Huntington's disease impairs the functioning of the brain, which can result in apathy, trouble organizing, impulsivity, irritability and anger, unawareness, disinhibition, preservation, and other psychiatric symptoms. These emotional and behavioral symptoms can further complicate the caregiver's role.
memory lapses. depression – including low mood, a lack of interest in things, and feelings of hopelessness. stumbling and clumsiness. mood swings, such as irritability or aggressive behaviour.
These patients often display a range of psychiatric symptoms, for example hallucinations or low mood, which coexist with behavioural change and symptoms such as apathy, irritability and aggression.
People with Huntington's may also be less able to control their emotions, possibly leading to outbursts of screaming, swearing, slamming doors, hitting walls, or the like. Patterns of behavior can change as the disease progresses.
HD patients present a broad range of psychological disturbances such as cognitive rigidity, mood disturbances, lack of empathy and breakdowns of social relationships that might also manifest even before the onset of motor dysfunction (Marvel and Paradiso, 2004).
Huntington's disease is a rare, inherited disease that causes the progressive breakdown (degeneration) of nerve cells in the brain. Huntington's disease has a wide impact on a person's functional abilities and usually results in movement, thinking (cognitive) and psychiatric disorders.
During the early stages of HD, irritability, depression, anxiety and aggression are common behavior symptoms. In the later stages, individuals tend to be less irritable and aggressive, as apathy and a lack of concern become more pronounced.
It affects approximately six people per 100,000 across Europe, North America, and Australia, with lower documented prevalence in Asia (4). Common emotional and behavioral difficulties among persons with HD include depression, anxiety, irritability-anger, aggression, perseveration, disinhibition, and apathy (5–14).
Weight loss can make symptoms worse and weaken the patient's immune system, making them more vulnerable to infections and other complications. Huntington's disease itself is not usually fatal, but it can lead to choking, pneumonia, or other infections that can lead to death.
The bottom line. Being physically and mentally active in life is good for everyone, and particularly for those at risk of developing HD, because it might affect symptom onset.
Although not directly related to HD, stress is nevertheless related to the progression of the disease because it adds to the neurodegeneration that is already taking place. Chronic stress can alter nerve cells, brain structure, and brain function.
Huntington's disease also causes a decline in thinking and reasoning skills, including memory, concentration, judgment, and ability to plan and organize. Huntington's disease brain changes lead to alterations in mood, especially depression, anxiety, and uncharacteristic anger and irritability.
Huntington's disease (HD) is an autosomal dominant neurodegenerative disorder that usually starts in mid-adult life. The clinical disease progresses to death over an average of 20 years.
Many people with Huntington's disease report that their sleep patterns are affected and sometimes are awake most of the night, then continually catnap or doze throughout the day. Many find themselves experiencing long periods being awake or asleep.
Categorizing Psychiatric Issues in HD
The first consists of mental illnesses which are common in the general population and are readily recognized by physicians, especially major depression, which has been estimated to affect 40% of people with HD at some point during their illness.
Stage 5: Advanced Stage
The fifth and final stage is when the disease will be more severe, and it's likely that the individual will require care 24/7. They will likely be immobile, unable to communicate and find it extremely difficult to perform basic motor functions such as swallowing.
Psychosis is a rare symptom complex that occurs in Huntington's disease and has a negative impact on the quality of life for patients. Psychiatric manifestations vary and may precede motor and cognitive changes. Personality changes and depression occur most commonly.
Of the troubling behavioral changes that occur with the onset of Huntington's disease (HD) and Juvenile Huntington's disease (JHD), and there are many, one of the most troublesome can be hypersexuality.
The overall presentation of HD was considered to be initially mild by most families in this study, but progression in motor and/or behavior symptoms eventually occurred in all 30 subjects evaluated more than once.
Impaired social functioning is a key feature of Huntington's disease (HD). In addition to motor limitations that prevent social participation (e.g., fall risk, driving cessation), personality changes caused by cognitive and psychiatric decline alter social functioning capacity in people with HD.
Unawareness of motor, cognitive, behavioral, and functional aspects of HD has been documented throughout the disease course. This can occur at motor and cognitive onset but is more pronounced as the disease progresses.
People with Huntington's disease may sometimes seem uncaring and thoughtless. Their apparent disregard for the emotional needs of a partner can be hurtful, especially when it contrasts with a formerly loving relationship; the natural tendency is for the partner to feel slighted.
The most painful conditions in Huntington's, said Achterberg, are limb pain, headache, abdominal pain and fractures. “I think we should do more work in validation of pain tools, including observational pain instruments,” he said. “And for clinicians, I suggest you be especially aware of abdominal pain.”