People get depressed pretty quickly. Patients find out that they have Parkinson’s disease and as part of that, they have the behavioral depression that goes along with realizing that they’re not going to live forever and their movements might get in the way of being able to take care of themselves and be independent. You can imagine how it all starts to snowball.
It is really complicated, because you’re balancing neurotransmitters in different ways. Most difficult would be a patient who has a psychotic disorder and parkinsonism, because basically you’re kicking up the level of dopamine with Parkinson’s treatments, and you’re bringing down dopamine at the receptor when patients are treated with antipsychotics. So in a way it’s in direct opposition.
Dr. Melton added that cognitive therapies can be as effective for depressed PD patients as medication, a claim we often hear from psychiatrists about the power of talk therapy. She said, “Parkinson’s patients can really benefit if they have a therapist who works with them on depressive symptoms and on changing the way they process the different thoughts they have, especially if they become suicidal.”