People with Parkinson’s disease may face a higher risk of depression. This can be tied to the mental health challenges of living with the disease, or a possible symptom related to Parkinson’s itself.

Many people with Parkinson’s disease also experience depression.

Depression may be a result of the emotional challenges that can come from living with Parkinson’s. Someone may also develop depression as a result of chemical changes in the brain related to the disease itself.

More than half of people with Parkinson’s may experience some type of anxiety or depression at some point in their lives with the disease. But even though it’s common, there are ways to help manage depression if you’re living with Parkinson’s.

People living with Parkinson’s are more likely to experience depression compared with others in the general population.

In the Parkinson’s Outcomes Project, the largest clinical trial that spanned 12 years starting in 2009 and included 19,000 people from five countries, the researchers found that depression and anxiety are the number one factors affecting the health and lives of people with the disease.

This includes those with both early onset and late-stage Parkinson’s.

The reason is believed to be that depression is commonly caused by the chemical changes that happen in the brain as a result of Parkinson’s.

This 2020 research found that people can experience depression throughout the entirety of the time they live with Parkinson’s. Depressive symptoms are typically the first Parkinson’s symptoms to appear that aren’t specific to motor skills and body movements, and they tend to increase as people get older.

In the advanced stages of Parkinson’s, about 60% of people with Parkson’s experience some type of depressive symptom.

Depression is sometimes missed in those with Parkinson’s because symptoms may overlap, including:

Depression can be overlooked if symptoms develop after the Parkinson’s diagnosis is made.

Symptoms that may indicate depression include:

  • consistent low mood that lasts most days for at least 2 weeks
  • thoughts of self-harm or suicide
  • pessimistic thoughts of the future, the world, or one’s self
  • waking very early in the morning, if this is out of character
  • excessive sleeping
  • loss of appetite

Depression may cause other seemingly unrelated Parkinson’s symptoms to worsen. Because of this, if you notice any sudden worsening of your Parkinson’s symptoms, it’s a good idea to tell your doctor that you’ve been feeling depressed.

Ways to find help for depression

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  • 988 Lifeline to talk with someone if you’re feeling depressed and alone.
  • There are also an increasing number of Parkinson’s support groups that you can attend. Your doctor or therapist may be able to recommend some. You can also search for them, or check this list to see if there are any you’re interested in.
  • If you’re unable to find a local support group, there are also online support groups that may be able to help you.

People with Parkinson’s can work with their healthcare team and doctor to determine the best path forward in treating depression and related mental health symptoms.

Some may find prescribed antidepressant medications are the most beneficial, while others may find alternatives in lifestyle changes or mental health support.

Medications

Many people may be treated with a type of antidepressant called serotonin reuptake inhibitors (SSRIs).

However, some other Parkinson’s symptoms may worsen from SSRI use in a very small number of people.

SSRIs shouldn’t be taken if you’re currently taking selegiline (Zelapar), a commonly prescribed medication to manage other Parkinson’s symptoms.

If you’re taking selegiline, talk with your healthcare team about possible side effects linked to higher doses, including for people who consume tyramine-rich foods (such as aged cheese, bologna, bacon, corned beef, or smoked or cured fish).

If both are taken at once, it could cause serotonin syndrome. This occurs when there’s excessive nerve cell activity, and it can be fatal. Symptoms can include:

  • confusion, disorientation, or hallucinations
  • anxiety or irritability
  • muscle spasms or rigidity
  • shivering or tremors
  • digestive issues like diarrhea or nausea
  • rapid heartbeat, or tachycardia
  • high blood pressure
  • overactive reflexes, or hyperreflexia
  • dilated pupils

Some medications used to treat other symptoms of Parkinson’s, like dopamine agonists, may have an antidepressant effect and could be beneficial for those with Parkinson’s who experience depressive symptoms.

It’s possible that these drugs may be helpful for people who experience periods when their medication isn’t effective. This is also known as “on-off” motor fluctuation.

Electroconvulsive therapy (ECT)

While it may not be a first choice or option for everyone, electroconvulsive therapy (ECT) could be an option for some with depression related to Parkinson’s. During this type of treatment, electrical currents are sent through the brain to induce a seizure.

A small 2021 study indicated that ECT has been a safe and effective short-term treatment for depression in people with Parkinson’s. ECT treatment may also temporarily alleviate some motor symptoms of Parkinson’s, though this is typically only for a short period of time.

ECT is generally used when other depression treatments aren’t effective. Common side effects of ECT can be include:

  • nausea
  • fatigue
  • headache
  • confusion
  • memory loss

Alternatives to medication

Nonprescription treatment options may also be beneficial for people who experience Parkinson’s-related depression. These lifestyle measures can help alongside prescribed antidepressants.

These may include:

  • professional mental health support or psychological counseling with a licensed therapist
  • cognitive behavioral therapy, which involves helping you recognize negative or unhelpful thought and behavior patterns
  • exercise can boost feel-good endorphins
  • sticking to a regular sleep schedule may help increase serotonin levels naturally

Depression in people living with Parkinson’s is common. Treating and prioritizing depression as a symptom of Parkinson’s can significantly improve a person’s quality of life and overall comfort and happiness.

If you live with Parkinson’s and you’re experiencing depression symptoms, talk with your doctor about your treatment options. This could include antidepressant medication, other forms of therapy, and possibly lifestyle changes ranging from sleep habits to exercise schedules.