Mental Health and Parkinson’s: What to Know and How to Treat

Mental health concerns are more common than we realize with Parkinson’s disease (PD). Prevalence of mental health concerns (psychiatric diagnosis) is around 40-60% of people with PD with the most common being depression and anxiety, which are typically experienced early in the disease course.

Mental health concerns can range from depression, anxiety, psychosis, apathy, impulse-control disorders, or cognitive issues, which all can be non-motor symptoms of PD. These non-motor symptoms often precede motor symptoms by 10 years or more. This is related to the shift in neurotransmitters within your brain which later lead to movement symptoms.

To complicate things more, sometimes PD medications can exacerbate or bring on mental health concerns. This is referred to as Levodopa-related fluctuations. Tracking these fluctuations with a daily log or journal is helpful to see if there is a pattern in terms of when you take your medication and when mental health symptoms occur.

It can be tricky to know when to seek medical advice for mental health concerns. A good rule of thumb is when your mental health concerns are interfering with your normal level of function.

7 treatment options I often see recommended and explored:

• Exercise: Regular exercise is known to improve your mental health by easing depression and anxiety. Exercise stimulates certain neurotransmitters that improve mood.

• Journaling: Journaling both your non-motor and motor symptoms will help you understand triggers and if there is a connection with your PD medication. Additionally, journaling your thoughts is a great way to get worrisome thoughts and feelings out of your head and onto paper for symptom relief.

• Social support: Staying connected with others both within and outside the PD community is helpful for connection, motivation, encouragement, and learning from others’ experiences. Click here to learn more about staying connected with your PD community.

• Breathing exercises: Breathing exercises can help you calm your fight-or-flight response, lower stress, and relax. Do not forget to breathe with good posture for better results.   

• Medications: Your medical team can explore the use of psychiatric medications as well as your PD medication should be checked to ensure it is properly optimized and appropriately adjusted.

• Music Therapy: Music therapy can help improve your movement, vocal production, and mood. I am sure we all have experienced how a certain song or music can instantly change our mood.

• Talk therapy: Talk therapy can help you learn ways to cope with distress, learn more about yourself, and improve your well-being. When your voice makes it harder to participate consider art for expression.