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Depression in Parkinson’s Disease

Posted Feb 18 2011 11:32am

The thing I like about having Parkinson’s disease (did I just say that?) is that you can blame so many other things on it and 90 out of 100 times, it’s really true. Like eating chocolate or ice cream.  It’s really true that a person with PD may very well not be able to taste mama’s homemade spaghetti, but bring in the dessert and our taste buds are all over it.  Salty and sweet?  We love it.  Anything else may be so so because, believe it or not, Parkinson’s disease can affect the taste buds.

What about depression?  At one of the very first appointments I had with my neurologist, I learned that depression is one of the very first signs of Parkinson’s disease, but it is also one of the most overlooked signs for Parkinson’s disease.

Most people, not knowing this fact about depression being connected with PD, often don’t want to talk about.  There has been such a stigma about those who are depressed that society often views depression as a mental illness, a sickness, a part of your life that you can’t or won’t deal with, a weakness.  The fact is, depression can be many things.  It is a chronic illness for some, needing constant medical supervision.  It can be a chemical imbalance that the patient has no control over except to be placed on medication.  It can be caused from pregnancy.  It can be from stress, fatigue, hormones and more.  It can be from having Parkinson’s disease.

According to pubmed.gov , “Depression has been shown to be more common in Parkinson’s disease (PD) than in other chronic and disabling disorders.”  In another report it is stated that “Depression and anxiety occur more frequently in PD than in controls. Depression occurs in a bimodal pattern in PD, with increased rates at the onset and a later peak in advanced disease. Both anxiety and depression can also occur before the first motor symptoms of PD and predate the diagnosis of PD, indicating that these co-morbidities are manifestations of the underlying disease process of PD.”

There is more than one person most likely breathing a sigh of relief.  In all honesty, I did.  I felt like I wasn’t going nuts and couldn’t handle the stress in my life.  That knowledge came after I had been placed on an anti-depressant four years prior for ‘depression’.  I wouldn’t really say I was depressed, although talking to my regular doctor back then, she seemed to think so.  It was more of an anxious feeling I felt – feeling on edge a lot of the time.

Depression occurs in up to 70% of PD cases, 20% of which are severe, meaning that the depression is constant and is most definitely connected with direct dysfunction and dementia.  Of the 70% of people with Parkinson’s disease that are diagnosed with pre-existing depression, 70% of those individuals develop anxiety and 90% of those with pre-existing anxiety develop depression.  This news can be both freeing and frustrating.  Freeing because it says, you’re not going crazy feeling the way you do. Frustrating because it’s just one more thing a person with Parkinson’s disease gets to deal with.  However, it is good to remember that there is a percentage of people with this disease that won’t get depression and/or anxiety issues.

The depression that is found in people with PD is not necessarily that of those without a neurological disorder.  The treatment of motor symptoms is already very effective, but depression and anxiety can be just as debilitating as motor symptoms. Psychosis and depression can actually be treated quite effectively, which is often overlooked by practitioners for Parkinson’s patients, who haven’t yet realized the extent that depression plays in Parkinson’s disease.

If you are struggling with depression, for whatever reason, you don’t have to.  If you have Parkinson’s disease and are fighting this dark monster, make an appointment to see your doctor and talk to him about it.  You’re not going crazy.  You’re not weak.  There is a better life and it’s just a phone call away.

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