Parkinson’s and Fatigue

Fatigue manifests itself differently depending on the individual: 

• Constant feeling of being overwhelmed and lacking energy that does not go away after a good night’s sleep.
• It is different from drowsiness which is associated with lack of sleep, and apathy, which is a state of emotional indifference.
• Fatigue usually develops early in the disease, and may even appear before the first motor symptoms.
• Fluctuating from day to day, even hour to hour.
• Physical or mental.

There exists many causes that interact with one another and are responsible for fatigue. Some of these causes can be treated and others cannot: 

• The decrease in neurotransmitters associated with Parkinson’s disease. The levels of dopamine and serotonin, which usually regulate movement and mood, decrease as neurons disappear.
• Medications to treat conditions such as insomnia, anxiety, muscle pain and spasms, as well as allergies.
• Medications taken to control the motor symptoms of the disease.
• Low blood pressure or orthostatic hypotension which are characteristics of Parkinson’s disease and which are aggravated by antiparkinsonian drugs.
• Involuntary muscle contractions (dystonia), slow movements (bradykinesia), muscle stiffness and tremors.
• Depression
• Lack of exercise which can fuel the vicious cycle of low energy.

Mental fatigue can also be exacerbated by difficulty concentrating, memorizing, or performing cognitive tasks.

People living with Parkinson’s disease often use these phrases to describe their fatigue:  

• I have no energy
• I am unable to do anything
• I am not able to motivate myself
• I feel overwhelmed

Out of the many medical conditions, lack of sleep and aging can be the cause of fatigue. In general, the fatigue associated with Parkinson’s disease improves with antiparkinsonian treatments, but does not go away completely.

Your neurologist can help you determine the cause of your fatigue and eventually find the best treatment.

To better manage this fatigue and improve your quality of life, take a comprehensive approach: 

• Consult your neurologist who will determine the cause of your fatigue and adjust your medication as needed.
• Preserve and manage how you use your energy. Find a balance between your activities and your rest.
• Improve your sleep by adopting a better sleep hygiene (regular schedule for getting up and going to bed, avoiding coffee, tea, chocolate and soft drinks before evening, etc.)
• Maintain good physical and mental health and have a healthy diet that will energize you and increase your stamina.

Fatigue can start a vicious cycle in which you become less and less active. Try to find a balance between regular physical activity and rest. Ask for help when you need it.

Some people who were “hyperactive” before their diagnosis will not return to their previous energy levels. However, this does not prevent them from being productive in their leisure time and activities.

Fatigue is usually treated by adopting new lifestyle habits. In the most severe cases, neurologists may find it useful to prescribe drugs to stimulate the nervous system