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Hello to all, I hope everyone is doing well. I have a question, and need some advice.
I had an interview with a potential client, where the mother whom is 70 has Parkinson's Disease, and she specifically asked me about PD and Depression and Severe Anxiety. I do know that about 40 million of the 100 million people diagnosed with PD do get depression and anxiety.

Does anyone out there have a clinical answer for this.

I understand that they need to be concerned about it with PD because

Anxiety is a major determinant of quality of life in people with PD even when accounting for
The presence of depression; and
The severity of the movement disorder.

ALSO,

As a caregiver, what are the ways or the best ways people have found to deal with severe anxiety. From my telephone call with the daughter, it sounds like her tremors are pretty bad, and they haven't found the magic medication for these to stop. Advice please?

Thanks so much.

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Dementia of any kind causes anxiety, because the patient KNOWS they are losing memories and abilities. Untreated, anxiety devolves into depression. The doctor can recommend medications to alleviate these symptoms. The MD cannot reverse the disease, but they CAN make the patient comfortable. Social interaction with peers is a key to survival and can improve the patient's outlook. Look for ways to improve both.
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This is a very complicated question about possible neurological pathways and neurochemical imbalances in the brain. Anxiety and depression are linked very strongly and often respond well to the same medications. The most popular neurochemical talked about is serotonin, though others are also involved. There are pathways in the brain that are studied. You may find some of the more in depth studies interesting.

PD is linked less strongly to the other two, so a person with PD can still live a good life despite the problems that go along with the disease. I would not be surprised, however, if people with PD may have damage in some of the other areas of the brain, such as what we see with Lewey Body dementia. I also wouldn't be surprised if the losses that go along with advancing PD can themselves cause anxiety and depression.

From what I've read about Robin Williams, he has suffered from depression for a long time. It made me wonder if he had a problem too many people suffer from -- not being able to feel happy. I knew a teenage boy who was so handsome and always trying to make others happy who had the problem. He said he never could be happy, no matter how he tried. He finally hung himself, because his life was so painful to him. It was a tragedy that probably happened because his brain was not geared to letting him feel pleasure or happiness. And I wonder if many comedians suffer from this -- always trying to act to make others happy, but never feeling it themselves.

We never appreciate what our brains do for us until there is a problem. Not being able to feel happy to me seems like it would be the worst one.
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Here is a little something about your question from NIMH. http://www.nimh.nih.gov/health/publications/depression-and-parkinsons-disease/index.shtml
Again we see serotonin in the spotlight, but it is probably more complicated.
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Thank you very much, I appreciate the answers.

All of this is very complex, and as many of us are caregivers to many of these loving clients, we want to be as well educated as we can be to provide the family assistance.
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I talked to someone with PD today. She told me that anxiety and depression are indeed part of the PD package. She said you just have to deal with the things and keep going. This lady always seems so upbeat that it's hard to believe she has anxiety and depression. She handles things so well.
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