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Anxiety and Stress Disorders

Extreme Anxiety

11/15/2007

Question:

My father is 75 and has just finished his 6th round of chemo for lymphoma. He also suffers from Parkinsons, and is on medication for it. During the night he is extremely anxious to the point of being violent, and cannot remain in any one spot (bed, chair, etc). for more than 5-10 minutes at a time. He needs assistance and is not strong enough to walk on his own. He is also "out of it" at night, saying crazy things, etc. He recovers a bit during the day, sleeping for an hour or so at a time. Any ideas in how to treat would be much appreciated.

Answer:

This is not a simple of case of anxiety.  In elderly people with serious illness, especially if there is cognitive decline (Alzheimer's, strokes, etc.), anxiety, especially at night, can be a serious problem.  Brain activity changes during the night, sleep is intermittent, sensory stimulation (light, sound, conversation, etc.) changes and all of these factors play into a brain that is no longer processing as it did when it was younger and healthier.

You would do best bringing in a geriatrician (a specialist in older people) to do a geriatric assessment as part of your father's care.  While a psychiatrist may be needed, you first need a thorough evaluation from a specialist in care of the frail elderly.

Good luck.

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Response by:

Nancy Elder, MD Nancy Elder, MD
Associate Professor
College of Medicine
University of Cincinnati