My mom has anxiety attacks that come on unprovoked out of nowhere, but the doctor wants to keep her off medication. What can we do?

It sounds like it's time to change doctors. The best would be a geriatric psychiatrist or gerontologist who can prescribe medication for her anxiety attacks. They're far more familiar with how to treat them because of their knowledge of the chemistry of the brain especially in the elderly. Help is out there for her. And besides making everyone else anxious she's miserable when she's having these attacks. She deserves relief and so do you.

Wife has FTD late stage. Reacts to percussive noises, even coughing sneezing, nose blowing. Attacked a busdriver, drew blood, attacked a daycare director, drew blood, attacked the aids trying to take vitals in geri/psyche unit. Team of university physicians didn't recognize FTD at the time and tried Alzheimers and behavioral Rx. All had no affect on symptom and had severe adverse physical effect. 2 years later. Cannabis edibles. Life is good for her and us. Improvement continues long past the medication disperse. We were never partakers of even alcohol, so it was foreign to us, but it works so well.

In an earlier post I said I was thankful for my mom's magic pill because it has really helped with anxiety and sundowners. That pill is depakote. However, we did not arrive at this point until going to geriatric phych. Hospital. It took trial and error and being in the hospital under close observation. She also cannot take adivan because it seems to really mess her up and she needs her balance. We also tried all kinds of holistic approaches before this pill because of her b.p. issues. She also is in the middle of Alzhimers so she couldn't remember any more tricks to help her calm down. I too don't like these meds but they help. If my mom had not had her fall then she would not have been in the hospital and skilled nursing unit and then been sent to phych.hospital. Our situation be just like yours now. There are so many variables to each person's medical problems that I still think a geriatric doctor would be a great next step. Life is so much better now for both of us.

Funny you mentioned the "I'm constipated" my mother thinks she's constipated everyday. I was beginning to think I was the only one with a mom who complains of this nonexistent problem!
The anxiety is a major problem too doc gave her Zoloft it helps a little
Best of luck to you

You do have to be more careful in what types of medications you provide for older adults. Often the doctors I work with recommend avoiding Benzodiazepine medications that are tranquilizers (lorazepam ect) . They work by putting the whole brain to sleep. This can work well if you are younger and fully intact cognitively but for older adults there are several downsides. If your brain is already working hard and is anxious due to some kind of cognitive impairment Benzos can have a paradoxical effect making people more anxious. They also lead to more falls due to the sedative effects. My doctors will usually try more traditional SSRI type medications (trazodone, and buspar are popular). They can take longer to work into the system but they are way safer. The answer shouldn't be to ignore the symptoms because you don't know how to treat them appropriately. A geriatrician or geriatric psychiatrist are usually your best bet for safe and effective treatment of complicated cases like this.

Goodness, try another doctor. Your poor mom shouldn't have to cope with anxiety at all. A good Physician would take the time to evaluate your mother's needs and find something that allows her to feel calm and cared for. 

That is interesting -- CBT in lieu of meds for anxiety. And talk therapy? Maybe. However, she is just way too perfect to need anything like THAT (according to her). And as for my part, I'm really not interested in taking up my time in hauling her around to psychologists. She said the other day that her doctor (I'm not allowed to go in with her) said something about balance/walking therapy. Well, that will have to be cleared through ME, as I'm the taxi driver. My mother has been through balance therapy (and I don't think she'd be interested in doing it again). I'm all for any therapies she can get, as long as *I* don't have to get involved. They can all do home therapy.

(I'm one of the ones who has been forced into caregiving. I don't do much other than drive, and I've put strict boundaries on that -- which my mother wasn't happy about at first. She isn't very grateful, and finds fault with so much of what I do. On the other hand, my Golden Boy brothers rarely come to visit her, and they can do no wrong....particularly the one who rarely calls her, doesn't even send a card for her birthday, and one time didn't come to see her and my father when he was alive for FIVE YEARS.)

I'm not big on prescription drugs if there is another way. With that being said, my mom does have dementia and so she is on several drugs for that. However, they have not been able to give her anything to help with her anxiety which ultimately leads to panic attacks. Most of the drugs used causes issues with sodium and we already have an issue with her sodium. So I tried essential oils and that seems to help tremendously. Specifically, I have used Serenity oil behind her ears and on her chest right below her nose and I can actually see her whole body settle down. As with anything with dementia, what works now may not work later. But if your mom is not dealing with dementia, you might want to try the essential oils and see if she can get any relief. At least there is no harm in trying. Good luck.

