There are many different ways in which a person with Parkinson’s can experience anxiety. The following is a list of common anxiety disorders and a description of symptoms associated with each form. As many as two out of five people with Parkinson’s will experience one of these forms during the course of their illness.
Generalized Anxiety Disorder
Generalized anxiety disorder (GAD) is characterized by feelings of nervousness and recurring thoughts of worry and fear. This worrying is in excess of what would normally be expected given the situation and often leaves the person feeling out of control. Physical symptoms that may accompany these feelings include butterflies in the stomach and nausea, trouble breathing or swallowing, racing of the heart, sweating and increased tremors.
Anxiety, or panic, attacks usually start suddenly with a sense of severe physical and emotional distress. Individuals may feel as if they cannot breathe or are having a heart attack. They may feel they are experiencing a medical emergency. These episodes usually last a few minutes to an hour, particularly when associated with “off” periods, though they can last for longer periods of time.
Social avoidance, or social anxiety disorder, involves avoiding everyday social situations because of a fear of embarrassment at having Parkinson's symptoms, such as tremor, dyskinesias, or trouble walking noticed in public. Exposure to social situations can lead to severe anxiety in these individuals, which goes away when the person is removed from or completely avoids the situation.
People with obsessive-compulsive disorder (OCD) may be plagued by persistent, unwelcome thoughts or images (obsessions), and by the urgent need to engage in certain rituals (compulsions) to try to control or rid themselves of these thoughts. As an example, they may be obsessed with germs or dirt, and wash their hands over and over. Performing these so-called rituals, however, only provides temporary relief, and not performing them markedly increases anxiety.
Page reviewed by Dr. Joash Lazarus, NPF Movement Disorders Fellow, Department of Neurology at Emory University School of Medicine.