I recently had the honor and pleasure of speaking at the 2010 Southeastern Parkinson Disease Conference & Young Onset Parkinson's Conference in Atlanta jointly sponsored by the Northwest Georgia Parkinson Disease Association, APDA and NPF. My topic was anxiety, a condition that complicates Parkinson disease for upwards of 3 out of 4 individuals with the diagnosis. Based on the follow-up questions and casual discussions between sessions, it was clear that a discussion on this topic is well-placed and not just for the individual with the neurological diagnosis.
What really surprised me was the number of partners who also recognized that they struggled with anxiety. As I was speaking, I could see the majority of the room nodding periodically (and sometimes enthusiastically). However, I mistakenly assumed that partners were acknowledging anxiety was a problem for the loved one with PD. When it comes to anxiety disorders it is not a matter of opposites attracting; it is more a birds of a feather situation. These individuals were acknowledging the condition in themselves!
There are many reasons why folks with PD might struggle with anxiety. The uncertainty of the disease process is the raw material for the manufacture of an anxiety disorder. It is also possible that changes in brain structure and neurotransmitter profiles lay the foundation for easily becoming anxious. Even some of the medications used to treat Parkinson's produce anxiety as a side effect. It is not so clear why so many individuals in relationship with someone who has PD report anxiety.
Perhaps one common link is stress. PD is stressful for everyone and unremitting stress can prime a body to respond to even innocuous situations as if they are imminently dangerous. In its simplest form, anxiety is an acute activation of the mechanism nature builds into each of us to respond to emergencies or threats. When a bear stands in our path, we are primed to respond through "fight or flight," a process that occurs almost instantaneously. In a dangerous situation, opening an internal debate about the best course of action gives the bear a decided edge. When stress occurs with some regularity, our bodies can go into a defensive mode that remains alert for danger. In short, we can become anxious because stress has made it difficult to fully let down our guard.
Anyone who has spent 15 minutes with me knows my mantra: There is no aspect of Parkinson's that gets better with stress. I am now more aware that this mantra applies to everyone whose life is touched by PD.
There is a medical axiom that Parkinson's is not contagious. Here is an instance for which accepted wisdom may not apply. Anxiety is one aspect of the disease that appears to be communicable. It spreads through close contact, love, and concern. Most of all, it spreads through the stress Parkinson's injects into the lives of everyone.
However, anxiety disorders are treatable, often without the need to add another drug. I will discuss some strategies for addressing anxiety in the next blog entry.