In having a good clear out, I've rediscovered some booklets I was given as part of classes on reducing Stress which I attended years before I was diagnosed with Parkinson's. These self-help information packs were created for a course called "Stress Control" by Dr Jim White. The information provided considers the question of "what is stress?" in great detail. So I have been reading this afresh, but now from the perspective of a Person with Parkinson's (PwP). Remember, this is a course written about stress itself, without any reference to Parkinson's. Yet, anyone affected by Parkinson's who reads it will be very familiar with what they find. I will be writing extensively on this subject, but to set the scene, here is a list Dr White provides which covers the ways in which stress can affect the body.
- Muscle aches and pains
- Sleeping problems
- Problems swallowing
- Voice tremor
- "Jelly legs"
- Blurred vision
- Bladder weakness
- Chest pain/tightness
- Pains in hands
- Pins and needles
- Clammy hands
- Dry mouth
- Shortness of breath
- Stomach pains
- Choking sensation
- Missed heart beats
- Loss of appetite
People affected with Parkinson's the world over will recognize very many of these as the acute symptoms of their condition - but remember here Dr White is writing about stress.
I have long held that a certain personality type is more prone to Parkinson's, because very many PwP I speak to can recall their own marked stressful behaviors prior to diagnosis. I also believe that many instances of Parkinsonism's, including my own, are, at least in part, due to ingrained and unrelenting stress which eventually causes the brain to fritz or to become locked into a permanent flight-fight-freeze state, as I describe in my article.
While this may [currently] be a controversial perspective, what is clear from "Stress Control" is that there is a huge overlap between the symptoms of stress and those attributed to Parkinson's Disease. Of course PD is inherently a stressful condition so the two tend to strongly feedback. Certainly, we know that acute stressors result in the symptoms of PD becoming very pronounced:
This overlap between Stress and Parkinson's, for which the list is just the tip of the iceberg, is something which now needs urgent attention by the healthcare sector.
Indeed, if we consider that many PwP see their neurologists only occasionally, usually for a rushed meeting in a clinical setting, this means that PwP are implicitly presenting to medical specialists under inherently stressful environmental conditions. According to Dr White's list, this means that the symptoms and progress of the disease which doctors are attempting to measure will be strongly masked by those of stress. I therefore find it hard to believe that any doctor is capable of distinguishing symptoms due to the stress of the appointment itself, with those of the underlying chronic disease. This, in my view, makes the prescription of extremely powerful drugs based on these types of clinical appointments inherently questionable if this is done without full regard to the PwP's stress behaviors or personality type.
I am thus calling for full consideration of Stress and Stress Management to urgently became a central part of the treatment of Parkinson's Disease. This includes:
- Large scale questionnaires of people affected by Parkinson's and their primary carers across the globe in order to confirm the correlations we have found between pre-existing stressful behaviors/natures of people who are diagnosed with PD.
- Medical practitioners to take full account of PwP's (i) stress history, (ii) behaviors and personality types, (iii) ability to cope with stress and (iv) tell-tale signs like obsessive-compulsive behaviors, as part and parcel of their diagnoses.
- Provision and proper discussion of self-help and educational materials about stress and stress management at diagnosis of PD.
- Interstitial appointments and reviews with neurologists which focus exclusively on how the PwP and their primary carer are coping with stress.
- Prescription of stress control and stress reduction courses such as those based on Dr White's course and cognitive behavioral therapies, with these therapies to be seen as at least as important as drug based treatment.
- The prescription of powerful drugs without also (i) taking proper mental health histories, (ii) giving full consideration of stress in the PwP's environment and (iii) providing effective ways to cope or control stress, to perhaps become seen as a violation of the hippocratic oath.
Because, as I described in the "Beast Within...", without addressing these underlying behavioral/environmental factors, even if a chemical cure was invented for PD tomorrow, this does not mean that the healthcare system will have fixed people with Parkinson's.