Anxiety Archive

Many people with anxiety disorders have trouble sleeping. That's a problem. Too little sleep affects mood, contributing to irritability and sometimes depression. Vital functions occur during different stages of sleep that leave you feeling rested and energized or help you learn and forge memories. Sleep usually improves when an anxiety disorder is treated. Practicing good "sleep hygiene" helps, too. Here are some steps to take:

• Go to bed and wake up at the same time every day, even on weekends.
• Daylight helps set sleep patterns, so try to be outdoors while it's light out for 30 minutes a day.
• Exercise regularly (but not too close to bedtime). An afternoon workout is ideal.
• Keep naps short — less than an hour — and forgo napping after 3 p.m.
• Avoid caffeine (found in coffee, many teas, chocolate, and many soft drinks), which can take up to eight hours to wear off. You may need to avoid caffeine entirely if you have panic attacks; many people who experience panic attacks are extra-sensitive to caffeine.
• Review your medications with a doctor to see if you are taking any stimulants, which are a common culprit in keeping people up at night. Sometimes it's possible to switch medicines.
• Avoid alcohol, large meals, foods that induce heartburn, and drinking a lot of fluid for several hours before bedtime.
• If you smoke, quit. Smoking causes many health problems, including compromising sleep in a variety of ways.
• Keep your bedroom cool, dark, and quiet, without distractions like TV or a computer. Avoid using an electronic device to read in bed; the light from the screen can trick your brain into thinking it is daytime. If your mattress is uncomfortable, replace it.
• Reading, listening to music, or relaxing before bed with a hot bath or deep breathing can help you get to sleep.
• If you don't fall asleep within 20 minutes of turning in (or if you wake up and can't fall back to sleep in 20 minutes), get out of bed and do something relaxing until you feel sleepy.

For additional tips and strategies for living with anxiety, buy Coping with Anxiety and Stress Disorders, a Special Health Report from Harvard Medical School. 

With the introduction of benzodiazepines such as chlordiazepoxide (Librium) and diazepam (Valium) in the early 1960s, a new era in the treatment of insomnia and anxiety began. The benzodiazepines were more effective and far safer than the older drugs — barbiturates, meprobamate, and glutethimide — that had been prescribed for these purposes. For many years, benzodiazepines continued to be the most popular prescription tranquilizers and sedatives. Since the mid-1980s, new alternatives have been assuming some of these roles, but benzodiazepines are not about to leave the stage.

More than a dozen benzodiazepines are available by prescription. Benzodiazepines have a common basic chemical structure, and they all increase activity at receptors for the neurotransmitter gamma-aminobutyric acid (GABA). This transmitter inhibits the activity of neurons, slowing down the brain and nervous system. Benzodiazepines differ mainly in how quickly they are absorbed, how long their effects last, and how long they take to leave the body.

The condition tends to strike many older adults, but there are ways to counter its paralyzing effects.

More and more, do you find yourself fighting feelings of worry? Do you feel increasingly anxious and tense? Do you obsess about things that may or may not happen? If so, you may be one of the millions who suffer from anxiety.

Anxiety can develop from many uncontrollable factors, such as genetics, personality, and life events, but the main issue for many older men is that they have too much time on their hands, according to Dr. Cornelia Cremens, a psychiatrist with Harvard-affiliated Massachusetts General Hospital.

Not all memory issues are cause for concern. Here is how to manage those annoying everyday lapses.

Everyone experiences the occasional "senior moment" as they age. You may misplace everyday items, fail to recall the name of someone you just met, or forget to do something. While these memory slips can be embarrassing and stressful, they usually don't mean that you are on a path to dementia.

"Some degree of memory lapses is a normal part of aging," says Lydia Cho, a neuropsychologist with Harvard-affiliated McLean Hospital. "You can't expect to hold on to all information you've gathered throughout your life, whether it was long ago or recent. It's not realistic or adaptive."

Research we're watching

A national coalition of women's health organizations recommends screening all adolescent girls (ages 13 and older) and adult women for anxiety. The goal is to improve detection and treatment for this common condition. The Women's Preventive Services Initiative (WPSI) recommends screening to look for all types of anxiety disorders, such as panic disorder, social anxiety disorder, and generalized anxiety disorder, in addition to depression screenings, which are already recommended for adults, says the WPSI. It would be up to individual clinicians to determine how often to do the screenings and to refer women and girls for follow-up examinations and screening.

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If you have experienced a heart attack or undergone a heart procedure, don't neglect your mental health during recovery.

Recovery from a heart attack, heart failure, angioplasty, or heart surgery — what doctors call heart events — can be stressful. Depending on your condition, it may also involve cardiac rehabilitation. This medically supervised program focuses on exercise, diet, and lifestyle changes. While the primary focus is to help you physically, you also need to address your mental and emotional health.

"It's normal to have some anxiety and stress after a heart attack or heart surgery," says Dr. Christopher Celano, assistant professor of psychiatry at Harvard-affiliated Massachusetts General Hospital. "But how long these feelings linger, and whether they are also associated with symptoms of depression, can affect your rehab recovery success and potentially increase your risk of future problems."

Normally associated with veterans, PTSD can also affect people of all ages who have experienced any kind of trauma.

Post-traumatic stress disorder (PTSD) is a severe and potentially debilitating mental health disorder that affects people who have experienced or witnessed a traumatic event. PTSD often occurs in combat veterans, but it can also strike older adults, and especially men.

About 70% of older men have been exposed to trauma at some point in life, according to the U.S. Department of Veterans Affairs. Many of these traumatic events are accidents (or near misses), injuries, or serious health issues.