Parkinson’s disease is a condition that affects nerve cells in the brain, which then impacts the way a person moves. But is there a link with depression?
Someone with a diagnosis of Parkinson’s disease may have trouble moving. Parts of their body may start shaking, their body and muscles may feel stiff, and they may move more slowly than usual.
Many people experience sadness or grief when they receive a diagnosis of a serious condition such as Parkinson’s disease. In some cases, depression can occur.
Depression is a mood disorder that can affect a person’s ability to carry out daily activities. At least 50% of people with Parkinson’s disease have depression at some time during their illness, and around 40% experience anxiety. This appears to be distinct from feeling sad about the diagnosis.
Doctors consider depression a symptom of Parkinson’s disease in the same way that involuntary shaking is a symptom. Both appear to stem from changes in brain chemistry.
It found psychological symptoms of the condition might have more of a negative impact on a person’s overall health than physical ones.
Depression in Parkinson’s disease can result from:
- psychological factors, such as social isolation and fear
- biological factors, such as changes in brain chemicals and a history of mental health issues in the 2–5 years before diagnosis
- environmental factors, such as stress and the adverse effects of medication
Parkinson’s disease affects the production of dopamine, norepinephrine, and serotonin in specific parts of the brain.
All these chemicals play a role in mood, energy levels, sleep, motivation, and appetite. Low levels of these chemicals can affect a person’s mood and may lead to depression.
In addition, dopamine helps regulate the way a person moves. Reduced dopamine leads to the physical symptoms of Parkinson’s disease.
Depression may appear before the physical symptoms of Parkinson’s disease become noticeable.
An older study from 2013 found that people with a diagnosis of depression were
In 2015, further
Scientists at The Michael J. Fox Foundation believe that decreased serotonin levels in the brains of people with Parkinson’s disease cause depression. The research to prove this link is ongoing.
The physical symptoms of Parkinson’s disease
- uncontrollable shaking, or tremors, in parts of the body, especially the arms, hands, legs, head, and jaw
- stiffness in the body and muscles, including prolonged muscle contractions
- moving more slowly than usual
- trouble balancing and coordinating movements
People with a diagnosis of Parkinson’s disease may also experience depression and anxiety.
Symptoms of depression include:
- ongoing sadness lasting for more than
- feeling hopeless or like everything is pointless
- feeling guilty, self-critical, or worthless
- not enjoying activities that were once pleasurable
- crying for no reason
- trouble sleeping or sleeping too much
- finding it very hard to get up in the morning
- eating too much or too little
- feeling very tired and lacking in energy
- thinking about death, disability, or self-harm
- feeling less able to do daily tasks, such as showering or doing housework
Symptoms of anxiety include:
- persistent worrying
- feeling restless
- feeling a sense of dread
- trouble concentrating
As it is common for a person with Parkinson’s disease to experience depression, their doctor will often ask questions about this when discussing their condition.
If a person with Parkinson’s disease experiences symptoms of depression, and their doctor has not already asked about it, they should raise it themselves. An individual might feel like signs of depression are a sign of weakness, but this is not the case.
Even so, a person may find it difficult to talk about changes in mood with their doctor. If this is the case, they may find it helps to bring a close friend or family member to appointments to talk about it for them.
Other barriers to diagnosing depression relating to Parkinson’s disease include the following:
- Symptoms can overlap, for instance, slowness of movement and sleep problems.
- Parkinson’s can affect a person’s ability to make facial expressions, which can mask their emotional state. For example, their face may not show signs of the sadness they feel.
- The individual may find it hard to distinguish between mood changes and the symptoms of Parkinson’s or other related factors. This can cause delays in seeking help.
Discussing both the physical and psychological symptoms of Parkinson’s disease with a doctor is essential so they can prescribe the right treatment.
Discussing feelings with friends or family may also help a person decide if it is time to ask for help.
Learn more about facial masking and Parkinson’s.
The following treatments may help people with Parkinson’s disease manage depression.
A doctor may prescribe one of the following:
- selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac) or sertraline (Zoloft)
- serotonin and norepinephrine reuptake inhibitors (SNRIs), for instance, venlafaxine (Effexor)
- other anti-depressants, such as bupropion (Wellbutrin)
Drugs can interact, and not all options suit everyone, so the doctor will work with the individual to find the best drug or combination of therapies for them.
Other options that may help include:
- complementary therapies
- gentle exercise
- individual or family counseling
- cognitive behavioral therapy
- electroconvulsive therapy, if other treatments do not help
Here are some lifestyle tips that people may find useful:
- planning small goals to achieve each day
- seeing friends and family or speaking on the phone
- trying to keep up with leisure activities
- reading about depression and trying to talk with close friends or family about it
Here are some answers to questions people often ask about depression and Parkinson’s disease.
Does Parkinson’s disease make you depressed?
According to the Parkinson’s Foundation, over half of those with Parkinson’s disease also have depression. Parkinson’s disease and depression appear to stem from similar changes in brain chemicals.
Why do people with Parkinson’s disease get depression?
A diagnosis of any serious disease can lead to feelings of sadness and sometimes depression because of the impact the condition may have on their life. However, with Parkinson’s, physiological changes in levels of dopamine and serotonin may play a role.
How does Parkinson’s affect mental health?
As well as depression, around 4 out of 10 people with Parkinson’s disease experience anxiety. Parkinson’s can also affect a person’s ability to think and remember things. In time, dementia and hallucinations can
It is common for a person with Parkinson’s disease to experience symptoms of depression. It may stem from some of the same brain changes that cause the physical characteristics of Parkinson’s disease.
Depression can have as much of an impact on someone’s life as the physical symptoms of Parkinson’s disease. Addressing this aspect of the disease can help make it easier to live with Parkinson’s.
A doctor can help the individual find treatments for managing depression.
For this reason, it is crucial to discuss any symptoms of or concerns about depression with a doctor.