Depression is one of the most common non-motor symptoms of Parkinson’s Disease, with up to 60 percent of patients being affected during the course of the disease. However, it often is overlooked and undertreated.
Causes and symptoms of depression
Depression is a mood disorder in which mixed feelings of sadness, loss, and hopelessness are experienced, interfering with quality of life. Depression can have different causes, including psychological, biological, and environmental. In people with Parkinson’s disease, the principal cause of depression is thought to be an imbalance in certain neurotransmitters that regulate mood.
Motor and cognitive symptoms of Parkinson’s disease may be intensified by depression and researchers have found that treating depression can improve the motor symptoms of the disease as well as the quality of life.
Different people may experience symptoms of depression in different ways and severity, from mild to severe. However, some are common, such as feelings of guilt, worthlessness or helplessness, thoughts of death or suicide, decreased interest or pleasure in activities, poor attention and concentration problems, sleep disorders, feeling slowed down or restless inside, pessimism or self-blame, changes in appetite, low energy or fatigue and ongoing aches and pains, headaches and/or digestive problems. People with Parkinson’s disease also may experience anxiety and stronger symptoms of pessimism and restlessness.
Managing depression in Parkinson’s disease
Some medicines may make people with Parkinson’s disease more prone to depression and some symptoms of the disease itself may overlap with the symptoms of depression.
People with Parkinson’s disease should be aware that depression may be a common symptom in the course of the disease, and be prepared to share their feelings with their healthcare providers.
As different people may experience different symptoms of depression, the best management solution is a tailored combination of medication, counseling, exercise, and social support.
- Medication – Antidepressants are commonly used to help manage depression, and include selective serotonin reuptake inhibitors (SSRIs) (fluoxetine, sertraline, paroxetine, citalopram, and escitalopram) and non-SSRIs (venlafaxine, mirtazapine, buproprion, and tricyclic antidepressants). Different people may react differently to the same medication. Therefore, if a treatment does not work in one patient, another one, or a combination of two, may be indicated.
- Counseling or psychotherapy is a treatment option for people with depression and is used in combination with medication
- Electroconvulsive therapy (ECT) is usually for people with severe or non-responsive depression when no other treatment works. It is relatively safe and effective for severe depression and also may help improve motor symptoms in people with Parkinson’s disease.
- Exercise is a simple and inexpensive way to improve mood and symptoms of depression. Yoga, Tai-Chi, stretching, and walking are examples of exercises that may be beneficial in people with Parkinosn’s disease.
- Non-conventional and complementary therapies also may be helpful and include light therapy, relaxation techniques, massage therapy, acupuncture, aromatherapy, meditation, and music therapy.
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