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| health > story page |         |
Anxiety: Most common mental health problem
By John A. Cutter (WebMD) -- Sometimes James Coats would wake his family in the darkness of a quiet night because he was sure he was about to die. His chest hurt, he felt dizzy, and he had an overwhelming sense of doom. "I'd haul my wife and children off to the emergency room, two or three in the morning, because I thought I was having a heart attack," says Coats, 56, a semiretired construction contractor who lives near Raleigh, North Carolina. "I'd find out it wasn't a heart attack, but it sure felt like one." He had other unexplained symptoms. Sometimes his heart and respiration rates would suddenly quicken. He would perspire excessively and tremble. Mostly, he would be struck with a pervasive sense of anxiety that left him incapable of performing routine tasks, including going out of the house. It took nine years for Coats to find out he has an anxiety disorder, and only then, after the proper diagnosis, did he get the help he needs.
While depression among older adults is the mental health problem that's most often discussed, it is not the most common one aging Americans face -- a fact publicized in a December 1999 government report, "Mental Health: A Report of the Surgeon General." Anxiety disorders such as that experienced by Coats are the most common form of mental illness among adults aged 55 and older, according to the report. These conditions -- such as panic attacks, phobias and obsessive-compulsive disorder -- are "important but understudied conditions in older adults," according to the report. People aged 55 and older are more than twice as likely to suffer from anxiety than from depression. During any one year, about 11.4 percent of adults aged 55 and older have anxiety, according to estimates in the report, compared to 4.4 percent who have a mood disorder such as depression. The 458-page report -- the first ever on mental illness from the U.S. surgeon general -- draws together reams of recent research relevant to all age groups. Like past reports on such issues as smoking, this one aims to shed light on a health problem so the public can "confront the attitudes, fear, and misunderstanding that remain as barriers (to treatment) before us," Surgeon General Dr. David Satcher writes in the preface. "Anxiety disorders in the older population appear to be an unrecognized and unaddressed problem," says R. Reid Wilson, Ph.D., a University of North Carolina, Chapel Hill, psychologist who also has a private practice and treated James Coats. The umbrella term of "anxiety disorders" is used to describe a range of mental health problems, including:
Like Coats, many older adults suffer for years without knowing what is wrong with them, Wilson says. Only one-third seek treatment. Some may feel stigmatized; others may not be aware that the symptoms they are experiencing add up to a treatable mental health condition. Mental illnesses, such as anxiety disorders, usually first appear when people are younger, but the stress of aging -- deteriorating health, bereavement over the loss of a spouse -- can prompt the expression of them in later years, according to the surgeon general's report. Today, more is known about treatment, and the success rate is usually high, according to mental health experts and research studies -- with obsessive-compulsive disorder often the only exception. Individual counseling and group therapy can help people understand anxiety disorders and the situations in which they occur. Relaxation techniques can assist with coping. Medications such as benzodiazepines are sometimes used, but the surgeon general's report states that they are more effective for acute episodes of anxiety in older adults than for the treatment of chronic anxiety. Coats participated in group therapy for two years and learned how to use exercise, self-help groups, and relaxation tapes to help him cope with his anxiety. "I'd say I was plagued by it for 16 years," he says. "I used to keep it all to myself and not talk about it. But now I find the more I talk about it and face my anxiety, the better I feel."
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