Symptoms - Mood Changes

Written by: Emily Downward | Last reviewed: March 2017 | Last updated: April 2019

Parkinson’s disease (PD) can have several effects on a person’s mood. Up to 60% of people with PD experience depression, and between 25 and 45% of people with PD experience anxiety. While simply dealing with a chronic condition can cause these mood disorders, depression and anxiety are also clinical non-motor symptoms of PD.1,2

Research has indicated that depression and anxiety in people with PD may be due to changes in brain chemistry caused by the disease. PD affects the pathways that create the neurotransmitter (chemical messenger) dopamine in the brain. These same pathways also create the hormonal neurotransmitter serotonin, which regulates mood, appetite, and sleep.2

Depression and Parkinson’s disease

Depression can be a disabling symptom of PD, and it may negatively affect a person’s long-term outcomes by causing them to withdraw from social situations, avoid activities like exercise, or being more reluctant to seek care. Some people experience depression as an early symptom of PD before the characteristic motor symptoms appear.2

Depression has a variety of symptoms, not all of which are experienced by every patient. Symptoms of depression can also range in severity or vary over time. Common symptoms of depression include:

  • Persistent sad, anxious, or “empty” mood
  • Feelings of hopelessness or pessimism
  • Feelings of guilt, worthlessness, helplessness
  • Loss of interest or pleasure in hobbies or activities, especially those which were previously enjoyable
  • Decreased energy or fatigue
  • Difficulty concentrating, remembering, and making decisions
  • Difficulty sleeping, early-morning awakening or oversleeping
  • Appetite and/or weight changes
  • Thoughts of death or suicide
  • Restlessness, irritability
  • Persistent physical symptoms3

There are many treatment options for depression that work well in people with PD. There are several types of antidepressants, including selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, and selective norepinephrine reuptake inhibitors (SNRIs). Many people also experience relief from their depression through psychological counseling, such as cognitive behavioral therapy. In addition, regular exercise has been shown to ease symptoms of depression.1,4

Anxiety and Parkinson’s disease

Anxiety is another common mood disorder of PD and is characterized by excessive nervousness or worry over several months. Patients with generalized anxiety disorder may experience symptoms such as:

  • Restlessness, feeling wound-up or on edge
  • Fatigue
  • Difficulty concentrating or having their minds go blank
  • Irritability
  • Muscle tension
  • Difficulty controlling the worry
  • Sleep problems, such as difficulty falling or staying asleep, or restless or unsatisfying sleep1,3

Anxiety is not linked with disease progression of PD. It may develop before or after a PD diagnosis. It is often experienced along with depression in people with PD, as the disease process of PD changes the chemistry of the brain. Treatment for anxiety may include anti-anxiety medications, psychological counseling, exercise, relaxation techniques, and/or meditation.1

Getting help for mood changes

When a person with PD experiences mood changes, they may withdraw from seeking help. However, talking about symptoms with a healthcare professional helps create more of a sense of control and enables the doctor to better understand how PD is affecting the patient. Many treatment options are available to relieve mood disorders like depression and anxiety.1

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