an article of Juan Carlos Ofarrill published in , a magazine specialized in the area of aging
When you think of the Parkinson’s disease (EP) the most common is to associate it with what specialists call motor symptoms (rigidity, tremors, slow movements, among others), however, almost 80% of those affected by this disease suffer at some point emotional problems, and even 40% will require psychiatric or psychological care. This article offers an overview of the causes and clinical manifestations of the psychoemotional alterations associated with this neurodegenerative condition.
General causes of psychoemotional disturbances in Parkinson’s disease
The psycho-emotional disturbances in Parkinson’s disease they can have different causes. One of them is the psychological reaction to the fact of suffering from an incurable, progressive disease, with very striking symptoms that can often make you feel ashamed in public. They can also occur as a result of the degeneration of different brain structures such as the hypothalamus and the frontal lobe or due to deficits in neurotransmitters. A third reason would be the side effect of taking L-dopa or high doses of other anti-Parkinsonian drugs.
Main psychoemotional alterations in Parkinson’s disease
Anxiety
One of the most common disorders is anxiety. Its clinical manifestations include anxiety, constant nervousness, restlessness, inability to relax, emotional instability, breathing difficulties, tachycardia or palpitations, muscle tension, and headaches. It can appear alone but the most common is that it appears associated with depression.
When an external problem causes anxiety in a Parkinson’s patient, Parkinson’s symptoms such as tremor and rigidity often worsen. It has also been found that some drugs such as selegiline, apomorphine and ropirinole can cause restlessness and anxiety.
Social anxiety and social phobia
It is also common for Parkinson’s patients to show intense anxiety-like discomfort when they are in social contexts, which can lead them to avoid everyday situations such as meeting friends, family meals, talking to strangers, spending vacations with other people, or going to the movies. Almost 70% of them are ashamed of their public image and tend to leave the house very little.
Hypochondria
Fears of having a disease worse than Parkinson’s or of dying soon may appear. Sometimes they become convinced that they already have brain cancer, heart disease, or some rare disease unknown to science.
obsessive-compulsive disorder
Obsessive signs appear more frequently in these patients than in the general population. Among such signs can be mentioned the performance of gestures or ritual behaviors (turning on the lights when entering any room, even if it is light, because of the belief that if it is not done, a misfortune will occur) and the presence of extreme attention to detail. On some occasions the appearance of these manifestations is due to a psychological defense against personal insecurity and the lack of control that patients feel in their lives. But in most cases it is due to neurological affectations.
Depression
This is the most frequent mental disorder, it occurs in 60% of Parkinson’s patients. In general, they tend to be depressions with an asthenic nuance that include symptoms such as low energy, apathy, apathy, lack of pleasure in activities, pessimistic hopelessness towards the future and a feeling of current helplessness with low self-esteem.
Insomnia
There is also a high probability that sleep will be affected. Insomnia can be initial (difficulty getting to sleep) or it can be intermittent (difficulty staying asleep through the night). The causes of this are multiple. They range from aspects of neurodegenerative disease that affect sleep in terms of neurological function to a sedentary lifestyle.
sexual disorders
Two out of three Parkinson’s patients show some type of sexual problem: male sexual impotence (60%), lack of sexual desire (20-30%), hypersexuality (12%), premature or delayed ejaculation (15%). Although these affectations do not compromise the patient’s life, they are one of the main sources of dissatisfaction, low self-esteem and couple conflicts.
Psychosis
When hallucinations, delusions or mental confusion appear, it is usually due to side effects of anti-Parkinsonian medication.
It is important to know that the very diversity of the causes of these clinical manifestations means that their treatment is varied and that each case must be evaluated in a very particular way. On some occasions it will be necessary to modify the medication, on others to incorporate a new drug and, sometimes, to attend psychotherapy sessions. But the common denominator is that only the person with Parkinson’s, or a relative who is in charge, detects any of these manifestations. go to a professional of health to determine the best course of action.
Bibliographic references
Anxiety, depression and emotional changes. Available at http://www.parkinsonsvic.org.au/parkinsons-and-you/anxiety-depression-and-emotional-changes/
Blonder, L., & Slevin, J. (2011). Emotional Dysfunction in Parkinson’s Disease. Behavioral Neurology, 24(3), 201-217.
Rodríguez del Álamo, A., Vicario, A., Donate, S., & de Benito, F. (2003). Mental disorders in Parkinson’s disease (part II): Clinical aspects and differential treatments.Pisquiatría.com, 7(2).