Movers and Shakers: Depression

A merry band of. movers and shakers prepares to talk depression

I hadn’t exactly been looking forward to this week’s episode of the world’s favourite Parkinson’s podcast. After all, there aren’t many laughs in depression. But Jeremy Paxman persuaded us that one of the most serious non-motor symptoms of Parkinson’s was worthy of investigation. He turned out to be right, and what do you know, there were plenty of opportunities for a giggle or even a guffaw along the way.

(Reminder - Movers and Shakers is available on all good podcast platforms and is free to download.)

“I think that the mental symptoms of Parkinson's are quite considerable.,” says Jeremy. “It does make you feel depressed. It may not kill you, but it does make you feel life's not worth living.”

He admits he’s been “a gloomy bugger” all his life but “I’ve now got real reason to be gloomy.” Gillian Lacey-Solymar wonders whether that doesn’t make him more cheerful and gets a firm “no!” for her pains.

But Paul Mayhew-Archer, ever the optimist, manages to find the sunny side of Jeremy’s gloom: “Just the relish with which you you want to be gloomy is joyous, actually.”

Some of us - like me and Gillian - have been through the kind of depression that Jeremy experiences, albeit for a finite period. I sank into a gloomy low mood for the first year after I was diagnosed but somehow did not associate that with Parkinson’s .

What’s difficult to work out is whether depression immediately after diagnosis is the natural reaction to bad news or is something chemical going on in the brain.

“It's a bit of a bone of contention,” our guest, the neuropsychologist Dr. Jennifer Foley tells us. “We don't really have a very good understanding of exactly what causes Parkinson's depression, whether it's a biological phenomenon, or whether it's a psychological phenomenon, and it's probably a bit of both. But what I would say is that when you're first diagnosed it is extremely normal to go through a phase of low mood or anxiety or distress.”

She points out that Parkinson’s does cause a whole lot of physical disruption in the brain, affecting dopamine and seratonin neurotransmitters but thats by no means the whole story :”What's interesting is that research has suggested that actually non Parkinsonian factors, such as previous history of depression, has three times greater impact than Parkinsonian factors such as disease duration or disease severity.”

As with so many aspects of Parkinson’s Dr Foley says the treatment for depression will vary widely according to each patient’s circumstances.

We hear from a couple of people who responded to a call on our Facebook group to talk about their experiences with depression. For Ben, exercise was the answer: “I do exercise every day. And it really makes me feel much, much, much better. Of course I take medication, of course I do lots of other things, that it really has made a difference. Lastly, my neurologist said to me, the key is to make Parkinson's part of your life and not your life. And that made a lot of sense.”

For Dave, it was about learning what triggers his depression :”I live in the countryside with lots of peace and quiet I wake up to birdsong This is critical for my personal mental health. I grew up in the suburbs of Manchester and I've lived in large towns but I find noise and crowds very difficult to handle.” But he has also found exercise , fresh air and dancing to Cuban jazz key to lifting his spirits.

Dr Foley says exercise is her number one recommendation for people suffering from low mood or anxiety:“Exercise gives you a great sense of control over your physical condition,” she explains.”The more of a sense of control you have over your condition, the better your mental outlook will be.” Medication, psychotherapy and cognitive behavioural therapy can also play a role but Jennifer Foley warns that, as in so many areas, provision of care is very patchy with many people being offered generic mental health services rather than something designed for Parkinson’s.

But she concludes that the best approach an individual can take is to find an activity they really enjoy - like starting a podcast. So you see, Movers and Shakers really is the answer to everything - it should be prescribed on the NHS.

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