Should You Find A Parkinson's Therapist?

Psychotherapy may not be the first thing that comes to mind when most people think about treatment for Parkinson’s disease (PD). However, like many chronic conditions, PD is often accompanied by significant mental health challenges. Working with a Parkinson’s therapist may be an important part of a treatment plan to improve quality of life and overall well-being in people affected by this disease.

Mood changes such as depression are among the most common symptoms Parkinson’s disease. However, according to Stanford Medicine, depression is an often undertreated condition among individuals with Parkinson’s. A therapist trained in cognitive behavioral therapy (CBT) may be able to help you manage these challenges, reducing the negative impacts of PD as the disease progresses. 

Various kinds of counseling may also be helpful for a variety of other mental health concerns that can accompany PD, such as anxiety, impulsive behavior, and sleep problems. Finding a mental health professional who has experience treating those symptoms may help make living with Parkinson’s disease easier. 

Treating Parkinson’s disease

The best-known symptoms when diagnosing Parkinson’s disease are often those associated with motor control, such as tremors, involuntary movements, muscle weakness or rigidity, and difficulty with speech and walking. This is because PD causes brain cells that make dopamine to die, leaving the brain without enough dopamine to trigger movement. A dopamine agonist can help manage those symptoms. The severe physical symptoms of PD often get much more attention, and can, in some cases, be managed through interventions such as deep brain stimulation, dopamine agonists, and levodopa therapy.

Mental health symptoms

Researchers are increasingly recognizing that non-motor symptoms are also common symptoms. Cognitive and emotional disruptions may be major obstacles to the enjoyment of everyday life and can cause significant distress, even when applying interventions like gait training, medication, or physical treatment to help Parkinson’s disease.

Notable mental health symptoms can include:

Depression

Depression, which is often characterized by feelings like sadness, numbness, apathy, and lack of pleasure and enjoyment, can be a common symptom of chronic disease. It is estimated that depression affects around 20-35% of individuals with PD.  Depression can manifest anytime, from the early stages of the disease through to the final stage when Parkinson’s disease eventually confines individuals to a wheelchair.

Anxiety

A 2010 research report published in Movement Disorders noted that approximately 25% of people with Parkinson’s were also diagnosed with anxiety disorders. Generalized anxiety disorder, panic disorder, and social phobia appear to be particularly common.

Cognitive changes

People living with chronic disease may experience mild impairments in cognitive functioning, including memory loss, difficulty paying attention, problems with planning and organizing, and slowed thought or speech. In addition to working with PD patients directly to address cognitive changes, a therapist may also recommend a speech-language pathologist to help with speech and communication challenges.

Dementia

In some individuals with advanced Parkinson’s disease, cognitive impairment can escalate to dementia, which may involve severe behavioral changes, hallucinations, and confusion. According to an article published in the journal Nature, epidemiological studies show that 20% to 40% of individuals with Parkinson’s also experience dementia.

Impulse control disorders

Impulse control disorders, which tend to involve a failure to resist temptations that can negatively affect oneself or others, can also be common among individuals with chronic disease. This can manifest in a variety of ways, such as compulsive gambling, compulsive sexual behavior, and compulsive buying.

How counseling can help people with chronic diseases

Whether you have mild or moderate Parkinson’s disease, the symptoms above can have a significant impact on your quality of life. They might also interfere with the treatment of other features of this disease. For example, depressive symptoms could make it hard to adhere to medication schedules or physical treatment routines. This is why it can be valuable to include a specially trained mental health professional in your healthcare team.

Talk therapy can be an important and effective source of support for people living with Parkinson’s disease. In particular, research indicates that cognitive behavioral therapy (CBT) can be effective in treating depression and sleep disorders in individuals with Parkinson’s disease.

In addition, research has demonstrated some promising results in other areas related to Parkinson’s disease:

• A 2013 randomized controlled trial published in the journal Neurology found that CBT significantly reduced impulse control symptoms in Parkinson’s patients.
• A 2022 systematic review concluded that there was a “good evidence-base for anxiety reduction using CBT approaches” for people with Parkinson’s disease in reducing anxiety in individuals with Parkinson’s using CBT.
• A study published in 2023 found that a mindfulness-based therapy treatment led to improvements in memory, attention, and other cognitive functions in individuals with Parkinson’s.

