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hi all this excerpt addresses the issues around being visible or invisible aka to be seen or not to be seen [sorry dennis] janet ----------------------------------------- At the early stages of Parkinson's disease, most individuals are physically and cognitively able to continue participating in nearly all social, vocational, and recreational activities. Some patients tend to withdraw from activities due to embarrassment about their symptoms, especially tremor. In the early stages of their illness, some patients are afraid to let others know that they have Parkinson's disease, and they devote significant effort to hiding their symptoms. Attempting to conceal symptoms can lead to increased anxiety, which in turn can cause an increase in the symptoms of Parkinson's disease. Those patients who have been able to inform others about their illness, its symptoms, and treatment tend to be the individuals who cope best at the early stages. Case summaries of two individuals with an early stage parkinsonism who used vastly different strategies in terms of coping with their Parkinson's disease illustrate this issue. Both of these individuals were college professors in their late fifties. The first person readily accepted her Parkinson's disease. She often took the opportunity to tell others about it and emphasized that it was not a major issue for her. In this example, the patient used the emotional strategy of coping by accepting her condition. On the first day of the semester, she would inform her class,'I have Parkinson's disease. 'It is usually well controlled by the medications I am taking, but some days you may notice that I have tremor or that I may have difficulty writing on the blackboard. 'I hope you will be understanding about this.' She found that once she told the students about her Parkinson's disease and did not appear distressed about it, her ailment was no longer an issue for her or for the class. In contrast, the second patient was frightened that others would find out about his Parkinson's disease. He tried to alter his environment in order to hide his symptoms, a coping mechanism that proved less than successful. When lecturing to his classes, he would arrange to speak from behind a lectern so that his tremulous hands were out of sight of the audience. He faced each lecture with a high level of anxiety that only interfered with his ability to give a lecture and exacerbated his Parkinson's disease symptoms. Nondisclosure of symptoms increases the stress of the illness and interferes with successful adaptation needed for managing Parkinson's disease. Individuals who use denial or avoidance as a primary coping strategy are most likely to attempt to conceal their diagnosis from others. At early stages of Parkinson's disease, this strategy may actually work for a period of time, but this strategy usually fails as the illness progresses. Social withdrawal due to embarrassment about early stage symptoms of Parkinson's disease has been a major issue for many patients. Those patients who withdraw from their usual social and recreational activities are most likely to experience depression. Depression is a common accompaniment of Parkinson's disease. In the early and middle stages of Parkinson's disease, the level of depression is a function of self-appraisal processes. The best predictor of depression is a person's self-rating of her/his own disability. Self-appraisal processes and the use of appropriate coping strategies can reduce the degree of emotional distress that a patient experiences. ----------------------------------------- Note: the above excerpt is from the following message: >----------------------------------------- >Subj: PS: Psychosocial Factors in the Treatment of PD >Date: 02 February 1998 >From: janet paterson >----------------------------------------- > >"re-re-post" > >hello cyber-siblings > >there seems to be a flock of new members on the list [siblets?] >and i thought it might be helpful to re-post this article >since there were so many positive reactions last time > >your psycho-social cyber-sis >janet >original posted 19 September 1997 >----------------------------------------- >Psychosocial Factors in the Treatment of Parkinson's Disease: >A Contextual Approach >----------------------------------------- >by >Robert G. Feldman, M.D., >Peter Mosbach, Ph.D., >Cathi-Ann Thomas, R.N., M.S., and >Linda M. Perry, R.N., M.Ed. >This is an excerpt of Chapter 14 from the book >The Comprehensive Management of Parkinson's Disease, 1995 >Demos Vermande Publications, 386 Park Avenue, New York, NY 10016 janet paterson 51 - 10 / sinemet - selegiline - prozac almonte - ontario - canada / [log in to unmask]