Who me depressed? Are you kidding? Why would I be depressed just because I have an incurable disease that makes me feel miserable and is going to get progressively worse with time? What is there to be depressed about?
Medically, depression is defined as a mood disorder characterized by a persistently low mood and a feeling of sadness and loss of interest that lasts longer than two weeks. Additional symptoms such as feeling worthless, weight loss or gain and change of appetite, lethargy or fatigue or loss of energy, inability to concentrate, and thoughts of death or suicide may also be present and help to confirm the diagnosis.
50% of PWP suffer from depression as compared to 5% of the US population. Additionally, 40% of PWP have an anxiety disorder. The Parkinson’s Foundation states that depression and anxiety taken together has a greater impact on the health of PWP than do the more noticeable physical motor symptoms that define PD.
Depression is so prevalent in PD that doctors now believe that depression may actually be a symptom of PD possibly rooted in the way the disease affects the brain. PD causes changes in areas of the brain that produce dopamine, norepinephrine and serotonin — chemicals that are involved in regulating mood, energy, motivation, appetite and sleep. In fact, the same pathways that create dopamine in the brain also create serotonin which impacts depression. PWP have an imbalance of neurotransmitters (brain chemicals) that regulate mood which is now thought to play a major role in the development of the disease. Researchers believe that many PWP experience depression or anxiety two to five years before physical motor symptoms appear and the diagnosis of PD is apparent. This means that depression is not simply a psychological reaction to the illness. It is a chemical imbalance in the brain and part of the underlying disease process. It's a double whammy. Depression can make PD symptoms worse and PD can intensify depression.
A comprehensive approach consisting of medication, counseling, exercise and social support is most often recommended to cope with depression. Social isolation and the lack of a supportive social network can intensify depression. Don’t isolate yourself. Become part of the PD community. Other PWP understand what you are going through. Learn all you can about PD and depression so you understand and deal with what it is doing to you. Physical exercise helps. Make plans to do at least one small activity each day. Do not make decisions late at night. Wait for the light of day. Don’t get too high it’s a long way down. Don’t get too low it’s an even longer way up. Attitude is everything. Unlike PD, depression can be cured. Don’t hide it. Talk to your doctor if you need to. Meds and cognitive therapy can help. There is help out there. Get it if you need it.
