Parkinson’s is commonly characterized by its motor symptoms. But many people experience other changes that are often not identified as symptoms of the disease. These are known as non-motor symptoms and are often left untreated. Below, you will find information outlining both types of symptoms, how to identify symptoms you may not realize are linked to Parkinson’s, and how to manage them.

Motor symptoms

Parkinson’s is characterized by:

  • Slowness of movement
  • Rigidity
  • Tremor
  • Postural instability

Non-motor symptoms

Non-motor symptoms can impact your quality of life and can be experienced prior to motor symptoms. You may not realize that these symptoms are linked to Parkinson’s disease. As a result, many non-motor symptoms often go untreated.

Depression may be an early symptom of Parkinson’s

Depression is one of the most common, and most disabling, non-motor symptoms of Parkinson’s disease. As many as 50 per cent of people with Parkinson’s experience the symptoms of clinical depression at some stage of the disease. Some people experience depression up to a decade or more before experiencing any motor symptoms of Parkinson’s.

Clinical depression and anxiety are underdiagnosed symptoms of Parkinson’s. Researchers believe that depression and anxiety in Parkinson’s disease may be due to chemical and physical changes in the area of the brain that affect mood as well as movement. These changes are caused by the disease itself.

Here are some suggestions to help identify depression in Parkinson’s:

  • Mention changes in mood to your physician if they do not ask you about these conditions.
  • Complete our Geriatric Depression Scale-15 to record your feelings so you can discuss symptoms with your doctor. Download the answer key and compare your responses.

How to manage depression in Parkinson’s disease

Other non-motor symptoms

Non-motor symptoms can vary substantially from patient to patient and can include:

  • drooling
  • change in taste and smell
  • choking and swallowing difficulties
  • nausea and vomiting
  • constipation
  • uncontrolled loss of stool
  • bladder dysfunction
  • unexplained changes in weight
  • dementia and cognitive impairment
  • hallucinations
  • sexual dysfunction
  • orthostatic hypotension
  • excessive daytime sleepiness
  • insomnia
  • REM sleep behaviour disorder
  • restless leg syndrome
  • leg swelling
  • excessive sweating
  • double vision
  • delusions and impulse control disorders

How to identify and manage non-motor symptoms

With support from donations, tools and resources have been developed that can help you and your physician identify and manage non-motor symptoms.

Download Parkinson’s Disease: An Introductory Guide

Book cover for Parkinson's Disease: An Introductory Guide
This guide will help you better understand Parkinson’s. Developed and authored with the McGill University Health Centre Patient Education Office with support from Parkinson Canada, it describes the illness, changes in your body over time, treatment and care options, possible health problems, as well as when and where you can find more help.

The focus of this resource is on providing you with the tools to understand Parkinson’s, and to live well. You are encouraged to review this guide with your family. Bring it with you to your appointments with your health care team.

Thanks to the generosity of donors, Parkinson’s Disease: An Introductory Guide is made available to anyone, anywhere in Canada.

Download the guide

Discuss with your physician

Non-motor symptoms can sometimes be difficult to recognize. Therefore, it is important to make your doctor aware of them.

One useful resource is the PD NMS Questionnaire. You can use this to record your symptoms and discuss them with your doctor.

Dr. Ron Postuma, whose research was funded by donations to the Parkinson Canada Research Program, has also developed tools to help people with Parkinson’s and their physicians identify and manage non-motor symptoms.

Resources for your physician

Contact our Information and Referral Helpline

The Parkinson Canada Information and Referral Helpline is a toll-free Canada-wide number for people living with Parkinson’s, their caregivers and health care professionals. We provide free and confidential non-medical information and referral services. When you have questions or need assistance, our information and referral staff help connect you with resources and community programs and services that can help you. We provide help by phone or email, Monday to Friday, 9:00 a.m. – 5:00 p.m. ET.

Contact our Information and Referral line

Managing depression in Parkinson’s disease

People with Parkinson’s, family members and caregivers may not always recognize the signs of depression and anxiety. If you are experiencing depression as a symptom of Parkinson’s, it is important to know it can be treated.

Here are some suggestions:

  • For information and support on living well with Parkinson’s disease, contact our Information and Referral line.
  • As much as possible, remain socially engaged and physically active. Resist the urge to isolate yourself.
  • You may want to consult a psychologist and there are medications that help relieve depression in people with Parkinson’s, including nortriptyline and citalopram (Celexa).

Understanding more about Parkinson’s