anxiety presentation in older adults

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Anxiety and Older Adults: Overcoming Worry and Fear

Clinical topic.

Anxiety , Healthy Aging

Publication Date

October 27, 2022

Feeling anxious or nervous is a common emotion for people of all ages and a normal reaction to stress. Feeling anxious can help us handle problems and strange situations, and even avoid danger. It is normal to feel anxious about illnesses, new social interactions, and frightening events. But when one feels anxious often and the anxiety is overwhelming and affects daily tasks, social life, and relationships, it may be an illness.

Anxiety is a common illness among older adults, affecting as many as 10-20 percent of the older population, though it is often undiagnosed. Phobia—when an individual is fearful of certain things, places or events—is the most typical type of anxiety. Among adults, anxiety is the most common mental health problem for women, and the second most common for men, after substance abuse.

Older adults with anxiety disorders often go untreated for a number of reasons. Older adults often do not recognize or acknowledge their symptoms. When they do, they may be reluctant to discuss their feelings with their physicians. Some older adults may not seek treatment because they have suffered symptoms of anxiety for most of their lives and believe the feelings are normal. Both patients and physicians may miss a diagnosis of anxiety because of other medical conditions and prescription drug use, or particular situations that the patient is coping with. For example, the anxiety suffered by a recently widowed patient may be more than normal grieving. Complicated or chronic grief is often accompanied by persistent anxiety and grieving spouses may avoid reminders of the deceased.

Untreated anxiety can lead to cognitive impairment, disability, poor physical health, and a poor quality of life. Fortunately, anxiety is treatable with prescription drugs and therapy.

What is Anxiety?

An anxiety disorder causes feelings of fear, worry, apprehension, or dread that are excessive or disproportional to the problems or situations that are feared. There are several types of anxiety disorders.

Specific phobias

A specific phobia is an intense, irrational fear of a place, thing or event that actually poses little or no threat. Some common specific phobias are heights, escalators, tunnels, highway driving, closed-in spaces, flying, and spiders. Agoraphobia is a fear of public places, leaving one’s home, or being alone. Phobias more common to older adults include fear of death, disaster to family, and dental procedures. Facing, or thinking about, these situations or things can bring on severe anxiety or a panic attack (chest pain, heart palpitations, shortness of breath, dizziness, or nausea).

Social phobia (also called social anxiety disorder)

Social phobia is when an individual feels overwhelmingly anxious and self-conscious in everyday social situations. An older adult might feel intense, persistent, and chronic fear of being judged by others and of doing things that will cause embarrassment. Some older persons suffer a social phobia because they are embarrassed about being unable to remember names or are ashamed of their appearance due to illness. A social anxiety disorder makes it hard to make and keep friends. Some with social phobia can be around others, but are anxious beforehand, very uncomfortable throughout the encounter, and, afterwards, worry how they were judged. Physical symptoms can include blushing, heavy sweating, trembling, nausea, and difficulty talking.

Generalized anxiety disorder (GAD)

Those with GAD suffer constant worries, and there may be nothing or little to cause these worries. Those with GAD are overly concerned about health issues, money, family problems, or possible disaster. Those with GAD usually understand that they worry more than necessary. Older adults with GAD have difficulty relaxing, sleeping and concentrating, and startle easily. Symptoms include fatigue, chest pains, headaches, muscle tension, muscle aches, difficulty swallowing, trembling, twitching, irritability, sweating, nausea, lightheadedness, having to go to the bathroom frequently, feeling out of breath, and hot flashes.

Post-traumatic stress disorder (PTSD)

PTSD develops after a traumatic event that involved physical harm or the threat of physical harm to the individual, a loved one, or even strangers. PTSD can result from traumatic incidents, such as a mugging, rape, abuse, car accidents, or natural disasters such as floods or earthquakes, in addition to resulting from experiences of war. Symptoms may emerge months or years after the event. Some older adults may relive a trauma 30 years or more after an event due to feeling helpless because of a new disability (for example, being confined to a wheel chair) or specific triggers that revive old memories (for example, news coverage of current wars).

