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

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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