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Depression and PD

In the general population, up to 10 percent of American adults are believed to have some form of depression. However, with Parkinson's disease, this number is believed to be much higher, perhaps up to 50 percent or more. If depression becomes a problem, medications and other alternative therapies can help people with Parkinson's feel better and improve quality of life.

Depression is a serious illness that can strike anyone at any age. It is estimated that nearly 10 percent of American adults experience some form of depression every year.

People with Parkinson's disease are not immune to depression. In fact, up to 50 percent of people with Parkinson's disease may also suffer from depression. However, this number may be low, as the true number of people with depression and Parkinson's disease is difficult to determine, given that there are no standardized tests designed to evaluate depression symptoms in the context of Parkinson's disease.

Unlike the occasional sadness everyone feels due to life's disappointments, depression is a serious illness that profoundly weakens a person's ability to function in everyday situations by affecting moods, thoughts, behaviors, and physical well-being.

The exact cause or causes of depression are currently unknown. However, certain factors can increase the chances for developing depression. This includes certain medical conditions, such as Parkinson's disease.

Similar to depression, Parkinson's disease is a condition that affects the brain. It is a chronic, progressive disorder mainly affecting the motor system, but also affecting thinking and emotion. It results from the loss of brain cells that produce dopamine, a chemical messenger that controls movement. The four primary Parkinson's disease symptoms include:

-Tremors or trembling in the hands, arms, legs, jaw, and face

-Rigidity or stiffness of the limbs and trunk

-Bradykinesia, or slowness of movement

-Postural instability, or impaired balance and coordination.

Individuals may also have difficulty walking, talking, or completing other simple tasks. Early symptoms of Parkinson's disease are subtle and occur gradually. At present, there is no way to predict or prevent the disease.

Symptoms of Depression

Healthcare providers must recognize a number of specific symptoms before diagnosing clinical depression. They will also consider how long the symptoms have been present.

If a person has five or more of the following symptoms for two weeks or longer, a diagnosis of depression may be made.

-A persistent sad, anxious, or "empty" mood

-Feelings of hopelessness and pessimism

-Feelings of guilt, worthlessness, and helplessness

-Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex

-Decreased energy, fatigue, and being "slowed down"

-Difficulty concentrating, remembering, or making decisions

-Insomnia, early-morning awakening, or oversleeping

-Changes in appetite or eating (either much less or much more) or a significant weight loss or gain

-Restlessness and irritability

-Thoughts of death or suicide; suicide attempts

-Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain.

People with Parkinson's disease who suffer from depression often have different symptoms from those without Parkinson's. People with Parkinson's disease and depression might have symptoms that also include:

-Higher rates of anxiety

-Sadness without guilt or self-blame

-Lower suicide rates despite high rates of suicidal thoughts.

Treating Parkinson's Disease and Depression

Depression is a serious and real illness. It can make a person feel exhausted, worthless, helpless, and hopeless. Such negative thoughts and feelings make some people feel like giving up. But the good news is that depression is treatable, including in people with Parkinson's disease. Treatment can help people feel better and cope better with their Parkinson's treatment.

Depression treatment options for people with Parkinson's disease are similar to those for people without the condition. Some of the options used most often include:

-Depression medications, which are known as antidepressants

-Psychotherapy, to learn more effective ways of dealing with life's problems (see Psychotherapy for Depression)

-A combination of the two.

While prescription antidepressant medications are generally well tolerated and safe for people with Parkinson's, more research is needed to determine which antidepressants work best for people with different subtypes of Parkinson's.

Recovery from depression takes time. Medications for depression can take several weeks to work and may need to be combined with ongoing psychotherapy. Not everyone responds to treatment in the same way. Prescriptions and dosing may need to be adjusted.

No matter how advanced the Parkinson's disease, however, the person does not have to suffer from depression. Treatment can be effective and help improve the person's quality of life.

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