A person with PTSD may startle easily, be emotionally numb with people with whom they were once close, have difficulty feeling affection, and lose interest in things they once enjoyed. Those suffering PTSD may be irritable, aggressive or violent. A person with PTSD can experience flashbacks, in which vivid thoughts of the trauma occur during the day or in nightmares during sleep. During a flashback, a person may believe the traumatic event is happening again.

Obsessive-compulsive disorder (OCD)

While OCD is not common among older adults, some older people do suffer from persistent, upsetting thoughts that they control by performing certain rituals, such as repeatedly checking things, touching things in a particular order, or counting things. Some common fears include possible violence and harm to loved ones. Some with OCD are preoccupied with order and symmetry; others accumulate or hoard unneeded items.

Panic disorder

Those with panic disorder have sudden attacks of terror, and usually a pounding heart, chest pain, sweatiness, weakness, faintness, dizziness, or nausea. Panic attacks can occur at any time, even during sleep. An attack usually peaks within 10 minutes, but some symptoms may last much longer. Panic disorder is not common among older adults, however, an older adult with the disorder may refuse to be left alone. An older person experiencing a panic attack may think he or she is having a heart attack or stroke.

Why should an older adult be concerned about anxiety?

For older adults, depression often goes along with anxiety, and both can be debilitating, reducing overall health and quality of life. It is important to know the signs of both anxiety and depression and to talk with a physician about any concerns. Anxiety is also strongly linked to memory. Anxiety can interfere with memory, and significant anxiety can contribute to amnesia or flashbacks of a traumatic event.

What leads to an anxiety disorder?

A number of things can contribute to an anxiety disorder:

• Extreme stress or trauma
• Bereavement and complicated or chronic grief
• Alcohol, caffeine, drugs (prescription, over-the-counter, and illegal)
• A family history of anxiety disorders
• Other medical or mental illnesses or
• Neurodegenerative disorders (like Alzheimer’s or other dementias).

The stresses and changes that sometimes go along with aging—poor health, memory problems, and losses—can cause an anxiety disorder. Common fears about aging can lead to anxiety. Many older adults are afraid of falling, being unable to afford living expenses and medication, being victimized, being dependent on others, being left alone, and death.

Older adults and their families should be aware that health changes can also bring on anxiety. Anxiety disorders commonly occur along with other physical or mental illnesses, including alcohol or substance abuse, which may hide the symptoms or make them worse.

It’s also important to note that many older adults living with anxiety suffered an anxiety disorder (possibly undiagnosed and untreated) when they were younger.

A stressful event, such as the death of a loved one, can cause a mild, brief anxiety, but anxiety that lasts at least six months can get worse if not treated.

Signs of an Anxiety Disorder

• Excessive worry or fear
• Refusing to do routine activities or being overly preoccupied with routine
• Avoiding social situations
• Overly concerned about safety
• Racing heart, shallow breathing, trembling, nausea, sweating
• Muscle tension, feeling weak and shaky
• Hoarding/collecting
• Self-medication with alcohol or other central nervous system depressants

Depression and Anxiety

In older adults, anxiety and depression often occur together. It is important for older adults to tell their physicians if they are experiencing symptoms of either.

Symptoms of depression usually last more than two weeks:

• Disturbed sleep (sleeping too much or too little)
• Changes in appetite (weight loss or gain)
• Physical aches and pains
• Lack of energy or motivation
• Irritability and intolerance
• Loss of interest or pleasure
• Feelings of worthlessness or guilt
• Difficulties with concentration or decision-making
• Noticeable restlessness or slow movement
• Recurring thoughts of death or suicide
• Changed sex drive

Who can help?

Older adults who think they may be suffering from anxiety should share their concerns with their primary care physicians. A physician can help determine if the symptoms are due to an anxiety disorder, a medical condition, or both. If the physician diagnoses an anxiety disorder, the next step is to see a mental health care professional. Both patient and provider should work as a team to make a plan to treat the anxiety disorder.

What are the treatment options?

Treatment can involve medication, therapy, stress reduction, coping skills, and family or other social support.

A mental health care provider can determine what type of disorder or combination of disorders the patient has, and if any other conditions, such as grief, depression, substance abuse, or dementia, are present.

