In the wake of Robin William’s tragic suicide this past week, I felt compelled to share some thoughts on not only the topic of suicide, but also the association between Parkinson’s disease (PD) and depression.  Research is showing how depression is directly caused by the neurochemical changes that occur in PD, specifically the loss of dopamine in the frontal lobe and the lower parts of the brain – the same areas that cause the motor changes in PD.  Often times, however, depression goes untreated in cases of PD because many of the symptoms of these two conditions overlap.  For example, fatigue, sleep difficulties, loss of energy, psychomotor slowing, problems concentrating and sexual dysfunction are all symptoms of both depression AND Parkinson’s.  If untreated, depression can actually make the motor symptoms of PD worse because individuals are less motivated or interested in doing the beneficial treatments, such as exercise, that clearly have been shown to improve motor symptoms and thereby improve the quality of life for individuals with PD.  A diagnosis of PD, while certainly life-changing, does not have to be life-ending.  Receiving treatment for not only the motor symptoms, but also the psychiatric symptoms of PD, allows patients and their families to life to the fullest.  As tragic as the loss of Mr. Williams was this week, it may serve as the necessary impetus for broader discussion about suicide, depression and Parkinson’s disease, hopefully diminishing the stigma attached to these diseases.