Recognizing and Managing Panic Attacks in Older Adults

Signs and Symptoms of Panic Attacks

Symptoms of panic attacks in older people are similar to what younger individuals might experience. However, when they occur in someone older, research suggests there might be fewer and less severe symptoms. Older adults also might exhibit less avoidance behavior.

Panic attacks can manifest through physical, emotional, cognitive, and behavioral symptoms. Recognizing the signs is essential for timely intervention and treatment for improved mental and physical health.

Physical symptoms

Physical symptoms of a panic attack in older people might include:

• Rapid heartbeat or palpitations
• Shortness of breath or difficulty breathing
• Dizziness or lightheadedness
• Sweating or chills
• Chest pain or tightness
• Trembling or shaking
• Nausea or stomach distress

Emotional and cognitive symptoms

Emotional symptoms of a panic attack in older people might include:

• Intense fear or terror
• Confusion or disorientation
• A feeling of impending doom
• Depersonalization (feeling detached from reality)

Behavioral indicators

Behavioral symptoms of a panic attack in older people might include:

• Avoidance of situations that trigger anxiety (for example, crowded places or small spaces like an elevator)
• Reluctance to be alone due to fear of experiencing another episode

Common Causes & Triggers of Panic Attacks in Older Adults

Several factors can contribute to panic attacks in older people. Triggers may stem from health concerns, significant life changes, or psychological stressors that impact quality of life and mental well-being.

Health-related concerns

Older adults often face health-related challenges like chronic obstructive pulmonary disease (COPD), diabetes, and dementia. Worrying about health can intensify anxiety and exacerbate feelings of fear and uncertainty about their safety and future — the added anxiety can lead to panic attacks in some people.

Loss and loneliness

Grief over the loss of a spouse, partner, child, family member, or friend can lead to anxiety in the later years of life. Studies show that older adults who are grieving a loss within the last 18 months are more than twice as likely to have anxiety.

Cognitive decline

Memory loss and cognitive decline associated with aging can cause disorientation that leads to panic attacks in older people. For example, someone with dementia might experience fear that worsens their anxiety, as it’s well-established that symptoms of anxiety are common in people with dementia.

Fear of losing independence

Life transitions like moving into a senior community or assisted living facility can create fears and vulnerability that translate to anxiety and panic. Older people often worry that their loss of independence will become burdensome to family and loved ones, turning into an anxiety trigger that could cause more panic attacks.

Traumatic memories resurfacing

Sometimes, past trauma resurfaces with age and triggers panic attacks. A good example of this is a veteran who experiences flashbacks of their time in combat. Learning ways to cope with war anxiety or other traumatic experiences can help reduce trauma-related panic attacks.

Distinguishing Panic Attacks from Other Medical Conditions

Panic attacks can be tricky because they might imitate other severe medical conditions, like a heart attack or stroke. Differentiating between an actual panic episode and another medical condition is crucial for getting appropriate care.

Heart attack vs. panic attack

Both conditions can cause chest pain, rapid heartbeat, and shortness of breath, but there are differences to be aware of.

• Heart attack symptoms worsen over time and often (but not always) occur during physical exertion.
• Panic attack symptoms typically resolve within 20 minutes and may occur even when at rest.

Anxiety disorders vs. panic attacks

Anxiety attacks and panic attacks are often confused, but they are distinct experiences. Anxiety disorders involve ongoing, persistent worry and fear over an extended period. In contrast, panic attacks are sudden, intense episodes of fear or discomfort that come on quickly and unexpectedly. Understanding that panic attacks are episodic, while anxiety is more chronic, can help you differentiate between panic attacks and generalized anxiety disorder (GAD).

If you’re experiencing severe chest pain that persists or worsens over time, seek immediate medical attention to rule out a life-threatening condition.

Managing & Preventing Panic Attacks in Older Adults

There are management strategies that can offer short-term relief and long-term approaches tailored to specific needs. The tools here can help you manage and resolve episodes quickly and effectively.

