What Causes Anxiety?
Anxiety is a mood disorder characterized by a general feeling of nervousness and agitation, and a looming sense that something bad is about to happen. Sometimes this emotional state can become so overwhelming that it interferes with the sufferer’s ability to lead a normal life. In people with Parkinson’s, anxiety can be caused by a combination of factors, including changes in the brain’s structure and natural chemistry as well as ongoing, stressful experiences that occur as a result of living with a progressive disease. Here are some common psychological and biological factors that may contribute to the development of an anxiety disorder in Parkinson’s:
There are many common fears and worries that go along with Parkinson’s disease which may trigger anxiety. One is a fear of being unable to function independently, particularly during a sudden “off” period (the time of day when medication is not working). Sometimes this can lead to a fear of being left alone. Another is a concern about being embarrassed—often related to interacting with others in public and not wanting to be watched or judged because of this illness.
Many of the brain pathways and chemicals affected by Parkinson’s are the same as those affected by anxiety and depression. People with Parkinson’s have abnormal levels of the brain chemical GABA. Similarly, anxiety and depression are linked to low levels of this neurotransmitter as well, and can be treated with one class of anti-anxiety medications designed to increase these levels. In some cases, anxiety is directly related to changes in motor symptoms. Specifically, patients who experience “off” periods can develop severe anxiety during these states sometimes to the point of full-blown anxiety attacks.
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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.