Mental health symptoms in parkinson’s: common but treatable

https://youtu.be/dzfQi5sfrjU?si=0apNiSAijkq3ndHF

Speaker Bio: Greg Pontone, MD, MHS is Division Chief and Professor Of Aging, Behavioral, and Cognitive Neurology at the University of Florida and Co-Director of Neuropsychiatry Program at The Norman Fixel institute for Neurological Diseases. Dr. Pontone earned his medical degree from the University of South Florida in Tampa. After medical school he completed a medical internship at Johns Hopkins Bayview followed by a residency in psychiatry and a fellowship in geriatric psychiatry and movement disorders research at The Johns Hopkins Hospital in Baltimore, Maryland. Time Stamps:

3:54 – Mental wellness challenges in Parkinson’s: anxiety, depression, apathy, and anger defined and discussed.

4:42 – Breakdown of anxiety symptoms—how it feels mentally and physically, and how it relates to medication cycles.

7:27 – What depression looks like in Parkinson’s and why it’s the single most impactful non-motor symptom.

9:36 – Apathy vs. depression: key differences and why apathy often goes unnoticed or unreported.

11:18 – Why these symptoms happen: neurochemical changes and how Parkinson’s affects mood regulation.

14:57 – Introduction to the “wellness pyramid”: exercise, diet, sleep, and social connection as proactive tools.

22:54 – Strategies for better sleep: sleep hygiene tips, melatonin, and setting a consistent “sleep opportunity.”

25:50 – Socialization’s impact on brain health, mood, and longevity—why isolation is a major risk factor.

33:46 – Medications for depression, anxiety, and apathy: what works, what doesn’t, and why patience is key.

45:25 – How caregivers can help build structure and routine to reduce apathy and support long-term engagement.

54:39 – Dr. Pontone shares what gives him hope: promising research on disease-modifying therapies for Parkinson’s.

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Anxiety in Parkinson’s Disease

Anxiety affects about 40% of people with PD and can manifest as persistent worry, restlessness, panic attacks, physical symptoms (racing heartbeat, sweating, nausea), and avoidance of social situations due to fear or embarrassment.
It can precede motor symptoms or develop during the disease course.
Causes include dopamine loss and changes in other brain chemicals, “off” periods when medication effects wear off, sleep disturbances, social isolation, and uncertainty about the future [2], [4], [2].

Depression in Parkinson’s Disease

Depression affects approximately 30-50% of people with PD.
It is often a direct symptom of PD caused by neurochemical imbalances involving dopamine, serotonin, and norepinephrine, not just a psychological reaction.
Symptoms include persistent sadness, loss of interest, fatigue, feelings of guilt or worthlessness, sleep disturbances, and in severe cases, thoughts of death or suicide.
Depression can worsen motor symptoms and overall functioning but is treatable with medication, therapy, exercise, and social support [1], [3].

Anger and Irritability in Parkinson’s Disease

Anger outbursts and increased irritability are common mood changes in PD, sometimes surprising to families due to personality shifts.
Causes include emotional stress from coping with PD, direct brain changes, medication side effects, cognitive changes, or psychosis.
These behavioral changes often coexist with depression, anxiety, or cognitive decline.
Managing anger involves identifying triggers, medication review, counseling, stress reduction techniques, and caregiver support [5], [2].

Important Considerations

Mental health symptoms may fluctuate with “on/off” medication periods.
Sudden changes in mood or behavior require medical evaluation for infections, medication side effects, or other illnesses.
Non-drug approaches should be tried first when possible.
Safety is paramount if anger or psychosis leads to aggression.
Collaboration among neurologists, psychiatrists, psychologists, and social workers is often needed [3], [2].

Last changed:

12/12/25, 6:44 PM