Parkinson’s and depression

Many people with Parkinson’s disease also experience depression. It’s estimated that at least 50 percent of those with Parkinson’s will also experience some form of depression during their illness.

Depression may be a result of the emotional challenges that can come from living with Parkinson’s disease. Someone may also develop depression as a result of chemical changes in the brain related to the disease itself.

People with all stages of Parkinson’s are more likely than the general population to experience depression. This includes those with both early onset and late stage Parkinson’s.

Research has suggested that 20 to 45 percent of people with Parkinson’s may experience depression. Depression can pre-date other signs and symptoms of Parkinson’s — even some of the motor symptoms. Many researchers believe that those with chronic illnesses are more likely to experience depression. But there’s a more physical correlation in those with Parkinson’s.

This depression is commonly caused by the chemical changes that happen in the brain as a result of Parkinson’s disease.

Depression is sometimes missed in those with Parkinson’s because many symptoms overlap. Both conditions can cause:

  • low energy
  • weight loss
  • insomnia or excessive sleep
  • motor slowing
  • diminished sexual function

Depression can be overlooked if symptoms develop after the Parkinson’s diagnosis is made.

Symptoms that may indicate depression include:

  • consistent low mood that lasts most days for at least two weeks
  • suicidal ideation
  • pessimistic thoughts of the future, the world, or themselves
  • waking very early in the morning, if this is out of character

Depression has been reported to cause a worsening of other seemingly unrelated Parkinson’s symptoms. Because of this, doctors should consider if depression is causing any sudden worsening of Parkinson’s symptoms. This can happen over a few days or over several weeks.

Depression must be treated differently in people who have Parkinson’s disease. Many people can be treated with a type of antidepressant called serotonin reuptake inhibitors (SSRIs). However, some other Parkinson’s symptoms may worsen in a very small number of people.

SSRIs should not be taken if you’re currently taking selegiline (Zelapar). This is a commonly prescribed medication to control other symptoms of Parkinson’s. If both are taken at once, it could cause serotonin syndrome. Serotonin syndrome occurs when there’s excessive nerve cell activity, and it can be fatal.

Some medications used to treat other symptoms of Parkinson’s may have an antidepressant effect. This includes dopamine agonists. These appear to be particularly helpful in those who experience periods when their medication isn’t effective. This is also known as “on-off” motor fluctuations.

Alternatives to medicine

Non-prescription treatment options are an excellent first line of defense. Psychological counseling — like cognitive behavioral therapy — with a certified therapist can be beneficial. Exercise can boost feel-good endorphins. Increasing sleep (and sticking to a healthy sleep schedule) can help you boost serotonin levels naturally.

These treatments are often very effective. They may resolve symptoms entirely in some people with Parkinson’s. Others may find it helpful but still need additional treatments.

Other alternative remedies for depression include:

  • relaxation techniques
  • massage
  • acupuncture
  • aromatherapy
  • music therapy
  • meditation
  • light therapy

There are also an increasing number of Parkinson’s support groups that you can attend. Your doctor or therapist may be able to recommend some. You can also search for them, or check this list to see if there are any you’re interested in. If you’re unable to find a local support group, there are also excellent support groups online. You can find some of these groups here.

Even if your doctor prescribes antidepressants, they’ll be most effective when used with therapy and other positive lifestyle changes.

Research has indicated that electroconvulsive therapy (ECT) has been a safe and effective short-term treatment for depression in people with Parkinson’s. ECT treatment may also temporarily alleviate some motor symptoms of Parkinson’s, though this is typically only for a short period of time. But ECT is generally used when other depression treatments aren’t effective.

Depression in those with Parkinson’s disease is a common occurrence. Treating and prioritizing depression as a symptom of Parkinson’s will significantly improve a person’s quality of life and overall comfort and happiness.

If you’re experiencing depression symptoms, talk to your doctor and see what treatment options they recommend for you.