The ‘unseen’ aspects of Parkinson’s disease

Involuntary trembling of the limbs, stiffness and rigidity of muscles, difficulty in maintaining balance, and disturbances in gait – these are some of the physical manifestations of Parkinson’s disease that one can easily detect.

What are not easily seen are the psychological aspects of the disease, which can also have adverse effects on the person suffering from it.

"Psychological effects are sometimes harder to detect," says Dr. Sal Teleg of PhilMove, a member of the team of medical experts in the fields of neurology and neurosurgery, with offices at the Cardinal Santos Medical Center in San Juan. 

"But they are very significant nonetheless," he adds.

Three of the major psychological effects of Parkinson’s disease include: depression, anxiety and psychosis.

Teleg says depression usually occurs when a patient learns that he is suffering from the disease, observes the occurrence of new physical symptoms, and adjusts to therapy.

It may also be a result of a patient’s altering his lifestyle, and giving up leisure activities and work.

"Worry and apprehensions are natural reactions," he says. "However, if these are prolonged, they can be very alarming."

Teleg says depression manifests itself in different ways and in varying degrees. 

Its symptoms include loss of energy or lethargy, insomnia or hypersomnia, feeling of worthlessness, inappropriate guilt, alarming weight change, decreased concentration, indecisiveness, and even recurring thoughts of suicide.

"We have encountered cases where patients feel that it would be better for them to end their lives than see themselves being slowly consumed by the disease," he says.

Teleg adds that depressed patients may also lose their appetite for food and intimacy and cry unexpectedly.

Teleg, however, clarifies that five of these symptoms should occur before it can be classified as depression.

Anxiety is another psychological symptom of Parkinson’s disease. It is characterized by tension, expectation of an impending disaster, and continuous vigilance for danger. 

"Anxiety and depression sometimes go hand in hand," Teleg says. 

Parkinson’s disease patients who suffer from anxiety attacks display the following physical symptoms: shortness of breath, clammy sweating, dizziness, and irregular heartbeats.

They may also display irrational fear of certain situations like phobia for open or enclosed spaces and fear of engaging in socialization.

"Though it has not yet been proven whether it is a result of biochemical reactions, it has been observed that patients suffering from Parkinson’s disease tend to suffer from anxiety attacks more than the patients of other diseases," Teleg says.

Teleg adds that it may also be largely due to psychological causes like having feelings of embarrassment, especially when the patient’s motor functions have been greatly debilitated by the disease.

"While (psychosis) is something that occurs to around 15 percent of patients, it is still something to watch out for," Teleg says.

Psychosis, he emphasizes, is a very difficult symptom to deal with. "It does not only affect the patient, but his loved ones as well," he says.

Symptoms of psychosis include visual hallucinations, belief that one is in adverse danger, and fear of being spied upon or threatened.

Teleg advises that once these symptoms occur, loved ones should immediately take their relative or friend suffering from it to a specialist.

For more information on the Activa Parkinson’s Control Therapy, visit the Philippine Movement Disorder Surgery Center at the Cardinal Santos Hospital in San Juan or call 726-0776 or 727-7653.