Focusing on the emotional and psychological changes that someone with Parkinson's experiences can be just as important as the physical changes in understanding and living with the disease.
Emotional factors that affect someone with Parkinson's can be seen as both internal and external. Some changes that occur can be directly due to the disease process itself, which causes an alteration in brain chemistry. Other emotional changes can be seen as influenced by external factors and the person's reaction to them. Having a chronic neurologic condition is stressful, and people react to stress in different ways. Some people see it as a challenge and others as a problem. Parkinson's disease has a significant impact on family and friends and can create many losses in a person's life. Listed below are some common emotional reactions to Parkinson's, followed by suggestions for coping techniques.
Denial, a feeling of shock and disbelief and the question of "Why me?" are common reactions, especially at the time of initial diagnosis and early on in the disease process. Because Parkinson's can have such a subtle onset before an actual diagnosis is made, people very often attribute symptoms to other causes. People also sometimes report a general feeling of uneasiness or some anxious, depressed feelings prior to diagnosis. When a diagnosis is finally made it can come partially as a relief, but there is often shock and fear for the future.
Depression is one of the most common reactions to Parkinson's, occurring by some estimates in 50% of people with the disease. Some doctors feel that depression may actually be part of the disease process itself. Medications for Parkinson's can also affect the experience of depression.
A depressed mood is also often a normal response to dealing with the losses and lifestyle adjustments that come with living with a chronic disease. Losses and changes often occur in the areas of social activities, work, relationships, physical mobility and general independence. Along with depression can come anger because this disease has upset your life and plans.
The good news about depression is that it is treatable and can definitely get better. Although depression is often mild, it can become severe. It is important to recognize the symptoms of clinical depression and inform your doctor.
Symptoms of depression include:
- Depressed/sad mood
- Diminished interest or pleasure in activities
- Loss of appetite or overeating
- Sleeping too little or too much
- Fatigue or loss of energy
- Feelings of worthlessness or hopelessness
- Difficulty concentrating
- Restlessness, feeling keyed up or being slowed down to the point that it is noticed by others
- Recurrent thoughts of death or suicide
Anxiety can range from a general feeling of tenseness or uneasiness all the way to a full blown panic attack. Sometimes these feelings are experienced prior to the diagnosis of Parkinson's. Anxiety can be the result of worrying about how Parkinson's will affect your lifestyle and future or concern about how quickly the disease will progress and what kinds of limitations to expect. Because Parkinson's disease has a different course for everyone, it is difficult to know what the future holds, and this can create anxiety. Like depression, anxiety can be treated by medications and counseling. Talk with your doctor.
Stress and chronic illness are interconnected. Stress comes from a variety of different sources that can be physical, as well as emotional. Stress can come from daily life tasks, events, problems, fatigue, anxiety and frustration with having to deal with the limitations and life adjustments that Parkinson's disease often creates. The important thing to be aware of, however, is that stress can worsen Parkinson's disease symptoms, especially tremor. Therefore, it is important to focus on stress management and relaxation in your daily life.
Stress can have a very negative impact on the symptoms of Parkinson's disease, so it is important to focus on managing the stress in your daily life and finding some relaxation. The following are some stress management techniques you may want to incorporate into your life. Not all techniques work for everyone. You have to experiment a little to find something that works for you. Try more than one technique, and then commit to regular use. Remember that the key to successful stress management is practice.
The American Parkinson Disease Association Information and Referral Center at Cedars-Sinai Medical Center can provide referrals to resources and services in the community that can help in coping with Parkinson's disease. Call toll free Monday through Friday (877) 223-3277.
