When Parkinson’s Escalates Confusion, I Use Emotion Management Tools

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by Dr. C |

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Every New Year’s Eve, I stay awake until the stroke of midnight. It is a tradition of mine. I use this moment every year to be thankful for the good things that happened in the year, and to set a contract with myself for next year’s goals.

This year, while getting ready for bed, I grabbed a large cup of black tea and half a dozen chocolate chip cookies and settled into video gaming to help keep me awake. After the crystal ball had dropped in an empty Times Square, I climbed into bed. That night was one of the worst of my life.

As someone with a history of sleep problems connected to Parkinson’s disease, and as someone who writes about it, I probably should have been smart enough not to mess around with my normal bedtime preparation ritual.

I was feeling unusually disconnected, deep loneliness resonated with me following the holidays, and I had an intrusive sense of uncertainty about the future. Proceeding with this annual tradition of being grateful for the previous year and welcoming in the new year with hope is something that normally grounds me through winter’s early, dark nights. I was looking to discover that center again, but that didn’t happen.

Instead, I found myself unable to control my thinking. I was having strong surges of distressful emotions followed by intrusive thoughts connected to those emotions. The thoughts were largely negative, matching the distressful nature of the emotions.

It was as if I were spinning around in a garden full of thorn bushes. I would turn in one direction and try to move, only to be jabbed by thorns. I tried every direction and every move, but every thought led to being jabbed by thorns.

This lasted for six hours. While I was in the middle of it, I feared it would never end. That anxiety added to my inability to see a solution. I kept spinning around in my mind, trying to find my way around the thorny bushes. I was stuck, and it was excruciatingly uncomfortable.

When life becomes very uncertain, we do not draw upon the same problem-solving mental resources that we do when we have some degree of certainty about outcomes. In his book about thinking during uncertain times, titled “Thinking, Fast and Slow,” Daniel Kahneman writes that during times of uncertainty, we revert to a survival mode of thinking: Fast thinking is tied to survival emotions.

We want to be certain that our basic needs are being met and will be continually fulfilled in the immediate future. If we are unconvinced our needs will be met, then our brains will spin around endlessly looking for actions to improve our certainty about meeting those needs. It is a natural, automatic thing our brain does, but it’s not very effective when it happens in the middle of the night on New Year’s Eve.

I came so close that night to waking up Mrs. Dr. C and asking her to take me to the hospital. What stopped me was a small, simple statement I said to myself: “You have gone over the emotion threshold and have to wait until you return to baseline.”

I kept telling myself I would get through it, and I held on to that hope while my chemistry readjusted. During the night, I fluctuated between hopelessness and grasping this simple statement of certain fact.

Although I had not experienced emotional dysregulation as intense as this, it was still something that functions like all my experiences with exaggerated emotion. It comes with a shift over the threshold, which eventually returns to baseline. If I do what I know needs to be done, then I can limit the amount of time spent over the threshold, spinning in exaggerated emotions. I used the certainty I have about threshold management to reel me back in.

The brain is a very plastic organ, and it molds itself to whatever I ask it to do on a regular basis. I am finding that as the disease progresses, I am working harder at emotion management. The loneliness and uncertainty of these times make it harder, but also most necessary. I now need a little extra time every day allocated to emotion management.

It’s not just about having a bad night. It’s also about everything my brain did during the day. It’s not an easy course to chart, but it is a whole lot better than a night of terrors.

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Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, BioNews, and are intended to spark discussion about issues pertaining to Parkinson’s disease.

Comments

Patricia avatar

Patricia

Black tea and all that sugar? It might have been as simple as that, or partially. If I have a brownie in the evening I am awake for hours after going to bed. I have a massive sweet tooth, but I am finding sugar (and of course caffeine) has quite a marked effect on how I am feeling, and following on from that, an emotional response which I wouldn’t have (before) connected to the caffeine in the tea and chocolate - and the sugar. Just a thought.

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Dr. C avatar

Dr. C

Hi Patricia ~ Absolutely! When life combines a lot of things together (not all good) then I can go over the threshold. Cookies and tea just opened the door...
The key is to be aware, like you mention that you are, that sometimes the things we used to be able to handle we can't anymore.
I appreciate your comment and thanks for reading the column.
Dr. C.

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Minna Schmidt avatar

Minna Schmidt

Dear Dr. C,

Thank you very much for your post. In some ways, now is a difficult time indeed, but there is also much opportunity for strength and growth. One of my interests in relationship to PD as well as to general well being, is the active role of the gut and the process of digestion. I wonder if some of what you described could be attributed to this aspect of physiology? For example, you had mentioned that you had some cookies. I wonder if the sugar could have induced the condition you speak of? Of perhaps, consumption of a probiotic at this time may have helped to introduce calming bacterial metabolites such as butyrate, which may have helped the vagus nerve?

Thank you once again for sharing your post! Wishing you and yours all the very best in the New Year!

With best regards!

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Dr. C avatar

Dr. C

Hi Minna ~ Thanks for your comment. Your post gives me the opportunity to address why I have not yet written a column on the relationship between the gut and Parkinson's disease. This is a fledgling science with numerous overlapping multi-dimensional systems, ranging from epigenetics (more bacteria than there are cells in a body) to neurotransmitters/mind-body phenomena, and diet. The research indicates that there is some association between the gut and Parkinson's disease but it is a very complex problem. There are so many things going on -- classic case of "which came first, the chicken or the egg".
And I sheepishly admit, chocolate chip cookies late at night are not good for me!
Dr. C.

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Hammock avatar

Hammock

I am watching the slow death of a husband, father, grandfather whom is greatly needed in our lives. I cannot find anyone or anything to offer us any hope. Please is there any hope!

Reply
Dr. C avatar

Dr. C

Hi Barbara ~ Thanks for taking the time to comment. We have a book coming out this year called "Possibilities with Parkinson's: A Fresh Look" by Atmosphere Press. Maybe some of the essays in that book will offer some insight and shared experiences. Our prayers go with you.
Dr. C.

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