Anxiety is a common symptom of Parkinson’s due to changes in brain chemistry.
Medication, exercise, and therapy for anxiety can maintain mental wellbeing.
What is anxiety?
When dopamine levels drop, it can cause chemical changes in the brain that may lead to anxiety. Living with a long-term condition like Parkinson’s, along with its motor and non-motor symptoms, can add to these feelings. This mix of brain changes and emotional stress makes anxiety a common non-motor symptom for people with Parkinson’s.
The good news is that anxiety can be managed. With the right support, including medication, regular exercise, and talking therapies, many people find ways to improve their mental wellbeing and feel more in control.
Anxiety & Parkinson’s
Living with Parkinson’s, unexplained anxiety can be a frequent and challenging experience, often as debilitating as the motor symptoms of the condition. Anxiety is a common but often under-recognised non-motor symptom in Parkinson’s disease. It can manifest as generalised anxiety, panic attacks, or social phobia. One study found that up to 68% of people with Parkinson’s experience anxiety, and its severity is positively associated with motor symptom fluctuations, especially during “off” periods when medication wears off.
Anxiety can significantly affect how you see yourself, your body, and your role in social situations. It’s not just about feeling nervous; it’s about how it changes your daily life and interactions.
Anxiety often occurs alongside other Parkinson’s non-motor symptoms like depression and apathy. It’s important for doctors to regularly check for anxiety because it can be missed during routine consultations, especially if you’re not actively seeking help for it.
Some people with Parkinson’s may resist taking additional medication for anxiety or seeing a psychologist or psychiatrist because they feel their anxiety is just another part of Parkinson’s. However, understanding and treating anxiety involves looking beyond just the physical symptoms and considering the emotional and social impacts as well.
Coping strategies
People use different ways to manage anxiety, like mindfulness, exercise, or connecting with others who understand Parkinson’s. These methods can help change how you relate to anxious thoughts and feelings.
Effective treatment should consider both the brain and your personal experience of anxiety. This means not only using medication but also therapies that address the psychological and social aspects of anxiety.
It’s necessary to have open discussions with your care partner and care team to explore all possible ways to manage it effectively. Future research aims to better understand the connection between anxiety and Parkinson’s to improve treatment options.
Understanding the link between Parkinson’s and anxiety is key to improving mental wellbeing. Fortunately, anxiety in Parkinson’s is treatable. With the right combination of medication, physical activity, and psychological therapies, people with Parkinson’s can manage anxiety and improve their quality of life.
Why Does Anxiety Happen in Parkinson’s?
Anxiety in PD is complex and can be caused by several factors:
- Brain Chemistry: Parkinson’s causes a loss of dopamine, a chemical that regulates both movement and mood. It also affects other chemicals like serotonin and norepinephrine, which help the brain manage fear and stress.
- Medication Cycles (“Wearing-Off”): Many people experience a surge of anxiety or even panic when their medication begins to wear off before the next dose. This is often called “off-period anxiety”.
- PD-Specific Worries: It is common to feel anxious about falling, the embarrassment of tremors in public, continence issues or how the condition will progress in the future.
Recognising the Signs
Anxiety doesn’t always feel like “worrying.” It can show up as:
- Physical symptoms: A racing heart, shortness of breath, excessive sweating, dizziness, or nausea.
- Mental states: Feeling “on edge,” a sense of doom or dread, or having repetitive, unwanted thoughts.
- Movement impact: Anxiety can actually make tremors worse or trigger “freezing,” where you feel temporarily unable to take a step.
How to Relieve & Treat Anxiety
Anxiety is highly treatable, and managing it can greatly improve your quality of life.
1. Medical Management
- Adjust PD Medications: If your anxiety is tied to “off” periods, your doctor may be able to adjust the timing or dose of your Parkinson’s medications to keep your dopamine levels more steady.
- Antidepressants: Doctors often prescribe SSRIs (like sertraline or paroxetine) or other antidepressants to help stabilize mood and lower anxiety.
2. Talk Therapy
- Cognitive Behavioral Therapy (CBT): This is a proven “talk therapy” that helps you identify and change negative thinking patterns. Research shows CBT significantly improves anxiety in people with PD, whether sessions are done in person or over the phone/video call.
3. Mindfulness and Exercise
- Mind-Body Activities: Yoga, Tai Chi, and Qigong are excellent for PD. They combine deep breathing with gentle movement, which can lower stress and improve balance.
- Relaxation Techniques: Simple practices like meditation and deep “belly breathing” can help calm the nervous system when you feel a surge of panic.
4. Lifestyle and Support
- Stick to a Routine: Having a predictable schedule for medications, meals, and rest can lower the “uncertainty” that often triggers anxiety.
- Stay Socially Connected: Social withdrawal can make anxiety and depression worse. Joining a support group allows you to share strategies with others who understand what you are going through.
Tips for Care Partners
- Look for Patterns: Help your loved one track when their anxiety happens. If it always occurs an hour before their next pill, it might be an “off” period that a doctor can fix.
- Offer Reassurance: Anxiety can make a person feel like they are losing control. Your presence and calm support during a panic attack or a “freezing” episode can help them feel safe.
- Encourage Professional Help: If anxiety is stopping your loved one from social events or exercise, encourage them to mention it to their neurologist. Anxiety is a medical symptom of Parkinson’s, and there is no reason to “just live with it”.
How do I access a mental health supports?
Accessing occupational therapy services can make a significant difference in managing the symptoms of Parkinson’s, improving quality of life and maintaining independence.
It’s advisable to explore all available pathways to find the support that best suits your individual needs. Look to:
- getting a GP referral and mental health plan
- Australian Association of Social Workers (AASW) find a social worker near you
- Australian Psychological Society (APS) find a psychologist near you
If you need urgent support, you are not alone, help is available.
- Lifeline – 13 11 14
- Medicare Mental Health – 1800 595 212
- Beyond Blue – 1300 22 4636
- Kids Helpline – 1800 55 1800
- 13YARN – 13 92 76
Further information about mental health support is available at Medicare Mental Health Centres. To locate other health advice visit healthdirect.gov.au.
In an emergency, always dial 000 (triple zero).
References:
(1) Chen, J. J., & Marsh, L. (2014). Anxiety in Parkinson’s disease: identification and management. Therapeutic advances in neurological disorders, 7(1), 52–59. https://doi.org/10.1177/1756285613495723
(2) Blundell, E.K., Grover, L.E., Stott, J. et al. The experience of Anxiety for people with Parkinson’s disease. npj Parkinsons Dis. 9, 75 (2023). https://doi.org/10.1038/s41531-023-00512-1
(3) Wang, Z., Wei, H., Xin, Y., & Qin, W. (2025). Advances in the study of depression and anxiety in Parkinson’s disease: A review. Medicine, 104(7), e41674. https://doi.org/10.1097/MD.0000000000041674
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