Short-term strategies for immediate relief

Several of the following short-term techniques will provide immediate relief from a panic attack.

Slow, deep breathing

Controlled, slow breathing exercises are proven to reduce feelings of panic by changing your feelings and reducing hyperventilation. Deep breathing activates the parasympathetic system to treat physical symptoms of anxiety. It slows your heart rate and reduces trembling, allowing panic to subside.

Grounding techniques to stay present

Grounding techniques use your senses to help you feel grounded. They focus on sensory experiences — like touching an object or identifying what you hear or see — so you can stay present during a panic attack.

Gentle movement

Engaging in light physical activity or gentle movement can release tension. The next time you feel panicky, try taking a walk outside.

Reassuring self-talk

Calm, reassuring self-talk reduces fear so you can overcome anxiety and panic. Have a handful of calming anxiety affirmations ready to go when you need them. Try telling yourself things like:

• “I know that this will pass.”
• “Feelings aren’t forever.”
• “I can overcome this fear.”

Temperature therapy

The next time you feel a panic attack coming on, try temperature therapy. Applying a cold compress to your forehead or the back of your neck can soothe physical symptoms of anxiety like sweating and nausea.

Long-term management approaches

While short-term strategies are essential for immediate relief during a panic attack, long-term management approaches are just as crucial. Knowing effective ways to manage anxiety before a panic attack starts will improve your quality of life and mental well-being.

Cognitive behavioral therapy (CBT)

Cognitive behavioral therapy (CBT) helps you identify negative thought patterns that might be contributing to panic attacks. Once you do that, you can then learn ways to alter your response to anxiety. CBT is a proven method that’s commonly used to manage anxiety disorders.

Medication considerations

Make sure you share every medication you take with your doctor or psychiatrist. Some common medications to treat anxiety — like buspirone — can be very effective in reducing panic attacks. However, when taken by older people, they require careful monitoring because of potential side effects, multiple medication interactions, and a slower metabolism, which can affect how any drug works.

Lifestyle modifications

Incorporating regular exercise, maintaining a balanced diet, and establishing a consistent sleep routine can significantly boost mental health and help manage anxiety. These lifestyle changes contribute to overall well-being, making it easier to cope with stress and anxiety.

Social support and engagement

For individuals over 65, social support plays a crucial role in mental health. Engaging in community activities helps combat isolation—a common trigger of anxiety. Building and nurturing a positive social network fosters emotional resilience and enhances overall well-being.

Supporting an Older Loved One Through Panic Attacks

When an older adult experiences a panic attack, caregivers play a crucial role in providing comfort and support. As a family member or caregiver, being equipped with the right tools and strategies can help reduce the intensity of panic attacks in older adults and provide reassurance to your loved one.

Effective communication during a panic attack

During a panic attack, it’s essential to remain calm and offer a reassuring presence. Here are a few things to keep in mind:

• Stay calm and offer comfort: Your steady presence can help your loved one feel safe and supported.
• Acknowledge their feelings: Don’t dismiss their fears—validate what they’re experiencing. Let them know you understand they’re feeling overwhelmed.
• Use reassuring words: Phrases like, “I’m here with you,” “This will pass,” or “You are going to be OK” can be very soothing.

When to seek professional support

If panic attacks become frequent or more intense, it might be time to explore professional help. A therapist who specializes in working with older adults can provide tailored strategies to manage panic attacks and address underlying anxiety.

For those caring for a loved one, online therapy can be a convenient and accessible way to get the help needed. Services like Talkspace, which Medicare covers in most states, provide therapy tailored to the needs of older adults. Seeking professional support can make a significant difference in helping your loved one manage their anxiety and panic attacks.

If you or someone you know is struggling with panic attacks, reach out to Talkspace today to learn more about online therapy covered by Medicare. You don’t have to face it alone—professional support can help bring peace of mind and a sense of relief.