Parkinson’s disease is a progressive disease, and while treatments for it are becoming more advanced every day, it’s still a disease that cannot be cured. It starts silently—often with a minor tremor or difficulty moving as quickly as you once did. Over time, however, the disease will affect everything from your speech to your ability to walk and express emotions on your face. For that reason, an important part of a successful Parkinson’s treatment plan is recognizing and managing secondary symptoms, those that affect your day-to-day life. Here are a few of the more common secondary symptoms and what you can do to help make them more manageable.

Depression
Depression among people with Parkinson’s disease is not at all uncommon. In fact, by some estimates at least 50 percent of people with Parkinson’s disease will experience depression. Facing the reality that your body and life will never be or act the same can take a great toll on your mental and emotional health. Symptoms of depression include feelings of sadness, worrying, or loss of interest. It’s imperative that you talk with a doctor or licensed psychologist if you think, or if a family member suggests, you may be struggling with depression. Depression is usually treated successfully with antidepressant medications.

Difficulty Sleeping
Individuals with Parkinson’s disease may have difficulty falling asleep. You may also experience restless sleep, where you wake up frequently during the night. More than 75 percent of people with Parkinson’s disease report sleep problems. You may also experience sleep attacks—episodes of sudden sleep onset—during the day. Talk with your doctor about taking an over-the-counter or prescription sleep aid to help you regulate your sleep.

Constipation and Digestive Issues
As Parkinson’s disease progresses, your digestive tract will slow down and no longer function as efficiently as it once did. This lack of movement may lead to increased bowel irritability and constipation. In addition, certain medications often prescribed to patients with Parkinson’s disease, such as anticholinergics, can cause constipation. Combat constipation by eating a well-balanced, nutritious diet that contains plenty of vegetables, fruits, and whole grains. In addition to offering vitamins, minerals, and nutrients, fresh produce and whole grains also contain a great deal of fiber, which can help prevent constipation. Fiber supplements and powders are also an option for many Parkinson’s patients. Be sure to ask your doctor how to gradually add fiber powder to your diet so that you don’t begin with too much too quickly and make your constipation problem worse. Eat a variety of fish and seafood, too—this food group contains omega-3 fatty acids, which may have additional benefits for people with Parkinson’s disease.

Urinary Problems
Just as your digestive tract may become weaker, so can the muscles of your urinary tract system. Parkinson’s disease and medications often prescribed to treat it can cause your autonomic nervous system (often referred to as your involuntary nervous system) to stop functioning properly. When that happens, you may begin experiencing urinary incontinence or difficulty urinating.

Difficulty Eating
In the later stages of the disease, the muscles in the throat and mouth may work less efficiently, which may make chewing and swallowing difficult. This same problem can also increase the likelihood of drooling or choking while eating. Fear of choking and other eating problems may put you at risk for inadequate nutrition. However, working with an occupational therapist or speech-language therapist may help you regain some control of your facial muscles.

Decreased Range of Movement
Exercise is important for everyone, but it is an especially important part of treatment for patients with Parkinson’s disease. Physical therapy or exercise can help improve mobility, muscle tone, and range of motion—physical capabilities often greatly affected by the disease. Increasing and maintaining muscle strength may be especially important as muscle tone is lost; in some cases, it can act as a buffer, countering some of the disease’s more harmful effects. Additionally, massage helps you reduce muscle stress and relax, which is especially beneficial to people with Parkinson’s disease.

Increased Falls and Loss of Balance
Parkinson’s disease can alter your sense of balance and make simple tasks such as walking seem more dangerous than they once were. When you’re walking, be sure to move slowly so your body can rebalance itself. Don’t try to turn around by pivoting on your foot—you may not have adequate balance and control, and you increase your risk of falling. Instead, turn yourself around by walking in a U-turn pattern. Also, don’t carry things while walking. Your hands are needed to steady you and help your body balance. Prepare your home and remove any fall hazards by arranging furniture with wide spaces between each piece so there is ample room to walk; position furniture and lighting so that no extension cords are needed; and install handrails in hallways, entryways, and stairwells and along walls.

Sexual Problems
Another common secondary symptom of Parkinson’s disease is decreased libido. Doctors are not certain what causes this, but it’s suspected that a combination of physical and psychological factors may contribute to the drop in sexual desire. The good news is the problem is often treatable with medications and counseling.

Hallucinations
Medicines prescribed to treat Parkinson’s disease may cause unusual visions, vivid dreams, or even hallucinations. If these side effects do not improve or go away with a change in prescription, your doctor may prescribe an antipsychotic drug.

Pain
The lack of normal movement associated with Parkinson’s disease can increase your risk of having sore, aching muscles and joints, and may lead to prolonged pain. Prescription drug treatment can help relieve some of the pain, but exercise has also been found to help relieve muscle rigidity and pain.

Medications prescribed to treat Parkinson’s disease may have additional side effects, such as involuntary movements (or dyskinesia), nausea, hypersexuality, compulsive gambling, and compulsive overeating. Many of these side effects can be resolved with a dose correction or change in medicine. However, it’s not always possible to eliminate the side effects and still treat the Parkinson’s disease effectively. Do not stop taking or self-adjust medications without talking to your doctor first.