Wednesday, June 12, 2024

Anxiety And Parkinson’s Disease

How Can I Cope With Anxiety And Stress

Ask the MD: Depression and Anxiety in Parkinson’s Disease

Article written by Karl Robb.

It is not uncommon for the stresses of daily life feeling overwhelmed, under prepared and over stimulated to bring about anxiety and unrest. These psychological issues can be very important to your health, and even exacerbate the symptoms of Parkinsons disease. That is why it is so important to take a good look at what may be causing stress in your life and learn how to deal with the situations that give rise to anxiety.

Anxiety May Be Unique For Each Patient

Anxiety can result in a sense of dread, constant worrying, and difficulty concentrating. Many people also suffer from physical symptoms such as dizziness, sweating, and nausea. Each persons experiences may vary.

There are days when I am pushed to my limits and the smallest things set me off. I tend to scream, often at the top of my lungs, and stomp away. I usually have no control over these emotions.

Stress Management For Living Better With Pd

Someone once uttered the maxim, Everybody talks about the weather, but nobody does anything about it. If we apply that notion to stress we could say, Everybody talks about stress, but nobody seems to do anything about it. This seems particularly true when Parkinsons disease patients and their caregivers experience stress.

Stress is about more than wanting to escape the torment of a chronic illness. So often, Ive wanted to yell at everyone because of the stress the illness places on just simply living in peace. Any internal or external event that triggers a shift away from my homeostasis can cause stress.

My book, Possibilities with Parkinsons: A Fresh Look, was written from our perspectives on how to manage PD. In that book, I propose the idea of a Parkinsons spectrum that includes homeostasis dysregulation, and avoid the outdated classic presentation of doom that progression will always lead to the end of a good life.

In the book, I propose the idea that improved self-management of stress with PD is possible. Parkinsons stress is more than a fight or flight response because of the role the second dopamine center plays in moderating homeostasis.

Read Also: Parkinson’s Disease Stage 1 Symptoms

Anxiety And Parkinsons: Ask The Expert

Amjad explains that 31% of people with PD will have symptoms of anxiety. This blog post identifies the emotional and physical symptoms of anxiety and the factors that make it more likely someone with PD will experience anxiety. Treatment options include SSRI medications and psychological treatments, like CBT. The best coping strategy is to continue doing things that make us anxious, but in a way that allows us to feel in control. A few ways to do this are outlined.

How To Find Out If You Have Anxiety Or Depression

Anxiety with Parkinson

If you notice these symptoms, if friends and family members have seen changes in your mood, or if you just donât feel like yourself lately, talk to your doctor.

Your doctor or a mental health professional can tell you if you have anxiety or depression. Theyâll ask you questions about how you feel, mood changes, and symptoms that can be linked anxiety or depression.

To find a mental health professional, ask your doctor or loved one for a recommendation. If youâre part of a support group or know others with Parkinsonâs, ask them if they know someone.

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Anxiety And Parkinsons Disease

This 2-page fact sheet explains that there are four types of anxiety. It outlines the psychological and biological factors that contribute to feelings of anxiety, as well as how anxiety is diagnosed and treated with both psychotherapy and non-conventional therapies. Tips for living with anxiety are also outlined.

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Mood Changes In Parkinson’s

When faced with a diagnosis of Parkinson’s disease , it is understandable to feel depressed or anxious. But mood disorders such as depression and anxiety are clinical symptoms of Parkinson’s, just as are slowness of movement and tremor. In fact, up to half of all people with Parkinson’s may suffer from depression and/or anxiety at some point during the course of their disease. Like all symptoms of PD, mood changes are different for different people. Some people with depression feel sad and lose interest in things they used to enjoy, while others feel irritable and have difficulty sleeping. People with anxiety often feel overly worried or concerned, or say they are “on edge.”

The good news: Over the past decade, researchers have placed increasing focus on these aspects of PD, and today we have a better understanding of how to treat mood disorders in Parkinson’s.

