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How can I help Mom deal with the depression she's developed as a result of Parkinson's?

A fellow caregiver asked...

My mom has had Parkinson's for 15-20 years and has progressed slowly. However, she is very negative and goes through times of anxiety and depression that get pretty bad. How can I deal with the negative responses?

Expert Answer

Graham A. Glass, MD, is the co-founder of PEAK Neurology and Sleep Medicine, LLC with multiple locations across Alaska. Previously, he was deputy director of the San Francisco Parkinson's Disease Research, Education, and Clinical Care Center PADRECC and assistant clinical professor of neurology at the University of California, San Francisco (UCSF). Glass received his medical degree from the University of Texas Health Sciences Center at the San Antonio School of Medicine and completed his neurology residency at Tufts-New England Medical Center. He subsequently completed a fellowship in movement disorders at the Mayo Clinic.

Parkinson's disease affects multiple areas of the nervous system and results in a number of symptoms other than tremor and movement problems that are frequently seen. Depression and anxiety are very common in Parkinson's and your mom is among over 40% of Parkinson's patients in this regard. We know that this is not due just to the functional disability that comes along with the disease, but rather involves the effect of Parkinson's on areas of the brain responsible for depression and anxiety. In dealing with depression in Parkinson's disease, it is important to consider both medications and "talk" therapy. In terms of medications, I would encourage you to meet with her doctor to discuss the fact that this is very common in PD and often requires higher doses of the medications and sometimes requires trying out several different "anti-depressants" over time until one is found that works. At the same time, it would likely be helpful to have your mom meet with a counselor, psychologist or preferably someone who specializes in "cognitive-behavioral therapy."