Coping with depression in patients with Parkinson’s Disease

While everyone feels sad from time to time–depression is different. Sadness is temporary and doesn’t last very long, but depression lasts for weeks or longer. Studies indicate approximately 50 percent of people diagnosed with Parkinson’s disease also have a mood disorder like depression. In fact, many people have depression years before their other symptoms of Parkinson’s disease.

Parkinson’s disease is a progressive illness which targets brain cells in the specific area of your brain that produce dopamine, a chemical that helps relay messages from your brain to your body. The loss of brain cells that produce dopamine can cause you to develop a tremor and have difficulty turning thoughts about movement into action. What so many people don’t understand, is the loss of dopamine can also affect your mood.

What are the symptoms of depression in Parkinson’s patients?

Symptoms of depression in Parkinson’s patients aren’t different than in a person who doesn’t have Parkinson’s disease. Unfortunately, the physical symptoms of depression such as downcast eyes, slow speech, slower movement, and fatigue are a challenge to diagnose in someone with Parkinson’s disease because they are also symptoms of the disease itself.

It is important to be aware of these symptoms, so if you experience them, you can be treated quickly. Symptoms will differ from person to person and can range in severity from mild to severe. Common symptoms of depression include:

• Prolonged sadness

• Crying

• Loss of interest in activities and motivation

• Decreased attention to medical and health needs

• Feelings of guilt, self-criticism, and worthlessness

• Low self esteem

• Increased fatigue

• Change in appetite or eating habits

• Complaints of aches and pains

• Feelings of being a burden to loved ones

• Feelings of helplessness or hopelessness

• Sleep difficulties

• Thoughts of death or suicide

Depression can make the physical effects of Parkinson’s disease worse, so it’s important to recognize depression and talk to your doctor right away.

Treating depression in Parkinson’s patients

The Parkinson’s Foundation found that mood, depression, and anxiety have the greatest impact on the health status of a person with Parkinson’s disease, even more than the body movement impairments you may associate with the disease. That is why treating depression is so important–it can improve quality of life as well as body movement.

The first step is to recognize when to be treated for depression. Many people with Parkinson’s aren’t treated for their depression because they do not recognize they have a problem or are unable to explain what they are feeling. Ask a family member or a loved one if he or she has noticed any changes in your mood. It is also recommended you:

• Get screened for depression once a year

• Discuss mood changes with your doctor

• Bring a family member to doctor’s appointments to talk about your mood and potential depression symptoms

Fortunately, there are effective treatments for depression, however, some medications that treat depression can make motor symptoms worse. It may take some time to find the treatment that will work best for you and your particular symptoms, so work closely with your doctor. Like tremors and other motor symptoms of Parkinson’s disease, depression can be improved with medications.

Exercise is proven to have an effect on improving mood and depression, as well as help with mobility issues that go along with Parkinson’s disease. Simple activities such as walking, stretching, yoga, and Tai-chi can have a significant impact.

Maintaining a positive attitude is also important. Parkinson’s disease is a chronic disease, not a fatal one. Patients and their caregivers need to focus on not just the physical, but on the mental and emotional aspects of life. The right medications and the right support system can make living with Parkinson’s disease more manageable, especially early in the disease.

If you have Parkinson’s and are concerned about depression, ask for help and keep an open mind. Depression is a chemical imbalance in the brain, not a sign of weakness. It takes courage to talk about depression, but getting proper treatment can significant improve your quality of life.

Wenzhuan He, MD, neurologist with UPMC Susquehanna, received his medical degree from Beijing Medical University, Beijing, China.

and completed his Neurology resident training New Jersey Medical School / Rutgers University, Newark, NJ and his Fellowship training at Penn State Medical Center, Hershey. Dr. He sees patients at the Neuroscience Center in Williamsport. To learn more, call 570-321-2820.


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