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Anxiety, Depression and Emotional Changes

Although Parkinson’s is classified as a movement disorder, it can affect people in different ways. Sometimes the emotional changes can be more troublesome than the motor changes, and can have a bigger impact on the day-to-day life of someone living with Parkinson’s.

Emotional changes that may be experienced include:


Anxiety and Depression

Many people living with Parkinson’s experience anxiety and/or depression at some stage during their illness.

Anxiety and depression can result from grief at being diagnosed with Parkinson’s and from loss of mobility and independence. They are also direct symptoms caused by the chemical changes in the brain that happen with Parkinson’s.

Some people living with Parkinson’s find feelings of anxiety and depression may fluctuate over the course of the day, particularly prior to taking the next dose of their Parkinson’s medication.

Often, the symptoms of Parkinson’s and depression can overlap, making diagnosis difficult. However, it is very important that mental health problems are identified and treated. With careful management, the symptoms of anxiety and depression can be treated along with other Parkinson’s symptoms.

Anxiety

Anxiety is a feeling of fear, nervousness or unease. It may bring on a particular response within your body such as a racing heartbeat, sweating, or feelings of breathlessness.

Usually, anxiety disappears when the situation changes, or if we get used to the situation or go away from it. However, some people become anxious for long periods and for no clear reason. This can make life difficult and may stop you from doing the things you want to.

Depression

Depression is more than just a low mood – it is a serious condition that has an impact on both physical and mental health.  Depression can be low, moderate or severe.

Depression involves intense feelings of sadness or low mood for long periods of time (weeks, months or years), sometimes without any apparent cause.


Useful Tips

  • Speak to your GP
    Your doctor may advise lifestyle changes, refer you to a psychologist or prescribe medication depending on your needs and the severity of your depression.
  • Ask for support
    The support of friends, family and professionals can help. You may want to call our Information Line on 1800 644 189 to speak to a member of our Health Team.
  • Look after your health
    Tempting as it is, eating comfort food and slumping on the sofa will only add to your negative feelings. Participating in regular exercise and maintaining a healthy diet will benefit your mind and body.
  • Relax
    It’s easier to say than do, but taking time out to relax in the bath, go for a stroll, read a book or just chat with friends can really help. Take every opportunity to give yourself a treat. It might be something as simple as enjoying a cup of tea or listening to a new CD, or it could be having a professional massage or a weekend away.
  • Start a journal
    Many people find it helpful to write down their thoughts and feelings. It can be encouraging to look back over the weeks and see how much you have moved forward.
  • Let yourself cry
    There will be some days when you just want to cry – and that’s OK. Recognise how you feel and let yourself express your emotions. Keeping powerful feelings bottled up tends to make things feel worse.
  • Laugh
    It may be difficult to find things to laugh about right now, but when you laugh your body releases its feel-good chemicals. If you like TV comedies, keep watching them, and allow your friends to tell you their latest corny joke.

The fact sheet ‘Parkinson’s disease, anxiety and depression’, jointly developed by beyond blue and Parkinson’s Australia, provides further information on anxiety and depression and how they can be managed in Parkinson’s.


Stress

Stress is a state of physical, mental or emotional strain or tension that can affect anyone at any stage during their life.

It is not unusual to feel stressed – most of us succumb to it at various times – but there are a number of reasons why stress worsens the symptoms of people with Parkinson’s.  Understanding why it occurs is the first step to overcoming it.  It is therefore important to learn stress management techniques to help reduce stress-related mental, emotional and therefore unwanted physical responses such as increased tremor, slowness of movement, freezing, speech and swallowing difficulties.

Parkinson’s and Stress

Dopamine, which is deficient in Parkinson's, is used by the body to produce adrenaline. Adrenaline needs to be produced in order for the body to cope with stress This explains why people with Parkinson's do not have optimum levels of stress controlling hormones (such as adrenaline and cortisol) which are needed to cope with physical, mental or emotional stress.

Sources of stress can be emotional and/or physical, for example dealing with life events like job loss or bereavement, difficulty coping with work, or day-to-day living tasks. Stress can also result from frustration about the adjustments or limitations that Parkinson’s may bring to your life; there could be a sense of loss of control.  All of these causes are quite understandable but with the right attitude, careful planning and lifestyle adjustments, many causes can be eliminated or their impact reduced.


Useful tips  

There are a number of ways to help reduce your stress levels.

  • Exercise
    Exercise is a great stress reliever that can help ease Parkinson's symptoms. It can reduce symptoms by increasing the body's mobility, which results in enhanced quality of life for those with Parkinson's. It also has emotional benefits by enhancing your mood. Some exercises that are beneficial for people with Parkinson's are tai chi and yoga, both of which improve balance and flexibility of the body.
  • Positive Outlook
    Your overall outlook can help reduce stressful feelings. If you try to keep your outlook positive and upbeat, your experience of uncomfortable Parkinson's symptoms will improve.
    You can do this by making sure that the condition does not define your existence and by focusing on other things in your life that make you happy.
  • Know your triggers
    Look for patterns of when you get stressed, and try and work around these. Be aware if there are particular triggers, or a particular time of day when you are more likely to get stressed.
  • Plan your day
    Learn to plan your day as much as possible to minimise stress. For example, plan outings when your medication is working well, and try not to schedule too many activities in any one day.  Learn what makes you happy and relaxed and schedule plenty of it in your life.
  • Peer Support
    Peer Support  provides the opportunity to talk to other people who understand exactly what you might be going through with Parkinson's and is a great way to relieve stress. It can greatly assist in coping, and allow you to exchange and get valuable information about Parkinson's and how to live with it.
  • Contact Parkinson's Victoria
    Speak to a member of our Health Team on 1800 644 189

Apathy

One of the other changes not related to movement that may affect people living with Parkinson’s is a symptom called apathy. Apathy is used to describe a lack of emotion or general lack of interest in things others might find interesting, or things you previously found interest in.

For people living with Parkinson’s, apathy will most commonly present as a general disinterest or indifference towards certain activities or people. In some people it might result in a lack of interest in previously enjoyed hobbies. When apathy is combined with fatigue, others might think the person is lazy and just not willing to participate in everyday activities. However, there is a valid reason why it occurs commonly in people diagnosed with Parkinson’s.

Apathy is different from depression. In people living with Parkinson’s apathy is directly related to the lowered dopamine levels in the brain. Dopamine is not only involved in coordinating movement; it is also involved in controlling the areas of the brain responsible for pleasure and motivation.

In many cases apathy can be more troubling for the family and/or carer, than it is for the person diagnosed with Parkinson’s. Despite the frustrations, family members and carers need to remain patient and be aware that apathy is directly related to the lowered dopamine levels linked with Parkinson’s. This symptom is beyond the person’s control.


Useful tips

Some of the ways to overcome the effects of apathy are:

  • Participate in regular exercise
  • Participate in social activities
  • Maintain good sleeping habits

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