Checkpoints The Prevalence Of Depression In Patients With Parkinson Disease Is Around 40% Half Of These Patients Meet Criteria For Major Depression And Half Meet Criteria For Less Severe Forms Of Depression Optimal Control Of The Physical Aspects Of Pd Is A Prerequisite To Adequate Treatment Of Depression Studies Have Shown A Tight Correlation Between Off Periods And Depression And Unless There Is Good Control Of The Fluctuations Antidepressant Therapy Will Be Suboptimal Findings Suggest That Dementia Develops Within 9 Years Of The Onset Of Parkinson Disease In About 26% Of Patients This Percentage Rises To About 52% After 13 Years And To About 78% After 17 Years The Personality Traits That Frequently Accompany Pd May Be Described As Decreases In Novelty
Despite the prevalence of depression in patients with PD, there are few controlled, well-designed studies that direct treatment. In a randomized trial that compared nortriptyline, paroxetine controlled-release , and placebo, nortriptyline was superior to placebo and paroxetine CR.9 The trial also established that treatment of depression leads to improvements in quality of life, sleep, and some aspects of cognition.10 Findings from a short-term, randomized, placebo-controlled pilot study suggest that both citalopram and desipramine are more effective than placebo.7
The two studies noted above have led to an increased focus on the role of norepinephrine for depression in patients with PD. As in all of psychiatry, however, there are significant interindividual differences in response to medications and often tolerability is the most important factor to consider. The many tolerability issues include the anticholinergic effects of tricyclics and the risk of a slight worsening of the motor signs of PD with SSRIs.11 In addition, there is a potentially serious interaction between selegiline and rasagiline-monoamine oxidase B inhibitors that are widely used for their mild therapeutic and potential disease-slowing effects-and antidepressants.
Patients should be encouraged to exercise, to keep up their social contacts, and to seek out local PD support groups. Furthermore, supportive therapy directed at education and maintenance of activities outside the home is often beneficial.
Neuropsychiatric Disorders In Parkinsons Disease: What Do We Know About The Role Of Dopaminergic And Non
- 1Inserm U1171 Degenerative and Vascular Cognitive Disorders, Lille University Medical Center, Lille, France
- 2CNRS, Institut des Sciences Cognitives Marc Jeannerod, UMR 5229, Lyon University, Bron, France
Besides the hallmark motor symptoms , patients with Parkinson’s disease have non-motor symptoms, namely neuropsychiatric disorders. They are frequent and may influence the other symptoms of the disease. They have also a negative impact on the quality of life of patients and their caregivers. In this article, we will describe the clinical manifestations of the main PD-related behavioral disorders . We will also provide an overview of the clinical and preclinical literature regarding the underlying mechanisms with a focus on the role of the dopaminergic and non-dopaminergic systems.
Increased Risk Of Parkinson’s Disease In Patients With Schizophrenia Spectrum Disorders
Clinical Neurosciences, University of Turku and Neurocenter, Turku University Hospital, Turku, Finland
Correspondence to: Dr. Tomi Kuusimäki, Division of Clinical Neurosciences, Turku University Hospital, Hämeentie 11, POB 52, FIN-20521, Turku, Finland; E-mail: tomi.kuusimaki@utu.fi
Clinical Neurosciences, University of Turku and Neurocenter, Turku University Hospital, Turku, Finland
Department of Neurology, Helsinki University Hospital and Department of Clinical Neurosciences , University of Helsinki, Helsinki, Finland
School of Pharmacy, University of Eastern Finland, Kuopio, Finland
Kuopio Research Centre of Geriatric Care, School of Pharmacy, University of Eastern Finland, Kuopio, Finland
School of Pharmacy, University of Eastern Finland, Kuopio, Finland
Kuopio Research Centre of Geriatric Care, School of Pharmacy, University of Eastern Finland, Kuopio, Finland
Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia
Clinical Neurosciences, University of Turku and Neurocenter, Turku University Hospital, Turku, Finland
Correspondence to: Dr. Tomi Kuusimäki, Division of Clinical Neurosciences, Turku University Hospital, Hämeentie 11, POB 52, FIN-20521, Turku, Finland; E-mail: tomi.kuusimaki@utu.fi
Clinical Neurosciences, University of Turku and Neurocenter, Turku University Hospital, Turku, Finland
Do Something Nice For Yourself Every Daydo Not Drop Out Of The Mainstream Of Life
• Enlist other family members to assist on a regularly scheduled basis• Hire aides at home for several hours on a regular basis• Participate in exercise programs• Participate in education seminars and support groups• Consult with a mental health professional• Have a home safety evaluation• Make use of adult day-care programs
Care partners must be reminded that their health is at stake, and that they are entitled to have some free time to recharge their emotional batteries. Recommendations for alleviating the burden for the primary care partner are listed in Box 2. Care partners should all be encouraged to participate in PD support groups and educational programs, as they will benefit from the advice and experience of others who have had to cope with similar situations. Consultation with a mental health professional is important for care partners who are becoming overwhelmed or depressed.
