Parkinson’s disease (PD) is a neurological disorder that can cause movement problems and behavioral changes, such as irritability and anger. These behavioral changes may occur together with cognitive problems and forms of psychosis, including delusions, hallucinations, or paranoia. Behavioral and mood changes in people with Parkinson’s can be especially hard for family members and caregivers, as MyParkinsonsTeam members often share.

“Are outbursts of verbal anger and a hateful tone part of PD? Hubby is getting more difficult,” wrote one member. Another member shared, “Today is OK, but a couple days ago my husband with Parkinson’s had an angry outburst at a friend’s house. It was quite embarrassing — and it was over nothing. My friend and her husband were both shocked and afraid.”

“My mom is more confused and very irritable as well. She says things that she would never have said before,” a member said.

Read on to learn more about what causes anger outbursts with Parkinson’s and how to manage mood changes, including tips on caregiving and self-care when things get tough.

What Causes Anger and Irritability in Parkinson’s Disease?

The emotional toll of a Parkinson’s diagnosis and dealing with motor and nonmotor symptoms can lead to feelings of frustration, shame, or fear. These challenging emotions can then lead to mood changes like anger and irritability.

However, Parkinson’s disease itself can cause mood disorders. Parkinson’s causes a decrease in dopamine, a chemical messenger that affects both movement and mood. Low dopamine levels are linked to an increase in depression and anxiety in people with Parkinson’s. The disease also causes changes to a protein in the brain called alpha-synuclein. This protein is linked to behavioral changes and cognitive impairment in people with Parkinson’s. Cognitive impairment can lead to feelings of confusion, insecurity, and anger.

Parkinson’s can also cause changes in brain chemistry, which can lead to psychosis. Psychosis may include:

• Delusions
• Hallucinations
• Paranoia
• Passage (the sense that someone is walking by when no one is there)
• Agitated behavior

Some medications for Parkinson’s that treat low dopamine may result in psychosis-like behavior as a side effect.

Behavioral and mood disorders may be treated with antidepressants, selective serotonin reuptake inhibitors (SSRIs), or antipsychotic medications like clozapine, along with mental health counseling.

Managing Anger and Irritability in Parkinson’s as a Caregiver

Informal caregivers — particularly family members — often play an important role in helping and caring for loved ones with Parkinson’s. Research has shown that caring for someone dealing with cognitive and mental dysfunctions from Parkinson’s is especially hard. These caregivers experience more burden and a lower sense of well-being and quality of life than caregivers of people with Parkinson’s who don’t have significant cognitive decline. Many caregivers of people with Parkinson’s experience anxiety and depression.

The stress of caregiving is a common topic of conversation on MyParkinsonsTeam. One member wrote, “My wife has Parkinson’s. It is hard to deal with all her ups and downs. We are both exhausted.”

Another member wrote about her husband with Parkinson’s: “His dementia is hard. He is emotional at times, angry at times, and is not aware where he is at times.”

A third member said, “My husband has Parkinson’s, dementia, diabetes, and a bad heart. It is getting more and more difficult to give him his medications, as he gets very angry and does not take them.”

It’s important to remember that anger and irritability in people with Parkinson’s is often a part of the disease. It’s not your fault.

Caregiving Tips for Parkinson’s Disease With Psychosis

Dealing with delusions, in particular, can be challenging. A delusion is when someone has a strong belief about something that isn’t true. Hallucinations, on the other hand, are when someone senses something that isn’t there. Hallucinations can involve sight, sound, smells, touch, or other sensations. It’s very important for care partners to plan ahead for disease progression — including behavioral changes.

“My husband has PD dementia. He suffers from delusions and some paranoia. The past week or so has been difficult. He believes the delusion so strongly that it keeps him stressed. At times he won’t eat, and he is having trouble sleeping,” wrote a member.

“I am a caregiver for my husband,” another member said. “His physical symptoms are getting worse, but the mental issues are by far the hardest to deal with. His paranoia, delusions, and hallucinations have gotten so bad that I am exhausted just trying to reassure him. I can’t remember the last time I have gotten a good night’s sleep. My husband naps all day long, then is up most of the night. I try to nap when he does, but it’s just not restful sleep.”

Here are some tips for caregivers on caring for someone with Parkinson’s who’s dealing with psychotic symptoms:

• Talk to their neurologist about any difficult or concerning symptoms. It may be necessary to adjust their meds.
• Don’t try to argue or reason with someone who has hallucinations or is delusional. Find strategies to distract them and help them calm down.
• Stay calm and respond in a gentle way.
• Keep everyone safe by hiding dangerous objects, car keys, or weapons. If a situation feels threatening or dangerous, have emergency contact numbers available, and call 911 or emergency services if needed.
• If caregiving is overwhelming, ask for help from family, friends, or resources for professional caregivers.

Self-Care for Caregivers

It’s very important for caregivers of people with Parkinson’s to find ways to cope with their own stress, especially when dealing with a loved one’s anger, agitation, or any psychotic symptoms of Parkinson’s. Here are some things you can do to help manage the challenges of caregiving:

• Be open to help when it’s offered. Let people know how they can help because they may not know what to do.
• Encourage the person you are caring for to handle tasks they can do themselves. This can help take some weight off your shoulders.
• Find time for yourself. Even short periods of time to read or relax are important.
• Exercise regularly to stay healthy, sleep better, and reduce stress.
• Participate in an in-person or online support group, like MyParkinsonsTeam.

If you’re feeling overwhelmed, talk to your health care providers. They can refer you to therapy or counseling to help you manage stress as a caregiver.

Talk With Others Who Understand

MyParkinsonsTeam is the social network for people with Parkinson’s disease and their loved ones. On MyParkinsonsTeam, more than 102,000 members come together to ask questions, give advice, and share their stories with others who understand life with Parkinson’s.

Are you caring for someone with Parkinson’s and dealing with anger and irritability? Do you have tips or questions about mood changes and Parkinson’s? Comment below, or start a conversation on your Activities page.