• Involuntary trembling
• Postural instability--difficulty with balance
• Muscle rigidity
• Loss of spontaneous movement, slowness, shuffling walk
• Depression
• Stiff facial expression

This disease can also impact thinking and emotions. Symptoms of depression, which are different than symptoms of depression found in individuals without Parkinson's, include high rates of anxiety, anger, apathy, lack of energy and lack of pleasure, and sadness with no connection to guilt or self-blame. As the disease progresses, patients may have difficulty in adjusting psychologically to its challenges. This can result in problems not only for the patient, but also others close to the patient. Family caregivers need to establish effective boundaries on their own emotions and capabilities to deal with loved ones afflicted with a chronic disease like this.

It is easy to confuse doing with caring. Caregiving is also about knowing how to take care of yourself and coming to terms with the fact that you cannot do it all alone. The average time interval involved with caregiving is four years. There can be ominous mental, physical and emotional consequences for caregivers taking care of a family member for that length of time.

Caregivers, when compared with noncaregivers, tend to suffer from inferior general health, higher occurrences of hospitalization and weakened immune responses, which means a higher rate of infection and risk for cancers. Depression and anxiety disorders and alcohol and substance use are also more common. Stress and emotional exhaustion lead to withdrawal from social activities and errors at the workplace. Caregivers dealing with these issues cannot effectively look after chronically ill family members. Respite care by other relatives, friends, in-home companion care companies or any other means of relief are necessary for the well being of all concerned parties.