Family members or friends often say they are willing to pitch in and help the primary care partner without committing to a specific schedule. The assistance of other family members should be arranged on a predictable and regular basis. This might enable the primary care partner to make plans in order to re-engage in the mainstream of life . The assistance of family members on a haphazard basis or only during emergency situations does not ease the ongoing daily burdens for the care partner.
Management Of Dual Diagnosis Of Parkinsons Disease And A Mental Health Disorder
Jasmine Carpenter, PharmD, BCPS
Adepeju Awodipe, PharmD Candidate 2015Howard University College of PharmacyWashington, DC
Washington, DC
US Pharm. 2015;40:34-38.
ABSTRACT: Mental health disorders are frequently seen in patients with Parkinson’s disease , possibly as a result of the complex imbalance of neurotransmitters in both disease states. This imbalance poses various treatment challenges, such as the exacerbation of both disease states and drug interactions between the medications used to treat PD and mental health disorders. Owing to these challenges, mental health disturbances in PD patients often go untreated. By assisting with ruling out causative medications and underlying disease states, simplifying antiparkinsonian regimens, and recommending antipsychotics, the pharmacist can help ensure that both of these disease states are adequately treated.
Parkinson’s disease , which impacts millions of people worldwide, is a neurodegenerative disorder involving the deterioration of motor, mental, and functional skills.1 This degenerative decline increases mortality rates and negatively affects patients’ quality of life. Motor movement disorders are heavily emphasized as cardinal signs of PD; however, nonmotor manifestations such as depression, anxiety, and psychosis are major concerns that must be addressed in this patient population.
Sidebar: Morris K Udall Centers Of Excellence For Parkinson’s Disease Research
The Morris K. Udall Parkinson’s Disease Research Act of 1997 authorized the NIH to greatly accelerate and expand PD research efforts by launching the NINDS Udall Centers of Excellence, a network of research centers that provide a collaborative, interdisciplinary framework for PD research. Udall Center investigators, along with many other researchers funded by the NIH, have made substantial progress in understanding PD, including identifying disease-associated genes; investigating the neurobiological mechanisms that contribute to PD, developing and improving PD research models, and discovering and testing potential therapeutic targets for developing novel treatment strategies.
The Udall Centers continue to conduct critical basic, translational, and clinical research on PD including: 1) identifying and characterizing candidate and disease-associated genes, 2) examining neurobiological mechanisms underlying the disease, and 3) developing and testing potential therapies. As part of the program, Udall Center investigators work with local communities of patients and caregivers to identify the challenges of living with PD and to translate scientific discoveries into patient care. The Centers also train the next generation of physicians and scientists who will advance our knowledge of and treatments for PD. See the full list of Udall Centers.
