Generalized Anxiety Disorder (GAD) is probably the most common mood disorder in older adults – more common than Depression. Anxiety, a form of worry with nervous system responses (sweating, palpitations, abdominal discomfort, trembling, and an impending sense of doom) is a normal experience along the spectrum of fear. It’s an extension of what we might experience if we found ourselves face to face with a saber-toothed tiger – less of the felid, of course.
I have experienced anxiety of this type for over two decades. It is unpleasant but not disabling. It has specific triggers. One of them is physical constraint – think claustrophobia. Another is fear of heights – think flyovers that are part of spaghetti ball highway interchanges.
I remember a gentle fellow at the VA outpatient clinic where I practiced decades ago; he confided in me that he could not visit his offspring in a nearby exurb. He said that when he drove over highway overpasses, he had overwhelming anxiety. I nodded sympathetically. I did not dare admit that I myself experienced similar dread driving on flyovers.
I listened to my patient; I explained that his feelings were common in people of his age (he was 20 years my senior at the time), and I gave him a prescription. What did I prescribe? Often, docs prescribe so-called anxiolytic medications. I did not. I prescribed driving only along the highway access roads. How did he do? I cannot say, it was decades ago.
I have dealt with my own anxiety symptoms by facing an upcoming flyover with a recitation of, “It’s just a fucking road,” as I negotiate the structure. I suppose that it is a bit like Frank Herbert’s quote in DUNE, “I must not fear.” I used something similar when I was placed in an MRI and subsequent CT-scan machines last year when I had a stroke. “I must not fear; it will be over soon, and the anxiety will have passed.”
Like driving on the access roads to avoid overpasses, these self-care measures work for mild GAD. Those with more severe symptoms probably need a doctor smarter than me.