Parkinson’s disease causes movement symptoms such as tremor and rigidity, but it can also cause nonmotor symptoms, which aren’t related to movement. Nonmotor symptoms are sometimes overlooked but can greatly affect daily life, including your emotional well-being and communication with friends and family.

In this article, we’ll talk about 10 common nonmotor symptoms of Parkinson’s disease, including what each of those symptoms feels like and how they may be treated to help make everyday life a little easier.

Research has shown that anxiety and depression have the greatest impact on the overall health of people with Parkinson’s. Both depression and anxiety can show up at any point during the disease. Because anxiety can manifest as sudden panic or persistent worry, building a care team that includes counseling alongside medical strategies can be life-changing for both people living with Parkinson’s and their partners.

Anxiety can be caused by Parkinson’s itself, which leads to changes in brain chemistry. Up to 40 percent of people with Parkinson’s experience one of the following types of anxiety:

• Panic attacks (anxiety attacks)
• Social anxiety disorder
• Generalized anxiety disorder

“My husband had major anxiety after his diagnosis. We left restaurants many times after being seated. Counseling was a huge help,” one MyParkinsonsTeam member said.

Treatment for anxiety might include medication, talk therapy, complementary therapy (such as relaxation strategies and music therapy), or a combination of these.

Research from the Parkinson’s Foundation has found that depression is also very common. At least half of people with Parkinson’s experience depression. Depression can last for weeks or more. Depression can also be caused by Parkinson’s, as Parkinson’s affects brain chemicals that have to do with mood, energy levels, and motivation.

Symptoms of depression can be mild or severe and are different in everyone. Some common symptoms include:

• Feelings of helplessness, hopelessness, or worthlessness
• Sadness that doesn’t go away
• Fatigue or low energy
• Changes in appetite
• Feelings of guilt or being a burden to loved ones or caregivers
• Sleep problems (sleeping either too little or too much)
• Thoughts of suicide
• Lack of motivation or interest in activities you usually enjoy (apathy), which can happen in Parkinson’s with or without depression

Depression may be treated with a combination of antidepressant medication and therapy along with lifestyle changes, such as getting more exercise and seeking social support.

Fatigue is common among people with Parkinson’s. It often shows up early on in the disease, but it can happen at any point. Fatigue with Parkinson’s can go beyond ordinary tiredness. It may feel like extreme exhaustion that makes movement seem impossible. “Some days, I feel I get nothing done because all I want to do is nap,” one member shared.

Sleep problems affect the majority of people with Parkinson’s and can contribute to fatigue. Sleep problems with Parkinson’s are caused by the way Parkinson’s affects the brain. Problems with sleep may also happen as a side effect of some Parkinson’s medications. You might notice sleep problems before motor symptoms. Some common sleep problems include:

• Trouble falling and staying asleep (insomnia)
• Restless legs syndrome
• Excessive daytime sleepiness
• Shallow or paused breathing that interrupts sleep
• Physically or verbally acting out your dreams (rapid eye movement sleep behavior disorder)

Although there is no singular proven treatment for Parkinson’s-related fatigue, there are some ways to fight it. For example, your healthcare provider might adjust your medication doses if they’re making you tired or address hidden roadblocks to sleep to help restore your daytime energy. In addition, your doctor may recommend treating other Parkinson’s symptoms that contribute to fatigue, such as sleep problems or depression.

People with Parkinson’s may experience cognitive impairment, such as issues with thinking and memory. Cognitive changes might also include difficulty staying focused, finding the right words, or solving problems. Cognitive problems may develop into dementia as Parkinson’s progresses.

Parkinson’s or Parkinson’s medications might also cause behavioral changes, such as irritability and impulsivity. Impulse-control disorders (ICDs) may be a side effect of dopamine agonists. Tell your doctor right away if you experience signs of an ICD, including gambling, compulsive shopping, or hoarding. This could mean your medications need to be adjusted.

Parkinson’s-related dementia, delirium, and medications can also cause psychotic episodes that include hallucinations and delusions. Between 20 percent and 40 percent of people with Parkinson’s experience hallucinations or delusions. They’re even more common as Parkinson’s progresses.

Medication and behavioral management strategies are used to treat cognitive changes. Certain antipsychotic medications may be used to treat psychosis in Parkinson’s, but because some dopamine-blocking antipsychotics can worsen Parkinson’s symptoms, the decision requires extra care and consideration.

More than 80 percent of people with Parkinson’s experience pain. For some, it’s their worst symptom. Common types of pain with Parkinson’s include:

• Pain in the muscles (rigid aches) and bones
• Sharp pain or tingling and numbness from crushed nerves
• Painful muscle spasms
• Pain in certain areas of the body or all over

Some people with Parkinson’s may also experience abdominal pain and joint pain. Because joint pain is commonly associated with age-related conditions such as arthritis, it can be hard to know if it’s directly caused by Parkinson’s.

