There are two forms of stress, acute stress and chronic stress. Both have different but important impacts on those with Parkinson’s disease. Acute stress is a physiological reaction in response to a perceived threat. Chronic stress involves a disruption in homeostasis due to a constant activation of the stress system. Stress is thought to be highly common in people with Parkinson’s. Why? Dopamine is needed to produce adrenaline to help the body cope with stress. In people with PD, they are lacking dopamine, thus lacking major chemicals that help with stress!
How is stress different from anxiety?
Stress is a reaction or response to an external cause, like a major project due at work or having an argument with your family/friends. The important part to note is once the situation has passed, the feeling of stress should resolve. Anxiety, however, is related more to the reaction to stress. Anxiety involves persistent and excessive worries that don’t go away even without a stressor. Want to learn more about how anxiety impacts PD? Check out this blog
How does stress impact Parkinson’s symptoms?
In acute stress, all symptoms of Parkinson’s has been shown to worsen. The most effected symptoms are freezing of gait, bradykinesias, dyskinesias, and tremor, with the strongest impact being tremor. Acute stress can make your dopaminergic medication less effective.
Common dopaminergic medications:
Pramipexole (Mirapex)
Ropinirole (Requip).
Sinemet (carbidopa and levodopa)
Rytary (carbidopa and levodopa)
In chronic stress, non-motor symptoms such as anxiety, depression, and sleep are impacted the most. Chronic stress is also thought to accelerate PD progression, but this has only been studied in rat models.
Stress (not specific to acute or chronic) is correlated with increased rumination (repetitive negative thoughts), lower quality of life, lower self-compassion , and lower dispositional mindfulness (being aware of our thoughts and feelings without self judgement).
What are the effects of not managing stress?
Increase in muscle tightness and tension.
Increased risk for hypertension (high blood pressure), heart attack, or stroke.
High cholesterol levels.
Dysregulation of cortisol secretion. Cortisol is a stress hormone that gives us energy throughout the day. It is supposed to be highest when we wake up and slowly reduce as the day goes on. In those with chronic stress, cortisol is the lowest in the morning and highest at night. This can lead to increased pain and fatigue in the morning, and difficulty falling asleep at night.
Increased difficulty of swallowing foods or increase the amount of air that is swallowed. The more air that is swallowed the more burping, gassiness, and bloating that can occur.
Alteration of testosterone production which can result in a decline in sex drive or libido. It can also cause erectile dysfunction or impotence.
In women, chronic stress can result in absent or irregular menstrual cycles, changes in the length of cycles, and more painful periods.
Suppressed immune system
Negative effects on learning and memory.
Gastro-intestinal tract movement disorders and increased intestinal bacteria counts
How to manage stress.
1. Guided meditation.
There are many apps and websites that can be very useful! These are a few of my favorites. You can download these apps on your favorite app store.
Buddhify Headspace Calm
2. Exercise!
Check out our website to see all the local exercise classes in your area. Can’t make these classes? Take a look at our trusted organizations page, many of them have free virtual classes
3. Support groups.
Look at this listing to see what support groups are in your area!
4. Eat well.
A well balanced diet that limits processed and sugary foods will help keep your body’s inflammation levels down.
5. Avoid drugs and alcohol.
Drugs and alcohol can add to the chemical changes that occur with stress, possibly making you feel more stressed than you would normally.
6. Work on your sleep hygiene.
Read our blog post on how to improve your sleep.
7. Get help!
Talk with your neurologist about what therapists they recommend for you.
Resources: