The act of taking one’s own life. Suicide is a significant risk of depression. Depression is among the symptoms of Parkinson’s, affecting close to half of people who have the disease. It is difficult to know how prevalent thoughts about suicide are among people with Parkinson’s. Statistics show that fewer of them commit suicide when compared to the general public even though depression is four to six times more common among people with Parkinson’s. It is also sometimes hard to know when a person’s comments and actions cross the line between what he or she experiences and expresses as the normal spectrum of emotions that accompany having a chronic, neurodegenerative disease and the point of concern. Sudden changes in behavior, such as giving away possessions or “getting things ready,” are potential warning signs.
Thoughts of suicide may occur when a person feels hopeless and helpless and does not want to continue his or her current experience of life. Although the situation may not appear so bleak to those on the outside, the narrow focus of the person’s perspective limits his or her ability to see beyond what appears to be an insurmountable problem or situation. The cause may be current physical symptoms that now preclude favorite activities or constrain independence or a projection of such restrictions into the future. Some people worry about the strain their debilitation, present or prospective, places on family members and in their despondent state believe it would be better to spare them this anguish. To the loved one this is frightening and extreme, but the person with depression cannot see other options.
It is important that the person with Parkinson’s have someone to talk to, whether or not he or she is depressed, who will just listen without being judgmental or dismissive and without putting forth solutions or giving advice. Sometimes just sitting quietly with the person, letting the person know he or she is not alone, is enough for the moment. Most people who are feeling suicidal or who have thoughts of suicide try to talk about their feelings. Because of the difficulty of hearing or understanding such expressions, loved ones naturally responded by attempting to comfort the person or fix the perceived problems. A family member or caregiver who is concerned that a loved one with Parkinson’s may be suicidal should contact a local suicide hotline (look in the telephone book’s entry for “suicide”) or the person’s physician for advice about what to do and how best to help. Sometimes a person who is feeling suicidal finds it easier to speak with a counselor or therapist.
It is most important to treat depression when it does exist; doctors should regularly check for depression using objective clinical assessments. Many specialists in Parkinson’s disease believe that depression is underrecognized and underdiagnosed and consequently undertreated. In Parkinson’s disease the imbalances among neurotransmitters in the brain fluctuate, often widely, in correlation with medication dosages. There really is no stable or steady state, biochemically, and that affects all brain functions to some extent including those related to mood and emotion. Researchers believe this is why depression is common among people with Parkinson’s and why depression typically responds well to treatment with ANTIDEPRESSANT MEDICATIONS such as the SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRIs), which act to rebalance the brain’s biochemicals.