Information given to Dr Katherine Deane – Senior lecturer in research at University East Anglia, Norwich on a Clinical study on stress and anxiety

First let’s look at what stress and anxiety actually are. Well in my opinion Stress is a feeling that is caused by the Pituitary and Adrenal glands releasing a hormone called cortisol, normally as a result of exercise or excessive heat. It is also produced when we have an adrenalin rush, a deadline to meet, or an occasion which is outside our normal habitual routine In the short term and on a daily basis it is undramatic and will fluctuate aligned with the Circadian Rhythm (24 hour body clock) It is expected that cortisol levels will be lower in the morning after a period of sleep and will be at their highest in the evening before a period of sleep. In between this period it can be influenced by the activities which define our lifestyle such as exercise, work, leisure, nutrition, our mindset and rest /sleep. Light and Darkness, and temperature extremes will also be factors that can explain our stress levels.

Anxiety on the other hand is an extension of the stress feeling and is an emotion caused by fear and other psychological factors which are fixed and remain sustained over a longer period.

To alleviate stress in the short term there are 2 therapies meditation ( Breathing control) and sleep ( Both types of sleep , Rem sleep – Dreaming sleep that helps process mental clutter and create a sense of being rested and vibrant and SWS – Deeper non dreaming sleep that helps in the restoration of hormones and muscles). In the longer term and a diagnosis of anxiety needs a different approach and we need to look at lifestyle and state of mind. It’s anxiety that in my opinion is prevalent with Parkinson’s disease and therefore, we need to identify the trends and patterns of stress that appear consistent with anxiety and educate and provide information via experts (Psychologist) that will enable the patient to be self aware and give him the choice to change his habitual attitude to overcome his anxiety.

First to my knowledge there are 3 methods of quantifying cortisol, Saliva, Blood and Hair. The most accurate measure is as you point out blood assessment. I think to identify whether a Parkinson’s patient has anxiety we need to look at cortisol levels twice daily for the same 3 days a week for a period of 3 weeks. I am not an expert when it comes to pathology so we would need to liaise with a pathologist on the method and volume of blood required to give us the gold standard of assessment. To enable them to provide an accurate report we would first require the patient to complete a questionnaire giving us indicators on lifestyle, nutrition, other underlying health issues and other factors which could influence the levels of cortisol such as medication and age. So we can provide an unbiased report the more patient’s we can include within this trial the better but I do recognise the cost implications.

Mr Danny James Lavender MBE- Parkinson’s patient and advocate –1 May 2015