I agree with Farmerswife that cognitive behavioral therapy could be quite effective. Learning some breathing techniques can control attacks without medication. Did the doctor suggest that? Refer you to a service that would provide this?

At issue here is whether WillyB's mother would benefit from learning some breathing techniques, having some talk therapy, etc. My mother, with dementia, might be able to learn them but would never have remembered them when needed. Maybe if someone was with her to coach her through it it would help. My husband, with dementia, could have learned it but would probably not remember in a moment of panic. A friend who has bipolar disorder but no cognitive impairment using breathing and imaging techniques all the time. If he feels an attack coming on when he is driving he pulls over and does the exercises until it passes. A young woman I know has some generalized anxiety and was going into panic attacks over the death of her brother. Her daughter talked her through each episode (and handed her a teddy bear!)

WillyB, I don't know if this would help your mother or not. If she doesn't have dementia or is in early stage dementia it might be worth investigating. Even if she couldn't remember herself, if she is with people who could talk her through it that might work.

As I have already posted, I don't object to drugs when they can help someone out of mental anguish.

(I have only had one panic attack in my life, and that was one too many. It is a dreadful experience.)

If your mom's doctor will not prescribe medication at this point when her panic attacks are severe, first find out if he is an elder care/geriatrics medical doctor, you need to find one who is. If he is a geriatrics doctor, read online about him and his reviews. If reviews are good, call him and discuss the matter and her need for medication. No need for an appointment. If reviews are bad, find a new doctor. If he refuses to help you mom, find a new doctor.

There is a flip side to anxiety meds. My MIL, age 90 and living with us, became very dependent on them, hoarded them, and engaged in med seeking behavior when she went to various doctors. She had paradoxical reactions, with increased anxiety, insomnia, and auditory and visual hallucinations. She was descending rapidly into what appeared like dementia. It also affected her balance and her falls became much more frequent. After a doctor consult, I took them away from her and tapered her off them. She has been a whole different person. Normalized day and night schedule, much more energy and engagement, and the dementia symptoms practically disappeared.

Cognitive behavioral therapy is quite effective in reducing anxiety, and would be a good place to start before psych meds.

There's a flip side to anxiety medication. My MIL (90) took benzodiazepines for years, and not only did she become increasingly dependent/tolerant, she had paradoxical reactions. Her anxiety increased, rather than decreased, she began showing signs of rapidly advancing dementia. She was abusing her meds. I took them away, didn't lett her self-medicate, and started tapering her off. Suddenly, she's a whole different person. Alert, oriented, much more active and engaged, and more like herself than she has been in years. Cognitive behavioral therapy is a very effective way to control anxiety and would be worth a try first, before setting sail on the psych pharmacopia sea.

I was at the beach last month. I Mentioned my husband has beginning Alzheimer's. Two women said when he gets anxious to try Marijuana. I have absolutely no experience with it. Some younger people said it might work and the modern stuff sold in stores is geared to various medical problems. I am in California and it is legal. Does anyone have experience with it? I keep trying to be prepared, even though I know it is a losing game.

Someone mentioned Xanax, My doctor told that someone in their 80's isn't supposed to take it. She put me on Buspar. I usually only take it at night when I feel overwhelmed.

I agree with BarbBrooklyn. My Mom is on the first two meds. Its not fair to ur Mom. My Mom has always had to be on the move but lately its been worse. She can't just sit for a visit. She would start to get mad because she couldn't be on the move. Then she started to hum and she would get louder and louder and then all day long. Shecwas just put on Lexapro. She is now quieter. Still can't communicate. Also, loss of appitite which I read is a side effect. Nurse told me it wasn't. My daughter, RN, says its now a quality of life thing. Being anxious all the time is not fair to them. I wentvto see her yesterday and she was sleeping at 4 in afternoon. Mom is 89 andvhas been going downhill since 2014. Its not goingvto get better.

Sunflo, my mother is a long way from being declared incompetent, because the bar for incompetency is so high. I expect that a fall (or stroke) will occur, and that will be the end of my mother living alone. In my mother's world, everyone is wrong but her, she knows more than the medical professionals, and me the local child doesn't really know what's going on and must be instructed in Every. Little. Thing.

