Depression in Parkinson's Disease

The link between Parkinson's Disease and depression has come to light more in the past 5 years or so. Researchers are finally beginning to notice that depression occurs in a large part of the PD population (estimates are 40-50%).

The exact reasons for why such a large portion of Parkinson's patients develop depression are not entirely known. It is thought that the biochemical alterations are a large culprit, but stess and psycho-social reasons probably play a role too. I am sure that people on hearing their diagnosis of PD are less than happy and may experience some level of depression for a while, but when does this depression cross the line from feeling down about a difficult disease into a clinical depression? Also, there is evidence that 12-37% of patients with depressive symptoms develop these symptoms prior to developing motor symptoms. Does this mean that the depression is mostly biochemical? I do not know.

How do you piece apart the chemical changes in a person's brain from the psycho-social or stress induced changes in someone's attitude or behavior? This is a question that I think will take years to answer, if it is able to be answered at all.

Since there is a large population of depression in PD you would think that treatments would be fairly well understood. That is not true at all and actually the opposite is closer to the truth. From the research I have read there are several anti-depressants that are possible for treatment, but none of them have significant research surrounding their use and efficacy in treating depression in Parkinson's. That being said, an anti-depressant may be the right choice for many patients. A motor disease specialist should be able to recommend some medications as possible treatments.

Besides anti-depressants a patient suffering from depression may want to consider other forms of treatments either jointly with anti-depressants or by themselves. Obviously qualified medical personnel should help the patient with any of these decisions. Some possibilities for treatments are: counseling, stress-management, relaxation techniques, coping strategies or support groups.

It is important to note that although Parkinson's is a difficult disease for all patients those with depression may suffer from a lower quality of life. It is important to work closely with the medical community to monitor the patient's mood and to help if warranted. Remember not all PD patients suffer from depression, but those that do may need help seeking treatment.