Ask the expert: Parkinson’s disease and mental health

Special reports

Author: Sarah McGrathPublished: 4 November 2021

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In the latest in our ‘Ask the expert’ series, Professor Dr Bernd Leplow shares insights on the way Parkinson’s disease can impact mental health – and offers advice for people experiencing symptoms

What drew you to study neurological conditions such as Parkinson’s?

My first contact with basal ganglia [structures in the brain involved in movement coordination] patients was very early in my career at the University Hospital in Hamburg, where I had the chance to meet people suffering from dystonia. This was long before the availability of botulinum toxin [Botox] treatment so I was confronted with the full-blown symptoms.

In a way, I was fascinated by the impact of situational demands and emotions on neurological dysfunction. I learned that in basal ganglia patients, you can see their emotional state via the state of the motor disorder – and that you can influence symptom severity and quality of life through psychological methods.

I met my first Parksinsonian patients at the psychology department of Christian-Albrechts University in Kiel, Germany, after I had left Hamburg University. I learned that this ‘motor’ condition was much more complex than how it was seen in those days. Parkinson’s patients could tell you a lot about psychology.

How ca Parkinson’s disease impact mental health?

Since Parkinson’s disease is now seen as a multidimensional disorder, including motor symptoms as well as behavioural, emotional and cognitive alterations, mental health can be – and in most cases is – severely affected in all of these domains.

Outside Parkinson’s community I feel sure that the relationship between Parkinson’s and mental health above is widely unknown. But within medicine, psychology and neuroscience, we have learned that (and in part how) behaviour, emotions, cognition and physiology are tightly connected – that they are aspects of the of the same coin, not independent entities.

What advice would you give to people with Parkinson’s who are experiencing mental health symptoms?

 My advice is talking, getting an expert’s help and not hiding symptoms – because hiding symptoms due to shame or stigma inevitably leads to exacerbation. Patients should contact their neurologist and discuss seeking additional help from a clinical neuropsychologist, who can offer treatments which ease the condition’s burden.

Patients should also contact their respective self-help group, because these organisations have contacts with experts in various and specific fields and can help ease any embarrassment patients may be feeling.

Image credit: Ute Boeters.

Why is it important for people with Parkinson’s to talk to their healthcare professional about mental health?

Patients and their caregivers should get an idea how physiology is linked to behaviour and emotions.

From this point of view, they can learn to understand why they feel like they feel and why cognitive functions are affected in varying intensity. For example, a common Parkinson’s symptom such as freezing has potential underlying psychological reasons.

My experience is that Parkinson’s patients systematically reduce anxiety, embarrassment and avoidant behaviour if they have a chance to learn about these interrelated topics.

What more needs to be done to raise awareness and support people with Parkinson’s experiencing mental health symptoms?

Interviews like this? But seriously – not resting on just doing research and communicating it in scientific papers.

I am convinced it is equally important to communicate to medical practitioners, psychotherapists, journalists and so on.

I think that especially in German-speaking countries, our research has added to the acceptance of psychology and psychological treatment methods. During my career I was convinced that neuropsychology and neuroscience have to be tightly related with clinical psychology and psychotherapy.

Need to know

Dr Bernd Leplow is a professor based in Germany. He was previously a professor for clinical psychology, psychotherapy, neuropsychology and biological psychology at Martin Luther University of Halle-Wittenberg, and was head of the psychology department. He has since become head of strategic planning at the Institute for Therapy and Health Research in Kiel.

His research focuses on developing psychological intervention programmes for neurological conditions and on the impact of dopamine replacement therapy on Parkinson’s patients. He also runs self-help groups and has written several books and scientific papers.

Parkinson’s disease and mental health

Anxiety and depression are two of the most common non-motor symptoms of Parkinson’s, with nearly half of all people with the condition experiencing them at some point.

Symptoms may range from mood swings, to feelings of sadness and restlessness. Some of these symptoms can be treated with regular exercise, staying socially active or by taking medication and seeking counselling. Make sure to discuss these concerns with a healthcare professional.

To find out more about mental health symptoms and Parkinson’s, visit Parkinson’s Europe website.

Read more:

Ask the expert: How does Parkinson’s disease impact dreams?

Ask the expert: Is Parkinson’s disease hereditary?

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