Considering the Link Between Parkinson's and Depression
It seems to Posy that researchers have decided that many people with Parkinson’s disease (PD) have probably experienced depression at some time in their lives. For some, it may be happening now, but for many others, it hit long before being diagnosed with PD.1
Posy thinks these ideas need more in-depth research. She would like to know more about the link between the 2. Basically, is the "cart being put before the horse?"
What is depression?
It is a strange thing, depression. It follows you around, nipping at your heels here and there. Indeed, the famous British war-time Prime Minister, Winston Churchill, likened it to a "Black Dog."
Depression is not sadness or grief. These (also debilitating, but hopefully with the possibility of recovery with time) are usually related to circumstances. Unless you have experienced actual depression, it is difficult to comprehend the terrible inertia and death-wish that it induces.
How can previously energetic, optimistic people want to run away and hide from the world when nothing bad has happened? It seems to the world around you that you are selfish and lazy. "Get over it! Pull yourself together!”
A frightening disease
Depression now frightens Posy more than any other disease. It felt as though she was losing her mind. Going mad. She was scared of ending up in an institution like Jack Nicholson in One Flew Over The Cuckoo’s Nest.
At her worst, she almost envied his fate thinking, "Lucky him!" She just wanted her brain, too, to stop. Really, she could not feel any lower. The sun might be shining, the birds singing for all they were worth, her family were all ok, but all she could think was "I can’t do this any more. Let me die."
Posy had fallen into a dark hole in her mind and she just could not see a way to climb out. The anxiety attacks prevented her from moving far from her bed. Normally a bright, active, enthusiastic person, she did not recognize this person who just wanted to die.
Depression is so utterly selfish: The depressed person has absolutely no resources to help others. Posy just about managed to keep her daughter fed and watered, but she felt an affinity with absolutely nothing. Why did people sound jolly on the radio? Why was anyone interested in anything? Nothing could engage that previously wonderful curiosity that had motivated her all her life.
Which came first?
Posy wonders, which came first: antidepressants or Parkinson's? Is this the moment that Parkinson’s began its invasion of Posy’s brain? Or was this the first sign that dopamine had been draining away because of inflammation of some kind?
Or ... were Posy's antidepressant medications actually telling her brain not to bother producing dopamine any more? "Hey there, brain ... here’s some serotonin instead!"
Is it dopamine deficiency or serotonin deficiency that cause depression? Does serotonin deficiency cause dopamine deficiency? In other words, can anti-depressants somehow stimulate the breakdown of dopamine?
Posy had been taking trazodone hydrochloride (an older med) for several years as it was originally prescribed to help with getting to sleep. For that, it was highly effective. But, as with any drug that calms the brain, Posy felt slightly apathetic and emotionless on this.
Finding the right medication
It was a nightmare to come off the trazodone hydrochloride. Posy tapered it down very slowly over the course of a year, but then was struck down with terrible anxiety and this debilitating depression.
After painful trial and error, Posy now takes escitalopram. When Posy finally experienced joy, contentment and true empathy again, she knew she was "better." But coming off escitalopram is not an option.
Posy wants to find out more about the connection between depression and Parkinson’s and would appreciate reading your responses to (any of) these questions:
- Did you/your loved one ever suffer from depression years before PD was diagnosed?
- Did you take antidepressants? If so, which ones?
- Do you suffer from depression now? If so, are you managing it with medication?
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