Parkinsons Disease And Anxiety: Why Does Anxiety Happen

Depression & Anxiety in Parkinson’s and How to Manage Them

People with Parkinson’s disease experience a number of different symptoms. As well as tremor, rigidity and slow movement, many PD patients feel depressed or anxious and struggle with the emotional impact of their illness.

Around 31% of people with Parkinsons disease will experience significant symptoms of anxiety. Those with early-onset Parkinsons are thought to have a higher risk of developing anxiety than older patients. Its unclear whether this occurs due to chemical changes in the brain, Parkinson’s medication side-effects or a combination of social, environmental and genetic factors, though scientists are devoting more research to this area.

According to Richard Brown, Professor of Neuropsychology and Clinical Neuroscience at Kings College London:

Anxiety, like all behavior and emotion, is ultimately controlled by our brain. Anxiety is related to a complex set of brain areas and chemicals, many of which are affected in Parkinsons.

There is no cure-all treatment for anxiety stemming from Parkinson’s disease because the cause of anxiety in PD is difficult to determine. If you experience anxiety with Parkinson’s disease, your doctor will suggest appropriate treatment that takes all of your PD symptoms into account.

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Treatment For Anxiety And Depression

Your doctor might suggest medication, talk therapy, and lifestyle changes like exercise and social activities. Many doctors find that a combination of treatments works best.

Everyoneâs different, so the doctor will base your treatment on your needs. Be patient. It may take time to figure out what works best for you.

Your doctor can prescribe antidepressants like SSRIs, SNRIs, or benzodiazepines, which are anti-anxiety medications. They might adjust the levels of your Parkinsonâs medications to see how it impacts your mood.

Talk therapy, which is also called psychotherapy, can help you understand your anxiety and depression and give you tools to manage your symptoms.

Your therapist may try cognitive behavioral therapy, or CBT, to help you change negative thought patterns and learn how to react to situations in a better way.

You can also get help through group therapy or support groups. Theyâre good for connecting with other people who relate to what youâre going through, sharing your thoughts, and learning from other peopleâs experiences.

What Are The Symptoms Of Parkinsons Disease Anxiety

Depression and anxiety with or without Parkinson’s disease can be debilitating. You may suffer from a “loop” of anxious thoughts about your illness or the future, or you may find yourself experiencing panic attacks or feeling afraid to go outside. You may also have a negative view of the world and your place in it.

While it’s normal to feel some degree of worry when you are diagnosed with Parkinson’s disease, persistent anxiety that doesn’t go away when you relax may require treatment. Here are some of the most common Parkinson’s disease and anxiety symptoms:

  • Constant feelings of worry or dread
  • Panic attacks characterized by heart palpitations, sweating, nausea and lightheadedness
  • Feeling out of control or helpless
  • Long, intense periods of unease
  • Feeling unsafe for in normal situations
  • Wanting to isolate yourself or being afraid to leave the house
  • Avoiding certain situations because they trigger anxiety

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Guidelines For Cbt For Depression And Anxiety In Parkinsons Disease

In terms of which patients it is appropriate to use CBT with, we suggest that this treatment is utilized in PD patients who do not have dementia. In trials we have typically excluded patients who score less than 24 on the Mini Mental State Examination. It is also helpful if the patient expresses some degree of willingness to attend psychotherapy, those who have been referred by a partner/carer but who are reluctant to attend of their own accord may be difficult to engage in therapy. In a recent book on CBT with older people, guidelines for working with clients with chronicity and comorbidity, Laidlaw updated previous recommendations that clinicians may find useful when working with clients presenting with depression and anxiety in PD . These include

The final stage of CBT involves individualized relapse prevention to ensure CBT is continued. The aim of CBT is for the person to become their own therapist and to continue to use the cognitive techniques of thought diaries, behavioral experiments, and behavioral activation to challenge negative cognitions and symptoms of depression and anxiety in the future.

Anxiety As An Early Warning Sign

Depression, Anxiety Can Lead To Parkinson

It may be that anxiety disorders that are diagnosed as much as two decades before Parkinsons disease may be a harbinger of the disease, says Gregory Pontone, M.D., director of the Johns Hopkins Movement Disorders Psychiatry Clinic. Parkinsons disease, like Alzheimers disease, has what experts call a long approach, he says, and anxiety may be part of that long approach.

