April 11th has been designated as World Parkinson’s Day 2020, and from the Center for Neuro-Regenerative Medicine we would like to offer a series of ideas or recommendations in the context of current circumstances. They are especially designed for people who has been suffering from Parkinsons Disease (PD) and their families and friends.
What the current situation means and how does it affects people with PD:
We will discuss separately how the new coronavirus would affect patients and how it affects the quarantine situation (stress, isolation, social factors, etc.).
1) New coronavirus and risk in Parkinson’s patients:
People with Parkinson’s are not at higher risk of being infected other than the rest of the population. Also, in the event that a person with Parkinson’s is infected, there is no greater risk of complications than might be expected from a common flu.
If you develop symptoms compatible with the new coronavirus, health authorities recommend staying calm and acting responsibly: Stay home, avoid visiting other people, do not go to the medical center or hospital. The appropriate thing is to contact the authorities by phone and take the steps accordingly to local authorities, where they will indicate the way to proceed to take care of you and protect your relatives.
So far, there is no interference of experimental drugs against the new coronavirus or symptomatic treatment drugs with the usual Parkinson’s medications has been described.
Whether you are infected or not, you can safely continue your Parkinson’s medication as usual. Also, a dose change or skipping a large number of doses in the medication could cause additional health problems.
2) Quarantine situation and risk in Parkinson’s patients:
Stress is a normal response to losing control of life circumstances and is part of a natural process in the face of any change. There is no need to be alarmed when you feel it, the important thing is what to do with it. All of us are experiencing this process in these circumstances, to a greater or lesser degree, and in one way or another.
To better understand how this response occurs, we will list the series of factors that are giving us a feeling of losing control of our lives:
– Changes in life habits (schedules, routines, spaces).
– Loss of freedom.
– Fear of losing health or of other people losing it; fear of losing stability in other aspects, for example in the economic one.
– Phenomenon of collective hysteria: the ideas that scare us, whether they are real or not, spread very quickly.
– Uncertainty about the evolution of the situation.
Stress or anxiety have many faces: some people feel worried and nervous, others depressed, others angry or frustrated. There are also people who just feel strange, uncomfortable, confused, or disoriented.
Anxiety can also manifest as a physical symptom. Some could be: shortness of breath, fast heart rate, high blood pressure, headaches and back pain, gastrointestinal problems, insomnia, dizziness and even panic attacks.
The human body responds to stress at three levels: neurological, endocrine (hormonal), and immune.
- Nervous and endocrine system: The stress response of the central nervous system to circumstances triggers the release of cortisol, a hormone evolutionarily involved in preparing the body to flee or fight in danger. In a circumstance like this, in which we cannot flee or fight, a kind of over-activation or overloading of the whole organism is triggered by stress hormones. For example, there is a decrease in the neurotransmitters serotonin and dopamine, responsible for functions such as our well-being or the control of our movements. As we know, dopamine plays a fundamental role in Parkinson’s, and how stress can worsen the symptoms of the disease has been extensively studied. It is not surprising then that a person with Parkinson’s experiences a rapid worsening of their symptoms during this situation. It is advisable not to be scared by this: it is an acute response to stress, and it is reversible if we learn techniques to manage it, which will have a therapeutic action.
– Immune system: the excess of cortisol in the body decreases the natural defenses through different mechanisms, for example, an important part of our natural defenses are produced in the gastrointestinal tract, which is dysfunctional due to stress. Again, stress management techniques are necessary, in this case to strengthen ourselves and prevent diseases.
How do we manage stress and strengthen our immunity?
- To cope with stress, the objective is that the negative emotions we feel (strangeness, fear, sadness or anger) are not paralyzing: to develop our abilities to overcome adversity. We all have these capabilities and we can take advantage of the situation to discover what ours is. Each person finds them little by little and slowly leads their mind and body to a healthier and more positive state. Don’t get frustrated if you need some time to start feeling better. The important thing is consistency.
Some of these abilities to overcome are: Sense of commitment (helping the community with some physical or intellectual activity. This also helps to get out of neurotic thoughts). Patience and responsibility. Openness to life changes: accept that change is part of life and see it as a learning option. Sense of humor. Artistic expression.
- Beware of overinformation and disinformation: In this situation where uncertainty and fear are present, it is very important to filter. Today, with the proliferation of social networks, there are many false and shocking news that seem true, but are not. It is essential for your physical and mental health that you do not believe everything you read, hear or see on TV, newspapers or social networks and WhatsApp messages. We recommend not exposing yourself to the news for more than half an hour a day, because too much information inhibits critical thinking. And always from reliable sources, that is, from official bodies, such as the ministries involved in monitoring the state of alarm and the World Health Organization.
- Take sensible and concrete precautions to feel safe. Repetitive thoughts or disproportionate actions do not protect us from anything, they only make stress worse. The only thing necessary to protect yourself is to follow the specific measures recommended by the authorities.
- Establish routines and schedules, especially respecting rest, meal times and physical exercise.
– Do not neglect personal hygiene and physical appearance. – In the event that you are teleworking: respect the hours you have setand the structure of your day.
- Social and emotional contacts: it is important not to isolate yourself, using calls or video calls. But beware of excess social contact: you must avoid spending many hours chatting or talking with others. Reserving time alone is also necessary.
- Solidarity, understanding, not judging: remember that each person is facing the situation as best they know and can. Avoid projecting negative emotions that we cannot manage on others. Avoid contributing to your and others’ discomfort, for example by entering fruitless discussions.
- Physical exercise to curb anxiety and depression and strengthen the immune system, within the possibilities of each (preventive and therapeutic indication).
- Meditation and breathing techniques (yoga, mindfulness).
- Visual and auditory contact with natural elements (images, sounds, pets). Our brain generates alpha waves when in contact with nature. They are relaxation waves.
- Balanced diet with an abundance of fruits and vegetables, and «good» fats such as Omega 3s, which nourish the nervous system (olive, coconut and flaxseed oils; fish, avocado, nuts). Awareness and control over the compulsion to overfeed due to anxiety, especially beware of increased carbohydrate consumption (risk factor for infections, diabetes, cardiovascular disease).
- Variety of activities throughout the day: enhance fun. Body expression to liberal emotions, also negative ones. Creative and manual activities: Painting, drawing, cooking, playing.
- Music helps release endorphins, which relax and provide well-being, just like singing and dancing.
- Moments of introspection and possible reorientation of vital perspectives and interests. It is a good time to stop and consider new options in life.
- Take advantage to learn new things. Intellectual stimulation is necessary.
– Ideas to remember: The only freedom that nothing and nobody can take away from us is attitude. Be aware that the situation is over. Will to improve and learn personal. We cannot feel optimally in these circumstances, of course, but we can try to feel our best.