Anxiety

It’s important to be able to recognise the symptoms of anxiety, so it can be treated as soon as possible. People with the condition may feel some of the following:

• a sense of dread
• constant worry
• difficulty concentrating
• feeling unable to relax
• difficulty sleeping

You may also experience physical symptoms if you’re feeling anxious. These can include:

• sweating
• a pounding or racing heart (palpitations)
• tightness of the chest or feeling breathless 
• dizziness
• trembling
• indigestion, nausea and stomach ache or cramps
• headaches
• loss of appetite
• a dry mouth
• muscle pain and tension
• restless legs and difficulty maintaining restful sleep

When anxiety carries on for a long time, you may have feelings of hopelessness. These feelings may affect your ability to carry out everyday activities. Sometimes you may have symptoms of depression as well as anxiety.

Depression is more than temporary feelings of unhappiness or frustration. It’s usually diagnosed when someone has lasting feelings of extreme sadness or hopelessness for weeks or months. These symptoms can range from mild to severe.

Find out more:see our information on depression and Parkinson's

There are 3 main types of anxiety, though these can overlap. Many people will experience more than one type.

Generalised anxiety disorder

This is when you experience excessive and uncontrollable worrying most of the time about everyday events in your life.

Panic attacks

Panic attacks are short periods of sudden, intense feelings of fear. They often happen in situations that are likely to make you feel anxious. You may also have a racing heart, sweating and shortness of breath. 

Some people think these symptoms are very serious, and they rush to the hospital for help. 

A panic attack can come on very suddenly, but you might experience symptoms of a panic attack over a long period of time.  

Panic attacks are different for everyone. You might experience them regularly, or you might have one once and never again. 

If you have regular sudden panic attacks, you may have panic disorder. It’s important to see your GP if you think this is the case.

Phobia

This is when you feel frightened of something that’s not dangerous and wouldn’t usually make other people feel scared. For example, agoraphobia is the fear of crowded spaces or being in situations where escape might be difficult.

For people with and without Parkinson’s, anxiety is likely caused by a combination of several things, including genetics and stressful life events. 

Any concerns you have about living with a long-term condition, such as Parkinson’s, may also cause anxiety. 

Medication and anxiety

Some people with Parkinson’s have anxiety that happens when they’re ‘off’. 

When a person takes their medication, their symptoms will improve. But these symptoms can sometimes return towards the end of a medication dose, or before the next one is due. This causes a person’s condition to fluctuate and is known as ‘wearing off’. 

You might also feel anxious or frustrated during an ‘off’ period if it stops you from doing your normal daily activities easily. For example, if you’re out for a walk and suddenly feel unable to continue walking, or if you’re sat down and aren’t able to get up to answer the door.

If your anxiety symptoms increase when your medication is wearing off before the next dose is due, talk to your specialist or Parkinson’s nurse. 

Changes to your medication regime may improve your symptoms. If you go ‘off’ and have difficulties moving, it can also make you feel anxious. When your movement symptoms are better controlled by medication, you may find that your anxiety improves.

Even if you don’t have ‘on’ and ‘off’ periods, you may still have generalised anxiety. This might be because your Parkinson’s symptoms aren’t responding to medication or need a different dose to help you better manage your symptoms. Again, changes to your medication may help. 

Always speak to your specialist or Parkinson’s nurse about any adjustments to your Parkinson’s medication. It’s important not to stop taking medication without talking to a healthcare professional, as this can be dangerous. 

It’s also important to talk to your health professional about your anxiety. In some cases, it may make other symptoms of Parkinson’s worse. For example, anxiety can worsen dyskinesia, tremor and problems with balance. But getting help early can give you more control.

Diet

Try to eat a healthy, balanced diet. It can also help to avoid too much caffeine (found in tea, coffee and some fizzy drinks) and alcohol, especially late in the evening. These can make some of the physical symptoms of anxiety worse.

Find out more: see our information ondiet and Parkinson’s.

Staying active

You can help ease stress and release anxiety through regular physical activity, such as walking or swimming.

Find out more: see our information on physical activity and exercise.

Yoga

Yoga is a gentle exercise that aims to improve flexibility, strength, balance and breathing. There is some evidence that yoga could help with anxiety and stress.

Tai chi 

Tai chi is a low-impact martial art that focuses on balance and movement. It involves moving the body slowly and gently – there’s no physical contact. It may have benefits for your mental health, including reducing anxiety. It can also help to improve breathing and ease tension in muscles.

We hear from many people with Parkinson’s who find complementary therapies relaxing. These include: 

Massage

Many people find that having a massage helps them relax and can ease discomfort. A massage therapist may use various techniques, including stroking, kneading and rubbing, to manipulate the body using pressure.

Massage isn’t suitable for people with certain medical conditions, such as a history of bleeding disorders. 

