Psychological guidance for patients with Parkinson’s disease

About 40% to 55% of Parkinson’s patients have mood disorders such as depression and anxiety, which are characterized by fatigue, reduced motivation, pessimism, loss of interest, loss of appetite, sleep disturbances, psychomotor inhibition, lowered self-esteem, feelings of guilt, reduced concentration, difficulty in making decisions, emotional lability, and suicidal ideation. Depression and anxiety can occur at any stage of Parkinson’s disease, but there are two peaks, the first in the early stages of the disease, shortly after the patient learns of the nature of the disease, and the second in the later stages of the disease, as a psychological response to the functional limitations and discomfort associated with the disability. Traditionally, anxiety and depression in Parkinson’s patients were thought to be a psychological response to their physical discomfort, but recent studies have linked the onset of depressive symptoms to reduced concentrations of serotonin and neurotransmitters such as dopamine and norepinephrine, with 5-hydroxytryptophan playing a more important role than dopaminergic, as well as to a reduction in localized blood flow to the cerebral cortex. The patient’s emotional state is not related to the severity of the disease, but to the family and the patient’s own adjustment. Family’s understanding, support, care and sympathy are important factors for patient’s recovery. Patients should be encouraged to establish confidence in overcoming the disease, arrange for patients to do household chores that are within their ability, cultivate their interests in various aspects, such as reading books, newspapers, listening to the radio, painting, planting flowers, etc., and encourage patients to participate in more social activities to distract their attention from the disease. When the symptoms are more serious, the patient can be treated with medication at the same time of psychotherapy. At present, the commonly used antidepressant drugs are paroxetine, promethazine, amitriptyline, maprotiline, etc.; commonly used anti-anxiety drugs are Gaglodin, Valium, Librium, etc.; for those who have difficulty in falling asleep, triazolam can be used to take orally before bedtime, and the therapeutic effect is accurate.