The Role of Psychology in the Treatment of Parkinson’s Disease by Kathryn Wyman-Chick
Often when we think of Parkinson’s disease, we think of the physical aspects of the disease including tremor, balance problems, and slowed movements. However, it is not uncommon for patients with Parkinson’s disease to experience changes in mood and/or thinking as the disease progresses.
Changes in Mood
Parkinson’s disease is related to changes in neurotransmitters in the brain, which can result in depression, anxiety, and even hallucinations. Patients can also experience sleep problems and apathy, a condition where patients lack interest or emotion, as the disease progresses.
Although changes in mood are common among patients with Parkinson’s disease, there are treatment options available. Research has demonstrated that exercise in patients with Parkinson’s disease can have a positive effect on mood in addition to helping other motor-related symptoms of the disease. Furthermore, patients may also benefit from a class of medications known as selective serotonin reuptake inhibitors (SSRI).
Changes in Thinking
Cognitive changes associated with Parkinson’s disease can range from mild problems (that do not impair day-to-day tasks) to dementia. A thorough evaluation can help patients understand the nature and severity of cognitive changes. There are three cognitive areas that are most frequently impacted by Parkinson’s disease:
Executive Functioning – Patients may begin to have difficulty with tasks that require problem-solving, multi-tasking, monitoring work for mistakes/progress, planning, organizing, and inhibiting inappropriate behavior or inappropriate speech.
Attention – Patients may become more distractible and have increasing difficulty focusing attention and dividing attention between two tasks. For example, a patient may have difficulty maintaining focus in a conversation when they are in a busy restaurant with background noise and visual distractions.
Processing Speed – Over time, patients may notice slowed thinking. It may take patients longer to find a word that they want to say or they may need more time to solve a problem than they needed in the past. Patients may also have difficulty in the following areas:
- Memory – Patients may notice memory problems as memory is often impacted by changes in executive functioning and attention. Patients often benefit from hearing/seeing information multiple times in order to help them remember the information at a later time. Memory in patients with Parkinson’s disease is often helped by providing cues to the patient to help them retrieve the information.
- Language – Many patients report that it is more difficult for them to find the words they want to say. Some patients have difficulty generating speech as the disease progresses.
- Visual-spatial skills – Patients may experience changes in their ability to perceive visual information and judge distance, which can increase the risk of falls.
How can psychologists help?
There are many ways psychologists and neuropsychologists can help patients with Parkinson’s disease and their families:
- Psychologists can work with patients experiencing adjustment issues related to a new diagnosis of Parkinson’s disease or a change in the disease process.
- Psychologists can treat symptoms of anxiety and depression in addition to teaching skills to improve sleep quality.
- Neuropsychologists can evaluate changes in mood and/or cognition (including executive functioning, processing speed, and attention) and make treatment recommendations in order to maximize the patient’s strengths.
If you or your loved one are experiencing changes in thinking or mood related to Parkinson’s disease, speak with your doctor about the possibility of adding a psychologist and/or neuropsychologist as a part of your treatment team.
For more information on Parkinson’s disease, patients and family members may consider the following resource: Parkinson’s Disease Foundation (http://www.pdf.org/).
Neuropsychology Pre-doctoral Intern at the University of Kansas –School of Medicine in Wichita, KS.
Clinical Psychology Doctoral Candidate at Pacific University in Hillsboro, OR.
Future Clinical Neuropsychology Fellow at University of Virginia – Department of Neurology in Charlottesville, VA.
National Psychologist Trainee Register Scholarship Recipient, Fall 2014
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Dubois, B., Burn, D., Goetz, C., Aarsland, D., Brown, R. G., Broe, G. A., . . . Emre, M. (2007). Diagnostic procedures for Parkinson’s disease dementia: Recommendations from the Movement Disorder Society task force. Movement Disorders, 22(16), 2314-2324. doi: 10.1002/mds.21844.
Lezak, M. D., Howieson, D. B., Bigler, E. D., & Tranel, D. (2012). Neuropsychological assessment (5th ed.). New York: Oxford University Press.