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Via Christi 50+: Anxiety and depression
Anxiety and depression are common issues faced by older adults. Generalized anxiety disorder is the most prevalent form of anxiety seen in older adults. Symptoms of anxiety include excessive worry, restlessness, difficulty concentrating, irritability, and sleep disturbances. Depression symptoms include sadness, loss of interest, changes in appetite and sleep, fatigue, feelings of worthlessness, and suicidal thoughts. Both conditions can be caused by biological, psychological, and social factors. Treatment options include pharmacotherapy with SSRIs or SNRIs in lower doses, cognitive behavioral therapy, relaxation techniques, social involvement, and lifestyle changes like exercise. Risk of suicide is higher in older white males with psychiatric or substance abuse disorders and physical illness. Protective factors include social connections
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- 1. Anxiety and Depression:Anxietyand Depression: Am I singing the blues?Am I singing the blues? Via Christi Health Shiloh Jiwanlal BA, BSN, MSN, APRN, PMHCNS-BC
- 2. 2 Gray hair isa crown of splendor! Proverbs 16:31 IntroductionIntroduction
- 3. 3 • Protective • Ifnot protective what is it? AnxietyAnxiety
- 4. 4 Fear: emotional responseto real or perceived immediate threat Surges of autonomic arousal necessary - fight or flight Anxiety: anticipation of future threat Muscle tension, vigilance- preparation for future danger and avoidance Fear…………………..AnxietyFear…………………..Anxiety
- 5. 5 Statistics: Older adultsages 60 plus 2050 World Demographics: 2 billion United States and Europe: Currently 1 in 5 persons 2050 – 1 in 3 persons Anxiety Estimates: 19% Depression: 7.7% Who gets it?- AnxietyWho gets it?- Anxiety
- 6. Anxiety- Life Span-Anxiety-Life Span- Neurodevelopmental DisordersNeurodevelopmental Disorders Children- Phobias Young Adults- Panic Disorders/Post Traumatic Disorder Older Adults- Generalized Anxiety Disorders Not counted: Fear Of Falling (FOF)- Fear and Avoidance- Agoraphobia Older Adult onset- 11% women 2% men (over half new to Anxiety Disorders) Biological, psychological and social variables Chronic psychological distress- Cognitive impairment/decline 6
- 7. 7 • Excessive worry,anxiety • Difficult to control the worry • Restlessness or feeling keyed up or on edge • Easily fatigues • Difficulty concentrating, mind going blank • Irritability • Muscle tension • Sleep disturbance • Affecting daily living (Worry and rumination – driving forces in late life mental disorders) What does it look like?- AnxietyWhat does it look like?- Anxiety
- 8. DepressionDepression A happy heartmakes the face cheerful, but heartache crushes the spirit. Proverbs 15:13 8
- 9. 9 Mood and Interest •Sad,empty, hopeless •Less interest or pleasure •Weight loss/gain •Insomnia/hypersomnia •Psychomotor agitation/retardation •Fatigue or loss of energy •Feelings of worthlessness, excessive or inappropriate guilt •Diminished ability to think, concentrate, indecisiveness •Recurrent thoughts of death, suicide What is it?- DepressionWhat is it?- Depression
- 10. 10 -Temperamental -Environmental -Genetic -First degree familymembers 2-4 fold higher Who gets it?- DepressionWho gets it?- Depression
- 11. WisdomWisdom Gracious words area honeycomb, sweet to the soul and healing to the bones. Proverbs 16:24 11
- 12. What can bedone about them? •Prevent •Prepare •Protect •Build resilience •Treatment support
- 13. PharmacotherapyPharmacotherapy Risk: Benefit Ratio Lowerdose even increases the risk Benzodiazepines- Short acting/short term SSRIs and SNRIs • Escitalopram • Venlafaxine • Duloxetine • Citalopram • Mirtazapine (Gait impairment, bone loss, Impaired clotting, Hyponatremia) 13
- 14. TreatmentTreatment Cognitive Behavioral Therapy:Relaxation Training is the most effective • Psycho-education • Problem-solving skills training • Exposure and habituation to anxiety situations • Sleep hygiene • Bibliotherapy • Guided self help- Here and Now (mindfulness)` 14
- 15. TreatmentsTreatments -Have a routine -Exercise -Roteactivity- Knitting- Rocking Chair -Social involvement -Volunteer activity 15
- 16. Suicide- Risk FactorsSuicide-Risk Factors Older Adults- 45 per 100,000 per year 4 times the national overall per year US population- 316.1 million Risk Factors: • White male • Psychiatric and substance use disorders (71-97%) • Mood disorders • Ill health/functioning = Perceived meaning of illness • Pain • Impact on autonomy • Living alone • Physical inactivity • Stressfull life events • Loss of a spouse • Loneliness • Perceived burdensomeness/Thwarted belongingness 16
- 17. Suicide- Protective FactorsSuicide-Protective Factors • Social Connections (50% increase likelihood of survival) • Hobbies • Physical activity • Having a confidante • Belonging • Sense of positive interactions • Feeling cared for • Spirituality 17
- 18. Suicide PreventionSuicide Prevention SuicideHotline: 1-800-273-8255 18
- 19. ConclusionConclusion Light in amessenger’s eyes brings joy to the heart, and good news gives health to the bones. Proverbs 15:30 19