Depression is a serious illness that can affect anyone at anytime in their life, it brings about feelings of sadness, hopelessness, anxiety and fatigue, people who suffer from Parkinson’s disease not only have to contend with the disease itself but over 50% of people suffering will also have to contend with depression too.

There is no clear reason which determines why those suffering from Parkinson’s have depression, though Parkinson’s is a debilitating, progressive disease in itself which when first diagnosed many people find hard to digest.

Despite the advancements in medicine over the past few years many cases of depression go undiagnosed and are often mistaken for underlying symptoms of Parkinson’s disease itself as symptoms brought about by depression overlap those of Parkinson’s. However once depression has been diagnosed it can be treated successfully along with Parkinson’s.

Symptoms of depression are

• Persistent feelings of sadness and anxiety.
• Feelings of guilt and helplessness.
• A loss of interest in hobbies.
• A loss of interest in sex.
• A decrease in energy.
• Difficulty in remembering and concentrating.
• Problems with sleep.
• Changes to the appetite or weight.
• Irritability and restlessness.
• Suicidal or negative thoughts.

If you have five or more of these symptoms and they last for longer than two weeks you may be suffering from depression, it is important you visit your Doctor who can then asses you for depression and suggest any relevant treatment.

A lot of the symptoms listed above are very similar to symptoms which Parkinson’s disease will normally bring about in the course of time, however your Doctor should be able to distinguish between what are symptoms of your disease and those which may be down to depression.

Getting treatment for depression

Coping with Parkinson’s is hard enough on its own so it is very important that if you think you may be suffering from depression too you get it treated, treatment for depression when combined with Parkinson’s disease should always be controlled by a mental health professional.

This is critical especially when anti depressant medication is needed and prescribed, this will help to alleviate any potential drug interactions between the anti depressant and your Parkinson’s medication.

Recovery from depression is a long process especially if you have been depressed for some time without fully realising it and the medications which are often prescribed for depression can take several weeks to start working to their full potential.

The amount of medication needed for your depression will vary and the dosage may have to be altered to suit you, but no matter how advanced your Parkinson’s is, treatment for depression can be very successful.

Early disease

The biggest question once a correct diagnosis of Parkinson’s disease has been made is when to start treatment and the medication used for that treatment. Treatments can vary greatly depending on the age, condition of the patient and understanding of the disease and its treatment that the patient has. In the early stages of the disease depression and anxiety may also play a part in the debilitating symptoms and therefore will become one of the main objects of concern when deciding on initial treatment.

Neuroprotective agents If Neuroprotective agents are identified then they will obviously be the first treatment which is offered to the patient and treatment will commence as soon as possible. However no agent has been known to offer 100% neuroprotection, one medication that has a mild symptomatic effect is Selegiline and this is very often used in the early stages of Parkinson’s disease.

Starting symptomatic therapy

The decision of when to actually begin treatment is one that is made between the patient and their Doctor and several factors are taken into account, these are the degree of impairment, the effects the symptoms are having on the patient’s employment and the patient’s attitude towards taking medication. If the patient fully understands the limitations and benefits they can reap from the medication then their preference will count for a lot in the decision making process.

The patients understanding makes a huge difference because many times over the treatment period they will have to be re-evaluated and have their medication adjusted with the progression of the disease or the patients response to the therapy. It is therefore in the best interests of both parties that they develop a partnership from the very beginning.

The initial treatment options

The patient’s age and condition will make a huge difference to the choice of initial treatment; the drug Levodopa is usually the first choice of medication for those sufferers who are elderly. A dopamine agonist will usually be chosen for the younger patient as younger people are more tolerant of the side effects the drug can produce.

In the younger patients delaying of the onset of motor skills problems is also a huge concern with Selegiline, amantadine or anticholinergic medication being excellent initial treatments for mild symptoms of the disease, providing of course that the side effects most of these medications produce can be tolerated.

If depression and anxiety are one of the concerns then this will usually be treated with medications such as anti-depressants, it is thought that over 50% of all those suffering with Parkinson’s disease will also suffer from depression and anxiety.