She can't hear well, short-term memory is going, reasoning going, can hardly walk, can't see out of one eye, but oh she is the Expert on All Things.

When (if?) it gets to the point where she can be declared incompetent, I will not be the one who will be her guardian. That job I will leave to my Golden Boy brother(s) out of state. If it has to be someone in the same state, then I will demand a salary.

My question is : What exactly happens during her panic attacks? Does she show any signs of forgetfulness? What time of day do these happen? By all means Get another opinion and right away. My mother was showing signs of extreme forgetfulness, I told her physician, he did nothing. Due to him moving we changed doctors, her new doctor has her on meds for dementia. We no longer have to stay up all night to keep her safe. Only on occasion does she wake up frightened looking for the children, the kittens or her dad. Switch doctors. Mom's old DR traveled under, "at your age" just keep them pain free. GRRR.

CNNT55 - sounds like my story. My mom hated drs once she got older and wouldn't listen to anything that would constitute that she was no longer able to manage her affairs; PC, neurologist, geriatric psychiatrist..ironically not a one of them was willing to sign an incompetency either -- just kick the can down the road. I had to deal with mom living fiercely independently but lacking the skills to keep herself safe, healthy, and up to date on bills/taxes. Well 6 yrs down the road, a yr of social worker intervention and catastrophic event (flooded house) - finally able to get dr to sign incompetency (mind you without even seeing her) and got her placed.

I agree with others. I'm not a proponent of medication in elders after 90 -- but in the case of anxiety and fearfulness - then ABSOLUTELY, the dr should prescribe based on poster's description. What's the use in living if elder is terrified? Dr. should prescribe medication and see how mom is. Liver failure or other, I'd prefer to take a pill and not feel fearful, anxious and die early from liver disease than face each day terrified and anxious.

See another doctor and document your observations. I'm pretty certain they will prescribe something in addition to some behavior modifications suggestions to help your mom.

Good luck

WillyB, it looks like you have gotten some helpful responses. I hope they help. I can't imagine a medical professional refusing to treat anxiety. Mental distress is as painful as physical pain. I'd try to figure that out immediately and get answers from him or a second opinion, so your mom can get some relief. Please post about how it goes.

Find another doctor.

My DH, 96 yr, was suffering Panic Attacks and Depression and his GP wanted him on Zoloft but I fought it for a year - until they became too frequent. Now he is calmer and smiles again. If they don't "overdose," the Zoloft (or whatever) is a blessing to the patient.

I have mixed feelings about holding off for the year. The attacks weren't as frequent and he denied depression so we did what we thought best. But when I saw him sitting "hang dogged with his head down" I knew the time had come.

Find another doctor. Just question everything - the medicine used and the dosage. My DH is on half a pill or 50mg and he can function well.

When my friend for whom I am her POA became agitated in her memory care apartment and wouldn't let people clean her up after she soiled herself, I was told to take her to a geri-psych ward at a hospital to find a drug and dosage that would calm her down without doping her up. It took 3 1/2 weeks there before they had things going smoothly for her. They began with small doses of the most likely solution and slowly increased it. When it didn't work, they had to slowly decrease it before trying another one. She was under watchful eyes and happy people's care the whole time. I didn't even know such places existed that could do this, but the staff at her memory care facility did. They have given me such good advice--which I needed since these things are all new to me. Her husband continues to live there, too, after she passed away when her brain was just shutting down and she could no longer swallow. The staff is watchful and alert and can clue me in when changes occur. A doctor sees him once a month, so there is good medical care, too. This level of care frees me up to do the other tasks, like cleaning out their town home to sell it. There are no children or close relatives, so it's up to me. I don't have help, but I also have the freedom to make what I think are the best choices.

About "pills". My mother, who has Alzheimer's, cannot take pills. They must be ground up and fed to her with applesauce.

