How Stress And Anxiety Are Related To Parkinsons And What You Can Do About It
People with Parkinsons disease often notice that their symptoms are worse when they are under stress. Stress, or emotional strain due to difficult circumstances, is an inevitable part of life for everyone, and can be caused for example, by tension with family or employers. Stress is therefore a response to an external situation.
In addition to life stress, people with PD may experience anxiety as part and parcel of their PD itself, caused by chemical imbalances in the brain. Anxiety is a very common non-motor feature of PD and is often accompanied by depression. Anxiety can also fluctuate throughout the day along with dopamine levels, with anxiety experienced most acutely during OFF periods.
Anxiety is fueled by internal forces and can persist when all external causes of stress have been resolved. It is often difficult for a person with PD to separate out stress and anxiety because practically, they may manifest in indistinguishable ways. Both can cause excessive worry, poor sleep, and inattention, as well as physical symptoms such as rapid heart rate, trouble breathing, sweating and headaches. In a past blog, I explored the perspectives of people with PD as it relates to their mental health.
What The Research Says
Researchers believe that depression and anxiety in Parkinson’s are due to changes in brain chemistry that are caused by the disease itself. The same pathways that create dopamine in the brain which are impacted in PD also create the brain chemical serotonin, which regulates mood, appetite and sleep. Scientists think that the effect of Parkinson’s on serotonin, as well as other brain chemicals that support mood, is responsible for symptoms of depression and anxiety.
The Michael J. Fox Foundation actively pursues research that can shed light on the connection between mood changes and Parkinson’s and lead to treatment breakthroughs for people living with the disease. The MJFF-funded Study of Antidepressants in Parkinson’s Disease found that certain antidepressants eased depression in people with Parkinson’s without worsening movement symptoms. Still, more work remains to find more and better treatments for depression and anxiety. Researchers are looking at several different therapies: medications such as buspirone for anxiety, as well as cognitive behavioral therapy and non-invasive brain stimulation for both depression and anxiety. Join recruiting studies in your area through MJFF’s online tool Fox Trial Finder.
Anxiety As An Early Warning Sign
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.
Read Also: How To Detect Parkinson’s Disease Early
New Treatment Would Target The Microbiome Of Parkinsons Patients
The guts of Parkinsons patients often face a variety of challenges, says Appel-Cresswell. Constipation is a very early and very widespread symptom. Their guts microbiomethe microorganisms, such as bacteria, fungi, viruses and protozoa, that live in the digestive tractare also more likely to drive inflammation.
This inflammation causes damage to the gut barriercomposed of mucosal membrane and other protective cellsallowing bacteria and toxins to escape, Appel-Cresswell explains.
Parkinsons patients can experience leaky gut problems in which toxins produced by microbes seep through the gut lining and into the bloodstream.
Leaked toxins may contribute to elevated levels of damaging microbial metabolites in Parkinsons patients, which Appel-Cresswell identified in her prior research. These toxins have also been found in higher concentrations in Parkinsons patients cerebral-spinal fluid, says Appel-Cresswell.
Bacterial strains contained within the Ecologic® BARRIER probiotic have been found to improve gut barrier function and mood, possibly due to its rebalancing of gut flora and promotion of healthy gut bacteria, says Appel-Cresswell.
There is quite a bit of evidence in the field of anxiety and depression research pointing to the benefits of probiotics, says Appel-Cresswell. As such, we anticipate that participants in the probiotics group will likely see a reduction in anxiety symptoms and improved overall quality of life.
Identifying And Treating Depression
Between 17 to 50 percent of patients with Parkinsons have depression. Depression and Parkinsons have so many similar-looking symptoms that it is hard to tell the difference between them.
Its important to note, however, that depression is not a reaction to the disability. Rather, it seems to be related to the degeneration of specific neurons in Parkinsons disease itself.
Typical symptoms include:
Recommended Reading: Virtual Reality Parkinson’s Disease
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.
What Treatment Is Available
There are many things you can do that may help to reduce feelings of anxiety. Learning how to relax, recognising triggers that make you anxious and regular exercise can all help to control anxiety. Reducing your intake of alcohol and caffeine , particularly late in the evening, may also help, as these can intensify anxiety symptoms.
