When you think of Parkinson's disease (PD), what likely comes to mind are the physical symptoms—tremors, stiffness, and slowness of movement. These are the visible signs of a disease that affects nearly one million people in the US alone. But there's another side to Parkinson's that often remains in the shadows, a side that doesn't always get the attention it deserves: the mental and emotional challenges.
If you or a loved one is living with Parkinson's, you may already know that it's not just the physical symptoms that are tough to deal with. The emotional rollercoaster, the anxiety, the creeping feelings of depression, and even cognitive struggles can be just as overwhelming, if not more so. These hidden struggles can make an already challenging journey even more difficult.
Yet, despite how common these mental health issues are for those with Parkinson's, they often go unspoken. It's easy to focus on what you can see—the shaking hands, the slow steps—but what about the things you can't see? The feelings of isolation, the fear of what comes next, the frustration when your mind doesn’t seem as sharp as it used to be?
Parkinson's disease is one of the most common movement disorders. It mostly affects your motor function, which includes your ability to control and coordinate movements. This disease occurs when certain nerve cells in a specific part of the brain called the substantia nigra start to break down or die.
These nerve cells are responsible for producing dopamine, a neurotransmitter that plays a critical role in coordinating smooth and controlled muscle movements. As the dopamine levels decrease, the ability to control movement becomes impaired, leading to the characteristic symptoms of PD, which include:
But beyond the hallmark motor function symptoms, you may also experience non-motor symptoms like:
These non-movement symptoms are common and affect the quality of life. In fact, according to the largest-ever clinical study of Parkinson’s by the Parkinson’s Foundation, depression and anxiety are the leading factors that affect the overall health of people living with the condition.
Depression, anxiety, cognitive changes, psychosis are all extremely common in Parkinson’s disease. Several large studies have revealed the magnitude of these symptoms. More than 50% of all Parkinson’s patients experience mental illness at some point in the disease. Sadly, studies have also shown that physicians often miss these signs, and even when they recognize them, they sometimes don’t treat them.
Many people experience grief or sadness when they get a diagnosis of a chronic condition like Parkinson’s disease. But depression is different. Unlike sadness which is temporary, depression lasts for weeks or months. Depression is a part of Parkinson’s itself, arising from Parkinson’s-related changes in the brain.
You may experience depression at any time in the course of Parkinson’s, even before diagnosis. And the depression symptoms may come and go. An older study found that people with a depression diagnosis were 3.24 times more likely to develop PD than those without. Another study established that depression might be an early sign or a risk factor for PD.
PD affects areas of the brain that produce dopamine, serotonin and norepinephrine – neurotransmitters that regulate mood, appetite, motivation and sleep. Experts believe that an imbalance in these chemicals is what contributes to depression. However, other factors such as negative thinking, social isolation, a history of mental health issues, severe stress, and the side effects of medications can also play a role in worsening depression.
Anxiety is another common mood disorder among people living with Parkinson’s. Like depression, anxiety isn’t just a reaction to your diagnosis but is part of the disease itself, rooted in the changes Parkinson’s causes in brain chemistry. About 40% of people with Parkinson’s also experience anxiety disorders, such as generalized anxiety disorder, social avoidance disorder, or obsessive-compulsive disorder.
These anxiety disorders can significantly impact your quality of life, making it difficult to cope with everyday challenges and potentially worsening the physical symptoms of Parkinson’s.
Psychosis, though less common than depression and anxiety, can be one of the most distressing mental health challenges associated with Parkinson’s. It typically manifests as visual hallucinations and illusions, where you might see things that aren’t really there or misinterpret visual information. Severe psychosis—characterized by delusions and significant behavioral disturbances—affects about 5% to 10% of people with Parkinson’s.
The goal of management of PD is to control the signs and symptoms for as long as possible while reducing the negative effect.
Counseling is a valuable tool in managing the emotional and psychological aspects of Parkinson’s. Your trained therapist who understands your medical history will help you navigate your feelings, develop coping strategies, and find ways to maintain a positive outlook. Therapy provides a safe space to express your concerns and work through the complex emotions that PD can bring.
Your doctor may also prescribe antidepressants or anti-anxiety medications like SSRIs and SNRIs. These help balance the chemicals in your brain, which can reduce the symptoms of depression and anxiety.
The most effective way to manage anxiety and depression in Parkinson’s is often a combination of counseling, medication, and lifestyle changes. Regular physical activity, maintaining social connections, and practicing relaxation techniques can all enhance the benefits of counseling and medication.
Coping with Parkinson’s disease is a journey. Some days are better than others, and that’s okay. Focus on taking one day at a time and be kind to yourself. Remember, managing anxiety and depression is a process, and you don’t have to do it alone.
Science 37 offers a clinical trial specifically for Parkinson's Disease. This trial provides an opportunity for individuals to participate in cutting-edge research that aims to improve the understanding and treatment of the disease. By joining, you can contribute to advancements in medical science while potentially gaining access to new therapies and support tailored to your condition. If you're interested in exploring this option, participating in a clinical trial could be a valuable step in your journey with Parkinson's.
