Dealing with a chronic, progressive condition like Parkinson’s disease (PD) can take a big toll on a person. Plus, the neurological changes in the brain can put people with PD at a greater risk for depression and anxiety. Up to 60 percent of people with PD experience depression, and between 25 and 45 percent experience anxiety.1,2
When a person with PD experiences mood changes, they may withdraw from seeking help. However, talking with your doctor about symptoms like mood changes helps create a sense of control. It also helps the doctor to better understand how PD is affecting the person. Many treatment options can help treat mood disorders like depression and anxiety.1,2
The difference between psychiatrists and psychologists
Psychiatrists and psychologists are both mental health professionals who treat depression and anxiety. However, there are important differences between them.3
Psychiatrists are medical doctors (MD or DO) who have completed medical school and a residency. Psychiatrists can prescribe medicine, like antidepressants or anti-anxiety drugs. They also conduct talk therapy (psychotherapy) and can order or perform a number of lab tests. They understand the complex relationship between medical illnesses and emotional health. Their training is more focused on biology and neurochemistry.3
Psychologists have advanced degrees, usually a master’s degree or PhD. They also have extensive training in research or clinical practice. Psychologists can perform psychological evaluations and treat mental health problems with psychotherapy and other behavioral interventions. Their training is more focused on behavior.3
Some people work with both a psychiatrist and a psychologist as part of their healthcare team.3
Treatment approaches for mood disorders
Mood disorders like depression and anxiety can be treated with:4
- Talk therapy
- Medicines
- A combination of therapy and medicines
Research studies have found that people who receive both therapy and medicine have better outcomes compared to those receiving treatment with just 1 or the other. Drugs for mood disorders often take several weeks to start working. As with all medicines, antidepressants and anti-anxiety drugs have side effects. Possible side effects and the risks and benefits of each drug should be discussed with a doctor.4
Research has shown 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. This regulates mood, appetite, and sleep.1,2,5
Some treatments for mood disorders target serotonin, like selective serotonin reuptake inhibitors (SSRIs). Selective norepinephrine reuptake inhibitors (SNRIs) are another class of drugs for depression. People taking these treatments should discuss them with a neurologist who is a movement disorders specialist. They are specially trained and understand which medicines are best for people with PD.1,2,5
Treatment for anxiety may include:1
- Anti-anxiety drugs
- Psychological counseling
- Exercise
- Relaxation techniques
- Meditation
Getting help for mood disorders
Depression and anxiety are common in people with PD. They can cause a large burden for people with PD and caregivers. Depression can also worsen long-term outcomes for people with PD. This is because people who are depressed tend to withdraw from social connections, engage in less physical activity, and are less proactive in seeking professional care.2