Anxiety and Osteoporosis: Symptoms and Treatments

Brandi Jones MSN-Ed, RN-BC is a board-certified registered nurse who owns Brandi Jones LLC, where she writes health and wellness blogs, articles, and education. She lives with her husband and springer spaniel and enjoys camping and tapping into her creativity in her downtime.

David Ozeri, MD, is a board-certified rheumatologist from Tel Aviv, Israel specializing in arthritis, autoimmune diseases, and biologic therapies.

Though anxiety and osteoporosis are two different diseases, having both conditions is common. This article reviews each disease, how they impact each other, complications, diagnosis, treatment, and coping.

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The connection between anxiety and osteoporosis may seem unlikely, but they affect each other. The following is an overview of each disease and the relationship between the two.

"Fight or flight" is the body's natural response to danger or stressors. It activates the nervous system, telling it to make extra epinephrine (adrenaline). This prepares the body by increasing the heart rate, breathing rate, blood pressure, and blood sugar. Extra adrenaline can cause worry, dread, and physical symptoms such as nausea or shakiness.

Anxiety disorder (AD) occurs when this stress reaction lingers or is out of proportion. AD is one of the most prevalent mental disorders and is frequently linked to depression, phobias, and panic attacks.

Many of those with anxiety also have panic attacks, which can cause:

Osteoporosis causes bone thinning and deterioration. Bones have a honeycomb-type structure that allows bones to be strong yet lightweight. Osteoporosis decreases bone mass, leaving larger structural gaps and making bones more fragile.

Symptoms of osteoporosis include:

Though this is not a complete list, risk factors for osteoporosis include the following:

Chronic anxiety produces long-term physical, emotional, and behavioral changes. It can worsen chronic health conditions and disrupt the endocrine, nervous, and immune systems, leading to poor bone health.

Osteoporosis causes physical limitations. This may force someone to make unwanted lifestyle changes and can cause anxiety due to:

Complications of anxiety involve depression, substance abuse, insomnia, and isolation. Osteoporosis can lead to fractures and increased difficulty in healing from fractures.

Anxiety and osteoporosis share risk factors that increase the risk of complications, including:

Feelings of hopelessness, fear, and uncertainty are common effects of anxiety and osteoporosis. These feelings can cause a person to avoid following their treatment for either condition.

When anxiety is excessive or ongoing, talking with your healthcare provider is best. This is especially true when it keeps you from your normal activities or causes work, school, physical health, and relationship problems.

If you or someone you know is having suicidal thoughts, contact the 988 Suicide & Crisis Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one is in immediate danger, call 911.

For more mental health resources, see our National Helpline Database.

Mental health providers typically treat severe anxiety, but all healthcare providers may detect and manage anxiety. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) helps providers diagnose mental disorders.

Anxiety is diagnosed based on the duration and severity of symptoms, such as:

Healthcare providers use bone density tests to screen for and diagnose osteoporosis. This non-invasive, painless test uses a low dose of radiation to determine bone density and measure the amount of calcium and minerals in your bones.

Mental Health America (MHA) offers an online anxiety self-test based on the GAD-7 anxiety screening questionnaire from the American Psychiatric Association (APA).

If your screening results indicate anxiety, reach out to a healthcare provider. A healthcare professional can make an accurate diagnosis.

Anxiety treatment involves lifestyle modifications, medications, and psychotherapy (talk therapy). Osteoporosis treatment includes lifestyle changes, medications, and supplements.

Though this is not an exhaustive list, examples of common medications that treat anxiety include:

Abruptly stopping anxiety medications could cause withdrawal symptoms. It's essential to notify your healthcare provider before you stop taking them.

Osteoporosis treatment begins with lifestyle changes and supplements, such as calcium, vitamin D, magnesium, and omega-3 fatty acids. Post-menopausal women may receive hormone (estrogen) therapy to decrease osteoporosis risk. It may also involve the following medications:

Many anxiety and osteoporosis medications can be taken together safely. This includes Prozac (fluoxetine) and Fosamax (alendronate), two of the most commonly prescribed medications for each. However, some anti-anxiety medications can increase the risk of falls and osteoporotic fractures.

Osteoporosis medications, such as Fosamax (alendronate) and Actonel (risedronate), could increase the risk for depression and anxiety. This does not mean your healthcare provider won't prescribe these medications. But they may want to monitor you for unwanted side effects and interactions.

If you experience adverse medication effects, notify your healthcare provider immediately. They may suggest adjusting your treatment. For example, if you experience anxiety with Fosamax (alendronate), they may switch you to Reclast (zoledronate) or Prolia (denosumab), which are less likely to cause anxiety. There are multiple options, and sometimes it takes a couple of tries to find the right combination.

Psychotherapy helps treat mental health disorders or disease-related stress. Types of therapy include:

Treating anxiety and osteoporosis requires professional help. However, there are lifestyle changes you can adpot during treatment to help with anxiety symptoms, bone health, and your overall health.

Healthy lifestyle changes that may increase your sense of well-being and bone health include:

If you have osteoporosis, preventing falls is also very important. Though this is not an exhaustive list, here are some fall prevention tips:

Support groups are beneficial because you can interact with those in similar situations. Ask your healthcare provider about local groups or explore one of the following online mental health support groups:

Online osteoporosis support groups include:

Anxiety is normal for short, brief periods. It becomes concerning when these symptoms linger or are out of proportion. Osteoporosis is a bone disease that thins your bones and increases the risk of fractures.

Anxiety and osteoporosis share risk factors and have an impact on each other. Those with anxiety and depression are more susceptible to osteoporosis, and those with osteoporosis often experience anxiety.

Treatment for each disease is multifaceted and includes a combination of lifestyle changes, medications, supplements, and psychotherapy. Exercise, proper nutrition, and getting more fresh air are lifestyle changes that can decrease anxiety and increase bone health.

Anxiety disorders (ADs) and osteoporosis are not normal parts of aging. If you are coping with either, it's best to seek treatment from a healthcare provider while incorporating lifestyle changes that are within your control.

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Ng JS, Chin KY. Potential mechanisms linking psychological stress to bone health. Int J Med Sci. 2021;18(3):604-614. doi:10.7150/ijms.50680

By Brandi Jones, MSN-ED RN-BCBrandi is a nurse and the owner of Brandi Jones LLC. She specializes in health and wellness writing including blogs, articles, and education.