How to Manage Parkinson's Non-Movement Symptoms

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Parkinson’s is a brain disorder that affects the way you move. But along with the tremors, stiffness, and slowness, most people get other health problems. Doctors call these non-movement symptoms.

The disease happens when nerve cells in a certain part of your brain die or stop working in the right way. This causes a drop in an important brain chemical called dopamine, which can lead to a wide range of non-movement symptoms.

Most non-movement symptoms are treatable. You can either manage them on their own or with the help of your doctor.

Depression, Anxiety, and Crankiness

As many as half of people with Parkinson’s get depressed or anxious at some point. You may feel sad, uninterested, tired, or cranky. Or you may worry and feel on edge all the time.

How can I manage them?

  • Exercise regularly. Research shows physical activity eases depression and anxiety.
  • Stay in touch with your friends and family.
  • Join a support group.

What are the treatments? You’ll want to see a mental health expert, such as therapist. One kind of therapy, called cognitive behavioral therapy, has been shown to help with depression. You learn to spot negative thoughts and respond in a better way. Your doctor may also prescribe medicine, like antidepressants or anti-anxiety drugs.

Trouble Sleeping and Daytime Sleepiness

You may have trouble falling asleep or toss and turn throughout the night. Or you may be unable to keep your eyes open during the day.

How can I manage them?

  • Step outside and get some sunshine during the day.
  • Exercise regularly before 8 p.m.
  • Go to bed and get up around the same time each day. Spend 7 to 8 hours in bed.
  • Don’t nap for more than an hour.
  • Have a regular nighttime routine. Avoid screens an hour or two before bed.
  • Cut back on alcohol and caffeine.

What are the treatments? Your doctor will want to rule out sleep apnea. Parkinson’s medicines can also affect sleep, so they may need to adjust your dosage. If lifestyle changes don’t work, your doctor may prescribe a sleep medicine or a drug to increase alertness.

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Talking or Moving Around During Sleep

Moving or jerking your legs during sleep is a sign of restless legs syndrome (RLS). Acting out your dreams by talking, yelling, kicking, or punching means you have REM sleep behavioral disorder (RBD).

How can I manage them?

  • You may need to pad the floor or use a bed rail to prevent injury.
  • Consider sleeping in a different room from your partner.

What are the treatments? If you have RLS, your doctor can prescribe a medicine. Taking the sleep hormone melatonin or an anti-anxiety medicine may help with RBD.

Constipation

About three-quarters of people with Parkinson’s have trouble with bowel movements. They’re either difficult or happen less often than normal.

How can I manage it?

  • Drink about 12 cups of fluids per day.
  • Eat high-fiber foods like prunes, dried apricots, beans, and whole grains.
  • Cut back on starchy, low-fiber foods.
  • Take a fiber supplement.
  • Consider laxatives. They work in different ways. But be careful. Your body can start to rely on stimulating laxatives, suppositories, and enemas, so save those products as a last resort.

What are the treatments? Some Parkinson’s drugs cause constipation, so the doctor may change you to another one. If over-the-counter products don’t work, you may need a prescription laxative.

Pain

Parkinson’s can cause pain, often in the legs. It may feel like cramps, stiffness, spasms, numbness, burning, or aching.

How can I manage it?

  • Take a warm bath.
  • Stretch regularly.
  • Get a massage or do a self-massage.
  • Do tai chi or yoga. These exercises make you more flexible. They also involve deep breathing, which can relax you.
  • See a physical therapist, who can use a variety of techniques. These include stretching and strengthening exercises, massage, heat, and ice.
  • Consider acupuncture, inserting tiny needles into various points on your body. Research shows it eases pain.
  • Take an over-the-counter pain reliever.

What are the treatments? Unexplained pain may be a sign that your medicine isn’t working well. The doctor can adjust your dosage. If that doesn’t work, you may need pain medicine. 

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Changes in the Way You Think

Some people with Parkinson’s have cognitive changes. That means you may have a harder time focusing, finishing tasks, forming thoughts, thinking of words, and remembering things. When these changes affect your day-to-day life, it becomes dementia.

How can I manage them?

  • Exercise regularly, eat a healthy diet, and get enough sleep.
  • Clear your home of clutter. Reducing things in the world around you may help with confusion.
  • Create a regular routine. You may feel more comfortable with a structured day.