Recommended Reading: Vegan Diet For Parkinson’s Disease
One Study Participant Said:
My own experience of anxiety is that it can be a crippling illness. I used to have panic attacks and the fear of getting one was almost worse than actually having it. I think anxiety can be a real scourge for people with Parkinsons who suffer from it.
Lead author, Chris Lovegrove, will now use the findings to develop a new occupation-based complex intervention to help people with Parkinson’s live well with anxiety. He has recently been awarded a Clinical Doctoral Research Fellowship by Health Education England and the National Institute for Health Research to pursue this.
Also practising as an Occupational Therapist at Royal Devon and Exeter NHS Foundation Trust, Mr Lovegrove said:
There has been research into non-medical interventions, such as talking therapy, for people with Parkinsons and anxiety, but this was the first study to speak to people themselves to understand what its like for them. I was fortunate to have conducted interviews with study participants in person pre-Covid, so I was able to really understand their experiences through their body language and ask how are you really?
It was very sad to hear how hard it has been for some people, but its great were on the road to help. Ultimately, I want to produce a framework to help people with Parkinsons live well with anxiety, as well as support their care partners and occupational therapists in the process. The findings from this research will be vital in shaping that.
Do You Have Panic Attacks
- Moderator
My Dad recently told me that he suffers from a periodic panic attack. When he spoke to a professional about the experience, he learned that the anxiety may be linked to his Parkinsons diagnosis. Do you have panic attacks or anxiety? Have you learned how to manage them, if so? And do you know why they might occur?
- You must be logged in to reply to this topic.
Newest Topics
- Active 7 hours, 14 minutes ago
Forums
Disclaimer:
Parkinsons News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
This site is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
CONTACT US
Read Also: Pants For Parkinson’s Patients
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
How Can I Help Myself
It is important to remember that anxiety is common and anxiety disorders can be effectively treated. Dont be afraid to say if you feel anxious this is the first step to getting help and overcoming your worries.
One of the most important ways in which you can help yourself is by staying positive. Below are some suggestions that might be helpful:
- Educate yourself about Parkinsons, its cause and treatment. Being informed generally helps you to feel more in control.
- Take an active role in managing your illness.
- Confront difficult situations rather than avoiding them, but try not to be disheartened if things dont turn out the way you hoped.
- Keep socially active to avoid social isolation.
- Let people know you have Parkinsons when asking for help.
- Be open with your doctor and other healthcare professionals mention if something is worrying you.
- Keep doing the activities you enjoy research has shown that keeping active can improve mood.
- Pace yourself know and accept your limitations and accept that these may change with time.
- Try to stay relaxed some complementary therapies such as Yoga and Tai Chi may help.
- Accept help when you need it.
- Contact your local Parkinsons organisation or other support groups.
Your carer, friends and family can also help by encouraging you to practise relaxation techniques. They may also suggest that you discuss anxiety with your doctor if they feel that it is affecting your quality of life.
Read Also: Ketogenic Diet And Parkinson’s
Dealing With Panic Attacks While Dealing With Parkinsons Disease
Twice in the last month I have experienced what I am calling a panic attack. Ive never experienced something such as I did when it happened. I had shortness of breath, my heart was beating much faster than normal. I figured since the only activity I was involved in at the time was trying to go to sleep and not being able to, it concerned me. It scared me enough that I told my husband about it the following day.
I consulted Dr. Google and heres what I found:
A study showed that panic attacks in Parkinsons disease could possibly be a long-term complication of levodopa therapy. Key word here is possibly. I skipped that one and continued my search. Possibly isnt definitive enough for me.
So, Dr. Google led me to the Parkinsons Foundation, which stated, Anxiety is a common non-motor symptom of PD. It is important to note that anxiety is not simply a reaction to the diagnosis of Parkinsons, but is instead a part of the disease itself, caused by changes in the brain chemistry of the brain.
