The Link Between Depression and Parkinson's Disease

Depression is common in people who have Parkinson's disease, a slow, progressive, and chronic neurodegenerative brain disease. Actor Michael J. Fox put a public face on this disease and many of us have seen him exhibit some of the trademark Parkinson's symptoms, such as shaking, tremors, slow movements, and stiffness or rigidity in the arms, legs, or trunk. Parkinson's disease also affects balance, speech, and smell.

Forty to 50 percent of Parkinson's patients also suffer from depression. Not only does it cause poorer quality of life for patients, depression is associated with faster progression of physical symptoms and greater cognitive decline. It's difficult to diagnose depression in Parkinson's patients; the symptoms often overlap and depressive symptoms can occur in Parkinson's patients who don't have depression. Furthermore, this disease affects the muscles of the face, so Parkinson's patients appear to express less emotion and they have trouble recognizing emotion in themselves.

It's understandable that someone with a chronic disease would experience depression. However, many patients suffer from depression or anxiety two to five years before they are diagnosed with Parkinson's, leading scientists to suspect depression is actually part of the disease. Regions of the brain affected by Parkinson's disease overlap with areas involved in depression.

Treating Depression

It's important to recognize symptoms of depression so you can seek help. Depressed individuals lose interest in pleasurable activities; have poor attention and concentration; low energy; suicidal thoughts; and experience feelings of self-blame, worthlessness, and guilt.

Fortunately, many treatments for depression are also effective in patients who have Parkinson's disease.

Antidepressants. In addition to current antidepressants, scientists are conducting clinical trials on new medications to treat depression.

Psychological treatments. Studies show that Cognitive Behavioral Therapy may be as effective as antidepressants for treating depression in Parkinson's patients, and may even be better for preventing a relapse. It's a good alternative for people who can't, or don't want to, take antidepressants.

Healthy lifestyle. Research shows that exercising, eating healthy, and staying socially connected alleviates depressive symptoms.

Electroconvulsive Therapy (ECT). ECT is one of the most effective treatments for severe or non-responsive depression and it temporarily improves Parkinson's motor control symptoms.

Transcranial Magnetic Stimulation (TMS). Repetitive TMS over a part of the brain involved in depression and cognitive function has antidepressant effects in patients with Parkinson's. Best of all, TMS has few side effects.

Alternative treatments. Many patients find relief from light or music therapy, relaxation techniques, massage, acupuncture, and meditation.


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National Parkinson Foundation. "PD 101." Web.

National Parkinson Foundation. "Depression." Web.

DeFronzo Dobkin, Roseanne, Ph.D., Menza, Matthew, MD, and Bienfait, Karina L., PhD. "CBT for the Treatment of Depression in Parkinson's Disease: A Promising Nonpharmacological Approach." Expert Review of Neurotherapy 8(1) (2008): 27-35. Medscape Medical News. Web. 15 April 2008.

Brooks, Megan. "Transcranial Magnetic Stimulation Helpful in Parkinsonian Depression." Medscape Medical News. Web. 2 September 2010.

Busko, Marlene. "Depression Common But Often Untreated in Early Parkinson's Disease." Medscape Medical News. Web. 17 July 2007.