Demoralization in Parksinson’s Disease

Demoralization is a psychological state characterized by helplessness, hopelessness and a sense of failure.  It often but not always goes along with depression.  We know that depression is common in people with Parksinson’s disease, as with other chronic disabling conditions.  A recent article finds the not surprising fact that people with Parkinson’s often also have symptoms of demoralization.

The study, called Demoralization in Parkinson disease, researchers gave questionnaires to patients with Parkinsons disease and similar people without Parksinson’s disease.  The questionnaires focussed on symptoms of depression and demoralization.  Demoralization was present in about 18% of people with Parkinson’s disease and about 10% of similar people without Parkinson’s.  Not all people with demoralization had depression and vice versa.  I would think of it this way:  depression is a result of an imbalance in brain chemistry that causes symptoms like low energy, lack of interest, poor concentration, changes in appetite and in the worst cases, suicidal thoughts or actions.  Demoralization is more of a mindset of hopelessness and failure not necessarily along with the spectrum of symptoms of depression.

We think about and treat depression often with medications which work well.  We don’t often think in terms of demoralization, though, because it’s not really a medical diagnosis.  The importance of this article is the fact that demoralization, when present, can be treated, but differently.  Cognitive behavioral therapy (CBT) with a psychologist seems to work better for demoralized feelings than the medications we use for depression symptoms.  CBT is also used for m any different psychological problems including depression, often along with medication.  CBT treatment, which helps a person retrain the way they think, takes time and effort, but as the best treatment option for demoralization it may be worth it and may help the person with Parkinson’s enjoy a better quality of life.

-DS (7-16-18)