who has anxiety:
Provide reassurance
Be supportive without supporting the anxiety
Encourage your loved one to use activities or actions that have been comforting in the past; for example, looking at a favorite picture, petting a dog or cat or listening to a favorite song.
Encourage participation in social activities or eating a favorite food or meal.
Discourage alcohol use. Drinking can mask symptoms or make them worse.
At times anxiety may come on quickly/suddenly and leave your loved one quite disturbed. If that happens:
Remain calm.
Think about your communication. Speak clearly and slowly. Use a soft tone of voice. Give clear directions, one at a time.
If you or your loved one cannot be calmed and/or is suicidal, seek urgent professional help. Call 911.
Please talk with your own/loved one’s healthcare provider before using any of this information.