One theory is that the anxiety that comes before Parkinsons results from the same underlying changes in brain chemistry and circuitry. Others believe that Parkinsons disease and anxiety share a common genetic risk factor. Either way, taking a closer look at the link can help doctors understand the causes of Parkinsons and treat patients with the disease.

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Anxiety And Depression In Parkinsons And How To Manage Them

Approximately 50-60% of people living with Parkinsons experience varying levels of depression and anxiety. Learn about the differences between depression and anxiety and how they are related different types of depression and anxiety causes of depression and anxiety in people living with PD when and how to treat depression and/or anxiety the latest in treatments, including non-pharmacological interventions. The speaker is Gregory Pontone, MD, director, Johns Hopkins Parkinson’s Disease Neuropsychiatry Clinic.

Studies Show Rise In Anxiety For People Battling Parkinsons Disease

Research shows increase in anxiety for those with PD amid pandemic.

RENO, Nev. – April is Parkinsons Disease awareness month and its been challenging for those living with the disease. According to the American Parkinson Disease Association studies have shown the coronavirus pandemic has been tough for people with PD.

There has been increases in anxiety, depression, and generally in isolation, and so theres been a lot of effects of the entire situation with people with PD, said ADPA Chief Scientific Officer Dr. Rebecca Gilbert.

She said in Nevada about 10,000 people have the neurodegenerative disorder. Dr. Gilbert explained thats when nerves in the brain die which could lead to different symptoms, most commonly tremors.

ADPA said the study Incidence of Anxiety in Parkinsons Disease During the Coronavirus Disease Pandemic shows 20% of patients polled felt the pandemic has exacerbated their symptoms. It also shows 12% increased their medication use during the pandemic.

According to ADPA another study of the impact of the COVID-19 lockdown on PD patients was conducted. Patients from the movement disorders clinic were assessed over the phone. The study demonstrated, compared to controls, PD patients had significantly increased levels of stress, depression and anxiety along with decreased measures of quality of life, as compared to controls. It also shows PD patients also reported a significant decline in physical activity as compared to pre-lockdown.

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Can Cbd Help With Parkinsons Disease

Parkinsons disease is a progressive neurodegenerative disease that leads to shaking, stiffness, and difficulty with walking, balance and coordination. People with Parkinsons also may suffer from depression, anxiety, apathy, irritability, pain, and difficulty sleeping. Many people with the disease go on to develop Parkinsons Disease dementia.

Over one million people in the United State are living with the disorder, though the figures could be even higher. Each year, 600,000 people are diagnosed with Parkinsons with the incidence 1.5 times more likely to affect men than women. The onset is more likely to occur with age, although an estimated four percent of people with PD are diagnosed before age 50.

Currently there is no standard treatment for the disease. An individuals symptoms will determine the best treatment, which could include medication and surgical therapy. Changes in lifestyle, including more rest and exercise, also are recommended for dealing with Parkinsons.

As with many medical conditions, research is being conducted with CBD to see if it can help with the disease. CBD interacts with two of the bodys cannabinoid receptors found on certain cells called CB1 and CB2. By interacting with one or both of these receptors, CBD may be able to delay tremor development as well as have protective neurological benefits, but there is no conclusive evidence yet and patients may react differently to the cannabidiol.

CBD Parkinsons Research Studies


Anxiety And Parkinsons Research

Anxiety in Parkinsons Disease

What does this finding mean for the future of diagnosis or treatment of Parkinsons? Ongoing research is compelling, says Pontone. Part of what we are doing is looking at anxiety disorders that occur long before the onset of Parkinsons to see if there are characteristics that may differentiate that anxiety or predict an increased risk of Parkinsons disease.

Meanwhile, because theres an established link between anxiety and Parkinsons disease, patients and their families should be upfront with their doctors about anxiety symptoms. Behavioral therapy and medications for example, anti-anxiety meds or antidepressants can effectively treat anxiety disorders. Theres no need for anyone to suffer in silence.