My mother (91) has always refused to take anti-depressants although it was recommended 10-15 years ago, especially after her husband died. In the last few years her anxiety & paranoia had accelerated to the point I realized I had to take over. This meant moving to her town, changing my and my husband's life. Just recently because of a fall, we moved her into AL and dit has been a life-saver. All said, she still had the anxiety attacks, sometimes I would have to go over in middle of night to calm her down. Her nurse who visits twice a week, finally recommended her taking Xanax. I watched her closely for side effects and mental problems. Within a week my mother was a different person; back to the sweet, thoughtful person she used to be. If she found she was taking Xanax she would not take it. So I try to keep the "name" from her. And a side benefit is I've been able to get off MY anti-anxiety pill I had started taking. It is a balancing act, I've had to stand up to her strong independent personality and insist on going in to doctor's visits with her, driving her everywhere, checking on her daily, many more things I didn't know I would have to do. It has calmed the entire family down in fact. Although she still complains about being in AL EVERY day, it is in a benign way now instead of anxious and attacking. Pray I can keep the Xanax a secret from her. I can't go back to the way she was.
PS: Also I bring her a vegetable smoothie twice a week to keep her bowels open and she loves the "treat".

My mom had a couple of weeks in a geriatric psych. Hospital. She was sent there from skilled nursing after a fall. As a family we were horrified. Who was this lady? Is that my mother? Finally received the medicines she needed and has been home now a couple of months. But last night I had to go spend the night. She was wild and looking for dead daddy and completely wound up. I discovered the remeron and depakote pills I gave her late afternoon were still on the table. My mistake for not watching her take them. We were wondering if this stuff was working. Well...YES! When this panic and anxiety is in full swing and sundowners going on, and you are this old, I think the relief with a pill is magic!

Heck, I would pipe his CD over the entire floor's sound system, it would do everyone a world of good to remain calm. Even the caregivers, but unfortunately, they would all have to be wearing headphones, if they contain "binaural" beats, only the sound therapy, containing only isochronic tones works without headphones.

I know this will sound like "woowoo" but I have anxiety, daily or twice daily I put on a set of headphones, and listen to a music that has been embedded with frequency that match that of a calm brain, it sort of entrains the mind to relax. SoundTrue I would back this therapy up anytime and anywhere. I am not affiliated with this. I happen to be in a bookstore, around 2009 and they had his Delta Sleep on sale, in CD form. Mind you, you must get compliance from the care providers to do this extra step. But well worth it.

Certain food additives, like MSG, can cause panic attacks. Your mom might try avoiding processed foods (packaged in cans, jars, bags, or boxes), because most of them have MSG and other chemicals. Indigestion due to low stomach acid can compound the problem. Your mom might do better if she takes a spoonful of apple cider vinegar in a glass of water before meals.

My Mom took ativan for anxiety. It seemed to work for her. but she also took other meds, antidepressents and stuff for LBD. Maybe you should find another Dr. It would be cruel to take her off meds completely. Anxiety attacks are no fun.

I think it's really a lot harder to diagnose anxiety, or memory loss, and some other aspects of older behavior, whether it's a parent or even ourselves. It's just not that clear cut. That's why I put emphasis on analysis.

Sometimes I read posts in which it sounds as if someone has aggregated a lot of terms and concluded the parent has a - c symptoms, or x - z symptoms. And sometimes the conclusions are very predictable, even if the circumstances don't fit.

I often wonder how much of what someone reads about older people and their conditions is really gathered from reading other posts as opposed to scientific, medical analysis.

Having observed that, I am not a medical professional and these are just observations from posts here, from a variety of people at different stages and comprehension of caregiving.

And I've also found that I sometimes experience strange symptoms and ask these questions of myself, especially in stressful times.

Analytical is my middle name, GA (and yes, I take it as a compliment!)

Look, I keep track of IQ points for a living. I did NOT recognize that my mom had lost any. Her doctor of many years treated her as "patient exhibiting some symptoms of anxiety" without investigating the causes.

One of the reasons I have such faith in geriatric psychiatrists is that over the years, we've gotten SUCH good advice from them. they seem to be the last MDs standing who actually consider the whole patient.

Barb: "She'd had a previously undiagnosed stroke which had essentially robbed her of her ability to prioritize, to reason and to see consequences (I'd be anxious too!)"

Barb, I think your approach was a very thorough one, investigating the situation and the options. And the information on the stroke made a significant impact on the decisions, at least in my opinion.

My impression of the OP's post was that none of the diagnostic work-up done for your mother had yet been done for the OP, and that she was at a point at she had not had the benefit of more investigative analysis of what her mother's condition was and why it was that way.

I've always thought that you had a particularly analytical approach to your mother's care (and that's a compliment.)