By Kate Kelsall
When I was diagnosed with Parkinson’s Disease (PD) in 1996, I quickly became familiar with the physical challenges of PD: tremors, slowness, stiffness, and postural imbalance. Had I known then about the non-motor or behavioral symptoms that frequently accompany this condition, I might have felt overwhelmed. But during the past 17 years in my journey with PD, I am no longer afraid of the good, the bad, and the ugly of PD. I have come to realize the benefits from examining all aspects of PD, I’ve learned that knowledge is power, and I’ve been able to be proactive in taking charge of and managing my PD.
Making the Connection Between Brain and Behavior: Coping with Parkinson’s Disease, Second Edition, (Demos Health, released August 13, 2013) by Joseph H. Friedman, MD is the only book that focuses entirely on an often overlooked area, the behavioral aspects of PD, including depression, anxiety, apathy, fatigue, hallucinations, delusions, confusion and delirium, disrupted sleep and compulsive behavior. Managing the behavioral aspects of PD has a huge impact on the quality of life of the patients and their families, and the good news is that many of these symptoms are treatable.
Dr. Friedman really “gets it” when describing PD-related behavioral issues. He illustrates his book with patient vignettes and excerpts from patient interviews where he digs deeper until he fully understands his patients’ experiences. His conversational style of writing and easy-to-understand language, allows his readers to benefit from his knowledge.
Tidbits of Dr. Friedman’s wisdom include the following:
About PD and Sleep Disorders: “In a nutshell, people with PD have difficulty getting comfortable in order to fall asleep. They frequently have pain. They can’t turn over. The tremor keeps them awake. They can’t get their head to lie comfortably on the pillow. They’re anxious and stay awake worrying about all sorts of things, whether they are worth worrying about or not. Then once they are asleep they awaken because their bladder is hyperactive. The tremor wakes them up. They napped for two hours during the day so they don’t need much sleep at night.” (p. 52-53)
About PD and Anxiety: “In some patients the anxiety develops only during “off” periods, that is, when the PD medications stop working and the patient loses mobility. Many patients, despite suffering through these episodes thousands of times, still feel as if they’re never going to snap out of it and become extremely anxious whenever their medications stop working.” (p. 68)
This book also has information on PD medications and the side effects that can lead to behavioral problems. Each chapter focuses on one specific issue which allows the reader to choose only the chapters from which they want to read. Dr. Friedman provides information on the treatment of these behavioral symptoms, specific tips for care partners in dealing with their partners’ symptoms, as well as practical suggestions to avoid burnout and maintain their own quality of life. There is also surprising information about why people with Parkinson’s shouldn’t go to the Emergency Room.
This book is written for individuals with PD, their care partners, families and loved ones. It helps the reader understand, address, and cope with common behavioral issues. Physicians and other health care professionals who work with those with Parkinson’s can also benefit by learning about the relationship between the brain and behavior and the impact neurology has on all facets of a patient's quality of life.
As a person living well with Parkinson’s, I benefited from reading and highly recommend Making the Connection Between Brain and Behavior: Coping with Parkinson’s Disease.
About Joseph H. Friedman, MD:
Dr. Friedman is the Director of the Movement Disorders Program at Butler Hospital; Professor and Chief, Division of Movement Disorders at the Alpert Medical School of Brown University; Adjunct Professor in the School of Pharmacy at the University of Rhode Island; and the Clinical Director of the American Parkinson’s Disease Association Information and Referral Center in Warwick, Rhode Island.
Author of Making the Connection Between Brain and Behavior: Coping With Parkinson's Disease (first and second editions) and co-author of Taking Charge: Good Medical Care for the Elderly and How to Get It, Dr. Friedman has also authored or co-authored over 400 papers, abstracts, and book chapters on a variety of topics related to movement disorders and has also presented numerous lectures to neurologists, psychiatrists, internists, health professionals, and patients throughout the United States and around the world.
In addition, Dr. Friedman is the recipient of the Aronson Chair for Neurodegenerative Disorders.