Parkinson’s disease (PD) is classified as a movement disorder, but in recent years, the non-motor symptoms, including mental health changes, have been acknowledged as components of the disease. At least 50% of people with PD experience depression and/or anxiety.

 

Identifying Anxiety and Depression

To determine whether you are experiencing mental health changes, ask yourself the following questions:

  • Have my sleep patterns, appetite, energy levels, or sexual function changed recently?
  • Am I more irritable and anxious than I used to be?
  • Do I experience physical symptoms, such as a racing heart, chest tightness, or rapid breathing?
  • Am I having difficulty concentrating?
  • Do I have motivation to engage with life?

If the answer to even one of these questions is yes, you may be experiencing depression and/or anxiety.

Depression and anxiety do not develop in all people with Parkinson’s, but are common symptoms of the disease. If you are experiencing symptoms of depression and/or anxiety, talk to your doctor.

 

Causes of Mental Health Changes

Mental health changes in PD can be caused by the reaction to your diagnosis, and to changes you experience as the disease progresses. It is normal to worry about your symptoms and wonder about the future. Depression and anxiety can also be caused by brain changes as a result of Parkinson’s disease itself. In addition to decreasing the amount of available dopamine, PD can affect other circuits and neural pathways that play a role in your mental health. In many cases, depression and anxiety precede the onset of physical symptoms of PD, particularly those such as tremor or rigidity, which finally lead to diagnosis.

 

Barriers to Diagnosis and Treatment

Depression and anxiety are treatable, but a number of factors can delay early diagnosis and treatment, such as:

  • Mental health concerns are stigmatized. Some people can feel embarrassed about what they are experiencing and ignore their mental health. Others may also deny being depressed or anxious.
  • Many healthcare professionals, including family physicians, are unaware that mood and anxiety disorders are part of PD. Depression and anxiety may thus go unnoticed and untreated.
  • The general public does not understand that changes in mental health are a result of PD, making these symptoms more difficult to discuss openly.
  • Some of the physical symptoms of PD mirror those of depression. For example, the lack of facial expression, fatigue, and slowed thinking processes can make someone appear depressed when they are not. As a result, the diagnosis of PD depression can be difficult.
  • Apathy is another common non-motor symptom of Parkinson’s, though it is separate from depression Ineichen & Baumann-Vogel, 2021). However, because apathy can also be present in depression, healthcare professionals unfamilar with PD may have a difficult time telling the two conditions apart.

 

Coping with Depression and Anxiety

Mental health problems can have a profound impact on your quality of life. They can also decrease your ability to respond positively to treatment. Left untreated, depression and anxiety can make self-management difficult, and hinder your ability to live a full and happy life with PD.

These symptoms may also keep you from socializing, exercising, and enjoying your usual hobbies. A variety of effective treatment options are available to help with depression and anxiety. Here are some important points to consider:

  • Depression and anxiety are real illnesses, and legitimate symptoms of PD that can and should be treated. An outside perspective is important. If your loved ones or physician suggest that you appear to have symptoms of anxiety or depression, be sure to take their concerns seriously, and seek help.
  • If you start taking medication for depression, remember that it may take several weeks before you feel better. Early side effects usually disappear as your body gets used to the new drug.
  • There are many types of medication for depression and anxiety. If the first one you try does not seem to be helping, ask your doctor about other options.
  • The support of friends and family is crucial during episodes of depression and anxiety. Do not hesitate to ask for help, even if just to set aside a time to talk to someone.
  • Counselling may help you monitor your mental health changes and provide you with support in establishing self-management strategies. Consider Parkinson Society BC’s free, short-term counselling. Learn more at www.parkinson.bc.ca/counselling
  • Exercise is a great mood booster. Consider incorporating a daily exercise routine into your life. If you need inspiration for PD-friendly exercises, consider taking a look at Parkinson Society BC’s event calendar, where a variety of exercise classes are posted regularly, and sign up for one that looks interesting! Visit www.parkinson.bc.ca/events to learn more.

 

Sources

Ineichen, C. & Baumann-Vogel, H. (2021). Deconstructing apathy in Parkinson’s disease: challenges in isolating core components of apathy from depression, anxiety, and fatigue. Frontiers in Neurology, 12. https://doi.org/10.3389/fneur.2021.720921 


Last updated: February 27, 2024