Depression

What is depression?

Depression is a mood disorder that affects how we think and feel. Depression can replace hope, joy, positivity, self confidence, and possibilities with hopelessness, sadness, insecurity, and impossibilities. Depression can ‘color our world with shades of grey'. Symptoms of depression include sadness, memory problems, fatigue, sleepiness, or insomnia. Other symptoms of depression include irritability, poor concentration, loss of enjoyment in social activities and hobbies, loss of appetite or increased appetite, decreased libido, feeling of hopelessness or guilt, excessive worrying, feeling of worthlessness or failure and even suicidal thoughts. Apathy or amotivation and anxiety can also be present.

What is the association between Parkinson’s and depression?

Many people with Parkinson’s experience depression. In fact, research studies report that up to 50% of people with Parkinson’s experience symptoms of depression. Depression can begin before the movement symptoms of Parkinson’s have become obvious. The cause of depression in Parkinson’s is thought to occur from biochemical changes (serotonin, dopamine, and norepinephrine) in brain regions that influence mood. Depression can also be caused by other circumstances and frustrations such as a reaction or response to your Parkinson’s diagnosis, life worries, social isolation, loneliness, or secondary to chronic frustrations when symptoms cause problems with everyday tasks. Depression can be present at all times, as a reaction to having a bad day or when Parkinson’s medications start to wear off just before the next dose of medicine is due.

How does depression change my life with Parkinson’s?

Depression affects you and your family’s well being in so many ways. It changes your perception of how well you are doing. For instance you may feel that your movement problems are worse than they actually are - further increasing your frustrations and anxieties. For this reason, it is so very important to recognize symptoms of depression and honestly discuss these concerns with your healthcare provider. Remember, the better your mood, the more apt you are to tend to your wellness with exercise, eat healthy, adapt to your difficulties, problem solve and socialize with people important to you.

What are the treatments for depression?

Depression is treatable. Treatment can be divided into broad categories as outlined below. Depression is best treated by combining many of these therapies and lifestyle changes. Look for more information about these treatments in the upcoming update section as we explore and highlight these overtime.

Lifestyle therapies: Exercise, healthy eating, healthy sleep, creative expressions, experiences with nature, social contact with family, friends and loved ones are very important steps not to be overlooked.

Behavioral counseling: These therapies are administered under the guidance of a psychologist, psychiatrist, counselor, social working or other mental health provider to help us explore our thoughts and feelings. Counseling helps us identify our feelings and find strategies or steps to take to improve how we feel. Counseling can explore the origins for many of our depressed thoughts. Cognitive behavioral therapy (CBT) explores the many conditioned negative thoughts we may not be aware of that lead to our depressed feelings and more negative thoughts. Through CBT we can learn to recognize these defeating thoughts and replace them with more positive or productive thoughts- in affect reshaping our mood. Counseling can also explore difficulties or problems you may be having in relationships or with family members.

Mindfulness and stress reduction: Mindfulness therapy works on the premise that wellness is enhanced by focusing on ourselves as a complete being including the mind, body and spirit. Mindfulness therapies include meditation, breath work, guided imagery, hypnosis, prayer and spiritual practices to name a few. These therapies can reduce our body’s response to stress, improve general wellbeing, aid our ability to adjust to life changes and add a sense of purpose to one’s life.

Medications: Antidepressants can help and may be needed. Parkinson’s is associated with deficiencies in the neurotransmitters dopamine, norepinephrine and serotonin suggesting that depression in Parkinson’s is related to these physiologic changes. Depression, then, is a symptom of the disease in the same way tremor or rigidity is a symptom. Talk to your doctor about your symptoms of depression and whether medication is right for you. Over the counter remedies such as St John’s Wart are used by some patients but should not be used unless under the care and recommendation of your healthcare provider.

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