Parkinson’s Disease and Depression: Causes and Treatments

Parkinson's disease and depression are incredibly common, but that doesn't make them easy to live with. Depression can occur as the result of the emotional challenges of Parkinson's disease as well as from chemical changes in the brain or medication side-effects. Depression in Parkinson's disease can be treated much the same as for the general population, with some exceptions. Let's explore everything we know about Parkinson's disease and depression, including causes, symptoms and treatments.

What’s the Link Between Parkinson’s Disease and Depression?

Parkinson's disease is a neurological condition caused by the loss of dopamine cells in the brain. As many people know, PD causes motor symptoms such as tremor, rigidity and slowed movement, but it can also be responsible for dementia, psychosis, anxiety and depression.

It is estimated that over 50% of people with PD will experience depression at some stage. Common symptoms of Parkinson's disease depression include:

• Loss of interest in hobbies and day-to-day activities
• Low energy
• Diminished libido or sexual functioning (see "Parkinson’s Disease and Sex Issues: Libido, Sex Drive")
• Sleep disturbances, such as nighttime waking or insomnia
• Change in eating habits, such as eating too much or too little
• Not wanting to socialize or interact with others
• Feeling tired all the time
• Irritability
• Persistent low mood and apathy – not seeing the point in anything
• Pessimistic feelings or views about the world
• Thoughts of self-harm or suicide, known as suicidal ideation

If you experience the symptoms of Parkinson’s disease depression, it’s important to report them to your doctor so you can access help and support. Parkinson's can take its toll physically and emotionally, but there is no need to suffer in silence. Depression is common in those with and without Parkinson's disease, and there are plenty of ways to treat it.

What Causes Depression in Parkinson’s Disease?

No one knows exactly what causes depression in Parkinson's disease. Scientists say it is unclear to what extent apathy and depression in Parkinson's disease are caused by degenerating nerve cells in the brain (specifically the loss of dopamine), or whether medication side effects or other factors could be to blame.

People with PD tend to be more isolated and less mobile than the general population, which can cause low mood. Others have financial struggles and concerns about their Parkinson's prognosis which could also contribute to their decline in mental health.

One study reported by England’s National Health Service found that depression was more common in the early stages of Parkinson’s disease, suggesting that depression has less to do with chemical changes or lifestyle factors, and more to do with the emotional adjustment of having PD. However, the same study found that levels of apathy and anxiety tended to increase as Parkinson’s progressed.

Parkinson’s Disease and Depression Treatment

All in all, there are several possible reasons why depression is so prevalent in Parkinson's disease. Your doctor will look at your symptoms and work with you to determine a treatment plan. This might include:

• One-on-one therapy or counseling
• Antidepressant medication, such as serotonin reuptake inhibitors (SSRIs)
• Dopamine agonists, which are known to treat Parkinson’s disease but also have antidepressant qualities
• Parkinson’s disease support groups
• Parkin's homeopathic therapy, such as massage, meditation or acupuncture
• Lifestyle changes, such as eating a healthy diet, exercising more or taking up gardening
• Electroconvulsive therapy (ECT), if your depression or motor symptoms are severe

If your doctor believes your depression is caused by medication, then your current prescription may be withdrawn or replaced with an alternative. Sometimes, changing your medication may result in a worsening of Parkinsonian symptoms such as rigidity or tremor. If this is the case, your doctor will discuss this with you so that you can make an informed choice about your future treatment.

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