Parkinson's Disease: Other Medical Concerns: Mental Illness

Certain mental illnesses, like depression and disturbances -- such as hallucinations, delusions, and paranoia -- are possible complications of Parkinson's disease and/or its treatment. But, for most people with Parkinson's disease, depression and mental disturbances can be controlled.

What Is Depression?

Depression is a mood disorder caused by a chemical imbalance. The term "mood" refers to an emotional state that affects how a person thinks or acts. With depression, a person experiences great sadness. Serotonin, a chemical in the brain, has been associated with depression.

Depression is common in patients with Parkinson's disease. Often, the depression begins years before any of the other symptoms of Parkinson's disease appear.

What Are the Signs of Depression?

Depression can actually increase the physical effects of Parkinson's disease and possibly cause a progression of the disease. If you experience any of the following symptoms for longer than two weeks at a time, you should contact your doctor.

• Depressed mood
• An inability to find pleasure in things that were once pleasurable
• Sleep disturbances (inability to sleep or sleeping excessively)
• Change in appetite
• Fatigue
• Altered level of activity
• Difficulty with concentration
• Low self-esteem
• Thoughts of death

How Is Depression in Parkinson's Disease Treated?

Depression may be treated with psychological therapy, as well as with medications. People seem to do better when they receive both psychological and drug treatments.

There are many anti-depressant medications available, each with their own advantages and disadvantages. The choice of antidepressant for patients with Parkinson's disease depends on their overall condition and specific needs. Most people with Parkinson's disease should not take Ascendin (amoxipine) because this medication could temporarily worsen the Parkinson's disease symptoms.

Psychological therapy can help a patient with Parkinson's disease re-establish a sense of self-worth in the face of declining functional abilities. It also can help the person maintain good relationships with caregivers and family members, despite increasing dependency.

Electroconvulsive therapy is a procedure in which a brief application of electric stimulus is used to produce a generalized seizure. ECT can be a valuable treatment for depression associated with Parkinson's disease. A major advantage of ECT is that it works very quickly, unlike medications that may take several weeks before they become fully effective. Moreover, symptoms of Parkinson's disease, in addition to the depressive symptoms, often improve with ECT. But, some people may have trouble tolerating ECT, so talk to your doctor to see what's right for you.

What Other Mental Disturbances Are Associated With Parkinson's?

Hallucinations, paranoia, and delusions are all possible side effects of Parkinson's disease treatments. A hallucination occurs when you think something is present when it isn't. For example, you may hear a voice but no one is there. An example of paranoia is when you think someone is following you when they are not. Delusion is when you are convinced something is true, despite clear evidence proving that it is not.