Discover why mood disorders are ignored and how to address them effectively.
Parkinson’s disease is commonly associated with movement-related issues like tremors, stiffness, or slowness in walking. Yet, there are several non-motor Parkinson symptoms that significantly impact patients’ quality of life but are often underestimated.
Among these, anxiety, depression, and apathy are particularly frequent and represent key aspects of the disease progression. Understanding and addressing these symptoms is essential for ensuring comprehensive care.
Causes of Mood Disorders in Parkinson Symptoms.
Mood disorders in Parkinson’s disease are believed to stem from changes in brain chemistry caused by the disease itself.
Neurotransmitter imbalances not only affect movement but also play a crucial role in mood regulation. Dopamine deficiency is closely linked to symptoms like anxiety and depression, while serotonin loss contributes to mood swings, insomnia, and reduced appetite.
Additionally, levodopa therapy, commonly used to manage motor symptoms, can lead to emotional fluctuations known as non-motor fluctuations. These require careful monitoring to balance the treatment’s benefits with emotional stability.
Common Symptoms to Watch For.
Mood disorders in Parkinson’s patients can manifest in diverse ways.
Anxiety often brings persistent worry, restlessness, muscle tension, trouble concentrating, and insomnia.
Depression may appear as apathy, a lack of interest in daily activities, and pervasive sadness, often accompanied by feelings of emptiness and guilt.
Rapid mood changes, from sadness to anger or irritability, are also common and noticeable to family and friends.
The Challenge of Diagnosis of Mood Disorders.
Diagnosing mood disorders in Parkinson’s is complex, as many symptoms overlap with those of the disease itself. For example, tremors and muscle restlessness may be misattributed to Parkinson’s rather than anxiety.
These symptoms can also appear years before motor issues develop, which themselves often precede a formal Parkinson’s diagnosis. Patients already dealing with motor difficulties may notice mood changes during “off” periods, when dopamine levels drop significantly.
In the 1970s, researchers Marsden and Parkes highlighted that off periods could be accompanied by intense anxiety, flushing, sweating, and limb pain. More recent studies, like those by Menza and Mark in 1994, revealed that mood disorders are more prevalent in Parkinson’s patients than in individuals with disabilities from other conditions.
These findings underscore the complexity of identifying mood swings in Parkinson’s and the need for an integrated approach to diagnosis and treatment.
Management Strategies: Medical and Non-Medical.
Managing mood disorders in Parkinson’s requires a personalized strategy that combines pharmacological treatments with non-medical approaches.
Medications for anxiety and depression can be effective but must be used carefully. SSRIs (Selective Serotonin Reuptake Inhibitors) are commonly prescribed but may cause side effects like insomnia or nausea. MAO inhibitors can improve both mood and motor symptoms but require strict dietary control to avoid dangerous interactions. Dopaminergic drugs, when dosed appropriately, can also stabilize mood, particularly in patients experiencing treatment-related fluctuations.
Non-pharmacological strategies also provide significant benefits.
Practices like yoga and meditation reduce cortisol levels, the stress hormone, and promote better emotional regulation. Music therapy fosters relaxation and evokes positive emotions, stimulating the release of dopamine, serotonin, endorphins, and oxytocin. Aromatherapy with essential oils such as lavender and chamomile helps calm the mind and alleviate tension.
Regular exercise, structured activities, and social interactions are equally crucial in combating apathy and enhancing psychological well-being.
Socialization: A Key Antidote.
Social isolation is one of the most insidious consequences of Parkinson’s, often leading to depression. The disease’s limitations can cause patients to withdraw from social life, increasing the risk of mood disorders.
Maintaining social connections is essential. Even small actions, like taking a walk to meet neighbors or having a chat with a friend, can positively impact mood and self-esteem. Innovative therapies, such as AMPS delivered through the Gondola® Home device, can enhance mobility, reduce motor blocks, and facilitate participation in social activities. Building connections with others is fundamental to fighting loneliness and stabilizing mood.
Addressing non-motor symptoms is essential to improving the quality of life for Parkinson’s patients. Don’t ignore these signs—recognizing and addressing them with proper support can make a real difference.
Sources:
- Depression, anxiety, and apathy in Parkinson’s disease: Essential aspects for patients. International Parkinson and Movement Disorder Society, 2018.
- Depression and anxiety disorders in Parkinson’s disease: Clinical and therapeutic implications. Moretti, G. Perugi – Department of Psychiatry, Neurobiology, Pharmacology, and Biotechnology, Section of Psychiatry, University of Pisa.
- Depression and Parkinson’s disease: Current knowledge. Neurol. Neurosci. Rep. L. Marsh, 2013.
- Parkinson’s disease and depression: The relationship to disability and personality. J Neuropsychiatry, Menza MA, Mark MH, 1994.
- Bromocriptine in parkinsonism. Lancet, Aug, Marsden CD, Parkes JD, 1976.
- Anxiety: An ignored aspect of Parkinson’s disease lacking attention. Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER). Dharmendra Kumar Khatri, Mamta Choudhary, Anika Sood, Shashi Bala Singh. Biomedicine & Pharmacotherapy, 2020.