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Most people are familiar with the typical symptoms of Parkinson's disease, like tremors, stiffness, and slow movement. Parkinson's can, however, lead to a whole host of symptoms you may not have known about.

The main, and most well-known, symptoms of the neurodegenerative Parkinson's disease are:

  • Tremor
  • Slowed movement
  • Stiffness/rigidity
  • Balance and coordination problems
Parkinson's can come with a whole host of other symptoms, however, including non-motor symptoms. What do you need to know about them? 

1. Dementia

Parkinson's disease may be classified as a movement disorder, but it can have a tremendous impact on cognition too, especially in its later stages. As the disease progresses, up to 80 percent of patients may have dementia. So-called Lewy bodies, clusters of abnormal protein in the brain, play a large role in this. 

Dementia may manifest as:

  • Memory loss
  • Loss of focus
  • Irritability and mood swings
  • Anxiety
  • Poor sleep
  • Impaired judgment
  • poor judgment
  • Hallucinations
  • Delusions — persistent false ideas

While some patients are aware of these changes as they increasingly impact their lives, some of the symptoms of dementia are more easily recognizable by other people in your life. Medications are available to help with dementia as the result of Parkinson's, particularly those designed for Alzheimer's disease.

2. Depression

Studies reveal that depression strikes Parkinson's disease patients much more often than others — as many as half of people living with the disease may become depressed. Not only does depression rob you of the quality of life you deserve, it can also aggravate your motor symptoms. Talk therapy and antidepressants can both play important roles in treating depression. 

In addition to depression, Parkinson's patients may also suffer from:

  • Anxiety
  • Mood swings
  • Personality changes
  • Psychosis

Sometimes caused by medications you take for your Parkinson's, it is important to seek medical help if you have noticed negative changes in your state of mind.

3. Trouble chewing and swallowing

Parkinson's can make even everyday tasks that used to be so simple you barely gave them a second thought very difficult, and this can include chewing and swallowing. Particularly common in the more advanced stages of Parkinson's, chewing and swallowing problems are caused by changes within your nervous system as well as the muscles you use to chew and swallow. Not only is this unpleasant, it can also be dangerous — choking and pneumonia (as the result of aspirating food) are possible complications.

Some people with Parkinson's produce too much salvia, which again makes swallowing hard, while others have a dry mouth as a side effect of medications. Ask your doctor about medications that can make swallowing and chewing easier, and also consider asking to be referred to a speech therapist, who can help in this domain as well.

4. Disordered sleep

Disordered sleep and daytime sleepiness are quite frequently seen in people with Parkinson's. You may suffer from insomnia (trouble falling asleep or frequently waking up during the night), sleep apnea (you periodically stop breathing while asleep), vivid dreams, nightmares, restless legs syndrome, sleep talking, difficulty turning over in bed, and you may even act out your dreams (REM behavioral disorder). Both Parkinson's and the medications you take for it can cause these sleep problems. 

To try to get a better night's sleep, work on your sleep hygiene:

  • Establish a regular bedtime
  • Wind down before you go to bed
  • Stay off the alcohol and caffeine in the hours before you're planning to go to sleep, and reduce your fluid intake during nightly hours if you often wake up to pee
  • Keep your bedroom cool
  • Keep electronics and bright lights out of your bedroom

Should these common-sense changes not help, ask to talk to a sleep specialist.

5. Bladder and bowel trouble

Parkinson's disease can interfere with the communication between your brain and your bowels and bladder, resulting in bladder problems like:

  • Urge incontinence or an overactive bladder — the patient feels the urge to pee all the time
  • Stress incontinence — urine leakage when sneezing, laughing, or exercising
  • Nocturia — needing to pee often during the night; you may wake up, or void during your sleep
  • A weakened urinary stream, sometimes because rectal stool build-up presses on the urethra

Bowel-related problems seen in Parkinson's can include:

  • Constipation
  • Diarrhea
  • Fecal incontinence
These problems can sometimes be resolved with the help of lifestyle changes, like a toilet routine, adjusting your diet, changing the timing of your fluid intake, and doing pelvic floor exercises. If these changes do not help, medications are also available.

6. Pain: A common but underestimated symptom of Parkinson's disease

Some doctors still believe that "Parkinson's disease doesn't hurt" — but they'd be wrong. More than half of all patients report that they live with pain during one point or another, and many suffer from chronic pain. This can partially be explained by the fact that the abnormal muscle contractions seen in Parkinson's take a toll — musculoskeletal pain is the most common kind of pain patients have, with cramps, aches, and burning sensations all seen frequently. Parkinson's may also, however, alter the way in which your body processes pain stimuli.

How can you try to beat Parkinson's related pain? 

  • Over-the-counter or prescription painkillers — always let your doctor know if you're taking OTC meds and ask them for dosage advice
  • Regular exercise, which reduces stiffness and increases flexibility
  • Spinal-cord stimulation
  • Massage
  • Mind-body techniques like yoga and Tai Chi
  • Music therapy

7. Low blood pressure

The autonomic nervous system — the bit that controls functions you have no conscious control over, including your blood pressure — undergoes changes as your Parkinson's disease progresses. This is why many Parkinson's disease patients suffer from hypotension or low blood pressure. You may have postural hypotension if you feel faint, lightheaded, or dizzy when you stand up from a sitting or lying position; around 20 percent of people with Parkinson's experience this problem, which can also be exacerbated by Parkinson's medications.

8. Low libido

As many as eight in 10 patients who live with Parkinson's report that their sexual desire and function suffers as the disease progresses. Motor symptoms, depression, fatigue, self esteem problems, erectile dysfunction, and vaginal dryness can all contribute. Viagra, vaginal lubrication, and talk therapy can all help you regain control over your sex life.

9. Fatigue

The fatigue so many people with Parkinson's disease suffer from can partially be explained by their poor sleep quality and medications, but you may feel so tired that you can hardly function. While the root cause of this kind of fatigue is still poorly understood, we do know that short daytime naps (on a regular schedule), taking your medications on time, and engaging in regular exercise can all help fight fatigue.

10. Dyskinesia: Involuntary movements

Dyskinesia, involuntary movements, are a common side effect of the drug levodopa (which increases dopamine levels), especially in higher doses or after long-ter, use. This may manifest as twitching, jerking, shaking your head, or fidgeting you have no control over. This problem is the result of fluctuating dopamine levels, which explains why many patients find it gets worse as their dose of levodopa runs its course. People who experience dyskinesia can talk to their doctor about long-acting slow-release forms of levodopa, which lead to more stable dopamine levels, in turn reducing involuntary movements.

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