While Parkinson’s is characterized by slowness of movement, rigidity, tremor and postural instability, many people with Parkinson’s may experience other changes; sometimes even prior to their motor symptoms. These other changes, known as non-motor symptoms, can also impact one’s quality of life and many patients may not realize that these other symptoms are linked to Parkinson’s disease. As a result, these non-motor symptoms often go untreated.
Parkinson Canada funded researcher Dr. Ron Postuma, developed tools to help people with Parkinson’s and their physicians identify and manage non-motor symptoms.
Non motor symptoms can sometimes be difficult to recognize and therefore, it is important to make your doctor aware of them. Use the PD NMS Questionnaire to record your symptoms and discuss them with your doctor.
Non-motor symptoms can vary substantially from patient to patient and can include the following*: 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; depression and anxiety; 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.
Depression and Parkinson’s disease
Depression is one of the common non-motor symptoms of Parkinson’s disease; with as many as 50 per cent of people with Parkinson’s experiencing the symptoms of clinical depression at some stage of the disease.
Although living with Parkinson’s can certainly be challenging, and the diagnosis can be frightening at first, depression in people with Parkinson’s may be caused by the chemical and physical changes in the area of the brain that affect mood, as well as movement. In fact, depression may be an early symptom of the disease, with some people experiencing depression up to a decade or more before experiencing any motor symptoms of Parkinson’s.
Depression can be one of the most disabling symptoms of the disease. But, it is important to know it can be treated. 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.)
For information and support on living well with Parkinson’s disease, call our toll-free Information and Referral line at 1-800-565-3000 or contact a regional office near you.
It is important to remember that clinical depression and anxiety are underdiagnosed in people with Parkinson’s and that they are symptoms of your disease. Researchers believe that depression and anxiety in Parkinson’s disease may be due to underlying changes in brain chemistry that are caused by the disease itself. In fact, depression in Parkinson’s patients can start before motor symptoms arise.
People with Parkinson’s, family members and caregivers may not always recognize the signs of depression and anxiety. In fact, your physician may not even ask you about these conditions if you don’t mention changes in mood. Complete the Parkinson Canada’s Geriatric Depression Scale-15 to record your feelings so you can discuss symptoms with your doctor. Download the answer key and compare your responses.