Those who have been treated before for an anxiety disorder should tell their provider about previous treatment. If they received medication, they should indicate what was used, dosage, side effects, and whether the treatment was helpful. If the patient attended therapy sessions, he or she should describe the type, how many sessions, and whether it was helpful. Sometimes individuals must try several different treatments or combinations of treatments before they find the one that works best for them.

Medication will not cure anxiety disorders but will keep them under control while the person receives therapy. Medication must be prescribed by physicians, often psychiatrists or geriatric psychiatrists, who can also offer therapy or work as a team with psychologists, social workers, or counselors who provide therapy.

The main medications used for anxiety disorders are antidepressants, anti-anxiety drugs, and beta-blockers, which control some of the physical symptoms.

Antidepressants

Antidepressants are typically prescribed for most anxiety disorders. They work by altering the brain chemistry. Because symptoms usually start to fade after 4-6 weeks of antidepressants, it is important to take them long enough for them to work. Antidepressants include selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), tricyclics, and monoamine oxidase inhibitors (MAOIs).

Anti-anxiety drugs

Anti-anxiety drugs, also called anxiolytics, are sometimes prescribed when a quick-acting and/or short-term medication is needed. Buspirone is an anti-anxiety drug that has been shown to be effective for older adults. Benzodiazepines, another anti-anxiety drug, are effective but should be prescribed carefully to older adults because of risk of memory impairment, unsteadiness, and falls. When they are used, benzodiazepines are usually prescribed for short periods of time. Some people experience withdrawal symptoms if they stop taking them abruptly instead of tapering off. When taken regularly for a long time, benzodiazepines can be addictive but typically are not.

Beta-blockers

Beta-blockers can help relieve anxiety by preventing the physical symptoms that go along with certain anxiety disorders.

Taking Medication

• Learn about the effects (for example, when it should begin to help and in what way) and side effects.
• Tell your doctor about any other drugs (both prescription and over-the-counter), herbal supplements, or alternative therapies you are taking.
• Find out when and how the medication should be stopped. Some cannot be stopped abruptly and must be tapered down under a doctor’s supervision.
• Some medications are only effective if taken regularly.

Therapy or psychotherapy involves talking with a trained mental health professional, such as a psychiatrist, psychologist, social worker, or counselor, to discover what caused the anxiety disorder and how to deal with its symptoms.

In cognitive-behavioral therapy, therapists help people change the thinking patterns that contribute to their fears and the ways they react to anxiety-provoking situations. A therapist can teach new coping and relaxation skills and help resolve problems that cause anxiety. When a patient is ready to face his or her fears, a therapist can teach exposure techniques to desensitize the patient to the situations that trigger anxious feelings. Therapists also teach deep breathing and other relaxation techniques to relieve anxiety. Behavioral therapy is short-term therapy of 12 or fewer sessions.

What else can a person do to relieve anxiety?

• Acknowledge worries and address any fears that can be handled (for example, if an individual is worried about finances, a visit to a financial planner may be helpful)
• Talk with family, a friend or spiritual leader
• Adopt stress management techniques, meditation, prayer, and deep breathing from the lower abdomen
• Caffeine (coffee, tea, soda, chocolate)
• Nicotine (smoking)
• Over-eating
• Over-the-counter cold medications
• Certain illegal drugs
• Certain herbal supplements
• Alcohol (While alcohol might initially help a person relax, it eventually interferes with sleep and overall wellness, and can even contribute to anxiety, depression, and dementia.)
• Limit news of current events. It is important to stay current, but too much negative news can contribute to anxiety.
• Allow time for treatment to work

Concerned about an older family member or friend?

If you suspect an older adult you know might have a problem with anxiety, notice and ask about any changes in:

• Daily routines and activities. Is the person avoiding situations and activities he or she once enjoyed?
• Worries. Does he or she seem to worry excessively?
• Medication. Is he or she taking a new medication, either prescription or over-the-counter? Or has the dosage changed for one of the medications?
• Is he or she drinking more alcoholic drinks than previously?
• Mood. Is the older adult tearful, lacking emotion, or “just doesn’t feel right.”