What are the treatments? These changes may be a medication side effect; talk to your doctor.

You may need to see an occupational therapist, who can teach you ways to make daily life easier. A speech therapist can help with language issues. There are also some Alzheimer’s drugs that treat these cognitive symptoms.

Delusions and Hallucinations

You may see something that isn’t there, like a dog in the room. Or, in rare cases, you may hear, smell, or taste things that aren’t real. These are hallucinations. Delusions are when you believe something that isn’t true.

How can I manage them?

  • Make sure your home has good lighting. You’re more likely to see a hallucination in a dim room or hallway.
  • Educate your loved ones. If you’re having a hallucination, the best thing they can do is to reassure you that you’re safe. Tell them to go along with it and maybe say “I’ll take the dog outside” instead of trying to argue with you that it really isn’t there.

What are the treatments? Delusions and hallucinations can be a medication side effect; talk to your doctor. They can prescribe an antipsychotic drug to balance the chemical levels in your brain.

Drooling

You move your mouth and swallow less often, which can lead to a buildup of saliva.

How can I manage it? Chew gum or suck on candy. This makes you swallow more often.

What are the treatments? If your drooling is severe, the doctor may prescribe drugs to reduce the amount of spit you make. Injecting Botox into your salivary glands is also an option. This also lessens saliva production

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Sexual Problems

You may have a low sex drive and trouble reaching orgasm. It might also be hard to have or keep an erection.

How can I manage them?

  • Have sex first thing. Parkinson’s symptoms, including fatigue, are usually better in the morning.
  • Talk to your partner. Fear, resentment, and other emotions can take a toll in the bedroom.
  • Experiment with lubricants and different positions.

What are the treatments? For men, sildenafil (Viagra) can treat erection issues. Women may consider hormone replacement therapy for sex drive, but it may raise your odds for heart disease and breast cancer. Talk to your doctor about the benefits and risks.

Light-Headedness When You Stand Up

When you stand up, your blood pressure may drop. This is called orthostatic hypotension. Other symptoms include confusion, headache, and shoulder and neck pain.

How can I manage it?

  • Don’t cross your legs while sitting.
  • Stand up slowly from sitting.
  • When you get out of bed, sit on the edge of your bed before you stand up.
  • Wear compression stockings or an abdominal band to improve your circulation.
  • Raise the head of your bed when you sleep.
  • Make sure you’re drinking enough fluids.
  • Ask your doctor about eating extra salt.

What are the treatments? Your doctor can prescribe a medicine to increase your blood volume or narrow your blood vessels.

Bladder Issues

An overactive bladder may cause you to urinate more often. You may rush to the bathroom even when your bladder isn’t full. Or you may not be able to hold it in.

How can I manage them? Plan regular bathroom breaks.

What are the treatments? Your doctor will need to rule out a bladder or urinary tract infection. There are different medicines that can calm an overactive bladder or relax the bladder muscle.

WebMD Medical Reference Reviewed by Jennifer Robinson, MD on May 08, 2020

Sources

SOURCES:

Parkinson’s Foundation: “Cognitive Changes,” “Constipation and PD,” “Depression,” “Does Parkinson’s Hurt?” “Drooling,” “Hallucinations/Delusions,” “Non-Motor Symptoms,” “Sleep Disorders,” “What is Parkinson’s?” “Urinary Incontinence.”

Michael Okun, MD, medical director, Parkinson’s Foundation; executive director, Norman Fixel Institute for Neurological Diseases, University of Florida.

National Institute on Aging: “Parkinson’s Disease.”

The Michael J. Fox Foundation for Parkinson’s Research: “Depression & Anxiety.”

Anxiety and Depression Association of America: “Exercise for Stress and Anxiety.”

Parkinson Society British Columbia: “A Guide to the Non-Motor Symptoms of Parkinson’s.”

Mayo Clinic: “Cognitive behavioral therapy,” “Hormone therapy: Is it right for you?” “Urinary Incontinence.”

International Parkinson and Movement Disorder Society: “Cognitive Impairment and Behavioral Problems in Parkinson’s Disease: Essential Facts for Patients.”

UpToDate: “Management of non-motor symptoms in Parkinson disease.”

American Parkinson Disease Association: “Sexual Effects.”

Cleveland Clinic: “Orthostatic Hypotension: Management and Treatment.”

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