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Living with any chronic illness can be difficult, and it's normal to feel angry, depressed or discouraged at times. Parkinson's disease presents special problems because it can cause chemical changes in your brain that make you feel anxious or depressed. Medications used to treat the disease can also cause depression and other mental changes. Furthermore, Parkinson's disease can be profoundly frustrating, especially in the advanced stages when ordinary tasks take longer to accomplish and walking, talking and even eating become more difficult.

• Depression

Some of the following suggestions may help you deal with the stress of living with Parkinson's disease:

Learn all you can about your illness. Find out how the disease progresses, your prognosis, and your treatment options and their side effects. The more you know, the more active you can be in your own care. In addition to talking to your health care team, look for books and information on the Internet, including the Web sites of various Parkinson's disease organizations.

Be proactive. Although you may often feel anxious or discouraged, don't let others — including your family and your doctors — make important decisions for you. Take an active role in your treatment.

Maintain a strong support system. More and more studies show that strong relationships are crucial in dealing with chronic illnesses. Although friends and family can be your best allies, the understanding of people who know what you're going through can be especially helpful.

Minimize work-related stress. A diagnosis of Parkinson's disease doesn't mean you have to stop working. In fact, 25 percent to 35 percent of people with the disease continue to hold either full- or part-time jobs. But you may need to approach work differently. Start by breaking your job down into individual tasks. Then consider whether your symptoms will affect your ability to perform each task.

Next, try to create a schedule that allows you to do the most challenging assignments when you're at your peak. In some cases, you may consider telecommuting, working part-time or even changing jobs.

Although you may not feel comfortable talking about your illness, in many cases it's best to be candid with your supervisor. That way, he or she can work with you to make the adjustments necessary to meet your needs. On the other hand, you're under no legal obligation to disclose your condition to your employer as long as you can do your job.

Maintain good communication with your partner. It's extremely important for couples to be open about their feelings, especially when it comes to living with Parkinson's disease. The disease may change your life and the lives of your loved ones in a number of ways. It's best if you can talk honestly about these changes. For instance, if you're no longer able to work full time, there may be financial issues that need to be resolved. The amount of care a person with Parkinson's disease needs is also often an issue. Because it may take you longer to do ordinary tasks, your partner might want to help. But most people with Parkinson's disease like to remain as independent as possible. You'll need to let your partner know when you need help and when you don't.

Sometimes couples also experience sexual problems. Parkinson's disease makes it more difficult to move easily, which can affect intimacy. In addition, some men with Parkinson's disease may have problems with impotence and women may experience decreased desire (libido). This may be the result of antiparkinson medications or of the disease itself. But these problems can often be helped. For instance, medications such as sildenafil (Viagra) have proved beneficial for many men with Parkinson's disease.

In addition, try to schedule time together when your medications are at their peak and you're less likely to be troubled by symptoms. And keep in mind that intercourse is only one way to be intimate. Just cuddling or holding each other often can deepen a relationship and make it more emotionally satisfying.

Most important, try to talk frankly about your feelings and concerns. Repressed feelings can be harmful to your immediate well-being and long-term health. If necessary, discuss your problems with your doctor or counselor.

Be honest with children. If you have children, don't try to hide the diagnosis from them. Children can usually sense when something is wrong in the family, and the anxiety and fear of not knowing is often harder on them than knowing the truth.

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