Understanding and Coping with Parkinson's Disease Psychosis

Understanding Parkinson's Disease Psychosis and Hallucinations

Parkinson's disease is a progressive neurological disorder that affects movement and motor skills. As the disease progresses, many people with Parkinson's will experience hallucinations and delusions known as Parkinson's disease psychosis. Hallucinations involve seeing, hearing, feeling, tasting or smelling things that are not really there. Delusions are strong beliefs that are not based in reality. These psychotic symptoms can be frightening for both the person with Parkinson's and their loved ones. However, there are ways to manage and treat Parkinson's disease psychosis to improve quality of life.

What Causes Hallucinations and Delusions in Parkinson's?

Researchers believe there are several factors that contribute to psychosis in Parkinson's disease:

• Chemical changes in the brain - Loss of dopamine and imbalance of other neurotransmitters play a role.
• Medication side effects - Some Parkinson's medications, especially dopaminergic drugs, can trigger psychosis.
• Sleep disorders - Lack of REM sleep and vivid dreaming are common in Parkinson's.
• Lewy body disease - Abnormal protein deposits called Lewy bodies affect cognition.
• Age-related changes - Older age increases the risk of Parkinson's psychosis.

Common Hallucinations in Parkinson's

Visual hallucinations are one of the most common types of hallucinations in Parkinson's disease psychosis. People may see images of animals, people, patterns or objects that are not really present. Examples of visual hallucinations include:

• Seeing bugs, insects or animals crawling on walls, floors or skin
• Seeing children or "shadow people"
• Seeing distorted faces or monsters
• Seeing wavy lines, grids, latticework or floral patterns

Auditory hallucinations involve hearing sounds that others cannot hear. Common auditory hallucinations include:

• Hearing doors slamming, guns firing, glasses clinking or phones ringing
• Hearing music or voices murmuring or talking when alone
• Hearing someone call the person's name

Other types of hallucinations may involve smelling odors like smoke, feeling sensations like crawling insects, or tasting flavors that are not really there.

Common Delusions in Parkinson's Psychosis

Delusions often involve paranoid or irrational thoughts. Some examples of delusional beliefs due to Parkinson's disease psychosis include:

• Belief that spouse is cheating
• Belief that someone is trying to harm or kill them
• Belief that spouse or caregiver is an imposter
• Belief that family members are stealing money or property
• Belief that there are hidden cameras in their home

Delusions make the person distrust those closest to them. They can sometimes lead to dangerous actions if the delusion involves paranoia or fear.

True Stories of Parkinson's Psychosis from Patients and Caregivers

Visual Hallucinations of Bugs and Shadows

"When my mom first started seeing hallucinations, she thought there were bugs crawling on her arms and legs. She would be constantly brushing off imaginary ants and beetles. Then she progressed to seeing black shadows moving across the walls. We took her to a neurologist who diagnosed her with Parkinson's disease psychosis and adjusted her medications. The hallucinations improved, but she still sees the occasional shadow." - Lisa, daughter and caregiver

Conversations with Deceased Father

"My father had Parkinson's for many years before he started hallucinating. At first, we thought his stories about conversations with dad were just dreams. But then he started talking to his father (who died over 40 years ago) like he was physically present in the room. Once my father even 'introduced' me to his father and asked why I wouldn't shake his hand. That's when we realized he was having hallucinations." - Michael, son and caregiver

Accusing Spouse of Infidelity

"When my wife started accusing me of seeing another woman, I was confused and hurt. She would see me talking innocently to a friend or neighbor and become convinced I was having an affair. Her delusional jealousy put a heavy strain on our marriage. It was very tough to convince her the delusions weren't real. I had to keep reminding her of our decades together and showing extra patience and love." - David, spouse and caregiver

Paranoia of Caregiver Plotting Against Them

"Caring for my mom's Parkinson's got extremely hard when the psychosis kicked in. She was convinced I was scheming with the doctor to lock her away and steal her money. Every time I tried to help her take medication or get dressed, she thought I was trying to harm her. When she angrily lashed out at me, I had to remember it was the illness making her paranoid and not my real mom." - Teresa, daughter and caregiver

Disorientation and Hallucinations of Being Abducted

"One of the scariest experiences in my life was when my Parkinson's hallucinations made me believe I was abducted by aliens. In my vivid hallucination, brightly colored aliens with huge eyes paralyzed me and took me into a spaceship. I was terrified they were going to experiment on me. When I snapped out of it, I was just standing next to my bed in the dark, with my heart racing." - Gabriel, person with Parkinson's disease

Auditory Hallucinations of Angry Voices

"The first hallucinations I experienced with Parkinson's were hearing angry, critical voices when no one was around. The voices scared me at first - they would shout insults and nasty names. Later on, the voices became more comforting and friendly. I actually started to enjoy the company of my imaginary friends, since I live alone. But it did concern my children when I told them about the voices." - Mary, person with Parkinson's disease

Visual Hallucinations During Visits from Family

"When my family comes to visit, I see extra people in the room that aren't really there. I'll talk to my son and daughter-in-law as well as a woman in a purple dress who stands behind them. I assumed it was my daughter's friend. But when I asked about her, they gave me strange looks. I realized later that she must be a visual hallucination related to my Parkinson's disease and psychosis." - James, person with Parkinson's disease

Tips for Coping with Parkinson's Hallucinations

Living with Parkinson's disease hallucinations and psychosis can be extremely challenging. Here are some tips for coping:

• Seek treatment right away - Consult doctors about medication adjustments and other strategies.
• Provide reassurance - Remind the person the hallucinations are not real without arguing.
• Consider safety measures - Remove weapons or hazardous objects if delusions or paranoia could lead to harm.
• Note triggers for hallucinations - Track activities, times, medications, sleep patterns and symptoms in a journal.
• Encourage socializing - Loneliness and isolation tend to make hallucinations worse.
• Limit caffeine and alcohol - Stimulants and depressants can exacerbate psychosis.
• Try calming activities - Listen to music, go for walks outside, or do puzzles together.
• Improve sleep habits - Get on a regular sleep schedule and limit daytime napping.
• Join a support group - Connect with others dealing with Parkinson's psychosis challenges.

While Parkinson's hallucinations can be disruptive, treatment and management strategies allow many people to live full, active lives. Being proactive and accessing resources for support can help both individuals with Parkinson's and their loved ones.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.