My Dad's Relationship to Parkinson’s Depression and Anxiety
"I don’t think I’m depressed," Dad tells me one afternoon over the phone: "I know that people with Parkinson’s often suffer from depression. But I don’t think I have that problem."
I’m glad to hear the words come out of his mouth. Dad already experiences so many challenges on a day-to-day basis. He has tremors, and some dyskinesia. His voice has gotten quieter than it used to be. And I really don’t want him to have to take on anything else, but I know that many Parkinson’s patients struggle with depression. So, I find myself asking him questions about his experience. Dad wouldn’t be alone if he struggled with depression.
In fact, as many as 50 percent of those with Parkinson’s will experience depression. Since Parkinson’s impacts parts of the brain that produce dopamine, norepinephrine, and serotonin, it makes sense that so many people would struggle with issues like mood regulation, a loss of energy and motivation, and inconsistent sleep. Or at least one of those symptoms.1
While dad doesn’t seem to struggle with depression, he does have inconsistent sleep patterns: "I’m sleeping pretty well, but today I was up at 5:30. And I couldn’t go back to sleep. Sometimes I just wake up. Sometimes I have to go to the bathroom. I wake up several times in the night but that’s normal."
And, for as long as I can remember, Dad has never been a soundly sleeper. He’d stay up late, watching the news and other television programs. He’d toss and turn all night. And then sometimes, when he had the time, he’d try to make up for his lack of sleep with a mid-day nap.
Symptoms of anxiety
Dad has also struggled with symptoms of anxiety: "Before I was diagnosed, I had panic attacks. I couldn’t figure out why. A few years after the diagnosis, they went away and I never had them again." Dad explained that he briefly saw a psychologist at the beginning of his Parkinson's diagnosis and they talked about his growing anxieties. They may have been directly related to the diagnosis. But they went away after a while.
About 40 percent of people with Parkinson’s struggle with an anxiety disorder. And it can show up in a lot of different ways. Some people, like dad, could experience anxiety attacks. Others have generalized anxiety, social anxiety, or even obsessive-compulsive disorder (OCD). And symptoms of anxiety are not tied to the disease progression, which means that Parkinson’s patients could experience it at any time. It might even come and go.2
I’m not sure that Dad recognizes his social anxiety as anxiety, but I think he struggles with this symptom, too. Understandably, he doesn’t always want to be seen in his current state. Children stare at him when they notice his tremors. Even friends sometimes do a double take, and I think that the sense of "otherness" that this experience creates makes it harder and harder for dad to socialize without anxiety.
Anxiety and depression causes
Like depression, anxiety can be tied to psychological, biological, and environment factors. But it, too, is likely related to brain changes that those with Parkinson’s experience. I asked Dad if he remember what his panic attacks were about, and he couldn’t recall: "Nothing in particular would set it off. It’d just happen to me."
Even now, he still has moments of heightened anxiety. But full-blown panic attacks are pretty rare: "Occasionally, I got panic attacks in a closed room, or if I was standing in line at the grocery store. I think it can be a problem if something totally new to me. But I haven’t had a panic attack in years." And hopefully, we’ll keep it that way.
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