If you’ve noticed your anxiety getting worse as you’ve gotten older, you’re not imagining things. And you’re definitely not alone.

After 15 years as a psychiatric nurse practitioner working primarily with women over 60, I can tell you: anxiety in this stage of life is incredibly common—and widely misunderstood.

Many of my patients come to me frustrated because they’ve been told their anxiety is “just stress” or “normal aging.” Some have been dismissed by doctors who chalk up their symptoms to being “worried about getting older.” Others have been handed a prescription for benzodiazepines without any explanation of why their anxiety suddenly appeared or worsened after 60.

The truth is more complex—and more hopeful. Anxiety after 60 has specific, identifiable causes. And once you understand why it’s happening, you can address it effectively.

Why Does Anxiety Increase After 60?

There’s no single reason anxiety tends to worsen with age. Instead, it’s usually a combination of biological, psychological, and life circumstance factors that converge in your 60s and beyond.

Hormonal Changes

Even years after menopause, your hormones continue to shift. Estrogen and progesterone—both of which have calming effects on the nervous system—continue to decline throughout your 60s and 70s. This ongoing hormonal change can make your brain more reactive to stress and more prone to anxious thoughts.

Additionally, cortisol (your stress hormone) tends to increase with age, while DHEA (which buffers stress) decreases. This creates a neurochemical environment where anxiety can flourish.

Medication Side Effects

This is one of the most overlooked causes of anxiety after 60. Many common medications prescribed to older adults can trigger or worsen anxiety as a side effect.

Blood pressure medications (especially beta-blockers), thyroid medications, corticosteroids, some heart medications, and even over-the-counter cold medicines can all contribute to anxiety symptoms. If your anxiety appeared or worsened after starting a new medication, this connection is worth exploring with your doctor.

Health Concerns

Chronic health conditions become more common after 60—and so does the anxiety that often accompanies them. Heart disease, diabetes, thyroid disorders, and respiratory conditions can all cause physical symptoms that mimic or trigger anxiety.

Sometimes what feels like anxiety is actually a symptom of an underlying health issue. And sometimes the health issue itself creates legitimate worry that manifests as anxiety.

Life Transitions

Your 60s often bring significant life changes: retirement, children leaving home, becoming a caregiver for aging parents or an ill spouse, losing friends or loved ones, changes in financial security, or health challenges of your own.

Any one of these transitions can trigger anxiety. Multiple transitions happening close together can be overwhelming for anyone’s nervous system.

Sleep Disruption

Sleep problems and anxiety create a vicious cycle. Poor sleep makes you more anxious, and anxiety makes it harder to sleep. After 60, sleep architecture naturally changes—you may spend less time in deep sleep and wake more frequently during the night.

This sleep disruption alone can significantly increase anxiety, even if nothing else in your life has changed.

How Anxiety After 60 Is Different

Anxiety in older women often presents differently than it does in younger people. This is one reason it frequently goes unrecognized or misdiagnosed.

Physical Symptoms Dominate

While younger people with anxiety often report feeling “worried” or “nervous,” women over 60 more commonly experience anxiety as physical symptoms: heart palpitations, shortness of breath, digestive issues, dizziness, muscle tension, or fatigue.

These physical symptoms can lead to extensive (and expensive) medical workups looking for heart problems, lung issues, or other conditions—when the root cause is anxiety.

Worry About Health

Health anxiety becomes more common after 60. Every new ache or pain can trigger fears about serious illness. News about a friend’s diagnosis can send you into a spiral of worry about your own health.

This is understandable—health risks do increase with age. But when health worry becomes consuming or prevents you from living your life, it’s crossed into anxiety territory.

Nighttime Anxiety

Many women over 60 experience their worst anxiety at night. Racing thoughts at 2 AM, catastrophic thinking about the future, replaying conversations or worrying about loved ones—these nighttime anxiety spirals are exhausting and can severely impact sleep.

What Actually Helps Anxiety After 60

Here’s the good news: anxiety after 60 is highly treatable. The key is finding approaches that work with your body’s current needs, not against them.

Get a Thorough Medical Evaluation

Before assuming your anxiety is “just anxiety,” rule out underlying medical causes. Request thyroid testing, check your blood sugar, evaluate your heart health, and review all your medications with a knowledgeable provider.

Address Sleep

Improving sleep often dramatically reduces anxiety. This might mean addressing sleep apnea, adjusting medication timing, creating better sleep habits, or treating insomnia directly.

Learn Nervous System Regulation

Your nervous system can learn to calm itself—but it needs practice. Techniques like diaphragmatic breathing, progressive muscle relaxation, and gentle yoga can help regulate an overactive stress response.

Consider Natural Approaches

Certain herbs and supplements can support anxiety relief safely. Passionflower, lemon balm, chamomile, and magnesium have evidence supporting their use for anxiety—and they’re generally safe for older adults when used appropriately.

Move Your Body

Regular physical activity is one of the most effective anxiety treatments available—and it doesn’t require intense exercise. Walking, swimming, gentle yoga, or even gardening can significantly reduce anxiety symptoms.

Seek Professional Support

If your anxiety is significantly impacting your quality of life, consider working with a mental health professional who specializes in older adults. Cognitive behavioral therapy (CBT) is highly effective for anxiety at any age.

You Don’t Have to Live This Way

Anxiety after 60 is common, but it’s not inevitable. It’s not “just how things are now.” And it’s certainly not something you have to accept as your new normal.

Understanding why anxiety increases with age is the first step toward addressing it. The biological, psychological, and circumstantial factors that contribute to anxiety after 60 are all things that can be managed, treated, or improved.

You deserve to feel calm in your own body. You deserve to sleep peacefully at night. You deserve to enjoy this stage of life without constant worry stealing your peace.

It’s possible. I’ve seen it happen hundreds of times in my practice. And it can happen for you, too.

Want to learn more? Download my free guide 7 Nights to Better Sleep to start addressing one of the most common triggers of anxiety after 60.

Read next: Breathing Techniques for Anxiety: A Nurse Practitioner’s Guide for Women 60+