Increased Risk Of Parkinson’s Disease In Patients With Schizophrenia
- Date:
- University of Turku
- Summary:
- A new study shows that patients with a schizophrenia spectrum disorder have an increased risk of Parkinson’s disease later in life. The increased risk may be due to alterations in the brain’s dopamine system caused by dopamine receptor antagonists or neurobiological effects of schizophrenia.
A new study conducted at the University of Turku, Finland, shows that patients with a schizophrenia spectrum disorder have an increased risk of Parkinson’s disease later in life. The increased risk may be due to alterations in the brain’s dopamine system caused by dopamine receptor antagonists or neurobiological effects of schizophrenia.
The record-based case-control study was carried out at the University of Turku in collaboration with the University of Eastern Finland. The study examined the occurrences of previously diagnosed psychotic disorders and schizophrenia in over 25,000 Finnish Parkinson’s disease patients treated in 1996-2019.
In the study, patients with Parkinson’s disease were noted to have previously diagnosed psychotic disorders and schizophrenia more often than the control patients of the same age not diagnosed with PD.
Study changes conception of the association between Parkinson’s disease and schizophrenia
Story Source:
Conversations From People With Parkinsons About Their Mental Health
Recently, I talked about mental health with two thoughtful people who are living with PD, to get their perspectives on the issues that they deal with and the strategies that work for them. Their approaches are by no means the only ones. There are as many different ways to maximize your mental health as there are people with PD. But hearing how other people deal with their challenges can help you craft ways to deal with yours.
Risk Of Parkinson’s Disease In Patients With Psychiatric Disorders
The influence of mental illness early in life on the subsequent risk of PD and its clinical picture remain obscure. Several studies have identified certain psychiatric illnesses, particularly anxiety, depression and schizophrenia as risk factors for PD. Anxiety has been suggested to be one of the earliest manifestations of PD in several case-control and cohort studies.
Difficulties In Diagnosing Depression In Patients With Parkinson’s
- Certain symptoms of depression overlap with symptoms of PD ? for example, sleep problems and feeling slowed down occur in both conditions.
- Some experts think that depression in PD often involves frequent, shorter changes in mood versus a constant state of sadness daily.
- Many people with PD express less emotion due to the effect the disease has on the muscles of the face. This symptom, called facial masking, makes a person unable to express emotion through facial expressions.
- Many people with Parkinson’s do not seek treatment because they often do not recognize they have a mood problem or are unable to explain symptoms. For these reasons, it is helpful to ask a caregiver or loved one if he or she has noticed any changes commonly reported in depression.
There Are Days I Am Depressed And Angry And I Just Want To Give Up
These days, it is hard to see a bright spot. All I can see is that “bad stuff,” and on those days there is no silver lining. When I reach this point, I want to give up and throw in the towel. On those days, please realize I have not given up, but I am just very tired of fighting and I am feeling discouraged.
What Is The Prognosis And Life Expectancy For Parkinson’s Disease
The severity of Parkinson’s disease symptoms and signs vary greatly from person to peson, and it is not possible to predict how quickly the disease will progress. Parkinson’s disease itself is not a fatal disease, and the average life expectancy is similar to that of people without the disease. Secondary complications, such as pneumonia, falling-related injuries, and choking can lead to death. Many treatment options can reduce some of the symptoms and prolong the quality of life.
Timely And Accurate Tremor Data Can Improve Virtual Appointments
- Date:
- University of British Columbia Okanagan campus
- Summary:
- Wearable health technologies are vastly popular with people wanting to improve their physical and mental health. Everything from exercise, sleep patterns, calories consumed and heart rhythms can be tracked by a wearable device. But timely and accurate data is also especially valuable for doctors treating patients with complicated health conditions using virtual care.
Wearable health technologies are vastly popular with people wanting to improve their physical and mental health. Everything from exercise, sleep patterns, calories consumed and heart rhythms can be tracked by a wearable device.
But timely and accurate data is also especially valuable for doctors treating patients with complicated health conditions using virtual care.
