depression is under-recognized in Parkinson’s

The recent events around Robin Williams’ suicide and the revelation he was battling the early stages of Parkinson’s disease, as well as depression, brings to light the importance of managing the non-motor issues related to neurodegenerative disease.


Depression is common in PD, and occurs in approximately one-quarter of those diagnosed. More importantly, depression and anxiety can occur up to 10 years before PD diagnosis. Depression is also under-recognized, so these numbers may not accurately reflect the widespread impact of mood disorders in this population. This highlights the importance of understanding how to manage mood disorders in the context of a neurodegenerative disease.

Depression occurs in persons with PD because their brain pathways closely associated with mood, and sleep are also affected by the disease.  The disease starts by affecting certain chemicals in the brain, long before the tremor and movement problems are evident. Depression may also be a side effect of the medication used to manage PD.

A recent article published in Neurology (Aug 15, 2014) by Dr. Weintraub (an expert in non-motor issues in PD) highlights the importance of this issue (article HERE). The study follows a cohort of people from the Parkinson’s Progression Markers Initiative, funded by the Michael J Fox Foundation for Parkinson’s Research. The mission of PPMI is to identify one or more biomarkers of Parkinson’s disease progression and includes cohorts from the USA, Europe, Israel and Australia. The discovery of a biomarker (“a measurable indicator of some biological state or condition” i.e. blood sample) is a critical step in the development of new and better treatments for PD.

423 people with PD and 196 “healthy” controls were followed for 24-months and measured: cognition and symptoms of depression, anxiety, psychosis, impulse control disorders (ICDs), sleep, apathy, and fatigue. People with PD had more depression, fatigue, apathy, and anxiety compared to controls… but more importantly, two-thirds of the people with PD who showed signs of depression were not being treated for depression by their physician.

This highlights that it is important that people with PD notice changes in their mood, and speak to their healthcare professional if they are worried about non-motor symptoms. And know that with Parkinson’s, You Are Not Alone. RIP Robin. much love.



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