Shaking the stigma: Anxiety and depression in Parkinson’s disease

What is less commonly known is that Parkinson’s disease affects more than movement. Behind the visible symptoms, people living with Parkinson’s (PWP) often face an invisible challenge - changes in mood and emotional wellbeing. Anxiety and depression are common, affecting roughly 40–50% of PWP. These can significantly affect daily functioning and have a major impact on quality of life to diagnosed individuals and their carers.   

Since 2009, the US-based Parkinson’s Foundation has led one of the world’s largest clinical studies on people living with Parkinson’s disease, the Parkinson’s Outcomes Project, tracking more than 13,000 participants across five countries. The study revealed that, collectively, anxiety and depression have a greater impact on the health of people with Parkinson’s (PWP) than the movement impairments normally associated with the disease. 

It is therefore just as important to understand and address these debilitating mental health concerns and impacts of Parkinson’s disease as it is the physical ones. They do not have to be faced or navigated alone. The MSWA Counselling and Wellbeing team is perfectly positioned to offer a caring and understanding space for people living with Parkinson’s and their families to explore and manage the challenges of anxiety and depression, providing person-centred care and support. Seeking support starts with identifying if what you are feeling could be depression or anxiety.  

Feeling sad from time to time is not unexpected when navigating life with progressive neurological condition such as Parkinson’s disease. It is normal and expected to feel down when the slowness and stiffness of movement that come with Parkinson’s can make even the simplest tasks exhausting and frustrating. Episodes of freezing - suddenly feeling “stuck” mid-stride - can be embarrassing or frightening in public. These experiences can chip away at confidence and contribute to feelings of sadness or discouragement. However, prolonged periods of low mood (more than two weeks) may be indictive of something more serious, warranting investigation and possibly intervention.  

Symptoms commonly reported are: 

• Persistent sadness.
• Crying.
• Loss of interest in usual activities and hobbies.
• Decreased attention to hygiene, medical and health needs.
• Feelings of guilt, self-criticism and worthlessness.
• Increased fatigue and lack of energy.
• Change in appetite or eating habits (such as poor appetite or overeating).
• Loss of motivation.
• Aches and pains.
• Feelings of being a burden to loved ones.
• Feelings of helplessness or hopelessness.
• Sleep difficulties (too little or too much).
• Poor attention or difficulty concentrating.
• Feeling slowed down or restless.

Feeling stress or worry is common when living with the unpredictability of Parkinson’s. Anxiety can stem from very real, everyday challenges. There may be worries about freezing or falling in public, or about tremors and involuntary movements being misread by others. Changes in speech or facial expression can create fears of being misunderstood, while the unpredictability of medication ‘wearing off’ can add another layer of uncertainty. However, if these feelings become constant, overwhelming, or start interfering with your daily life, it may be a sign that you could benefit from professional support. 

Signs of anxiety include: 

• Ongoing worry or fear.
• Feeling nervous/tense.
• Sense of impending doom or panic.
• Repetitive thoughts (rumination).
• Trouble concentrating or thinking about anything other than the present worry.
• Racing heart.
• Breathing rapidly. 
• Sweating.

Your emotional wellbeing matters when living with Parkinson’s. If persistent sadness or worry is affecting your day-to-day life, don’t hesitate to reach out an MSWA Counsellor. Counsellors at MSWA are both knowledgeable and experienced in supporting people living with anxiety and depression.  

As mentioned earlier, depression and anxiety are two of the most common – and impactful – challenges faced by people living with Parkinson’s disease (PD). These mood changes don’t arise from a single cause and are not signs of personal weakness or failing. Instead, they reflect a mix of changes in the brain and the day-to-day realities of living with a long-term neurological condition. 

Parkinson’s doesn’t just affect movement. It also disrupts key brain chemicals, including dopamine, serotonin and norepinephrine, which play vital roles in mood regulation. These changes can make people more biologically vulnerable to depression and anxiety. 

Living with an unpredictable illness like Parkinson’s disease often involves major losses – independence, roles, work and social connections. Adjusting to these changes can increase emotional distress and raise the risk of depression. The uncertainty about the future, combined with the unpredictable nature of Parkinson’s disease, can further fuel worry and fear. 

Common Parkinson's disease symptoms such as fatigue, sleep problems, pain and reduced mobility can sap energy and lower mood. They may also intensify feelings of anxiety or concern about the future, making recovery from depression more challenging. 

MSWA Counsellors can be powerful allies in your healthcare team to empower you take control of your mood, worry less and find meaning in daily life.  

1. Listening 
   Counselling is a professional and confidential service that provides people with a safe and non-judgemental space to speak about their feelings, thoughts and life experiences. MSWA Counsellors listen to you to understand your story, fostering a meaningful connection with you to understand what is happening for you. 
    
2. Guided conversations 
   Counsellors facilitate guided discussions in a supportive and compassionate setting, enabling individuals to clarify their thoughts, manage emotional challenges, enhance self-awareness and establish a foundation for personal development and growth. 
    
3. Evidence based interventions 
   Counselling isn’t simply talking, or a one-size fits all approach. Counselling is individually targeted, and it employs evidence-based interventions and therapeutic techniques to enhance psychological and emotional wellbeing.  
    
4. Strengthening social connections 
   As Parkinson’s progresses, changes in movement and other symptoms can sometimes make self-consciousness more noticeable, often leading to reduced participation in social activities and contributing to feelings of depression. Working through these challenges with a counsellor can improve confidence, increase self-efficacy and help to maintain social engagement.  
    
5. Encouragement  
   Staying committed to exercise, therapy and medication adherence and other PD related activities can be challenging when living with a long-term condition like Parkinson’s, especially if anxiety or depression are also present. An MSWA Counsellor can act as a supportive cheerleader, helping you stay motivated when chronic illness makes maintaining these routines difficult.
    
6. Wellbeing service  
   For those who find counselling intimidating, MSWA offers a broad range of stand-alone Wellbeing sessions which put you in control. You can focus on the areas that matter most to you, building skills, confidence and strategies to improve your daily functioning and overall life satisfaction.
    
7. Support for loved ones  
   Living with Parkinson’s can affect more than just the person diagnosed. Family members and caregivers may also experience anxiety and depression through the witnessing and supporting of a loved one with a chronic neurological condition. The MSWA Counselling and Wellbeing team is here to support carers too. 
   
   While Parkinson’s, depression and anxiety aren’t choices, how you live with them is - and every step you take toward wellbeing matters. MSWA Counsellors are here to walk alongside, guide, encourage and support you. Make the call today and see how we can help you take the steps to live your best life.