I've studied this one for years and one of my docs is an expert on depression with PD. I've volunteered for a lot of research studies, so my docs are happy to answer my questions and teach me. So let me add to the wisdom offered above:

There's depression as in down-in-the-dumps, caused by things like an attitude of "oh no, I have a chronic disease and my life is ruined," and then there's clinical deprssion, also called major depression, which can be caused by physical factors alone, as in faulty brain chemistry due to brain cells dying off from PD. In many cases, clinical depression comes with the PD and often appears before the PD gets obvious. A neuropsychiatrist who specializes in Parkinson's Disease is qualified to make the distinctions as few others are, but neurologists with a movement disorder specialty are a good bet. Apathy is also likely to be a symptom of PD sooner or later, and it's not necessarily part of the depression. The symptoms of PD, clinical depression, and apathy all overlap, so it's very difficult to sort out.

Kari, I hope you and all readers understand that depression that comes with PD, to upwards of 40 or 50% of us PWPs, is in most cases physically caused, as I've described, and is not something we can "snap out of" or "cheer up" from. It takes medication and sometimes counseling to treat it. The good news is that it is treatable. The bad news is that untreated, eventually, clinical depression is fatal, but before that it damages the brain further. My expert doc will probably keep me on antidepressant medication until they come out with something better, because nothing so far can restore the brain cells that have fizzled.

Finding the right dose and the right brand of antidepressant can take a year or two, so we have to persist in observing ourselves and reporting as well as we can.

Some people go on and off antidepressants, and I've observed that those PWPs often tend to think the depression is something either to be embarassed about or that they should be able to control. These are the same people who heal broken legs by mind power and refuse to use a cast because they would appear weak. No, no, not! But sometimes I wonder why they choose the one ailment to refuse to be treated for. This is my own opinion based on what I've been taught.

I've taken Zoloft, Wellbutrin, Effexor, and Cymbalta. Cymbalta is by far the best for me, and everyone differs, but I have no side effects from it. I've been on it for about a year. It helps relieve pain in a minor way, too, especially at higher doses. It doesn't make me foggy, either. It doesn't relieve or mask PD symptoms by itself, although relieving depression will help the PD, according to my docs. But everyone's meds are different.

Do you have PD? What kind of neurological exam were you given? Tapping forefingers on thumbs rapidly? Rotating wrists in the air rapidly? Touching finger to doc's finger and then your nose, again and again as doc moves his hand to different places in the air? Walking down the hall and turning and walking back while carefully observed? Being pulled by the shoulders from behind and watched for how you stayed upright? Have a Strine test? Have your limp wrist rotated by the doc both with an without the other hand patting your leg? Questions about tingling, numbness, weakness, etc.?

We're not doctors here, but we've been through some stuff. I hope this helps.

Jaye