What Causes Anxiety?

While anxiety is less well studied, it may be as common as depression in those with PD. Up to 40% of patients experience some form of anxiety, most commonly:

• Generalized Anxiety Disorder
• Anxiety Attacks
• Obsessive-Compulsive Disorder
• Social Avoidance

There are many different ways that a person can experience anxiety.  As many as 2 out of 5 patients with PD will experience one of these forms during the course of their illness.

Psychological Factors

• There are common fears and worries that go along with anxiety in PD.
• One is a fear of being unable to function, particularly during a sudden “off” period. This sometimes leads to a need to be with someone at all times and a fear of being left alone.
• Another is a concern about being embarrassed—often related to having people notice symptoms of PD in public.

Biological Factors

• Many of the brain pathways and chemicals linked with depression in PD are also likely related to anxiety.
• PD patients also have abnormalities in GABA, a brain chemical closely linked with anxiety and which one class of anti-anxiety medications can target.
• In some cases, anxiety is directly related to changes in motor symptoms. Especially in patients who experience “off” periods can develop severe anxiety during these states sometimes to the point of full-blown anxiety attacks.

Medical content reviewed by: Nina Browner, MD—Medical Director of the NPF Center of Excellence at the University of North Carolina at Chapel Hill in North Carolina and by Fernando Pagan, MD—Medical Director of the NPF Center of Excellence at Georgetown University Hospital in Washington, D.C.

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