Problems with mood, behaviour, and thought

Problems with mood, behaviour and thought are non-motor symptoms of Parkinson’s disease (PD) that involve a person’s response to the world around them, and the processes in the mind that control these responses.

Mood/depression

A change in mood is a natural reaction to being diagnosed with PD, or developing a particular symptom. However, depression in PD can also be caused by the disease itself lowering the levels of chemicals in the brain that control mood. Signs of depression include: a negative view of oneself, one’s surroundings and the future; loss of motivation, energy, and interests (including social and sexual); poor sleep and memory; and a decreased appetite.

Depression is a treatable condition and, because it can have such a big impact on everyday life, it is important that the doctor is told about any mood changes in order to provide prompt treatment (for further information on the treatment of depression, see section on ‘Emotional support’). In addition, relieving depression can improve a person’s response to the therapy of other PD symptoms, and it can also offer relief to the caregiver, who may find it more difficult to offer support to a person who is depressed.

Apathy

Apathy is a lack of interest or motivation for daily life that may be seen in PD, and which is closely related to depression and other mood changes. Apathy may be caused by the chemical changes occurring in PD itself, or may be a reaction to coping with the PD diagnosis and any associated lifestyle changes.

Apathy can have a significant impact on life for both the person with PD, and the people surrounding them, but is often not reported to the doctor as a symptom, as it is not seen as a ‘medical problem’. However, as for all mood-related conditions, an approach of support, carefully selected therapies, and counselling can offer relief once the problem is recognised.

Anxiety

Anyone who experiences a new or stressful situation may become anxious. Anxiety disrupts sleep, and can also worsen PD symptoms such as tremor. Extreme anxiety can produce panic attacks, which include periods of dizziness, shortness of breath, and sweating. Anxiety may be experienced as a constant feeling, or it may be triggered by certain situations, e.g., going out in public. In addition to these triggers, anxiety may also be a sign of depression.

People with PD can be taught relaxation methods, and often find that therapies such as breathing techniques, muscle relaxation, massage, meditation, yoga, aromatherapy, Tai Chi, etc., can help to relieve anxiety. In some situations, medication can be prescribed.

Thought and memory

Because PD affects more than one part of the brain, some people find that they experience changes in thought and memory, in addition to the more common movement-related symptoms.

In early PD, these changes may include difficulty with concentration, or subtle changes in memory and thinking – often barely noticeable to the person with PD. The ability to plan complex tasks or perform several
tasks at once may also be affected. These impairments may gradually progress along with other symptoms of the disease, although it should be noted that medications can also have an effect on thought processes (e.g., producing confusion or hallucinations), and so any changes should be reported to a doctor as soon as possible in order to determine the cause.