When talking to an older adult who has an anxiety problem:

• Be calm and reassuring
• Acknowledge their fears but do not play along with them
• Be supportive without supporting their anxiety
• Encourage them to engage in social activities
• Offer assistance in getting them help from a physician or mental health professional

American Psychiatric Association

1000 Wilson Boulevard, Suite 1825 Arlington, VA 22209-3901 Phone: (703) 907-7300 Website:  www.psychiatry.org

American Psychological Association

750 First Street, NE Washington, DC 20002-4242 Phone: (800) 374-2721 Website:  www.apa.org

Anxiety and Depression Association of America

8701 Georgia Avenue, Suite 412 Silver Spring, MD 20910 Phone: (240) 485-1001 Website:  www.adaa.org

National Association of Social Workers

750 First Street, NE, Suite 800 Washington, DC 20002 Phone: (800) 742-4089 Website:  www.socialworkers.org

Find a Geriatric Psychiatrist

A geriatric psychiatrist is a medical doctor with special training in the diagnosis and treatment of mental illnesses that may occur in older adults. These include, but are not limited to, dementia, depression, anxiety, alcohol and substance abuse/misuse, and late-life schizophrenia. Geriatric psychiatrists can help their patients navigate the health care system.

“Anxiety Disorders” by the National Institute of Mental Health. 2007. NIH Publication No. 06-3879

Sakauye KM.  Geriatric Psychiatry Basics . New York: WW Norton & Company; 2008.

“Anxiety Disorders in Older Adults” by the Anxiety Disorders Association of America. Online at  www.adaa.org .

“Late Life Anxiety Disorders: What you need to know.” By the Late Life Depression Evaluation and Treatment Center at the University of Pittsburgh Medical Center. ( www.wpic.pitt.edu/research/depr/anxiety.htm )

Mental Health: A Report of the Surgeon General. Chapter 5. Older Adults and Mental Health. 1999.

This brochure was funded by individual contributions made in memory of Philip H. Sheridan.

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Anxiety and Older Adults: A Guide to Getting the Relief You Need

Apr 22, 2022

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Key Takeaways

For National Older Adult Mental Health Awareness Day (May 20), NCOA is working to remove barriers to understanding anxiety disorders.

Anxiety disorders affect nearly 4% of older adults worldwide. However, many more cases go undiagnosed due to misconceptions about mental illness.

Severe anxiety isn’t an inevitable part of aging. With the right treatment, you can find relief from your symptoms and return to a normal and productive life.

Anxiety is a natural response to many life stressors, such as meeting new people, speaking in public, or getting lost in an unfamiliar environment. But when those feelings of nervousness become overwhelming and make everyday life more difficult, it may be a sign of an anxiety disorder. Anxiety disorders affect nearly 4% of older adults worldwide 1 —and those are only the cases that are recognized and diagnosed.

What are the symptoms of an anxiety disorder?

Symptoms of anxiety vary from person to person. But in general, mental and behavioral signs of an anxiety disorder include:

• Uncontrollable feelings of panic, fear, and/or apprehension
• Obsessive thoughts
• Reactions that are disproportional to the triggering fear
• Restlessness
• Trouble with memory and focus
• Refusal to engage in routine activities
• Ritualistic behaviors (e.g., repeated handwashing)

Anxiety is often accompanied by physical signs such as:

• Racing heart, or heart palpitations
• Hot flashes
• Frequent urination
• Shortness of breath
• Tense muscles
• Excessive sweating
• Cold or sweaty hands

While symptoms are an important aspect of diagnosing anxiety in older adults, even more critical is how these symptoms affect day-to-day living. Anxiety is considered problematic when it interferes with your daily functioning, your quality of life, and even your health.

What is the most common anxiety disorder in older adults?

Generalized Anxiety Disorder (GAD) is believed to be the most common anxiety disorder among older adults . People who have GAD find themselves constantly worrying about many things. They fear the worst in every situation, even if that fear is unfounded. Adults suffering from GAD may feel like they're always on edge and in a high state of alert. They may understand that their nervousness is excessive but feel a lack of control over their emotions. General Anxiety Disorder tends to be more common among older women compared to older men, particularly in the event of divorce, separation, or the loss of a spouse or partner.

