Some people with Parkinson's may experience anxiety, including feelings of unease, worry and fear.
It is often a natural reaction to situations we find threatening or difficult. There are a number of ways of managing anxiety.
What is anxiety?
Anxiety is a feeling of unease, such as worry or fear.
Everyone has feelings of anxiety from time to time. It's a natural reaction to situations we find threatening or difficult, such as moving house or money problems.
Usually anxiety disappears when the situation changes, or if we get used to the situation or can move away from it.
But some people become anxious for long periods of time and for no clear reason. This can make life difficult and may affect your work and social life.
If you feel anxiety is affecting your daily life, it's important to seek help from a healthcare professional. You may also need to find things you can do to manage your symptoms effectively.
What are the main symptoms of anxiety?
It's important to be able to recognise the symptoms of anxiety, so it can be treated as soon as possible.
People with anxiety may experience some of the following:
- a sense of dread
- constant worry
- difficulty concentrating
You may also experience physical symptoms if you're feeling anxious. These may include:
- pounding or racing heart (palpitations)
- feeling breathless
- nausea and stomach cramps
- a pale face
- a dry mouth
- muscle pain
When anxiety and panic carry on for a long time, you may experience feelings of hopelessness. These feelings may affect your ability to carry out everyday activities.
Sometimes, you may have symptoms of depression as well as anxiety.
Are there different types of anxiety?
There are 3 main types of anxiety, though these can overlap. Many people will experience more than 1 type.
Generalised anxiety disorder
This is when you experience excessive and uncontrollable worrying most of the time about everyday events in your life.
These are short periods of sudden, intense feelings of fear. They often happen in situations that are likely to make you feel anxious.
You may experience a racing heart, sweating and shortness of breath.
Some people think these symptoms are a sign that they are going to die, and they rush to the hospital for help. But usually a panic attack will last between 5 and 20 minutes before symptoms subside.
This is when you feel frightened of something that is not dangerous and would not usually make other people feel scared.
For example, agoraphobia is the fear of going out where there are other people around.
How does anxiety affect people with Parkinson's?
Anxiety may be related to changes in brain chemicals, which control and regulate your mood. Any concerns you have about living with a long-term condition may also cause anxiety.
Some people with Parkinson's have anxiety that happens when they are 'off'. When a person takes their medication, their symptoms will improve. But these symptoms can sometimes recur before the next dose is due, causing a person's condition to fluctuate. This is called 'wearing off'.
If you go 'off' and have difficulties moving, it can make you feel anxious or even cause a panic attack.
It's not only mobility problems that can be affected by wearing off. Some people may also experience an 'off' period with symptoms that are not related to movement, which can cause them to feel anxious.
You may find that when your movement symptoms are better controlled by medication, your anxiety improves.
If your anxiety symptoms increase when your medication is wearing off before the next dose is due, talk to your specialist or Parkinson's nurse. Changes to your medication regime may improve your symptoms.
Even if you don't have 'on' and 'off' periods, you may still have generalised anxiety if your Parkinson's symptoms aren't properly treated. Again, changes to your medication may help.
Always speak to your specialist or Parkinson's nurse about any adjustments to Parkinson's medication. Stopping your medication without talking to a healthcare professional can be dangerous.
Medication for anxiety
There is no evidence to suggest that the symptoms of anxiety in people with Parkinson's can be treated effectively with medication, additional to your Parkinson's drugs.
But your GP or specialist may discuss this option if severe anxiety is affecting the quality of your day-to-day life.
The most common medications used to treat anxiety in these circumstances are antidepressants. These may improve symptoms of both anxiety and depression.
There are other types of medication available for anxiety, so speak to your GP, specialist or Parkinson's nurse about what may be best for you. They should also be able to advise you on how to take antidepressants alongside your Parkinson's medication.
Lifestyle adjustments that can help anxiety
Finding ways to relax
Simple measures, such as making time to relax, can be helpful. Try doing things you enjoy, such as reading a book or listening to some music.
