Dial Down Your Anxiety!

By Dr. Eric Egli, PhD

Persons with Parkinson’s understandably worry about their future. Uncertainty and fear add to the physical concerns that make living a fulfilling life challenging. Throughout our life we develop strategies for dealing with many challenges. Unfortunately, when dealing with the special circumstances of PD our usual ways of coping don’t always work well and may actually work against us.

In threatening and challenging times our nature leads us to be vigilant and to anticipate danger and threats.  We are motivated to think deeply and extensively about what may come and how we should prepare for or prevent what we fear may happen. When a threat is perceived, we worry. Ideally that worry will engage us in developing problem-solving, coping strategies.

However, there are times when we have done all the problem-solving we can and there is nothing more to do for the moment. At such times our natural drive to worry is no longer productive. If we can’t step away from the worry it can dominate our life and well-being. It can turn into its own harmful and disruptive presence, sapping the pleasures one could be having now and worsening our health, our physical symptoms and our energy. When worry grows to a point where instead of being adaptive it produces needless suffering and disrupts our quality of life it becomes problematic anxiety. I sometimes refer to this as “premiserating” i.e. “I will suffer now because I think I might later.”

There are various forms of anxiety. Some, like panic, are very physical with heart racing, shortness of breath, dizziness, butterflies in the stomach, sweating, shaking, tremors and more. Clearly this will aggravate PD symptoms. Other forms are more mental/emotional as discussed above, but all have physical and psychological aspects that can aggravate PD and other health conditions.

One question people have is how much of their anxiety is due to the neurology of PD itself? While clearly this is involved, other important factors include normal reactions to the stress, disability and uncertainty of PD. Other people may also have lifelong issues with anxiety apart from PD, which simply adds to the challenge. In addition, sometimes PD medications themselves can affect anxiety reactions. The reality is that all these factors may be in play and there may not be a simple answer. Fortunately, addressing the anxiety does not require figuring out all the different possible causes. What is needed is a comprehensive approach based on each person’s set of challenges, symptoms and strengths. 

Regardless of the source, many behavioral and cognitive strategies can help with anxiety reduction. Completely eliminating anxiety is not a realistic or necessary goal. It is more useful to think of people as having dials not switches in this regard. We may not switch it off, but if we can dial down the magnitude of the worry and anxiety to a manageable level, we are doing well.

Recommendations for dealing with anxiety include:

1 Recognize that some level of anxiety is normal and adaptive.

2 Get exercise and stay engaged with friends, acquaintances and loved ones.

3 Find ways to continue your favorite activities. Explore new interests if some are taken away.

4 Tell your doctor about your symptoms and get a referral to a psychiatrist if needed.

5 Learn relaxation practices such as deep breathing, imagery and meditation.

6 Consult a psychotherapist to help you improve your stress and anxiety management strategies and to help you cope with the broader challenges PD presents.

7) Live each present day to the fullest you can.