3 posts tagged “mental health treatment”

Parkinson’s disease + anxiety/depression: Stigma-busting for Mental Health Month

Posted 5 months ago by

Stress. Anxiety. Depression. Have you experienced any of these along with Parkinson’s disease (PD)? As National Mental Health Month comes to a close, we’re highlighting how common these non-motor symptoms and mental health issues are among people with PD.

Plus, see some new research on the prevalence of feeling demoralized (vs. depressed) with PD, and explore how members of the PatientsLikeMe community try to manage their mental health.

Research shows that the vast majority of people with PD have non-motor symptoms (NMS) — with psychiatric symptoms (like anxiety, depression and psychosis) accounting for 60 percent of NMS in one large-scale study.

“That’s why taking action is important,” says Andrew Ridder, M.D., a movement disorders specialist at Michigan Health. “If you or a loved one has had a new diagnosis of Parkinson’s disease, we recommend an immediate evaluation for depression, mood and cognitive problems. Frequent monitoring should also be done throughout the course of the disease.”

Dr. Ridder cites some key stats:

  • About 5 to 40 percent of people with Parkinson’s disease have a clinical diagnosis of anxiety
  • Between 17 to 50 percent of patients with Parkinson’s have depression

“Anxious mood” and “depressed mood” are commonly reported symptoms of PD on PatientsLikeMe. Hundreds of members have reported a diagnosis of PD plus a mental health condition.

Work with your doctor or care team to find treatments that work best for you. Some of the treatments Dr. Ridder mentions for people with PD and depression or anxiety include:

  • Selective serotonin reuptake inhibitors (SSRIs) such as paroxetine or sertraline
  • Serotonin/norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine
  • Cognitive behavioral therapy or psychotherapy (learn more about types of therapy and finding a therapist)

He also discusses some lesser-known treatments, adjustments to carbidopa-levodopa (Sinemet) regimens (to treat anxiety during “off” times) — as well as some treatments that are not prescribed or advised for people with PD — so check out his full article on PD and mental health (also, check out this video).

Anxiety and Parkinson’s

clinical diagnosis of anxiety is marked by frequent, long-term “feelings of worry, nervousness or unease that may be accompanied by compulsive behavior or panic attacks.” Dr. Ridder says some of these symptoms can be worse or occur only when Sinemet is wearing off, also known as “off times.”

Join PatientsLikeMe to see what members living with PD have shared about their experiences with anxious mood as a symptom (and the treatments they’ve tried) — after joining, click here. Nearly 300 members report having diagnoses of both PD and generalized anxiety disorder.

Depression and PD

“Depression and Parkinson’s have so many similar-looking symptoms that it is hard to tell the difference between them,” Dr. Ridder says. “It’s important to note, however, that depression is not a reaction to the disability. Rather, it seems to be related to the degeneration of specific neurons in Parkinson’s disease itself.”

Both PD and a depression can bring: sadness, pessimism, decreased interest in activities, slowing movements and fatigue. Clinical depression or major depressive disorder is often accompanied with guilt and self-blame, which you don’t often see in Parkinson’s disease depression, Dr. Ridder points out.

Join/log into PatientsLikeMe to explore what other members with PD have shared about their experiences with depressed mood as a symptom (and the treatments they’ve tried for it) here. Also, connect with about 300 members who say they’ve been diagnosedwith both PD and major depressive disorder.

Depression vs. feeling demoralized

New research published in the journal Neurology sheds light on how many people with PD may feel demoralized (and not clinically depressed). Among the 94 study participants with PD, 17 of them (18%) felt demoralized, while 19 of them were depressed.

“Demoralization is a state of feeling helpless and hopeless, with a self-perceived inability to perform tasks in stressful situations,” PsychCentral explains in a report about the new study. “With depression, a person usually knows the appropriate course of action and lacks motivation to act. With demoralization, a person may feel incompetent and therefore uncertain about the appropriate course of action. The two can occur together.”

Study author Brian Koo, M.D., says the distinction is important because “demoralization may be better treated with cognitive-behavioral therapy rather than antidepressant medication, which is often prescribed for depression.”

Get tips to help handle or prevent demoralization in this recent Parkinson’s Foundation blog post.