Try to maintain a healthy, balanced diet. It can also help to avoid too much caffeine (found in tea, coffee and some fizzy drinks) and alcohol, especially late in the evening. These can make some of the physical symptoms of anxiety worse.
You can help combat stress and release anxiety through regular exercise, such as walking or swimming.
Therapies for anxiety
In the majority of cases, anxiety can be treated. And there are different things you can try to help manage your symptoms.
We hear from many people with Parkinson's who find complementary therapies relaxing. Types of therapy include:
Yoga is a gentle exercise that aims to improve flexibility, strength, balance and breathing. There is some evidence that yoga could help with anxiety and stress.
Many people find that having a massage helps them to relax.
A massage therapist uses various techniques, including stroking, kneading and rubbing, to manipulate the body using pressure. It is not suitable for people with certain medical conditions, such as a history of bleeding disorders.
Acupuncture is part of traditional Chinese medicine. It involves a therapist inserting thin needles at particular points on your body.
Although the evidence that acupuncture can reduce anxiety is mixed, some people may find it helpful.
Tai chi is a Chinese martial art that puts emphasis on balance and movement. It involves moving the body slowly and gently – there's no physical contact.
There is not enough evidence yet to say whether it reduces anxiety, but it may have psychological benefits.
If you want to take anything by mouth or apply it to your skin as a complementary therapy, check with your GP, specialist or Parkinson's nurse first.
Talking to others about anxiety
Sharing your worries and fears with a trusted friend or family member can help reduce anxiety.
Talking to other people with Parkinson's can also help, as you share your experiences and find out how others cope with similar problems. It may help you to visit your Parkinson's UK local group.
If you'd prefer to speak to a professionally trained counsellor, ask your GP for information. Many surgeries have counsellors linked to their practice.
There are also counselling organisations that can give you details of private counsellors, including the British Association for Counselling and Psychotherapy.
The mental health charity Mind produces a free guide - Making Sense of Talking Therapies. This explains the different types of talking therapies available, how they can help and what they involve.
Cognitive behavioural therapy (CBT)
You may find cognitive behavioural therapy (sometimes called 'talking' therapy) effective in dealing with anxiety. It works by changing 'unhelpful' everyday thoughts and behaviours that can lead to feelings of anxiety or make anxiety worse.
CBT can take place in groups or individually with a therapist, who may be a clinical psychologist, psychiatrist or specially trained nurse. It usually involves a course of weekly sessions.
You can also find CBT courses online, such as 'FearFighter', which may be available through your GP. Talk to your GP or Parkinson's nurse for advice.
There are a number of self-help CBT books that are recommended by the NHS for people with anxiety.
Many of these are available at your local library via 'Reading Well Books on Prescription'. Again, ask your GP or Parkinson's nurse for more advice.
Advice for family, friends and carers
Anxiety symptoms can significantly affect a person's quality of life. If this happens to someone you know, try to encourage them to speak to their GP, specialist or Parkinson's nurse.
They may be referred to a mental health specialist who can recommend treatment.
If you are a carer, it's completely natural for you to feel many of the same feelings as the person with Parkinson's. These feelings may include anxiety, fear about the future, depression, fatigue and concern about any changes in your relationship.
With this in mind, you should also try to look after your own physical and mental health as much as you can.
Taking care of yourself can be difficult, but it is important. It will also mean you are better able to care for your loved one.
Many carers find it helpful to join a support group where they can meet other people in a similar situation. Many Parkinson's UK local groups have special activities for carers.
Other useful contacts for anxiety
Download PDF or order a printed copy
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"I've become aware of certain triggers over time, but all too often there's no apparent reason and there's still no telling when anxiety might strike."
Helpline and local advisers
Our helpline and Parkinson's local advisers are here to answer any questions you have about anxiety.
Call us on 0808 800 0303.
Last updated March 2015. We review all our information within 3 years. If you'd like to find out more about how we put our information together, including references and the sources of evidence we use, please contact us at [email protected].