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Anxiety Recognition and Treatment in People with Mental Retardation

For people with mental retardation, anxiety is a fairly common experience. Persons having virtually every type of mental retardation have been known to exhibit symptoms of anxiety and (in some cases) signs of an anxiety disorder.

This article will explore common causes of anxiety for mentally retarded persons, the most common forms of anxiety experienced, how anxiety presents in individuals with mental retardation, and the advisability of various treatment options.

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What is Causing the Anxiety?

Research has shown that those with learning disabilities tend to be more likely to suffer from anxiety than the rest of the population. Some of this comes from the parents, whose anxiety over parenting a mentally handicapped child can cause more anxiety for those that are struggling. Make sure you take my anxiety test to learn more.

But of course the biggest issue is simply the difficulty the child has in living in an increasingly stressful world. Living with mental retardation means that you can't grasp concepts like those around you. You feel like you can't fit in, you feel like you can't understand what's going on, and you feel like you can't cope with your own stresses and anxiety.

The world was not made for those with mental retardation and learning disabilities, and unfortunately that means that living with those conditions can be very difficult.

Other Causes of Anxiety

Mentally retarded persons may also react with anxiety to a variety of triggers. These include:

  • Environmental changes Moving to a new place or being somewhere for the first time can be startling and unsettling. The world becomes unfamiliar, while the familiar world and its comforts has been left behind, perhaps for unknown reasons. A new environment (and or the abandonment of an old one) offers plenty of reasons to feel anxiety, and may take some adjusting.
  • Side effects of medication While medication side effects can certainly be unpleasant physically, they can also sometimes be unpleasant emotionally. Not understanding why the side effects are occurring, but feeling abnormal sensations such as dizziness or headache, is liable to result in feelings of confusion and worry, if not panic.
  • Changing medications New medications always have surprises to offer, due to the fact that the body has become used to integrating one kind of chemical and must now learn to integrate a new one with a slightly different composition and effect. The different effect, and/or different side effects, can be anxiety-causing due to unfamiliarity and sometimes physical discomfort as well.
  • Depression - Feeling** **sad and not being able to control or change the feeling can cause emotional strain that results in anxiety. Anxiety can also lead to depression, however. Any type of change or struggle that causes depression may end up leading to some types of anxiety symptoms.

The real key here is change. Change can be hard for those with learning disabilities because change requires a lack of comforting routine and the need to re-adapt to surroundings that are hard to adapt to in the first place.

Common Forms of Anxiety: What to Look For

Ideally, you need to make sure that you're taking the time to monitor your those with mental retardation for anxiety. Remember there are different types of anxiety and different severities. Anxiety symptoms present differently depending on whether the person has mild, moderate or severe mental retardation.

  • Mild May describe feeling jittery or being on edge all the time.
  • Moderate to Severe Primarily behavioral symptoms such as irritability, restlessness or agitation.

Experts recommend that those with severe mental handicap be examined by multiple people to come to a consensus. The symptoms are generally similar, but moderate to severe mental retardation often have a very difficult time understanding the questions and verbalizing the symptoms. Adjusting the way the symptoms are communicated (through pictures, play, etc.) is beneficial, as is repeating them as necessary to recognize different answers.

Below is an overview of the most common forms of anxiety and the general symptoms associated with each.

Generalized Anxiety Disorder (GAD)

A person with GAD worries about everyday things to a degree that is disproportionate to the source of the worry, and is unable to control their anxiety.

SYMPTOMS: Seemingly constant nervousness. In those with mental struggles, they may complain of physical symptoms, be generally apprehensive, or express fears with no apparent trigger.

Panic Disorder

People who have a panic disorder experience severe recurring panic attacks, which are intense physical anxiety sensations that resemble a heart attack.

SYMPTOMS: Sudden, inexplicable nervousness often characterized by rapid breathing and/or shaking. Individual may express breathing issues, heart issues, or chest pains.


Agoraphobia is the fear of public spaces, which may be perceived as dangerous or disproportionately uncomfortable due to being "too crowded" or "too empty." It is often accompanied by an unwillingness to leave spaces perceived as "safe," such as the home.

SYMPTOMS: Refusal to leave home or comfortable space. This often co-occurs with panic attacks and may cause an extreme fear response when out of the home.

Post-Traumatic Stress Disorder (PTSD)

PTSD causes people to relive and/or avoid situations that remind them of traumatic experiences they have had in the past, which may involve, but are not limited to: sexual assault, serious injury or a near death experience.

SYMPTOMS: Reacting to mental or physical traumas from the past (which is to say, a month or more in the past) with nightmares, nervousness and/or excessive self-defense. Individual may also have a quick startle reflex, especially with loud noises or around things that remind them of the trauma.

Treatment Options for Anxiety

Behavioral management therapy should be the first course of action in helping a mentally retarded person overcome their anxiety.

As has already been noted, the effects and side effects of new medications can be unsettling and may actually worsen anxiety. For this reason, medicating anxiety in mentally retarded persons should be used as a last resort only when advised by your doctor or the mentally handicap individual's psychotherapist.

If further action is needed after behavioral therapy has been tried and not had the necessary effect, benzodiazepines may be used as anti-anxiety and anti-depressant medication.

Because of possible side effect of slowing the development of growing children, and the tendency of benzodiazepines to cause confusion, they should only be used in extreme cases (particularly if the anxiety sufferer is a child).

How to Prevent a Relapse

Abruptly stopping a medication that is not working or having problematic effects or abruptly switching to another should be avoided at all costs due to the fact that these actions may cause severe behavioral relapses.

A process called "cross-titration" should be followed instead. Cross-titration is the process of slowly decreasing the dosage amount of one medication while gradually introducing the new medication and keeping track of how well the patient is responding to it.

Increasing Mental Stability

Studies have shown that, at least in cases involving mildly mentally retarded adults, employed and/or socially active individuals were much less likely to experience severe anxiety.

It is important for any individual to be in regular contact with other people in order to learn and maintain appropriate behaviors and coping mechanisms in social situations.

Physical contact with other people has been scientifically proven to decrease stress levels by releasing the chemical "oxytocin" in the brain. Oxytocin is known as the "bonding" or "love" hormone. It is a fascinating substance that can not only heals physical wounds by reducing inflammation, but also has a role in healing "mental" wounds as well by increasing trust and lowering anxiety.

As with most people, mentally retarded persons who experience social bonding and physical contact that makes them feel accepted and loved on a regular basis will be happier, healthier and less prone to anxiety overall.

Your Anxiety and Treating Those With Mental Handicap

Individuals that were born with mental retardation also tend to pick up on the anxiety of those around them. If you're someone that suffers from stress and anxiety, you may want to make sure that you're taking the steps necessary to reduce your own anxiety so that the person in your care doesn't pick up on your emotions.

Take my free 7 minute anxiety test to find out more about some of these effective ways to reduce anxiety, and learn what you can do to be free of anxiety symptoms.

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Cooray, Sherva Elizabeth, and Alina Bakala. Anxiety disorders in people with learning disabilities. Advances in psychiatric Treatment 11.5 (2005): 355-361.

Lindsay, W. R., Clare Neilson, and Helen Lawrenson. Cognitive behaviour therapy for anxiety in people with learning disabilities. Cognitive Behaviour Therapy for People with Learning Disabilities (1997): 124-140.

Author: Micah Abraham, BSc Psychology, last updated Sep 28, 2017.

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