Mental Health and Counseling

Dealing with a chronic, progressive condition like Parkinson’s disease (PD) can take a significant toll on a person. In addition, the neurological changes in the brain can put people with PD at a greater risk for depression and anxiety. Up to 60% of people with PD experience depression, and between 25 and 45% of people with PD experience anxiety. When a person with PD experiences mood changes, they may withdraw from seeking help. However, talking about symptoms including mood changes with a healthcare professional helps create more of a sense of control and enables the doctor to better understand how PD is affecting the individual. Many treatment options are available to relieve mood disorders like depression and anxiety.1,2

The difference between psychiatrists and psychologists

Psychiatrists and psychologists are both mental health professionals that may be consulted for depression and anxiety. However, there are important distinctions between the two specializations.3

Psychiatrists are medical doctors (M.D. or D.O.) who have completed medical school and a residency. Psychiatrists can prescribe medication, like antidepressants or anti-anxiety medications, as well as conducting psychotherapy (or “talk therapy”). Psychiatrists can also order or perform a number of laboratory tests, and they understand the complex relationship between medical illnesses and emotional health. Their training is more focused in biology and neurochemistry.3

Psychologists have advanced degrees, usually a master’s degree or Ph.D., and 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 health care team.3

Treatment approaches for mood disorders

Mood disorders like depression and anxiety can be treated with psychotherapy, medications, or a combination of therapy and medication. Research studies have demonstrated a better outcome when people receive both therapy and medication compared to those receiving treatment with just one or the other. These medications often take several weeks to start working. As with all medications, antidepressants and anti-anxiety drugs have side effects. Possible side effects and the risks and benefits of each drug should be discussed with a physician.4

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. Some treatments for mood disorders target serotonin, like selective serotonin reuptake inhibitors (SSRIs). Another class of medications for depression is selective norepinephrine reuptake inhibitors (SNRIs). People taking these treatments should discuss them with a neurologist who is a movement disorders specialist, as they are specially trained and understand which medications are best for people with PD.1,2,5

Treatment for anxiety may include anti-anxiety medications, psychological counseling, exercise, relaxation techniques, and/or meditation. In addition, regular exercise has been shown to ease symptoms of depression.1

Getting help for mood disorders

Depression and anxiety are common in people with PD and can cause significant burden for both the person with PD and their caregiver. Depression can also worsen long-term outcomes for people with PD, as people who are depressed tend to withdraw from social connection, engage in less physical activity, and are less proactive in seeking professional care.2

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Written by: Emily Downward | Last reviewed: November 2020