Acupuncture

Acupuncture is part of traditional Chinese medicine. It involves a therapist inserting thin needles at particular points on your body. Although the evidence that acupuncture can reduce anxiety is mixed, some people may find it helpful.

If you want to take anything by mouth or apply it to your skin as a complementary therapy, check with your GP, specialist or Parkinson's nurse first.

Find out more: see our information oncomplementary therapies and Parkinson's.

Anti-anxiety medication, such as antidepressants and anxiolytics (also known as sedatives) may help with anxiety if you have Parkinson’s, under certain circumstances. However, long-term use of anxiolytics may not be recommended as it's easy to become dependent on them.

Speak to your GP, specialist or Parkinson’s nurse about what may be best for you. They should also be able to advise you on how to take antidepressants alongside your Parkinson’s medication.

Applied relaxation focuses on learning how to relax muscles during situations that make you feel anxious. This includes practising relaxing muscles quickly in stressful situations, so that the technique becomes more natural to you over time. 

Applied relaxation needs to be taught by a trained therapist and usually takes place in weekly sessions for 3-4 months. This treatment is offered by the NHS, however, it might not be available in all areas.

Sharing your worries and fears with a trusted friend or family member can help reduce anxiety. Talking to other people with Parkinson's can also help, as you can share your experiences and find out how others cope with similar problems. Parkinson’s UK haslocal groups across the UK. 

You can also call our helpline on 0808 800 0303 or speak to other people with Parkinson's on our forum.

Counselling involves a trained therapist listening to you and helping you deal with any emotional difficulties you’re experiencing, including anxiety. They can help you better understand your thoughts, feelings and behaviours, and what’s causing you to feel anxious. 

If you’d like to speak to a counsellor about your anxiety, ask your GP for information (many GP surgeries have counsellors attached to their practice). 

You can also refer yourself directly to NHS counselling services without needing a GP referral. For more details, visit theNHS website.

NHS counselling services are free. There is usually a waiting time for these services, which can range from a few weeks to a few months, depending on your local area. 

If you would prefer to see a counsellor privately, there are counselling organisations that can give you information and details of private counsellors, including theBritish Association for Counselling and Psychotherapy (BACP).

Mind has an online guide, ‘Talking therapy and counselling’. The guide explains the different types of talking therapies available, including counselling, how they can help you and what they involve. You can read the guide online onthe Mind website.

Cognitive behavioural therapy (CBT) can be helpful in dealing with anxiety. It works by changing ‘unhelpful’ everyday thoughts and behaviours that can lead to feelings of anxiety or make anxiety worse. 

CBT can take place in groups or individually with a therapist, who may be a clinical psychologist, psychiatrist or specially trained nurse. It usually involves a course of weekly sessions. 

There are a number of self-help CBT books that are recommended by the NHS for people with anxiety. Many of these are available at your local library via the Reading Well scheme. Again, ask your GP or Parkinson’s nurse for more advice or visit the Reading Well website.

Anxiety symptoms can hugely affect someone’s quality of life. If this happens, you should try to encourage the person affected to speak to their GP, specialist or Parkinson’s nurse. 

They may be referred to a mental health specialist who can recommend treatment. If you’re caring for someone with Parkinson’s, it’s completely natural for you to feel many of the same feelings as the person with the condition. 

These feelings may include anxiety, fear about the future, depression, fatigue and concern about any changes in your relationship. With this in mind, you should also try to look after your own physical and mental health as much as you can. Taking care of yourself can be difficult, but it’s important. It will also help you be better able to care for your loved one. 

Many people who care for someone with Parkinson's find it helpful to join asupport group where they can meet other people in a similar situation. 

Many Parkinson’s UK local groups have special activities for carers. Visit our local groups page for details of your local group or contact our helpline on 0808 800 0303. 

Carers UK andCarers Trust also run groups for carers. See the ‘More information and support’ section for details.

Find out more: see our information oncaring for someone with Parkinson’s.

Anxiety UK
Anxiety UK has a range of information and support services for people
with anxiety.
03444 775 774
07537 416905 (text support service)

British Association for Counselling and Psychotherapy (BACP)
Visit the website to find a therapist near you. 
01455 883 300
[email protected]

Carers UK
Carers UK provides information and support to people who are caring at home. The charity has support groups, branches and local offices throughout the UK.
0808 808 7777
[email protected]

Carers Trust
This charity provides support, information and centres for carers throughout the UK and most centres run carers’ groups.
0300 772 9600 (England)
0300 772 7701 (Scotland)
0300 772 9702 (Wales)
[email protected]

Mind
Mind provides support and advice on all kinds of mental health problems for people living inEngland andWales. It has a range of publications and local support groups.
0300 123 3393
[email protected]

Inspire
Inspire offers a range of services that provide support for mental health in Northern Ireland.
0808 189 0036
[email protected]

Scottish Association for Mental Health (SAMH)
SAMH provides information and support on mental health for anyone experiencing mental health issues and their loved ones.
0344 800 0550 
[email protected]