A new study from the Southern Medical Program , based at UBC Okanagan, has examined the use of wearable health technology and telehealth to treat patients with Parkinson’s disease.
Dr. Daryl Wile, a movement disorder specialist and SMP clinical assistant professor, routinely uses telehealth to connect with Parkinson’s patients across the vast and rugged landscape of BC’s Interior.
To add a new layer of health information, Wile and the research team added wearable technology to the equation.
“With the integration of accurate and reliable data from wearable devices, we were able to tailor a patient’s medication to better manage their symptoms throughout the day,” adds Wile.
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What Lifestyle Changes Can I Make To Ease Parkinsons Symptoms
Exercise: Exercise helps improve muscle strength, balance, coordination, flexibility, and tremor. It is also strongly believed to improve memory, thinking and reduce the risk of falls and decrease anxiety and depression. One study in persons with Parkinson’s disease showed that 2.5 hours of exercise per week resulted in improved ability to move and a slower decline in quality of life compared to those who didn’t exercise or didn’t start until later in the course of their disease. Some exercises to consider include strengthening or resistance training, stretching exercises or aerobics . All types of exercise are helpful.
Eat a healthy, balanced diet: This is not only good for your general health but can ease some of the non-movement related symptoms of Parkinson’s, such as constipation. Eating foods high in fiber in particular can relieve constipation. The Mediterranean diet is one example of a healthy diet.
Preventing falls and maintaining balance: Falls are a frequent complication of Parkinson’s. While you can do many things to reduce your risk of falling, the two most important are: 1) to work with your doctor to ensure that your treatments — whether medicines or deep brain stimulation — are optimal; and 2) to consult with a physical therapist who can assess your walking and balance. The physical therapist is the expert when it comes to recommending assistive devices or exercise to improve safety and preventing falls.
Improve the quality of your sleep.
How Are Mental Health Problems Treated In Parkinsons Disease
Mental health problems in Parkinson’s disease can be treated with a combination of medication, talking therapy and lifestyle changes. Your doctor may also suggest joining a Parkinson’s support group so that you can share your challenges with other PD patients.
Other ways to care for your mental health if you have Parkinson’s include:
Parkinson’s disease and mental health problems are not easily cured. However, there are a variety of treatment options and lifestyle changes that can boost your mental wellbeing and improve your overall quality of life.
Kathy: On Anxiety Going It Alone And Being Kind To Yourself
Anxiety is also the biggest mental health challenge for Kathy , a 72 year old woman with PD diagnosed 4 years ago. Her mental health concerns are deeply influenced by a major external stressor, namely an adult child who is facing an illness of her own. Kathy was always a very active and capable person, and remains so, but PD is starting to cause some physical limitations for her. She wants to help her daughter as much as she can, but has begun to realize that she can’t do everything she used to be able to do. This is extremely frustrating, because not only must she accept her limitations, but others around her must do so as well.
She often feels very lonely. She is not married and finds herself shouldering her own physical and mental struggles, as well as those of her daughter, by herself. She is lucky to have some close friends, but they have health challenges of their own to deal with and can’t always be there for her. She finds it mildly exasperating to constantly read how important it is for PD patients to surround themselves with supportive family – what if you are alone?
She also finds it irritating to read articles about PD that are relentlessly “perky” about PD. Yes, exercise can be very helpful and can sometimes help keep symptoms at bay. But “there is a down-side to PD as well. You should be allowed to feel that and express that”. It is also not your fault if your PD worsens – it does not mean that you did not do enough.
There Are Days When I And Even My Family Dont Want To Talk
Sometimes I get tired of hearing myself discuss and explain things. I don’t want to give another update, and I am just tired of thinking about it. It is nothing personal. I am not shutting you out. I just don’t want to discuss it and deal with it at that moment. I still appreciate you and want your help, so please don’t take it personally. Often, there is just really nothing you or I can say to make this better.