Let’s not forget stress

Stress refers to “the emotional, psychological, or physical effects as well as the sources of agitation, strain, tension, or pressure.” Stress can manifest itself both physically and mentally, so it’s also important to keep in mind in managing PD.

See how stress affects the PatientsLikeMe community as a symptom, and what members with PD have tried to help manage it. Also, check out the Michael J. Fox Foundation blog posts on 7 Apps for Stress Relief and Wellness and the benefits of low-key calming activities for overall well-being.

Explore the forums

As a logged-in member, click on these links to see what other members living with PD have shared in forum posts about:

And keep in mind that you’re not alone in experiencing these symptoms or conditions.

How have mental health symptoms or conditions affected you along with your PD? Make a comment here or join the community discussions through the links above.

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Primary care that treats mind and body? It’s happening in Alaska

Posted 9 months ago by

Integrated care for both mind and body under one roof? It may sound pie in the sky, but it’s really happening at an award-winning healthcare center in Anchorage, recently featured in Politico. How does it work? And can it be replicated?

A shining example in Anchorage

“It’s a truism that the mind and body are connected, but the U.S. health care system has long treated them as separate — with separate doctors, separate hospitals, separate payment systems,” Politico reports (detailing the history of these health care “silos”).

The Southcentral Foundation, which runs a healthcare center for native Alaskans in Anchorage, is in the spotlight for successfully bridging the mind/body divide.

“In part because of their Alaska Native heritage, which puts a high value on spiritual health, the leaders of Southcentral recognized decades ago that behavioral health is tightly linked with bodily health,” Politico says. “So they became one of the early adopters of integrated care.”

At Southcentral, checkups include a mental health evaluation, and a patient’s primary care team includes on-site psychologists or social workers.

For one patient, Vera, profiled in the Politico piece, “accessing mental health treatment was as easy as going to her regular doctor, and there was no stigma attached: Her mental health services were provided at the same time and in the same place as other medical care, just like heading down the hall for an X-ray or a blood test.” Vera was sexually abused as a child and later diagnosed with major depression. She experienced suicidal thoughts and may not be alive today without the integrated care she received at Southcentral, she says.

Advantages of integrated care

The World Health Organization (WHO) has recommended integrating mental health care into primary care for decades. Here are some of the benefits of integrated mental/physical health care that WHO outlined back in 2001:

  • Less stigmatization of patients and staff, as mental and behavioral disorders are being seen and managed alongside physical health problems
  • Improved screening and treatment, in particular improved detection rates for patients presenting with vague somatic (physical/bodily) complaints which are related to mental and behavioral disorders
  • The potential for improved treatment of the physical problems of those suffering from mental illness, and vice versa
  • Better treatment of mental aspects associated with “physical” problems

A popular notion — and the roadblocks

Research has shown that Americans value physical health and mental health equally. Also, “nearly half of Americans think they have or have ever had a mental health condition (47 percent), yet fewer than two in five have received treatment (38 percent),” according to a 2015 survey by the Anxiety and Depression Association of America.

In a 2017 PatientsLikeMe poll of more than 2,000 members, support for the Affordable Care Act (or “Obamacare”) is highly popular among those living with mental health conditions, perhaps because the policy’s “parity” requirement means that insurers have to cover mental and physical health issues equally.

Politico reports that there’s broad support for physical/mental (behavioral) health integration in both the healthcare sector and in Congress.

The Southcentral Foundation won the Malcolm Baldridge National Quality Award in both 2011 and 2017 for its innovative, top-quality care (psst: 97% patient satisfaction) at a relatively low cost. Douglas Eby, vice president of medical services at Southcentral, says he is often invited to speak at conferences in Washington, D.C., because the Southcentral model is “popular with the whole political spectrum.” (What? Whoa.)

So what are the biggest hangups? Money and stigma.

The U.S. health care and insurance system is structured in such a way that doctors are paid more for (physical) procedures, and they can actually lose money by integrating mental health. The longtime stigma of mental illness extends into the provider space, where mental health clinicians and services are valued much less, dollar-for-dollar, than their “physical care” counterparts.

“Solving these problems will take more than money; it will require changing the culture of medicine,” Politico concludes.

On PatientsLikeMe, thousands of members are living with both physical and mental-health conditions. Join the community today to talk about topics like this with patients like you!

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