This was information that I basically already knew, but I think it is one of the few times that i have heard a professional say that depression was actually a manifestation of the disease itself.

rosie asked: With reference to the symptoms of depression having a negative impact quality of life in Parkinson’s disease, is that not the nature of depression? Is there a suggestion that there is some difference between the impact of depression in Parkinson’s and its impact in other contexts?

Rosie, this is not a relatively new theory, but I believe after people like Dr. Laura Marsh have been preaching it for years, it is finally getting attention. PD is a movement disorder - right? PD is also a long list of non-movement symptoms or syndromes - right? Right to both of the above questions/comments.

From what I have read and researched, you can have two types classification of depression associated with a chronic illness -exogenous and endogenous depression. Exogenous depression occurs because of one's "situation." For example, you have PD, you have to quit your job or take early retirement, your physical activity is limited, and relationships change - often for the worse. That is enough to bring on deression in ANY situation. Then there is endogenous depression - what we refer to as a "chemical imbalance." You get down because your molecular chemical homeostasis goes haywire, and you cannot change this type depression by an attitude adjustment (broadly speaking). PD is a neuroligic illness - and dopamine, in which we are deficient, is the "feel good" chemical in our brains. When we alter our dopamine levels (which we must do in order to have fluid movement) it messes around with other chemicals involved in this balancing act - seritonin, etc. Dopamine, in other words, not only is required for "normal" synaptic processes to function properly, it also is very much tied to our mood or mental well being.

What Dr. Richard pointed out in this podcast is that she thinks that depression is a manifestation of the disease (PD) itself. I don't have time to look up the references right now, but there are studies that say in many instances, depression preceeds a diagnosis of Parkinson's.

So rosie, I say all of this to answer from my perspective, and apparently also from some reputable researchers and professionals, that depression definitely impacts PD patients differently than it does many other syndromes or diseases. When one is depressed, our "wiring" is not operating with the right chemical balance, so our movement symptoms exacerbate.. If you take care of the depression, often the movement symptoms improve.

I know this first-hand, as I have to keep my mood stabilized with "chemicals" consistently. And once it's "fixed," it may not stay in balance with the same regime - it's a constant trial and error effort.

Sorry I didn't back this up with scientific references, but I promise I have read numerous studies on this very topic.

And only speculating, since arthritis is not a neurologic disorder, the results would vary greatly from the association of depression/movement in Parkinson's.

Carey - Jaye - help me out here with some of Dr. Marsh's work!
Peggy