Drug Reactions: Psychosis And Impulse Control Disorders
PD pharmacologic treatment emphasises dopamine replacement, dopamine receptor stimulation, or prevention of enzymatic breakdown of dopamine in the synaptic cleft.3 While these drugs have their effects on a variety of CNS neurotransmitter systems, they primarily affect dopamine transmission. Thus, it is not surprising that they often produce dramatic behavioural changes that cause significant difficulties for patients and their families and carers.5 There are convincing data that suggest that treatment with dopaminergic agents may be associated with the development of a variety of impulse control disorders in some patients.5 Impulse control disorders, including severe gambling and hyper-sexuality as well as shopping and binge eating, can be extremely disruptive to patients and families.
As with psychosis, impulse control disorders are more commonly associated with the dopamine agonists, pramipexole and ropinirole.11 Given the impact of impulse control disorders, clinicians need to educate patients and monitor them for the early signs of these disturbances.5
Delusions are uncommon in the first two years of PD therapy, but may also occur and, as with hallucinations, are often preceded by vivid dreams.5 These delusions are usually persecutory in nature, including fears of being injured, influenced, poisoned, filmed, and/or tape-recorded.5
What Are The Treatment Options For Parkinsons Psychosis
Because Parkinson’s drugs can cause psychosis, your doctor will likely start by taking you off your medications, one at a time, or adjusting the dose. Changing your medication may make your movement symptoms worse.
Your doctor will keep adjusting your medication. The goal is to get you to a dose that improves your movement without causing hallucinations and delusions.
If changing your medication doesn’t work, the next step is to go on an antipsychotic medication. These drugs prevent psychosis symptoms by altering levels of chemicals in your brain.
Older antipsychotic drugs can make Parkinson’s movement symptoms worse. Newer drugs, called atypical antipsychotics, are less likely to affect your movement. These drugs are off-label, meaning they’re not approved to treat Parkinson’s specifically. They include:
- clozapine
- quetiapine
In 2016, the Food and Drug Administration approved pimavanserin . It’s the first drug designed specifically to treat Parkinson’s disease psychosis. Nuplazid reduces the number of hallucinations and delusions without affecting movement.
Nuplazid and other newer antipsychotic drugs do carry a black box warning. They can increase the risk of death in older people who have psychosis related to dementia. Your doctor will consider this and other risks before prescribing one of these drugs.
What Are The Surgical Treatments For Parkinsons Disease
Most patients with Parkinson’s disease can maintain a good quality of life with medications. However, as the disease worsens, medications may no longer be effective in some patients. In these patients, the effectiveness of medications becomes unpredictable – reducing symptoms during “on” periods and no longer controlling symptoms during “off” periods, which usually occur when the medication is wearing off and just before the next dose is to be taken. Sometimes these variations can be managed with changes in medications. However, sometimes they can’t. Based on the type and severity of your symptoms, the failure of adjustments in your medications, the decline in your quality of life and your overall health, your doctor may discuss some of the available surgical options.
What Is The Outlook For Persons With Parkinsons Disease
Although there is no cure or absolute evidence of ways to prevent Parkinson’s disease, scientists are working hard to learn more about the disease and find innovative ways to better manage it, prevent it from progressing and ultimately curing it.
Currently, you and your healthcare team’s efforts are focused on medical management of your symptoms along with general health and lifestyle improvement recommendations . By identifying individual symptoms and adjusting the course of action based on changes in symptoms, most people with Parkinson’s disease can live fulfilling lives.
The future is hopeful. Some of the research underway includes:
- Using stem cells to produce new neurons, which would produce dopamine.
- Producing a dopamine-producing enzyme that is delivered to a gene in the brain that controls movement.
- Using a naturally occurring human protein – glial cell-line derived neurotrophic factor, GDNF – to protect dopamine-releasing nerve cells.
Many other investigations are underway too. Much has been learned, much progress has been made and additional discoveries are likely to come.