Other types of anxiety disorders affecting older adults include:

• Social anxiety disorder: Adults with social anxiety feel extreme nervousness and self-consciousness in everyday scenarios involving other people. They fear judgement from others and worry they'll do something to embarrass themselves. They may actively avoid social situations and have a hard time making and maintaining friendships.
• Phobia: If a person has an extreme, debilitating fear of something that does not pose a major threat—and this fear leads to avoidance of specific situations or objects—it's called a phobia. Some common phobias include dental procedures, the outside world (agoraphobia), heights, insects, thunderstorms, and driving a vehicle.
• Obsessive-compulsive disorder (OCD): Older adults with OCD struggle with unwanted, recurring thoughts or compulsions. They often feel that by performing certain actions repeatedly (e.g., counting the number of tiles on the floor), they will be able to feel a sense of control. Intrusive disturbing thoughts, like being injured in a car accident, are also a form of OCD.

What are some causes of anxiety in older adults?

Anxiety doesn’t always have a specific cause, and scientists aren’t completely clear why some adults suffer from excessive anxiety. It’s possible that multiple situational and environmental triggers are at play. Some common risk factors for anxiety disorders in seniors include:

• Stressful life events (e.g., death of a loved one )
• Limited physical mobility
• Loss of independence
• Financial insecurity
• Sleep disturbances (e.g., insomnia )
• Chronic health conditions (e.g., diabetes, obesity )
• Side effects of medications (e.g., steroids, stimulants)
• Misuse / abuse of alcohol or prescription medications
• Trauma from childhood

There may also be physiological risk factors for anxiety disorders in older adults. Some people have a chemical imbalance brought on by extreme stress. Anxiety may also run in families. For example, if your mother had GAD, you’re at greater risk for developing it, too.

If your anxiety is having a negative impact on your life, it's time to speak to your healthcare provider. They'll likely start with a complete physical exam to help rule out any potential medical causes of your symptoms. If there are no signs of physical illness, your provider may refer you to a licensed mental health counselor, psychologist, or psychiatrist. These professionals are specially trained to diagnose anxiety, depression, and other mental health disorders through interviews and other assessment tools.

How do you treat severe anxiety in older adults?

Too many older adults neglect to seek help for their anxiety due to shame and a lack of understanding about mental illness. That’s why it’s important to know that an anxiety disorder is not something you can control or will away. It’s considered a chronic health condition that requires medical treatment, just like diabetes or high blood pressure. Anxiety disorders are generally treated using talk therapy, medication, or a combination of both.

• Talk therapy (also called psychotherapy or counseling) is conducted one-on-one with a therapist or counselor. Many anxiety sufferers benefit from a type of therapy called exposure therapy. It involves tackling your fears head-on in order to become more comfortable with those activities or objects. Cognitive behavioral therapy (CBT) is another therapeutic approach used with anxiety disorders. CBT helps you identify harmful, anxiety-provoking thought patterns and work on changing them.
• Prescription medications can help alleviate feelings of panic or nervousness and allow you to function more normally. Some of the medications used to relieve anxiety include anti-anxiety medications (e.g., benzodiazepines) and antidepressants. Beta blockers, normally used to treat hypertension, have been found to be helpful in reducing some of the physical manifestations of anxiety.

How can older adults manage anxiety?

Seeking medical intervention should be a priority if your anxiety exceeds typical, everyday worries. But there are also lifestyle practices you can adopt to make your anxiety more manageable:

• Talk it out: Oftentimes, sharing our feelings and experiences can help us feel less anxious. Consider joining an online or in-person support group for those with anxiety disorders, or talk with a trusted friend, family member, or spiritual leader.
• Manage your stress: Meditation, yoga, mindfulness , deep breathing, and other stress management techniques can help relieve the physical symptoms of anxiety and make you feel more relaxed.
• Avoid stimulants: Certain substances can worsen anxiety disorder symptoms. These include caffeine, nicotine, over-the-counter cold medications, alcohol , and certain herbal supplements.
• Get plenty of sleep: A study by University of California, Berkeley researchers showed that sleeplessness can increase anxiety by up to 30% the next day. 2 Older adults should aim to get 7 to 9 hours of sleep per night.

Severe anxiety is not a normal part of aging—and you don’t have to accept living with it. If excessive worry is keeping you from a happy and productive life, talk to your doctor. Today’s anxiety treatments are safe and effective and can help you feel like yourself again.

