Parkinson’s disease is a progressive neurological disorder that affects movement and can lead to a variety of physical and cognitive symptoms. While tremors, stiffness, and difficulty with movement are often associated with Parkinson’s, many people with the disease also experience depression and anxiety early on. In fact, research shows that depression and anxiety are often the first signs of Parkinson’s, and can precede motor symptoms by several years. In this article, we’ll explore the link between depression, anxiety, and Parkinson’s disease, and how understanding this connection can help with earlier diagnosis and management of the disease.
Parkinson’s disease is a progressive nervous system disorder that affects movement. While the disorder is often associated with physical symptoms, such as tremors, rigid muscles, and impaired balance and coordination, it is also linked to mental health conditions, such as anxiety, depression, and apathy. Despite the prevalence of these conditions in those living with Parkinson’s, only 2% receive referrals to mental health professionals.
Vikas Channin, a 45-year-old man who was diagnosed with Parkinson’s disease in February 2022, experienced depression, apathy, and cognitive impairment before his diagnosis. Initially, Channin attributed these symptoms to his mobility challenges, such as prolonged stiffness and pain in his legs that made it difficult to walk. However, after his Parkinson’s diagnosis, he learned about the disease’s connection to mental health conditions and realized that the mental health symptoms he had experienced were part of the disease itself.
Research indicates that up to 50% of people with Parkinson’s disease will experience depression, up to 40% will experience anxiety, and about 40% will experience apathy. The Parkinson’s Foundation attributes mental health challenges to changes in brain chemistry caused by the disease’s degenerative impacts on dopaminergic pathways. As dopamine levels decrease in the brain, individuals may experience depressive, anxious, or apathetic symptoms ahead of or alongside of a Parkinson’s diagnosis, which could be the earliest signs of the disease.
However, data from the Parkinson’s Foundation Parkinson’s Outcomes Project showed only a 2% referral rate to mental health professionals, as well as potential underdiagnosis and undertreatment of anxiety and depression in those living with Parkinson’s. To address this issue, the foundation recommended assessing, talking about, and addressing the non-movement symptoms of Parkinson’s disease, such as depression and anxiety, to improve the quality of life for patients.
Channin, who continues to see a therapist on a regular basis, also uses several self-care strategies to manage his physical and mental symptoms, such as complying with medication prescribed to him, eating a healthy diet, engaging in exercise, prioritizing good sleep hygiene, practicing stress reduction, and socializing.
Parkinson’s patients and their families can also turn to resources, such as the Parkinson’s Foundation website, which provides expert briefings, podcasts, fact sheets, videos, and webinars, to gain additional support. Seeking care from a psychiatrist who understands Parkinson’s or collaborating with a neurologist is also recommended when taking medication for mental health conditions. Overall, prioritizing mental health is as important as physical health for those living with Parkinson’s disease.
It’s a cruel irony that the diseases which affect us the most are often the hardest to detect. As we’ve explored in this article, depression and anxiety can be warning signs of a much more severe condition: Parkinson’s disease. While it can be challenging to diagnose and manage such disorders, the good news is that there are treatments available that, aided by early detection, can make a significant difference in a Parkinson’s patient’s quality of life. It’s essential that we continue to raise awareness of these warning signs and take them seriously, both as individuals and within the wider medical community. By doing so, we can work towards better supporting those affected by Parkinson’s and improve the chances of early intervention, leading to better outcomes for all.