Psychiatric Symptoms Associated With Parkinson Disease
Matthew A. Menza, MDPsychiatric Times
Parkinson disease is the second most common neurodegenerative illness in the United States, affecting more than 1 million persons. Disease onset is usually after age 50. In persons older than 70 years, the prevalence is 1.5% to 2.5%.1 While the primary pathology involves degeneration of dopaminergic neurons in the substantia nigra, circuits important in emotion and cognition-such as the serotonergic, adrenergic, cholinergic, and frontal dopaminergic pathways-are also variably disrupted.
Parkinson disease is the second most common neurodegenerative illness in the United States, affecting more than 1 million persons. Disease onset is usually after age 50. In persons older than 70 years, the prevalence is 1.5% to 2.5%.1 While the primary pathology involves degeneration of dopaminergic neurons in the substantia nigra, circuits important in emotion and cognition-such as the serotonergic, adrenergic, cholinergic, and frontal dopaminergic pathways-are also variably disrupted.
Depression
Many of the symptoms used to make a diagnosis of depression, including poor sleep, decreased energy, psychomotor retardation, and poor concentration, are seen in nearly all patients with PD and are more properly seen as direct manifestations of PD and not of depression. Therefore, while the usual screening instruments are useful, a careful interview, focused on mood, affect, and hedonic capacity, is critical.
Sometimes I Just Need A Hug And Someone To Sit With Me
Many think there must be some great act of kindness or tremendous gift or service, but sometimes the smallest things mean the most. Many days, I just need someone to put their arm around me, hug me, maybe even cry with me, and just say, “This sucks, but I am here for you.” This small and simple gift is the greatest thing anyone can do for those of us and our families caught in this battle.
I have no idea what the future will hold, and I have no idea how difficult things will get. But walking this path with people who care and seek to understand makes this journey that much more easy to travel. Without you helping us, we would not make it, so even when you don’t think I am thankful, please know I am and that your love and care give me the strength to keep fighting and take that next step.
Getty image via Victor_Tongdee
Mental Health Concerns In Advanced Parkinsons Disease
Today we continue Parkinson’s Disease: Planning for the What Ifs, a special series of posts to address both motor and non-motor issues of people with advanced Parkinson’s disease . We are defining advanced PD as those who are no longer independent in their activities of daily living, and require help for their self-care such as eating, bathing, dressing and toileting. Remember, PD is a very variable condition and many never reach the advanced stages. Additional background and the full introduction to the series is still available if you missed it.
I receive a lot of questions through our Ask a Doctor feature on our website concerning advanced PD, specifically around mental health issues. In a previous blog, I discussed the management of psychosis and behavioral problems in advanced PD. Today I will discuss cognitive decline/dementia, depression, anxiety and apathy in advanced Parkinson’s disease .
What Medications Are Used To Treat Parkinsons Disease
Medications are the main treatment method for patients with Parkinson’s disease. Your doctor will work closely with you to develop a treatment plan best suited for you based on the severity of your disease at the time of diagnosis, side effects of the drug class and success or failure of symptom control of the medications you try.
Medications combat Parkinson’s disease by:
- Helping nerve cells in the brain make dopamine.
- Mimicking the effects of dopamine in the brain.
- Blocking an enzyme that breaks down dopamine in the brain.
- Reducing some specific symptoms of Parkinson’s disease.
Levodopa: Levodopa is a main treatment for the slowness of movement, tremor, and stiffness symptoms of Parkinson’s disease. Nerve cells use levodopa to make dopamine, which replenishes the low amount found in the brain of persons with Parkinson’s disease. Levodopa is usually taken with carbidopa to allow more levodopa to reach the brain and to prevent or reduce the nausea and vomiting, low blood pressure and other side effects of levodopa. Sinemet® is available in an immediate release formula and a long-acting, controlled release formula. Rytary® is a newer version of levodopa/carbidopa that is a longer-acting capsule. The newest addition is Inbrija®, which is inhaled levodopa. It is used by people already taking regular carbidopa/levodopa for when they have off episodes .
