Rose,

Thank you for unveiling this fascinating connection. I had read a bit about it sometime ago, and you bringing it up now is great timing. It is slowly sinking in that Parkinson's has stolen most of my adult life, including my sense of who I was. Maybe there is no real sense of being this whole person, maybe we are constantly in a state of flux, and to think other wise is an illusion. Although 43 years in,, and I still can't remember to pick up my clothes off the floor.

I think back to the years just preceding my shaky hand. I was in a constant state of anxiety; I began having social phobia for the first time ever...all of it seemed to appear out of nowhere. However, I have come to realize it did have a partner in crime...that would be Parkinson's. Researchers are now just starting to recognize the serious nature of depression in PD, yet even fewer are looking at anxiety. They are even beginning to assemble a clinical "profile" of the anxious PWP.

- They have YOPD
-They tend toward social phobia and anxiety to panic disorder over symptoms (this is my recent welcome into the world of freezing).
-Most often women

However, most studies look at anxiety after the fact, and I am saying for me it was a calling card. It looks like that is the case for many others:

This study contributes to the growing body of literature examining the role that psychiatric disorders may play prior to PD motor symptom onset. There is evidence of a prodromal phase in PD from imaging, pathology, and clinical, epidemiological, and animal studies [11], [30], [31], [32]. Estimates of duration of the prodromal period vary widely, from 3 up to 20 years, and symptoms can include olfaction deficits, dysautonomia, and sleep and psychiatric disorders[11], [30], [32]. While we assumed an average duration of 5 years for prodromal symptoms in this study, age and disease etiology may be important factors determining the actual length of this phase [11], [30], [32]. Although the pathophysiology of depression and anxiety in pre-clinical PD is not fully understood, [33] its basis may be noradrenergic, dopaminergic or serotonergic [34], [35] and the neurologic structures involved may included the substantia nigra or coeruleus/subcoeruleus complex, where dysfunction occurs in Braak Stage 2, and has been estimated to begin ten years or more prior to motor symptoms.

"Occurrence of Depression and Anxiety in PD" Parkinsonism & Related Disorders. November 2010

Bob,

Thank you for that visual of lobsters following you. I recently told a psychiatrist who inquired about phobia that I had a fear of lobsters but really it was an homage to one of my favorite film directors, Woody Allen. I had happened to have watched Annie Hall the night before. They never make it far enough to have Othello Syndrome, but leave us laughing and thinking lobsters.