Pain with Parkinson’s may be ongoing and can make it harder to do everyday activities. Treatment for pain in Parkinson’s depends on what’s causing the pain. For example, muscle relaxants may reduce pain caused by muscle spasms. A personalized exercise plan made by a physical therapist can help with most pain, including pain in the muscles and bones.

Because Parkinson's slows down the autonomic nervous system governing digestion, chronic constipation is common among people with Parkinson’s. It usually shows up before motor symptoms and is often an ongoing problem throughout the disease.

In addition to not having a bowel movement for days, constipation symptoms might include bloating, straining to poop, and not feeling done after pooping. Constipation with Parkinson’s might be caused by nerve changes that make it harder to push food through the gastrointestinal tract.

Constipation can be treated with diet and exercise, but for some people, medications such as laxatives may be needed.

Problems with urinating are also common among people with Parkinson’s, including a frequent and urgent need to pee. Studies from the Parkinson’s Foundation have found that about 30 percent to 40 percent of people with Parkinson’s experience problems with urinating.

Urinary incontinence (leaking pee) may also occur with Parkinson’s, but it’s less common. Urinating problems can be treated with medication and may need expert help from a bladder specialist.

Sexual problems are common among people with Parkinson’s, more often for men than women, according to the Parkinson’s Foundation.

Parkinson’s disease itself might cause sexual dysfunction because it leads to decreased dopamine, which is important for feeling pleasure. Other factors, such as mood disorders or fatigue in Parkinson’s disease, can also contribute to sexual dysfunction. In addition, some Parkinson’s medications, such as dopamine agonists, affect sex drive.

Problems with sex due to Parkinson’s include:

• Low libido (lack of desire to have sex)
• Difficulty with movements during sex
• Inability to orgasm
• Erectile dysfunction
• Very high or compulsive sex drive

Treatment for sexual problems with Parkinson’s often involves open communication, sex therapy, or couples therapy.

Changes in voice volume and the safety of your swallowing are critical health markers. Parkinson’s can lead to speech and swallowing problems. This is because Parkinson’s affects the nervous system and causes problems with the nerves and muscles used for speech and swallowing.

Speech problems are often one of the earliest signs of Parkinson’s. Problems with speaking can make everyday conversations difficult. Speech problems may include:

• Speaking quietly
• Speaking in a monotone
• Stuttering, stammering, or mumbling
• Slurring words

Swallowing also becomes harder for many people with Parkinson’s. Swallowing problems can be mild or severe. For example, it might just take longer to finish eating, or it can be more serious, like choking. “I choke all the time and lose my voice, too. My husband used to say I hollered at him. Now he can’t even hear me speak,” one member shared.

The primary treatment option for speech and swallowing problems is working with a speech-language pathologist. They can recommend communication devices to help with a soft voice and individualized training, including exercises, swallowing strategies, or modifications to food and liquids to prevent dangerous choking risks.

For some people, Parkinson’s disease can lead to vision changes because of how Parkinson’s affects the eye muscles and reduces blinking. If Parkinson’s disease affects your eyesight, you might experience blurry vision, double vision, or trouble seeing objects that are close to you.

Anticholinergics taken for Parkinson’s disease can also affect your eyesight. Tell your doctor if your vision becomes blurrier while taking anticholinergics or other medications for Parkinson’s disease.

Orthostatic hypotension is a drop in blood pressure that happens when you change positions, like when you sit up after lying down or stand up from a seated position. This can lead to a range of temporary symptoms, including:

• Dizziness, lightheadedness, or vertigo
• Trouble thinking or concentrating
• Headache
• Dim or blurry vision
• Muscle weakness

When orthostatic hypotension occurs as a nonmotor symptom of Parkinson’s disease or another neurologic disorder, it’s called neurogenic orthostatic hypotension (nOH). In Parkinson’s, this can happen because the nervous system either can’t make or doesn’t release norepinephrine, which is a chemical that constricts your blood vessels to increase blood pressure.

Because orthostatic hypotension can be associated with some medications, your doctor will review your medications if they determine you have nOH. They might suggest behavior changes to minimize symptoms, including drinking more water, avoiding long periods of sitting, or eating frequently.

Hyposmia, or a reduced ability to smell, is one of the most common nonmotor symptoms of Parkinson’s. Some people may notice a loss of their sense of smell years or even decades before they experience motor symptoms, likely because of damage to nerves and structures involved in smelling.

The sense of smell is closely linked to the sense of taste, so if you experience hyposmia, you may notice changes in the way food tastes, too. This may result in a reduced appetite or reduced enjoyment of food.

While there aren’t any proven treatments to increase the sense of smell, there are steps you can take to manage any appetite changes or weight changes resulting from your impacted sense of taste. A dietitian or nutritionist can help you make sure you’re eating enough despite these changes.