More Than Tremors: The Lesser-Known Symptoms of Parkinson’s Disease
For about 90% of those living with the disease, the real struggle begins when the lights go out / ShutterStock
When most of us hear about Parkinson’s disease, the first image that comes to mind is of an older person whose hands tremble. It is a powerful and familiar image, but it reflects only a small part of the complex reality of the tens of thousands of people living with the disease in Israel. In fact, for many Parkinson’s patients, tremor is not the main symptom at all, and in some cases it does not appear at all. Parkinson’s is a progressive neurodegenerative neurological disease caused by the degeneration of nerve cells in an area deep in the brain called the Substantia Nigra. These cells are responsible for producing dopamine, an essential neurotransmitter that serves as a “messenger” transmitting signals that allow the body to carry out movement. When dopamine levels in the brain drop, the ability to carry out and control body movements properly is impaired, and a range of symptoms begins to appear, severely affecting quality of life.
The myth of old age: when Parkinson’s meets the “prime of life”
One of the most common myths is that this is a disease of old age only. While the average age at diagnosis is around 60, reality shows that Parkinson’s disease does not spare younger people. In fact, studies and reality show that for many, symptoms first appear already in their 40s, and sometimes even in their 30s. For these younger patients, the disease lands on them at the peak of their lives, while they are managing demanding careers, raising children and planning for the future. Their challenge is not only medical, it is social and family-related. The need to continue projecting “business as usual” while the body begins to slow down and create a sense of sluggishness and heaviness places an emotional burden on them. Early diagnosis and an understanding that the disease is not a “death sentence” removing people from active life are critical to building a treatment strategy that preserves functioning and good quality of life over the years.
The “invisible” symptoms: what the body feels, but the eye cannot see
Parkinson’s disease also affects the lives of those living with it in ways that are not visible to outside observers, but which also contribute to the erosion of quality of life. The “invisible” symptoms include: • Slowness: Unlike tremor, the main and defining symptom of the disease is bradykinesia, slowness of movement. It is the feeling that the body becomes “heavy,” and that simple actions such as buttoning a shirt, typing, or standing up from a chair become an enormous effort. Sometimes it is reflected in handwriting that becomes small and cramped, or in a “masked face,” a face lacking emotional expression, so the patient’s expression may be mistakenly interpreted as disinterest or indifference. • Sleep problems: For about 90% of those affected, the real difficulty begins when the lights go out. Sleep becomes a struggle, patients suffer from muscle stiffness that makes it hard to move and turn over in bed, and from pain that wakes them repeatedly. In addition, there is a unique phenomenon in which patients “live out” their dreams, shouting, kicking, or falling out of bed in their sleep. But sleep is not the only thing affected, because when people do not sleep at night, the day looks different too, fatigue takes over, concentration declines, and patience shortens. • Digestive problems: The disease directly affects the autonomic nervous system, leading to a significant slowing of intestinal motility and sometimes causing chronic constipation. Beyond the discomfort and heaviness, a slow digestive system can disrupt the way the body absorbs medication, leading to instability in the disease’s symptoms throughout the day.
The roller coaster of “ON” and “OFF”
As the disease progresses, many patients find themselves on an unpredictable “roller coaster” of motor fluctuations. They experience hours of “ON,” when the treatment works and they feel vital and able to function, and then sometimes suddenly and without warning, the body “shuts off” and shifts into “OFF.” In this state, symptoms return with full force, stiffness takes over and the ability to move disappears. The feeling that the day has become unpredictable and that even a short social meeting or a trip to run errands cannot be planned in advance is one of the main factors harming self-confidence and social interaction. At times, involuntary movements, dyskinesia, also appear at the peak of the medication’s effect, and these can be just as troubling and embarrassing as the disease itself.
Seeing the full picture: not just a movement disorder
It is important to understand that Parkinson’s disease also affects a person’s emotional and cognitive world. Changes in mood, anxiety, low spirits, or a drop in motivation are not a “character flaw,” but an inseparable part of the chemical changes taking place in the brain because of the dopamine deficiency. Identifying these symptoms and providing a personalized medical response are an integral part of a holistic treatment plan that views the person as a whole.
Do not let Parkinson’s run your life
It is important that you know, there is no reason to “accept” the situation, or to wait until the symptoms become unbearable. Medicine today offers a wide range of solutions that can improve symptoms and quality of life, and restore stability and control to the lives of those affected. Contact the treating neurologist and together examine the right solution for you that will allow continuity of care and a better quality of life.
*The information in this article is provided as a public service and does not constitute medical advice or a substitute for consultation with a doctor. Any change in treatment should be made in consultation with the treating medical team. Public service. Sponsored by AbbVie without involvement in the content. For more information on treatments that can improve the quality of life of people living with Parkinson’s disease >> click here