Other forms of mental health support

Individual counseling may not be the only way to incorporate mental health care into Parkinson’s treatment. Other potentially helpful complementary therapies may include:

Group counseling

Some individuals with Parkinson’s may experience feelings of loneliness or isolation, as the symptoms of the disease can pose challenges to social interaction. Some research indicates that group therapy can help reduce stress and improve quality of life in individuals with PD, while also offering an opportunity to connect with others.

Peer support groups

Rather than applying a specific treatment, support groups offer an opportunity for people living with Parkinson’s to come together and talk about their experiences. These groups may provide participants with an important sense of community, especially for those with early Parkinson’s disease who recently received a diagnosis, and serve as sources of advice and mutual encouragement. 

Movement

Some forms of mental health and occupational treatment can incorporate physical movement, such as dance or yoga. Research has found that an exercise program like tai chi or yoga may improve physiological functions while also improving mental health and quality of life in individuals with PD.

Finding a Parkinson's counselor that can support you

If you’re thinking of seeking counseling, you may want to find a therapist with experience in Parkinson’s disease. This condition tends to have many distinctive features and unique challenges, and so it may be helpful to connect with a professional who is well-versed in the subject. 

To locate an experienced Parkinson’s therapist, you might want to start by talking with your existing healthcare team. Any physicians, neurologists, physical therapists, or social workers you’re already working with may be able to refer you to mental health professionals with relevant experience. Searching online can also be a good option. Many therapists now have some type of online presence that lists their areas of specialization, so a simple search for therapists who treat people with Parkinson’s may yield useful results. Finding those trained in CBT could also be productive.

It may also be helpful to turn to other individuals with Parkinson’s for recommendations. If you have friends or relatives with PD, they may be able to put you in touch with therapists they’ve worked with in the past. This is also an area where peer support groups may be useful—other members may be able to recommend a physical therapist, occupational therapist, or other provider with experience treating people living with Parkinson’s disease. 

That said, even a therapist without Parkinson’s-related experience may be able to significantly improve your well-being. Most mental health therapists are willing and able to educate themselves on the specific hardships faced by their clients. And if you can’t find a therapist who’s familiar with PD, you might be able to search for one who’s dealt with similar situations, such as managing emotional health through a chronic illness or managing neurological disorders.

Online therapy options

The mobility and cognitive changes that can accompany Parkinson’s disease may make it difficult to travel to a therapist’s office, and for those in certain areas, it may be challenging to find a therapist locally who has relevant experience. Seeking counseling online may make it easier to keep up regular attendance and to connect with a therapist who is a good match for your needs. Online therapists can also work around situations specific to PD, like time and travel constraints for clinical trials. 

With online therapy, you can be matched with a licensed therapist without geographic limitations, and you can then have sessions wherever you have internet—including the comfort of home. from the comfort of home or anywhere you have an internet connection. You can communicate with your therapist via phone, videoconferencing, live chat, or a combination of these methods depending on how you’re feeling for each session.

Research has also demonstrated that online counseling can be an effective option for reducing some mental health symptoms associated with Parkinson’s disease. For instance, one research study examined the effectiveness of guided individually tailored internet-based cognitive behavioral therapy (ICBT) for individuals with PD. It found that the participants who received ICBT reported “significantly higher functioning after treatment", and that symptoms of anxiety, depression, and insomnia were all significantly lower after treatment compared to the control group. 

Getting the most from mental and physical treatment

Once you find a therapist you want to work with, there are a few steps you can take that might help make counseling as productive as possible:

1. Define your goals. It may be easier to make progress with your therapist if you can clearly explain what you’re hoping to get out of treatment. Are you looking for better motivation and impulse control? Do you wish you were able to get more enjoyment out of life? Are you hoping to improve your memory and attention?
2. Practice between sessions. Talk therapy (especially cognitive-behavioral therapy) often comes with mental exercises, reading, and other “assignments” to do between sessions. Diligently keeping up with these assignments can be a major factor in successful treatment.
3. Work on your lifestyle. In addition to engaging with a therapist, you might consider talking to your healthcare team about the steps you can take outside of sessions to support your mental health. Lifestyle factors like regular exercise, a healthy diet, and good sleep habits may be vital to effectively managing your mental health.