Using Principles of Cognitive Behavioral Therapy to Treat Anxiety in Parkinson's Disease

Anxiety significantly affects persons with Parkinson's disease (PwP), often emerging in the prodromal phase before the onset of symptoms and persisting throughout the disease's course. It is among the most disabling, stigmatizing, and under-recognized symptoms of Parkinson's disease (PD). Consequently, it is critical to provide tools that can be universally applied and that are accessible to help all PwP live better. This article discusses the nature of anxiety in PwP, how to identify it, and how to treat it across stages of the disease. We highlight cognitive behavioral therapy (CBT), a type of psychotherapy in widespread use for anxiety and depression in general and increasingly used in PwP. The neurologist can apply the basic principles of CBT. The principles can be used by clinicians who are treating PwP globally, as they require no pharmacological intervention and minimal resources. As the disease progresses, a multidisciplinary team may be preferable to address the complex challenges that PD presents, including anxiety. The focus is on a patient-centered approach, providing compassion, hope, and resources to optimize the mental and physical well-being of PwP. Empowering PwP fosters self-agency and can significantly improve quality of life.