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Emotional and Psychological Care with Dr. Mark Mapstone

[The Parkinson's Podcast™]

Emotional and Psychological Care with Dr. Mark Mapstone


“Depression may be one of the earliest symptoms of a subsequent Parkinson’s diagnosis.”
Dr. Mark Mapstone, Professor of Neurology at the University of California, Irvine School of Medicine

The symptoms of depression are very common in people with Parkinson’s. In fact, depression is probably one of the most common non-motor symptoms of Parkinson’s. Some studies suggest that over half of people living with Parkinson’s experience symptoms of depression. In this episode, Dr. Mark Mapstone talks about the symptoms of depression and how it’s diagnosed, how depression is treated and the other rarely talked about psychological symptoms people with Parkinson’s often face.


  • Several risk factors that increase the chances of experiencing depression are early-onset Parkinson’s, family history of depression and being female
  • Depression may be one of the earliest symptoms of a subsequent Parkinson’s diagnosis (prodrome)
  • Depression is often underrecognized, underreported and undertreated
  • It’s often difficult to parse out whether it’s depression or it’s Parkinson’s
  • Common symptoms include: feeling down or blue, feeling sad, getting too little or too much sleep, eating too little or too much, feeling fatigued and unmotivated
  • If you’re experiencing symptoms and they’ve lasted for several weeks or more, it’s important to get help as soon as possible. There are treatments that can help
  • If you are diagnosed with depression, a doctor will typically try medicine to reduce symptoms
  • Selective Serotonin Reuptake Inhibitors (SSRIs) are usually the first option proposed (Celexa, Lexapro, Zoloft, etc.) SSRIs increase the neurotransmitter serotonin in the synaptic cleft, which is a small space between brain cells
  • Monoamine oxidase B (MAO-B) is not commonly prescribed. MAOIs reduce the activity of the enzyme MAO, leading to higher levels of norepinephrine, serotonin and dopamine in the brain. They are used less frequently as they have many more negative side effects than SSRIs do

  • Other psychological symptoms people with Parkinson’s often experience include dysregulation of motor symptoms, cognition/thinking and mood
  • Problems with cognition/thinking include issues related to memory, attention. processing speed, language, etc.
  • Memory can include issues with retrieving as well as encoding. People with Parkinson’s often struggle to get the info in and then find it quickly and efficiently
  • Some people with Parkinson’s may experience the “tip of the tongue” phenomenon and difficulty seeing where objects are in space, though those symptoms are less frequent
  • Current research is looking into the basic biology of why depression happens before clinical symptoms are present – if we can detect what happens in a pre-clinical state, we may have more time to intervene and turn the clock back on Parkinson’s

If you’re experiencing symptoms of depression, please speak with your doctor as soon as possible. There are proven treatments that can help you live better with Parkinson’s. Just be sure that if you and your doctor decide to try medication, that you inform everyone else on your care team about it.

Concepts Mentioned in this Podcast & Further Reading

The Upside of “Negative” Emotions in Coping with Parkinson’s
How to Build Resiliency and Live Well with Parkinson’s
How to Bring Light to the Darker Side of Parkinson’s: A primer on hallucinations and delusions and how to manage them
Impulse Control Disorders and Parkinson’s: What are they and how to manage them
Parkinson’s Depression & Anxiety: The demon, the witch and the everyday hero
Can You Identify Your Depression Triggers?
Signs of Depression
How are Depression, Anxiety and Apathy Treated?
Is Depression Common for People with Parkinson’s?
What are the Differences between Depression, Anxiety and Apathy?
What Are Some Signs that a Person Should Ask for Help with Depression?


Dr. Mark MapstoneDr. Mark Mapstone is Professor of Neurology at the University of California, Irvine School of Medicine where he is also a member of the Institute for Memory Impairments and Neurological Disorders (IMIND) and a Fellow in the Center for Neurobiology of Learning and Memory.

Dr. Mapstone’s research focuses on early detection of neurological disease especially Alzheimer’s and Parkinson’s using cognitive tests and biomarkers obtained from blood. He has a special interest in developing strategies to maintain successful cognitive aging through diet, exercise, sleep hygiene and cognitive engagement. In the clinic, he specializes in cognitive assessment of older adults with suspected brain disease.

Dr. Mapstone earned a Ph.D. in Clinical Psychology at Northwestern University and completed fellowship training in neuropsychology and experimental therapeutics at the University of Rochester. He has authored over 75 manuscripts and is the recipient of a Career Development Award from the National Institute on Aging. His research has been funded by the National Institutes of Health, the Michael J. Fox Foundation and the Department of Defense.


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