Parkinson's disease and depression
With the tragic death of actor and comedian Robin Williams last month, the national dialogue became filled with questions about Parkinson’s disease and depression. The connection between the two conditions, however, has a long history.
Over the past 15 years, symptoms beyond “movement” problems have become recognized in Parkinson’s disease. Many of the well-known symptoms of this condition such as tremor and mobility changes, have been known for decades to be related to declining levels of the brain chemical called dopamine. However, it is now recognized that other brain chemicals are affected as well.
s disease due to its effect on the brain chemicals serotonin and norepinephrine, which causes the mood changes to occur.
Additionally, especially for those with a previous history of mood disturbances, reactionary depression can occur as result of getting the diagnosis and dealing with the symptoms and the resulting life changes.
It is estimated from studies that about 40-50 percent of Parkinson’s disease patients have depression and or anxiety. Of that group, 10-20 percent have what can be classified as Major Depression, which is more severe.
At what point is a “down mood” something to be concerned about?
Any degree of depression or other mood problem in Parkinson’s disease is concerning as this can lead to decline in quality of life, social interaction and overall function, including a decline in motor function. However, depression that is persistent (more than occasional feelings of being blue), interfering with activities, appetite, nutrition, social interaction or family relationships, or causing feelings of hopelessness and thoughts of self-harm especially, need to be addressed in an aggressive fashion.
What steps can someone take to combat depression when living with a neurological disorder?
The best way to combat depression as well as decline in mobility in Parkinson’s disease is to stay active and exercise daily. Activity and aggressive exercise enhances the release of brain chemicals that can improve mood. Getting involved in regular activities, and continuing occupational and family responsibilities – even if some adaptation has to be made for changing mobility – helps maintain a sense of self-worth and independence.
It is also important for family members and care partners to avoid doing “too much” for a person with Parkinson’s disease. Being supportive and offering help where needed is important, but not encouraging and allowing the person with Parkinson’s disease to do chores and self-care can quickly create a sense of dependency and decline in a worthwhile identity.
Additionally, depression is less likely to occur if good nutrition, adequate hydration and proper sleep patterns are maintained.
As a caregiver, what should one look out for as warning signs for depression?
- Decline in social interactions or desire to leave the home
- Discontinuation of enjoyable activities, becoming more sedentary with less motivation for activity (though can be seen in Parkinson’s disease in general as well)
- Vegetative signs such as decline in verbal output, slower thought processing, sleeping more or new insomnia and weight loss may be signs of mood disturbance
- Frank statements of feeling hopeless about life and disease treatment, as well as comments regarding self-harm or suicide should be addressed on an urgent basis
If you are interested in learning more about depression and Parkinson’s disease, there are a number of online resources with more information. These include: The National Parkinson’s Foundation, the American Parkinson’s Disease Association, the Parkinson’s Disease Foundation and the Michael J. Fox Foundation.