They went on to say that, Anxiety attacks usually start suddenly with a sense of severe physical and emotional distress. Individuals may feel as if they cannot breathe or are having a heart attack. They may feel they are experiencing a medical emergency. These episodes usually last a few minutes to an hour, particularly when associated with off periods, though they can last for longer periods of time.
Parkinsons Disease And Anxiety: Causes And Treatments
It’s no surprise that Parkinson’s disease and anxiety go hand-in-hand. However, the level of anxiety in a person with PD does not always correspond with their degree of illness or disability. It’s easy to assume that anxiety is just another offshoot of Parkinson’s disease and a result of the emotional challenges of a long-term illness. However, Parkinson’s disease anxiety is not just feeling nervous or unsure about your condition it is a clinical syndrome that deserves proper recognition and treatment.
You May Like: Treatment Of Orthostatic Hypotension In Parkinson’s Disease
Parkinsons Symptoms And Stress
Although tremor in particular tends to worsen when a person is anxious or under stress, all the symptoms of PD, including slowness, stiffness, and balance problems, can worsen. Symptoms, particularly tremor, can become less responsive to medication. The solution in these situations is not to increase medication but to find ways of reducing stress. Read on for tips on how to do that.
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.
Also Check: What Part Of The Brain Does Parkinson’s Disease Affect
Anxiety And Antiparkinsonian Medications
There is no consensus on whether antiparkinsonian medications are responsible for symptoms of anxiety in Parkinson’s disease.
Stein et al found that the levodopa dose was similar in anxious and non-anxious patients. Hendersonet al noted that 44% of patients with Parkinson’s disease noticed anxiety symptoms before starting levodopa. Menza et al found that the levodopa dose did not significantly correlate with anxiety levels: they suggested that anxiety in patients with Parkinson’s disease is unlikely to be a side effect of levodopa treatment. In contrast, Vasquez et al found that panic attacks were related to levodopa therapy but not to other agonist drugs.
Lang reported anxiety in five of 26 patients when pergolide was added to their treatment regimen. Menza et al found no differences in measures of anxiety in patients receiving or not receiving pergolide. Menzaet al found no differences in measures of anxiety in patients receiving or not receiving selegeline.
The temporal relationship between panic attacks and off periods have led some authors to suggest that panic attacks may be related to falling brain levodopa levels. Anxiety fluctuations may be an important component of levodopa induced fluctuations. In a double blind placebo controlled trial, Maricle et al found that anxiety levels fell and motor performance improved during a levodopa infusion.
Anxiety In Parkinsons Disease
It is normal to feel anxious at times. We worry about our children, our spouses, our friend, our finances, arriving on time for an appointment. There is always something to worry about. But some people worry too much. They worry to the point that it interferes with their lives. An appropriate amount of anxiety is a necessity for a normal life. But where appropriate crosses the line to inappropriate is not always clear.
We consider a person to suffer from an anxiety disorder if they have excessive fears or concerns that are beyond what is considered reasonable. It is normal to worry about your adult childrens health but so much that you call them every hour. The psychiatrists divide anxiety into a number of different forms, but for our purposes, we can consider anxiety a disorder in which someone worries too much about a problem, whether a possible problem, like what will I do if my roof caves in, or an actual problem, like how will I pay the mortgage this month.
Anxiety occasionally appears as an isolated problem, but a large percentage of PWP who suffer anxiety often suffer from depression as well. And both anxiety and depression, like all behavioral problems, is increased in people who have memory and cognitive problems.
Anxiety is a common and underappreciated mental health issue, which should be brought to the attention of the doctors.
Read Also: Does Parkinson’s Cause Foot Cramps
Moving With Mood Changes In Aging And Parkinsons: A Look At Depression And Anxiety
In this one-hour webinar a panel of physicians and people with PD that include a psychiatrist, neurologist, and a music producer discuss how and why mood changes, such as depression and anxiety, happen in Parkinsons, how you and your loved ones can talk about these symptoms with each other and with your providers, and what treatment options are available.
Webinar Notes on the Stanford PD Community Blog
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.
Recommended Reading: Wearable Devices For Parkinson’s Disease