Learn more about mental health for older adults and take an anxiety screening.

1. Mental health of older adults, World Health Organization. Found on the internet at https://www.who.int/news-room/fact-sheets/detail/mental-health-of-older-adults

2. Overanxious and underslept, Nature Human Behavior. Found on the internet at: https://www.nature.com/articles/s41562-019-0754-8

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According to the CDC, 20% of people age 55 years or older experience some type of mental health concern. Get more information or managing your mental health as you age or find ways to cope with difficult emotions from grief or unexpected life changes.

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• Anxiety in Older Adults

What older adults, their families and friends need to know.

Feelings of anxiety can be normal and healthy, or they can indicate an anxiety problem. It’s normal, for example, to feel afraid when a large dog snaps at you or to worry when a family member is several hours late and has not called. These feelings can help you to protect yourself and others you care about. Once the situation is resolved or changes, the fear or worry should go away. However, you may have an anxiety problem if your feelings of worry or fear:

• occur most of the time
• keep you awake at night
• prevent you from doing things during the day.

Anxiety problems in older adults are common, and they often go unrecognized. Anxiety problems may be caused by:

• stressful or traumatic events
• alcohol, medications and caffeine
• family history of anxiety disorders
• other medical or psychiatric problems. 

Types of anxiety problems

Anxiety problems can take different forms. The following are some of the more common forms, listed in order of how often they are seen in older people. Generalized anxiety disorder: where people worry often over a long period of time.

Phobias: where people fear a specific thing, such as going outside, heights or spiders.

Posttraumatic stress disorder: where intrusive memories, dreams or flashbacks cause people to relive the intense fear experienced during a traumatic experience, such as war, a violent assault or an accident.

Panic disorder: where people have episodes of extreme fear, often with physical symptoms, such as shortness of breath and chest pains.

Obsessive-compulsive disorder: where troubling uninvited thoughts, urges and images surface in the mind repeatedly and lead people to perform time-consuming rituals aimed at calming their distress.

What are the signs of anxiety problems?

• irrational and excessive worry or fear
• checking and rechecking for safety
• avoiding routine activities
• avoiding social situations
• racing heart
• shallow breathing, trembling, nausea, sweating. 

What can I do about an anxiety problem?

People with anxiety problems are often aware that their fear is excessive, but are unable to control it. Anxiety problems can make it hard, if not impossible, to enjoy life. Fortunately, help is available. The first step is to rule out a physical problem by visiting a family doctor. If an anxiety problem is diagnosed, it can often be managed with a combination of counselling, medication and relaxation techniques.

There are other things that you can do to help ease an anxiety problem.

Become an expert on your condition. Learn about your condition, your symptoms and how to recognize when symptoms begin. Develop and stick to a plan for managing symptoms of anxiety. Use skills learned in therapy to manage symptoms and take medications as prescribed. Develop a social support network. Family, friends and a support group can help you to recognize when stressful situations may trigger anxiety symptoms, and can remind you of your strengths when you feel discouraged. Learn to cope with stress. Stress, fatigue and feeling out of control can trigger symptoms of anxiety. Ways to manage stress include doing things that are relaxing, pleasurable or interesting to you. This can help to take your mind off the things that cause you stress and make them seem less important. Other ways to manage stress include breathing techniques, meditation and exercise.

Live a healthy, well-balanced life. Eating well, getting enough sleep and keeping active can all help you to manage stress and feel well. Faith, religion or spiritual practices can also help. Focus on developing a balance in your life, with time for family, friends, work or volunteer and leisure activities. 

Where can I get more information?

For information and referral to mental health services available in Ontario, contact ConnexOntario  toll-free at 1 866 531-2600. This free and confidential service is open 24 hours a day, seven days a week. Many resources on anxiety are available, including books, videos, support groups and websites. Two reliable sources of information are the Anxiety Disorders Association of Canada , 1 888 223-2252, and the Canadian Mental Health Association , Ontario, 1 800 875-6213.

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Older Adults See Biggest Spike in Mental Health Diagnoses

New report details insurance claims for mental health from billions of americans.

Elizabeth Agnvall,

It may feel to many that the COVID-19 pandemic is over, but Americans are still feeling the effects of the years of isolation and anxiety.

