The Impact of Parkinson’s Disease on Mental Health and Emotional Wellbeing

Parkinson’s disease ranks as the second most widespread neurodegenerative ailment. It mostly affects over 1% of 60+ adults all over the world. Besides physical symptoms, such as movement disorders, there are also Parkinson’s personality changes. Understanding these impacts on mental health and emotional well-being is important to take proper care and support to individuals with Parkinson’s.

Understanding Parkinson’s Disease

Researchers believe that Parkinson’s occurs due to genetic and environmental factors. Emotional trauma and Parkinson’s disease are closely connected. Life stress may contribute to the development of depression and then the disease itself.

Does Parkinson’s affect your mind? It sure does! Here is the physiology of Parkinson’s disease. Nerve cells in the basal ganglia, a part of the brain that manages movement, are damaged or lost. This way, neurons produce less dopamine, which causes

• Tremors and shaking
• Rigid muscles
• Slow movements
• Loss of automatic movements
• Impaired balance and coordination
• Trouble peeing and constipation
• Dizziness and blurred vision
• Excessive sweating
• Excessive production of saliva
• Swallowing and chewing problems
• Skin problems
• Parkinsonian faces or limited expressions
• Sleeping problems

Parkinson’s personality changes affect mental health and emotional well-being, leading to

• Anxiety and depression
• Emotional changes, also known as Parkinson’s mood swings
• Memory and thinking problems
• Speaking problems

Parkinson’s Disease Mental Symptoms

Adults with Parkinson’s symptoms experience various mental health troubles alongside physical ones. There is a mutual cause-and-effect relationship between Parkinson’s disease and stress. Both the disease and mental issues lead to Parkinson’s personality changes and impaired quality of life for patients. 

Depression

Depression refers to feelings of persistent sadness, loss of hope, interest, or pleasure in activities that used to bring joy. People with Parkinson’s disease may experience depression while coping with chronic symptoms and physical limitations.

Anxiety

Anxiety is a feeling of excessive worry, nervousness, or fear about future events or situations. People with Parkinson’s disease might feel anxious. They are uncertain about their health and worry about changes in their abilities and the disease progression.

Apathy

Apathy is a lack of motivation, interest, or enthusiasm for activities and social interactions. It also refers to a general disinterest in life and a lack of emotional engagement.

Psychosis

Psychosis involves a loss of contact with reality, leading to hallucinations. This includes seeing or hearing unreal things and false beliefs or misinterpretations of reality. 

Cognitive Impairment

Cognitive impairment refers to trouble remembering, thinking, learning new things, concentrating, or making decisions that affect their everyday lives.

Depression and Parkinson’s Disease

Depression is one of the most common psychiatric symptoms of Parkinson’s disease, affecting up to 40% of patients. Quite often, it goes undiagnosed and untreated, which results in Parkinson’s personality changes. Also, the combination of physical and mental limitations contributes to the development of depression. 

Common symptoms in this case include:

• Fatigue and weakness
• Sadness and helplessness
• Lack of interest and drive
• State of unease or dissatisfaction
• Irritability
• A feeling of despair or lack of hope. 

Diagnosing can be difficult because the symptoms overlap with those of the disorder. Yet, early identification and management of Parkinson’s disease mental symptoms are important for optimal care. 

Anxiety and Parkinson’s Disease

Anxiety disorders are quite common in adults with Parkinson’s disease. Up to 55% of patients experience various anxiety disorders, such as generalized anxiety disorder (GAD), anxiety attacks, social anxiety disorder, and obsessive-compulsive disorder (OCD).

The uncertainty about disease progression, anticipation of physical troubles, and independence loss trigger fear and worries. Treating anxiety with medication, therapy, and stress-management techniques may improve well-being and coping skills.

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Apathy and Parkinson’s Disease

Apathy is often overlooked in disease care and coexists with depression. Social and behavioral apathy is prevalent in people with Parkinson’s disease.

Apathy leads to a lack of motivation, interest in new activities, and a desire to see other people. Therapies focusing on increasing stimulation, setting achievable goals, and managing depression help ease apathy symptoms.

