When facing a diagnosis of Parkinson's disease, it is understandable to feel anxious or depressed. But mood disorders such as anxiety and depression are real clinical symptoms of Parkinson's, just as rigidity and tremor. In fact, at least half of all Parkinson's patients may suffer from clinical depression at some point during the course of their disease, according to some estimates.
The good news: Over the past decade, researchers have placed increasing focus on investigating these aspects of the disease, and today we have a better understanding of how to treat mood disorders in Parkinson's and increase quality of life.
On this page you'll find up-to-date information from clinicians and researchers, as well as quotes from our Guide for the Newly Diagnosed, authored by Parkinson's patients themselves as a resource for those just beginning their journey with Parkinson's disease. We've also included various multimedia interviews with Dr. Irene Hegeman Richard, MD, of the University of Rochester School of Medicine and Dentistry and our Scientific Advisory Board, who has done extensive research into depression and Parkinson's disease.
"While depression and anxiety can be normal reactions to being diagnosed with a serious disease, clinical depression is real. These symptoms, if left untreated, are damaging at best and deadly at worst. Make sure you discuss depression and anxiety with your doctor. It is important to remember that clinical depression and anxiety are underdiagnosed in people with Parkinson's and that they are symptoms of your disease, not character flaws."
Depression can be seriously detrimental, and, for people with Parkinson's, it can affect long-term outcomes for the worse by hindering critical elements of an overall treatment regimen such as staying socially connected, exercising to manage motor symptoms, or being proactive about seeking care.
Be on the lookout for a lack of enjoyment in activities and situations that once brought you joy. Also pay attention to observations made by family and friends because you or your physician may not always recognize the signs of depression and anxiety. In fact, your physician may not even ask you about these conditions if you don't mention changes in mood or outlook.
Depression and anxiety can be treated with medications, lifestyle changes and therapy or counseling from a qualified practitioner. Support groups may also be source of help.
NOTE: If you are in crisis, call the National Suicide Prevention Lifeline at 1-800-273-TALK or visit www.suicidepreventionlifeline.org.
"Even within the past decade, quality of life for Parkinson's patients has greatly improved. The prospects for the next five to 10 years are even better."
Researchers believe that depression and anxiety in Parkinson's disease may be due to the underlying changes in brain chemistry and circuitry that are caused by the disease itself. In fact, depression in Parkinson's patients can start before motor symptoms even arise. The Michael J. Fox Foundation actively pursues research that can shed light on the connection between depression and Parkinson's, and lead to treatment breakthroughs for everyone living with the disease.
The same pathways that create dopamine in the brain -- which are impacted in Parkinson's disease -- also create the hormonal neurotransmitter serotonin. Serotonin regulates mood, appetite and sleep. If dopamine is like the motor oil to keep the body's systems controlling movement running smoothly, then serotonin is like the motor oil for a person's mood. Researchers hypothesize that the effect of Parkinson's on this system is responsible for the clinical symptoms of depression and anxiety. The Foundation is supporting research to clarify this relationship.
In April 2012, the Study of Antidepressants in Parkinson's Disease (SAD-PD), the first major clinical study testing common antidepressants in people with Parkinson's, found that some of these drugs can ease depression in Parkinson's patients without aggravating motor symptoms.* Needless to say, work closely with your physician before adding any drug to your Parkinson's treatment regimen.
"A Parkinson's diagnosis, although life-altering, is not a death sentence. Symptoms will change over time, as will your attitude; no one should expect, nor should you expect from yourself, that this will be easy to deal with. But people with Parkinson's and others alike should all value and make the most of every day. In a best-case scenario, a Parkinson's diagnosis can become a real wake-up call: a chance to re-examine your priorities, and focus not on what you cannot do, but instead, on what you can."
*A specific note on drug interactions: It is critical that patients with Parkinson's disease educate themselves and work closely with their physicians and medical team to understand potential drug interactions between antidepressants and Parkinson's treatments. The results of combining incompatible drugs can be serious.