Mental health symptoms of Parkinson's
As well as affecting movement, Parkinson's often affects the way people think
and feel. About two-thirds of people with Parkinson's experience
mental health problems at some point during the course of their
condition.
It's normal to feel anxious and depressed when you are first diagnosed. In time this may subside.
Wira MacIntyre, Information and Support Worker
People often don't realise that these mental health symptoms
could be related to Parkinson's.
This means the symptoms can remain untreated, despite the fact
that they can have a bigger impact on people's lives than the
movement-related problems.
Mild memory problems
In the earlier stages of Parkinson's, many people complain of
certain difficulties in thinking and memory that can interfere with
day-to-day life.
This can be experienced as a slowing down of thinking, much in
the same way as they might experience slowing down of movement.
While some people do complain of forgetfulness, memory problems
are not usually a significant complaint in the early stages of
Parkinson's.
It is more likely that other factors, such as stress, depression
and poor general health will have an impact on the ability to
think, recall and process information efficiently.
Read more on memory problems and mild cognitive impairment and
learn some coping strategies in our Mild
memory problems information sheet.
Dementia
A diagnosis of Parkinson's dementia is given if the symptoms of
dementia appear after those of Parkinson's.
Symptoms of dementia can include:
- slowness of thinking
- poor recall
- executive dysfunction (poor planning, multi-tasking)
- impaired concentration and attention
- less talking
Memory problems, such as forgetfulness and repetitive
questioning, can also be experienced. However, some people can have
dementia with hardly any memory problems.
In general, people with Parkinson's dementia find they have
problems with judgment and problem solving. This means it is
difficult for them to make complex decisions, such as financial
decisions and choice of medical treatment.
Activities of daily living, such as dressing, hygiene, cooking
and cleaning may also become increasingly difficult. Extra help
from carers may be necessary.
Read more about the impact of dementia and its relation to
Parkinson's in our Parkinson's dementia
information sheet.
Depression
Depression is more than feeling sad or unhappy now and then. A
diagnosis of depression will be made if someone has been in a low
mood for a long time - usually at least 2 weeks.
When someone is depressed they may experience a loss of pleasure
or interest in their usual activities.
A depressed person might also experience feelings of
hopelessness, helplessness, low self-esteem and inappropriate
guilt.
Other symptoms can include problems with thinking, sleep,
appetite, energy and sexual drive. Anxiety, panic attacks and
feelings of being 'wound up' often accompany depression.
Sleep changes include excessive sleeping and not wanting to get
out of bed, or having difficulty falling asleep, accompanied by
waking up in the early morning.
In some cases, depression may be particularly severe and may be
accompanied by suicidal ideas or abnormal changes in perceptions
(hallucinations) and beliefs (delusions). In such cases, it is
called 'psychotic depression' and may require hospitalisation.
Treatment can include medication or 'talking therapies', such as
cognitive behavioral therapy.
It can be very difficult for someone to recognise depression in
themselves. Therefore, if you think the person you care for is
depressed, it's important to let their healthcare professionals
know.
Read more in our Depression and
Parkinson's information sheet.
Anxiety
Anxiety can be an entirely normal feeling, ranging from worry
and stress to the bodily symptoms, including sweating, pounding of
the heart, shortness of breath and unpleasant feelings in the
stomach.
Some people with Parkinson's have anxiety related to the
'on/off' state of their motor symptoms. When 'off' and less able to
move well, they may develop significant anxiety symptoms and, at
times, may even have panic attacks.
If anxiety is related to movement problems, then talking to
a doctor about altering anti-Parkinson's medication can help.
For anxiety symptoms that do not respond to changes in
anti-Parkinson's medication, a trial of either talk therapy, such
as cognitive behavioural therapy, or medications may be
helpful.
For those who experience mild anxiety every now and then,
avoiding stimulants, such as caffeine, alcohol and cigarettes, can
help.
Some people find relaxation tapes, yoga, massage, acupuncture
and complementary therapies beneficial. Read more in
our Complementary therapies and
Parkinson's booklet.
Find out more about coping with anxiety in our Anxiety and Parkinson's information sheet.
Hallucinations
When a person hallucinates they may see, hear, feel, smell or
taste something that, in reality, does not exist.
Hallucinations are rare, but some people with Parkinson's may
experience visual hallucinations of quite complex scenes.
Typically, these involve seeing small animals, insects or other
people in the room. The length of the hallucination varies and is
usually visual. Auditory hallucinations are rarer for people with
Parkinson's.
Sometimes, when people with Parkinson's hallucinate, they
experience a feeling that an animal or object is present, just next
to them, but they do not actually see it.
Hallucinations are caused partly by Parkinson's itself and
partly by the medication that is prescribed to treat it. Dopamine agonists and anticholinergic drugs are more likely to cause
hallucinations.
If you are experiencing hallucinations, it is important that you
visit your doctor so that the cause can be identified and any
appropriate treatment given.
Our Hallucinations and delusions in
Parkinson's information sheet provides more detail on the
causes, treatments and kinds of hallucinations that people with
Parkinson's may experience.
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