Symptoms of depression and Parkinson’s

Some symptoms of depression are also common in Parkinson’s, which can make depression difficult to diagnose. 

These can include:

• Trouble sleeping. You may have difficulty getting to sleep, but that doesn’t necessarily mean you’re depressed.
• Fatigue. An overwhelming sense of tiredness can be a symptom of both Parkinson’s and depression.
• Changing mood. Your mood may go up and down because of how your Parkinson’s symptoms can change, either over the course of a day or over time. These changes don’t always mean that you have depression. Sometimes, these feelings may be related to changes in your Parkinson’s medication.

See our information on fatigue and Parkinson’s and sleep and night-time problems in Parkinson’s.

What causes depression in people with Parkinson’s? 

There isn’t a single cause of depression generally and we don’t know for sure why people with Parkinson’s get depression. 

Generally, depression may be linked to:

• Family history. Depression can be connected to genetics. If you have a family history of depression, you are more likely to have depression yourself.
• Stressful life events such as health, family or money worries.
• Menopause, especially in the first few years.
• Serious or long-term illness. 

For people with Parkinson’s, depression may be related to:

• A lack of dopamine. Some research suggests that a shortage of dopamine, which causes the symptoms of Parkinson’s, can trigger depression and anxiety.
• A Parkinson’s diagnosis. This can be very stressful and upsetting. For some people Parkinson’s can impact every aspect of life. So it’s completely understandable that you might have feelings of depression.
• Social isolation. As Parkinson’s symptoms progress, some people may find they’re not able to socialise as much as they used to. This could lead to loneliness and isolation, which may increase the risk of depression.
• Parkinson’s medication "wearing off". This type of depressed mood or anxiety may improve after the next dose of Parkinson’s medication is taken. 

People with Parkinson’s can develop depression at any stage of the condition. Some people have depression months before they notice Parkinson’s symptoms. 

See our information on wearing off and involuntary movements.

Things you can do yourself

There are some things you can try yourself to help with symptoms of depression.

Treatment and therapies for depression 

If self-help measures don’t improve your symptoms, or if your depression is more moderate or severe, your GP may suggest a course of talking therapy. 

Cognitive behavioural therapy (CBT) 

CBT is a talking therapy designed to change how you think and act and reduce symptoms of depression. It looks at how you think about yourself, your environment and the people around you, and how these thoughts affect your mood and behaviour. You may do this individually with a therapist or in a group.

CBT tries to help you manage problems by breaking them down into more manageable parts which feel less overwhelming. It is a practical kind of talking therapy that usually focuses on issues you’re going through at the time. 

Your therapist will try to teach you new skills to help deal with negative thoughts and problems more effectively. They may use techniques including relaxation, distraction and goal setting.

As part of a CBT session, your therapist may ask you about your thoughts, feelings, and behaviour (how you respond to your thoughts and feelings) related to Parkinson's and its impact on your life.

Therapy for depression 

A therapist can work with you to understand underlying issues that may be contributing to your depression. 

Therapists may use different types of talking therapy, including CBT. 

Some GP practices have a therapist, or your GP, specialist or Parkinson’s nurse can refer you. 

You may be able to refer yourself to an NHS talking therapy service without a GP referral on the NHS website.

Unfortunately, there can be long waiting lists to access NHS talking therapies (including CBT). Your healthcare professional should let you know how long the wait for treatment is likely to be and who to contact to ask about your progress on the waiting list. They may provide you with some self-help resources, such as books or apps, to try as you wait to see a therapist.

Speak to your GP or Parkinson’s nurse to see what’s available near you.

You can also pay to see a therapist or counsellor privately. To find one in your area, contact the British Psychological Society or the British Association for Counselling and Psychotherapy.

The Health and Care Professions Council website provides a list of UK-registered therapists and counsellors.

Antidepressants 

Antidepressants are drugs used to treat moderate to severe depression. There are several types of antidepressants. They work by increasing the levels of certain chemicals in the brain. They may be prescribed by themselves, or alongside talking therapy.

It’s important to remember that some antidepressants will be more suitable for you than others. Your prescription will depend on your symptoms and what other medications you’re taking. If your GP or specialist thinks that antidepressants are right for you, they can talk through your options. Your specialist will also be able to advise you on how to take antidepressants alongside your Parkinson’s medication. 

Not every antidepressant works for everyone and you may have to try different options to find one that works for you. Your doctor will advise you about this. 

It may take up to 4 weeks before you notice an improvement in your symptoms. 

As with most medications, antidepressants can have side effects. Speak to your GP, specialist or Parkinson’s nurse if you have any concerns about potential side effects. 