Targeting Parkinsons-Linked Protein Could Neutralize 2 of the Diseases Causes

Researchers report they have discovered how two problem proteins known to cause Parkinsons disease are chemically linked, suggesting that someday, both could be neutralized by a single drug designed to target the link.

Also Check: Parkinson’s Disease Mental Health

Help For Depression And Anxiety

Depression is a serious matter for anyone. For people with Parkinson’s, it can affect critical elements of disease management such as staying socially connected, exercising and proactively seeking needed care.

It is not always easy to recognize depression in oneself. Be on the lookout for a lack of interest in activities and situations that once brought you joy. Pay attention to observations made by family and friends, and talk to your doctor if you’re not feeling like yourself. Sometimes, your physicians 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 with a qualified practitioner. Support groups also may be a source of help.

NOTE: If you are in crisis, call the National Suicide Prevention Lifeline at or visit

How Is Anxiety Diagnosed

Anxiety is usually diagnosed by a primary care physician, or a mental health professional, who will ask questions about certain symptoms. The doctor will talk with the patient about mood changes and behaviors. For people with an anxiety disorder, their symptoms become so intense that they are unable to function normally in life. Overall, it is easier to diagnose anxiety than depression in PD, because symptoms of anxiety and PD do not overlap as much.

In general, symptoms of anxiety may include:

  • Excessive fear and worry
  • Dizziness
  • Nausea

In people with Parkinsons, a diagnosis of an anxiety disorder is made only if the symptoms involve a clear change in a patients previous behavior and are not easily confused with motor symptoms. For example, even though a patient may have a legitimate concern that a tremor or change in walking ability may be noticed in public, a diagnosis of social avoidance is only made if the patient realizes that the concern is excessive, the social situation is avoided, and it causes interference in the persons social or work life.

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Managing Anxiety And Depression In Parkinsons Disease

A combination of medication and other therapies can help ease non-motor symptoms affecting those with Parkinsons disease.

Most people think of Parkinsons disease as marked only by tremors, muscular rigidity and slow, imprecise movements, but Parkinsons is more than a movement disorder.

Most people with Parkinsons also have quite a few non-motor symptoms, such as anxiety, depression and psychosis. Many of these symptoms may have started before the Parkinsons disease became obvious.

The effects are widespread. Several years ago, a large clinical study of more than 1,000 people with Parkinsons disease of various durations demonstrated that only 1.4 percent of the participants did not report any non-motor symptoms.In other words, 98.6 percent of the study participants had some form of NMS. Psychiatric symptoms accounted for 60 percent, while visual hallucinations that could have signified psychosis were present in about 35 percent of patients.

Thats why taking action is important. If you or a loved one has had a new diagnosis of Parkinsons disease, we recommend an immediate evaluation for depression, mood and cognitive problems. Frequent monitoring should also be done throughout the course of the disease.

Here are some of the common symptoms and treatment methods for Parkinsons patients with depression and dementia:

A Cognitive Behavioral Model

Parkinson disease and anxiety

A case example is outlined to demonstrate the benefits of developing a case conceptualization based on a guiding model of CBT for anxiety and depression in PD as shown in Fig. 1.

The CBT model outlined in Fig. 1 is a new model that has not been outlined before, and is based on standard cognitive-behavioral models where core beliefs are defined as rigid and inflexible beliefs which are developed due to early life experiences and then activated later in life due to stressors such as the diagnosis of PD. In the case of Bill his core belief I am incompetent lead him to value being able to try and prove his competence through being highly independent and solving problems and he thus had associated beliefs that A man stands on his two feet and If I cannot do things by myself, then I am incompetent.

There are also illness beliefs which arise from core beliefs that make someone more likely to react with negative emotions to PD, for Bill this was watching his best friend die of PD, and was linked with his fear I may die at any stage due to my PD. Cohort beliefs refer to values and beliefs shared amongst a generational group of individuals born at a similar time period . For a man of Bills generation, he possessed a common cohort belief that people who are disabled are weak, needy and dependent.

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