Psychosis and Parkinson’s Disease

Psychosis usually occurs in the latter stages of Parkinson’s disease. Common symptoms are visual hallucinations, sensory issues such as illusions, and paranoid delusions. These symptoms typically come back or worsen as time goes on.

Psychosis results from the use of certain medications, delirium, and dementia. This condition increases the risk of morbidity and mortality. Decreasing the dosage of anti-Parkinson disease drugs may ease these symptoms, but worsen physical ones.

Non-pharmacological methods, such as reality orientation and caregiver help, are also important in managing psychosis.

Cognitive Impairment and Parkinson’s Disease

Cognitive impairment contributes greatly to Parkinson’s disease personality changes. There may be mild cognitive impairment in 20-50% of patients that doesn’t affect daily life or work much. Up to 40% of Parkinson’s disease patients develop dementia, which significantly impairs daily life.

Cognitive impairment makes people feel distracted and disorganized. They find it difficult to plan, focus, and accomplish tasks. These symptoms impact daily functioning and develop emotional distress.

Parkinson’s Mood Swings

Mood swings are common in people with Parkinson’s disease and can fluctuate throughout the day. Up to 50% of people suffer from depression and anxiety, 40% for apathy, and up to 30% for Impulse Control Disorders (ICB). 

Parkinson’s Disease and anger outbursts are also strongly linked, which affects not only patients but also their caregivers. Learning the disease triggers and using relaxation techniques and mindfulness can help calm mood swings.

Managing Mental Health and Emotional Wellbeing With Parkinson’s Disease

Medications to manage symptoms of depression, anxiety, and psychosis

For depression in Parkinson’s Disease, cognitive-behavioral therapy (CBT) is often the first-line choice due to its effectiveness and minor side effects. If CBT alone isn’t enough, doctors may prescribe antidepressants like selective serotonin reuptake inhibitors.

Pimavanserin (Nuplazid) is the only medication approved to treat psychosis symptoms in patients with Parkinson’s disease.

Counseling or therapy to address emotional issues related to the disease

Emotional support and counseling play a significant role in managing Parkinson’s disease. Patients and their families find support and guidance from mental health professionals and learn how to deal with the emotional and psychological effects of the condition.

Specialists can also assess changes in mood and cognitive functions, and adjust treatment.

Researchers believe that cognitive-behavioral therapy (CBT) may be effective in improving anxiety and depression symptoms and sleep quality in people with Parkinson’s disease.

Exercise and physical activity to improve mood and reduce stress

Physical activity, including yoga, mindful walking, and swimming are highly beneficial. Exercises help improve mood, foster relaxation, support balance, and mobility. Aerobic activity and stretching may also support cognitive skills in Parkinson’s patients.

Support groups or peer counseling to connect with others who have the condition

Support groups and counseling programs help interact with people with the same mental and physical problems. There, people may support each other and share experiences. Also, compared to medications, this type of therapy has no side effects and can be a long-term treatment.

Stress-reduction techniques, such as meditation or relaxation exercises

Various methods can help individuals manage stress, reduce anxiety, and reduce other symptoms’ severity in people with Parkinson’s Disease. Among them are mindfulness meditation, deep breathing exercises, and progressive muscle relaxation techniques. Research shows that it is especially effective in managing anxiety and depressed mood.

Stem cell therapy for Parkinson’s disease

Using stem cell therapy with mesenchymal stem cells (MSCs) for Parkinson’s disease relies on the ability of MSCs to turn into the same kind of brain cells that PD patients are missing. They’ve shown they can restore the activity of certain brain cells that are important for movement.

Many patients have had an improvement in speech, the reduction of tremors, and disease progression halt. Stem cell therapy might also help by reducing inflammation in the brain, supporting nerve cells, and encouraging the growth of new blood vessels.

Discover more about the innovative treatment options for Parkinson’s disease involving stem cells in this article.

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MD, Endocrinologist, Pediatrician, regenerative medicine specialist, R&D director

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Anna Nadiryan Author

Dr. Aleksandra Fetyukhina, MD Reviewer

Medical Advisor, Swiss Medica doctor