The most common Parkinson’s disease symptoms. Remember that although these are the typical symptoms, they can vary greatly from individual to individual—both in terms of their intensity and how they progress. Motor symptoms generally involve movement, while non-motor symptoms do not.

Read about them [HERE]

A Parkinson's Foundation video of dystonia (abnormality of muscle tone) v. dyskinesia (abnormality of movement) is here. 

Key differences between dyskinesia and dystonia are also explained in this HealthCentral story. 

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].

1. Depression and Mood - Parkinson’s Foundation

2. Anxiety and Depression in Parkinson’s - Parkinson’s UK Progress Summer

3. Treatment Approaches To Anxiety and Depression in Parkinson’s Disease

4. Managing Anxiety in Parkinson's - Parkinson’s Foundation

5. Mood and Cognition Webinar Notes - Stanford Parkinson’s Community

Motor symptoms — which means movement-related symptoms — of Parkinson’s disease include the following:

• Slowed movements (bradykinesia). 

• Tremor while muscles are at rest.

• Rigidity or stiffness.

• Unstable posture or walking gait.

Additional motor symptoms can include:

• Blinking less often than usual.

• Cramped or small handwriting. 

• Drooling.

• Mask-like facial expression

• Trouble swallowing (dysphagia). 

• Unusually soft speaking voice (hypophonia).

Sleep Disturbances in Parkinson’s Disease

People with Parkinson’s Disease frequently experience a range of sleep problems that differ from those typical in the general population. Common disturbances include:

• Insomnia: Difficulty falling asleep or staying asleep.

• REM Sleep Behavior Disorder (RBD): Acting out dreams during REM sleep due to loss of normal muscle paralysis, which can cause injury to self or bed partner.

• Restless Legs Syndrome (RLS): Urge to move legs often at night, which disturbs sleep.

• Excessive daytime sleepiness: Feeling very sleepy during the day, sometimes to the point of sudden sleep attacks.

• Sleep fragmentation: Frequent waking and disrupted sleep architecture.

These disturbances reduce sleep quality, leading to fatigue and worsening other PD symptoms such as cognitive difficulties and mood changes.

Causes and Mechanisms

Sleep dysfunction arises from several PD-related factors:

• Neurodegeneration in brainstem and hypothalamic areas critical for sleep regulation.

• Effects of dopaminergic and other PD medications can disrupt sleep.

• Motor symptoms such as rigidity and tremor interfering with comfortable sleep.

• Psychiatric symptoms associated with PD like anxiety and depression exacerbate sleep problems.

Approaches to Improve Sleep in Parkinson’s

• Medication Review: Adjustments to PD and other medications can improve sleep quality.

• Behavioral Techniques: Sleep hygiene education, regular sleep schedules, reducing daytime naps.

• Treatment of Specific Disorders: For example, melatonin or clonazepam for REM sleep behavior disorder.

• Light therapy: Shown to improve circadian rhythms and sleep quality in PD.

• Exercise: Regular physical activity helps improve sleep and overall motor symptoms.

• Addressing co-morbidities: Treating sleep apnea, restless legs, or mood disorders.

Health Disclaimer

Sleep disturbances in people with Parkinson’s Disease are complex and individual. Please consult a neurologist or sleep specialist experienced in PD for diagnostic assessments and tailored treatment plans.

Sources

1. Parkinson's Disease: Sleep Disturbances and Fatigue | Sleep Foundation

2. Classification of sleep stages from EEG, EOG and EMG signals by SSNet (ArXiv)

3. End-to-End Automatic Sleep Stage Classification Using Spectral-Temporal Sleep Features (ArXiv)

Symptom management  By Marco Meglio & Alexa Dessy, MD NeurologyLive.com August 8, 2025      Mind Moments is a podcast from NeurologyLive, and brings you an interview with Alexa Dessy, MD, on Improving Quality of Life in Movement Disorders through Non-Motor System Management.       The 17-minute podcast is here.