Antidepressants are not addictive, although some people may experience symptoms, such as irritability or nausea, when they stop taking them. Symptoms which you get after you suddenly stop taking a medicine are called withdrawal symptoms. 

It is very important that you take antidepressants as prescribed, even if you feel better. Treatment will normally continue for 6 months after your symptoms improve, but may continue for longer, depending on your health professional’s advice. Your doctor may advise that you stop taking your antidepressants gradually, reducing your dose over time. This may help you avoid withdrawal symptoms. 

St John’s wort

St John’s wort is a herbal treatment that can be used for depression. It is not recommended by doctors generally and is not recommended for people with Parkinson’s. This is because it can interact with your Parkinson’s drugs.

St John’s wort can come mixed with other components to create different brands of the herbal treatment. This could increase the possibility of side effects and interactions.

Parkinson’s drugs 

If you’re feeling symptoms of depression, talk to your GP, specialist or Parkinson’s nurse to make sure your Parkinson’s drugs are working well. 

Dopamine agonists and impulsive and compulsive behaviours 

Parkinson’s medication can cause impulsive and compulsive behaviours. An impulsive behaviour is when someone can’t resist the urge to carry out a certain activity. In compulsive behaviour, a person has a strong desire to act in a certain way, often repeatedly. 

Taking dopamine agonists for any Parkinson’s symptoms increases the risk of impulsive and compulsive behaviours.

Not everyone taking dopamine agonists will experience these behaviours. However, people with Parkinson’s with depression or apathy are at a higher risk of developing impulsive or compulsive behaviours when taking dopamine agonists.

Because of this, it’s important to speak to your specialist or Parkinson’s nurse as soon as you notice impulsive or compulsive behaviours.  

Examples include:

• eating, shopping or gambling too much
• unusually strong sexual thoughts and urges (hypersexuality). 

You might also notice a strong urge to:

• work on your hobbies, such as gardening, for long periods of time (hobbyism)
• collect and store items you don’t need (hoarding)
• do activities that have no purpose, over and over (punding). For example, taking electronic equipment apart.

If you support someone with Parkinson’s, you might notice these behaviours before they do. 

See our information on drug treatments for Parkinson’s and impulsive and compulsive behaviour in Parkinson’s.

Advice for people close to someone with Parkinson’s

If you support or are close to a person with Parkinson’s, you may spot the symptoms of depression more clearly than the person themselves. You may also notice their symptoms changing or getting worse if they’ve already been diagnosed with depression. If this is the case, speak with the person and encourage them to talk to their GP, specialist or Parkinson’s nurse. 

Other types of support include: 

• Helping someone to take their medication, including for depression, as prescribed. This can feel like a big responsibility. Ask their GP, specialist or Parkinson’s nurse to help you understand the type and timing of medication. A chart or diary may be useful to help record this.
• Supporting someone during medical appointments. Have a chat with the person you support about how you can help them get the most out of appointments. With permission, it may help them if you speak about any symptoms of depression. 

Looking after your own mental health

It’s important for family, friends and carers to recognise that the mood of someone with Parkinson’s can negatively affect their own emotions.

It’s normal, if you support someone with Parkinson’s, to feel many of the same feelings as the person with Parkinson’s. 

These feelings can include depression. You may feel:

• difficulty accepting the Parkinson’s diagnosis
• fear about the future
• anxiety
• confusion about the changes to your role and relationship with the person close to you.

Because of this, people close to someone with Parkinson’s should try to look after their physical and mental health as much as they can. This can be difficult, but there is support available.

There are lots of things you can do which may help:

• Joining a support group. The Parkinson’s UK Facebook Community Group and the Parkinson’s UK forum could connect you to other people in a similar situation. Support groups might meet online or in person, depending on the area. Find a Parkinson’s UK group on our website or visit our forum.
• Staying connected to family or friends. They will hopefully be there to support you where they can.
• Speaking to your employer. If you’re working, look into ways of making things easier, such as flexible working or specific leave arrangements, or an employee assistance programme.
• Relaxation. Meditation, yoga or massage are just some ways to relax. But find what suits you best.
• Taking a break when you need one. Read more about respite care.
• Looking after your physical health. Physical activity, good sleep and eating well can help you feel your best. 

For professional support, talk to your GP. Don’t be worried about telling them how you feel. They are there to help.  

Our helpline can provide more information on any aspect of supporting someone with Parkinson’s, including how you’re feeling. They can help you work out what support may be available locally. Call free on 0808 800 0303. 

The Carers UK website has information on looking after yourself, including on depression.

Get this information in other formats

If you prefer to have something printed to read or want to download a PDF, choose an option below:

• Download our Depression and Parkinson’s booklet (PDF)
• Order a free printed booklet from our online shop
• Order a free printed booklet by phone