Sara sat down in my room with a big sigh, her left hand is shaking a little, betraying the reason for her arrival in the room.
"They told me that we should talk.., so I came, even though I don't know what can be done to help me..."
Sara, a young woman, good-looking, about 55 years old. Engaged in banking in a fairly senior position. A mother of young adult children who has been married for many years continues to tell -
"I was diagnosed with Parkinson's, about five years ago. Everything was fine until now. I continued everything as usual and even managed to add to my really active lifestyle the physical activity that everyone says you must do.
I exercise every day, I work, I continue to meet with friends, for today I am a good mother, a good partner - as if everything is fine, but Noya, I don't have the strength for all this.
I feel like I'm running out of energy. It's the physical strength that runs out, I get to the middle of the day and feel like a phone with a low battery warning. I have to stop everything in the middle of the day and rest, really rest. And sometimes I have to stop more than once a day..."
This feeling that "the battery is running out" is familiar to all of us. Suddenly in the middle of the day the energy runs out. But among Parkinson's patients the "battery" runs out faster and the need for rest is greater, if I'm not mistaken. As the disease progresses, more rest is needed throughout the day. It is important to allow this rest, if possible. This enables better and more energetic working hours.
"But it's the physical side, with which I'm still managing, the worst thing is that I don't have the mental strength to carry it. I feel it's unnecessary, I feel sadness, fear, frustration and so many other difficult emotions that I'm afraid to even talk about them. I've always been someone who succeeds to see the glass as half full, always. I've been through hardships in the past, I've faced crises of various kinds. But now, it's big on me I feel. All I want every morning when the clock rings, is to put the blanket over my head and not fight anymore. I'm tired, I'm worn out, no taste…"
I looked at Sarah, who is sitting in front of me, she is not the first to sit here in the room and feel this way. She is not the first to feel like a drained battery - body and soul.
Parkinson's is known as a disease whose main characteristic is tremors, at least that's how most people know it. But Parkinson's, unfortunately, is so much more than that.
Parkinson's is a disease caused by a decrease in the neurotransmitter dopamine, dopamine is like our fuel - for body and soul. Therefore, the damage to Parkinson's is physical - tremors, slowness of movement and other characteristics, but dopamine is involved in our ability to maintain motivation, mood, desire for action and more. A decrease in the level of dopamine can lead to the creation of depression, its increase, as well as anxiety. Sometimes depression or anxiety are the first signs of the disease, even before the appearance of motor symptoms. (I will write about anxiety another time).
The mental parts of Parkinson's disease have been talked about more in recent years, but many times they are still not talked about enough.
There will be patients and family members who will come to the neurologist, after waiting for many months for the long-awaited appointment, sit in front of the doctor and tell the difficulties, all the difficulties but will "forget" to tell about the bad mood, the anxiety, the lack of desire to do anything. Why won't they tell? For many reasons - because they will not understand that it is part of the disease, because they will be ashamed to admit that they have reached this state, because they will think that there is nothing to be done about it. and many other reasons. And the doctor will not always ask and check. Mental health is a sensitive issue, yet, for many people, we tend to think that mood and motivation are a matter of the person's choice and way of coping. We are forgiving of physical signs and less so of mental ones.
The prevalence of depression in Parkinson's patients ranges between 30-50%. Depression is a major factor in affecting the quality of life of these patients and worsens the prognosis. The clinical expression of depression in Parkinson's patients is similar to its expression in the general population. At the same time, some symptoms are more pronounced in Parkinson's patients while other symptoms are less pronounced. The clinical manifestations include apathy, psychomotor slowness, sadness, pessimism.
Depression in Parkinson's patients has been found to be related to the severity of the disease, sleep disorders, cognitive decline, repeated falls and balance disorders.
There are Parkinson's patients who during the "off" period (the period of time in which the dose of dopamine taken wears off and the next dose of dopamine has not yet had an effect - something that may appear several times a day even) feel depression and anxiety with great and frustrating intensity. In this situation, it is important to contact the treating neurologist in order to examine the drug treatment and check its suitability and effectiveness.
It is very important for me to emphasize - anxiety and depression are often not a companion to the disease but a part of the disease itself. It's not a "mental crisis because I'm sick" (sometimes that's the reason too) but another way that Parkinson's shows its presence.
Know - there is something to be done with depression. And not only is there something to do, but it is important to do so as not to remain depressed, so as not to harm the quality of life which could be much better without the depression. Quality of life for the patient but also for his environment. The treatment can be adjusting the existing medications, adding medication to the mood or referring to conversations in order to learn ways to deal with the depression.
Contact the family doctor, the neurologist, the clinic nurse, the social worker or any professional in the field today to say "I have a problem" and to start treating it.