A new report from nonprofit organization FAIR Health has found that the percentage of patients with mental health diagnoses increased across all age groups, with the largest increase seen in those age 65 and older. The organization used a database of about 46 billion private health care records — including Medicare Advantage — to examine in-network claims between 2019 and 2023. The report found that there was a 57.4 percent spike in the percentage of mental health diagnoses in those age 65 and older, and a nearly 36 percent increase among adults ages 51 to 64.

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After those 65-plus, the second-highest rise in mental health diagnoses were seen in those ages 19 to 30 and 31 to 44. ​

Symptoms of General Anxiety Disorder

• Feeling restless, wound-up or on-edge
• Being easily fatigued
• Having difficulty concentrating
• Being irritable
• Having headaches, muscle aches, stomachaches, or unexplained pains
• Difficulty controlling feelings of worry
• Having sleep problems, such as difficulty falling or staying asleep

This latest report tracks with other research that has found the prevalence of mental health conditions has risen since the start of the pandemic. It found that nearly 20 percent of privately insured patients who received medical services were diagnosed with a mental health condition in 2023, a number that is similar to estimates from the National Institute of Mental Health.

Anxiety, depression on the rise in older adults

Generalized anxiety disorder was the most common diagnosis for all Americans, including those 50 and older. For adults 65 and older, this was a change from 2021, when diagnoses for major depressive disorder — marked by symptoms of sadness and anhedonia, or an inability to experience pleasure — was slightly higher than anxiety.

• The two diagnoses were very close, however, with 6.17 percent of adults age 65 and older being diagnosed with anxiety and 6.11 percent with depression in 2023.
• In adults ages 51 to 65, 7.3 percent were diagnosed with anxiety and 5 percent with depression in 2023.
• The diagnoses among older adults of both conditions rose significantly — nearly doubling from 2019 to 2023. ​

Signs and Symptoms of Depression

If you have been experiencing some of the following signs and symptoms, most of the day, nearly every day, for at least two weeks, you may have depression:

• Persistent sad, anxious, or “empty” mood
• Feelings of hopelessness or pessimism
• Feelings of irritability, frustration, or restlessness
• Feelings of guilt, worthlessness, or helplessness
• Loss of interest or pleasure in hobbies and activities
• Fatigue, lack of energy, or feeling slowed down
• Difficulty concentrating, remembering, or making decisions
• Difficulty sleeping, waking too early in the morning, or oversleeping
• Changes in appetite or unplanned weight changes
• Physical aches or pains, headaches, cramps, or digestive problems without a clear physical cause that do not go away with treatment
• Thoughts of death or suicide or suicide attempts

Although some anxiety is a normal human emotion and can be useful in helping us stay safe as we worry about potential threats, it can become a problem when the fear becomes overwhelming. For people with anxiety disorder, the anxiety does not go away and can get worse over time, according to the National Institute of Mental Health.

In addition to anxiety and depression, other common mental health diagnoses in 2023 across all age groups included attention-deficit/hyperactivity disorder (ADHD), adjustment disorders (strong emotional or behavioral reactions to stress) and bipolar disorder.

Mental health issues in women vs. men

In the FAIR report, women had a higher percentage of mental health diagnoses than men in all but the youngest age groups. Although the percentage of mental health diagnoses increased for both women and men during the study period, the increase for women was greater, with 44.6 percent, compared with 32.7 percent for men.

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• In women ages 51 to 64, mental health diagnoses increased 37.8 percent; in men it increased 33.4 percent.
• In women 65 and older, mental health diagnoses increased 58.9 percent; in men it rose 54 percent.

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Although women tend to make up the greater share of patients with mental health diagnoses, suicide risk is especially high for older men.

A report from the Centers for Disease Control found that between 2001 and 2021, suicide rates increased significantly for men from age 55 to 74 and in women from age 55 to 84. Men ages 85 and older have the highest suicide rate of any age group.

Elizabeth Agnvall is the health and healthy living editor at AARP.org. She has worked as editor of Staying Sharp, AARP’s brain health platform and as a health editor at the  AARP Bulletin . She also wrote for the  Washington Post  health section.

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