I remember reading a journal on international health about the shifting trend of diseases from the time when antibiotics weren’t a commonplace to the present when there’s cure for most diseases. It said there that people now have longer life expectancy compared before. It’s a happy thought. Reaching 60s, 70s, 80s and even 90s is an accomplishment in itself. It means more time to see and do things; more time for self and family; more time for enjoyment and relaxation as these are ages of retirement from a lifetime of work.
However, there is also a downside to living long. In the arena of health, longer life sits side by side with chronic illnesses like diabetes, hypertension, cancer among others whose onset are usually later in life (though they are getting earlier and earlier now). This new trend commands a shift in the focus of health care to meet its varying needs.
On Parkinson’s Disease
All over the world, especially in developed countries, a huge percentage of the population are elderly. A big chunk of them are battling one or two kinds of chronic disease that needs long-term care.
Parkinson’s Disease is one example of a chronic illness that usually begins on the 5th decade of life. It starts unnoticeable until the 6th to 7th decades when progressive degeneration of a region of the brain makes the symptoms evident enough for clinical diagnosis.
Michael J. Fox is a famous actor of the 70s to the late 90s. But who would have known that someone so famous could contract such a progressively debilitating disease? No one. Even Muhammad Ali, famous professional boxer and voice of the black and white youth, who was diagnosed in 1984. Recently, Robin Williams, comedy actor, was also diagnosed with Parkinson’s disease in its early stages. Some had hypothesized the diagnosis as well as the medications he was taking to have caused his suicide apparent suicide by asphyxiation last August 11, 2014 Monday.
But can Parkinson’s actually cause depression? That’s a question that Science continues to probe into. But, many experts have already said yes. Let’s widen our understanding of Parkinson’s Disease through these questions and answers.
What is PD?
Parkinson’s Disease or what is also termed “Shaking Palsy” is a chronic and progressive debilitating disease that is caused by the degeneration of the nigrostriatal pathway because of substantial reduction of the neurotransmitter dopamine in the substantia nigra of the brain. The degeneration of the nigrostriatal pathway which is responsible for movement and motor functions accounts for the symptoms of Parkinson’s Disease
What causes PD?
PD has various possible causes such as toxic reactions to chemicals, severe carbon monoxide poisoning, as side effect of antipsychotic medications (i.e. phenothiazines, butyrophenones), repeated head trauma and a possible complication of encephalitis infection.
Repeated head trauma was believed to have caused the PD of boxer Muhammad Ali especially in his last fights where he received severe punches. However, most PD is known to be idiopathic, arising spontaneously with its cause unclear or unkown.
As for genes, there is the Parkin gene which is attributed to the development of early onset Parkinson’s Disease.
What are the symptoms of Parkinson’s Disease?
Symptoms of PD develop slowly and gradually. By the time, they are evident, the loss of the neurotransmitter dopamine, which is responsible for movement and mood has reached 80%.
The 3 main symptoms of PD are physical and include slowness of movement, rigidity and tremor with tremor being the most visible of the 3. Rigidity refers to resistance to movement most seen during passive range of motion. It usually begins in one side but eventually affects the other. Movements of people with PD are described as Cog-wheel or Ratchet-type.
Other symptoms that vary from person to person are loss of smell (anosmia), constipation, problems with urination, erectile dysfunction, balance problems (a tendency to fall backwards), swallowing difficulties, extreme salivation and dizziness or fainting.
Does having Parkinson’s Disease affect the psychological and emotional aspect of a person?
Some believe that Robin Williams who was already initially depressed had worsened depression because of PD. That, as mentioned earlier, is still being continuously probed by Science. However, looking into the neurotransmitter Dopamine, which is known to affect mood, experts say that the loss of dopamine is indeed associated with depression. Quoting the President and CEO of the National Parkinson Foundation, “Dopamine is a feel-good chemical. If you are low in dopamine, you are not going to feel so good.” And indeed studies show that about 60% of people with PD experience episodes of mild to moderate depression.
How is Parkinson’s Diagnosed?
There is no singular laboratory tests that would diagnose PD. Diagnosis is based on the characteristic of symptoms as examined by a physician. Usually, a diagnosis is made when a person has at least 2 of the 3 main symptoms of PD.
What are the treatments for Parkinson’s Disease?
Currently, there is no treatment that can reverse Parkinson’s disease. However, medications focused on increasing the supply of dopamine in circulation to control the symptoms are available. Physiotherapy as well as speech therapy also helps in keeping the body at its best possible. There is also surgery options that can be applicable for some. Doctors call it “Deep Brain Stimulation” in which a pulse generator is inserted in the chest to deliver a safe current to stimulate a targeted portion of the brain. This cannot cure PD but is believed to help in easing the symptoms.
In life, we can have one without the other. There is always two sides to a coin. But this is not a cause for depression. Although many illnesses have no clear cause and are thus unpredictable, many are still preventable. And preventing diseases only requires some effort and discipline on our part. A good quality of life beginning at a young age. Avoidance of risky behaviors and activities that may have long-term implications to health is one important habit. Let us not wait for that diagnosis to come and wake us up. Let us not just be aware and cognizant but truly concerned for ourselves and one another. Let us not just aim to live long, but to live a long life of quality. And if we can, also aim to contribute to universal knowledge that would make life even better for the generations to come.
- Porth, C.M. (2002). Pathophysiology: Concepts of Altered Health States. 6th Edition. Chapter 21. Lippincott Williams and Wilkins. Philippine Edition.
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