Which Medicines Are Used To Treat Parkinson’s Disease
Guidelines released by the Scottish Intercollegiate Guidelines Network recommend starting with a dopamine agonist, levodopa with a dopa-decarboxylase inhibitor or a monoamine-oxidase inhibitor. Other medicines are also sometimes used, usually in addition to one of these three main types of medication.
David: On Anxiety Sleep And Focusing On The Positive
David , a 74 year-old man with PD diagnosed two years ago, has been dealing with anxiety and depression for decades. “I was in therapy as a teenager and young adult for issues of anxiety and depression.” But about five to six years ago, the anxiety worsened, and he sought out the care of the same therapist he saw when he was in his thirties.
The intensification of his anxiety preceded his diagnosis of PD by a few years, a relatively common phenomenon in which particular non-motor symptoms of PD appear before the motor symptoms. In addition, since his diagnosis of PD, he started noticing some cognitive issues – specifically trouble with his memory and word-finding difficulties.
Initially, controlling the anxiety and dealing with the cognitive changes were very difficult for David – and the two issues were inter-related for him. A word-finding difficulty would inevitably trigger anxiety. “I used to go crazy because I couldn’t think of particular words.” And that anxiety would then make it even harder to find the right word.
He can’t emphasize enough the importance of a good night’s sleep. He used to get four hours of restless sleep. Now with the help of his more relaxed view of life and current medication regimen, he is able to get 6-7 hours of restful sleep and that has led to a major improvement in his quality of life.
Key lessons that David can share about his mental health include:
Parkinsons Disease And Mental Health: Whats The Link
The relationship between Parkinson’s disease and mental health is not straightforward. This is because, when it comes to the brain, no one is entirely sure what causes either Parkinson’s disease or mental illness. However, there is no evidence to suggest that a pre-existing mental health condition increases your risk of developing Parkinson’s disease . On the other hand, a diagnosis of Parkinson’s disease does make you more susceptible to developing mental health conditions.
Anxiety and depression are the most common mental health symptoms in people with Parkinson’s. Signs to look out for include:
- Changes in appetite, either eating too much or too little
- Excessive tiredness
- Lack of interest in hobbies and activities
- Feeling hopeless or “down” most days
- Feeling fearful or constantly worried
The mental health symptoms of Parkinson’s disease can also affect your physical symptoms and vice versa. For example, some people find that their anxiety increases when they have OFF episodes where their medication doesn’t work as well. Others report feeling depressed as a result of worsening symptoms.
If you’re struggling with the mental or emotional effects of Parkinson’s disease, you should talk to your doctor. He or she may suggest changing or adjusting your medication.
What Are The Different Stages Of Parkinsons Disease
Each person with Parkinson’s disease experiences symptoms in in their own unique way. Not everyone experiences all symptoms of Parkinson’s disease. You may not experience symptoms in the same order as others. Some people may have mild symptoms; others may have intense symptoms. How quickly symptoms worsen also varies from individual to individual and is difficult to impossible to predict at the outset.
In general, the disease progresses from early stage to mid-stage to mid-late-stage to advanced stage. This is what typically occurs during each of these stages:
Early stage
Early symptoms of Parkinson’s disease are usually mild and typically occur slowly and do not interfere with daily activities. Sometimes early symptoms are not easy to detect or you may think early symptoms are simply normal signs of aging. You may have fatigue or a general sense of uneasiness. You may feel a slight tremor or have difficulty standing.
Often, a family member or friend notices some of the subtle signs before you do. They may notice things like body stiffness or lack of normal movement slow or small handwriting, lack of expression in your face, or difficulty getting out of a chair.
Mid stage
Mid-late stage
Standing and walking are becoming more difficult and may require assistance with a walker. You may need full time help to continue to live at home.
Advanced stage