Nervous System Regulation
- Kristi Riker
- Nov 28
- 5 min read
Written By: Kristi Riker OTD, OTR/L
Parkinson’s disease is a neurological disorder, meaning it impacts the nervous system both physically and emotionally. Most people think of PD as a ‘movement disorder’, but the emotional system is just as affected. This article will focus on the ways PD affects the part of the nervous system in charge of emotional regulation and executive functioning.
What is the nervous system?
The nervous system is the body’s communication network — it sends, receives, and interprets signals between the brain and body so you can think, move, feel, and regulate your emotions and body states.
The nervous system is made up of 2 main branches:
The Central Nervous System:
Made up of the brain and spinal cord
The Peripheral Nervous System:
In charge of carrying signals between the brain and body
Includes the somatic nervous system (responsible for the intentional movement of your body)
Includes the autonomic nervous system (responsible for functions you don’t think about, such as breathing, heart rate, digestion)
Map of the Nervous System
The Autonomic Nervous system:
This is the part of the nervous system that controls your emotional state. Nervous system regulation is the body’s ability to stay balanced, adjust to what’s happening around you, and return to a state of calm and stability after stress or challenge. The autonomic nervous system is further broken down into two branches (promise these are the last branches!)
Sympathetic Nervous System:
Responsible for ‘alerting’ body functions, such as raising heart rate, increasing breathing rate, increasing alertness
Think: “fight of flight”
Parasympathetic Nervous System:
Responsible for ‘calming’ body functions, such as resting/digesting, recovery, slowing heart rate, slowing breathing
Think “rest and relaxation”
SO! Now that we can see what is happening in the body when we feel certain things, how is this connected to Parkinson’s?
Why does PD affect your emotional state?
Autonomic Nervous System (ANS) dysregulation means emotional dysregulation. If the ANS is in charge of telling your brain/body when to be alerted OR calmed, then what happens when this system becomes unstable with PD?
When this instability occurs, the brain gets mixed messages. The ‘flight or fight’ response is a necessary defense mechanism and it makes sense! Humans have needed this alerting response evolutionarily to respond to danger quickly and stay focused. But what if your body is sending this “I am unsafe” massage when it isn’t needed? Well, this is basically what happens with PD.
The brain receives this message at all the wrong times:
“My body is currently unsafe so I need to go on alert. I need to raise my heartrate, increase my blood pressure, speed up my breathing, start sweating, and feel a bit stressed.”
This would be a helpful response if you’re being chased by an aggressive dog, but what about if you’re just walking into a small social gathering? Do you want your body sent into high alert in these moments? Probably not!
In summary, when PD throws off your autonomic NS, you are likely to experience:
chronic “on-edge” feelings
irritability
internal restlessness
low emotional tolerance
stress sensitivity
emotional fatigue
withdrawing
snapping
crying unexpectedly
freezing under stress
needing more recovery time than before
Fun, huh? Now that we know what is happening in our body when we feel so off, what can we do about it?
WHAT TO DO:
Reduce Nervous System Load (the FIRST and most important step)
In PD, the nervous system has reduced bandwidth, so lowering overall demand prevents overwhelm.
Reduce noise, clutter, and visual chaos
Simplify daily routines
Avoid multitasking
Build in “transition time” between activities
Allow more time to complete tasks
Use predictable routines
Take breaks before the system crashes
Support the Autonomic Nervous System (ANS)
Small regulation practices help stabilize your nervous system:
Slow breathing (but with modifications)
People with PD often benefit from: shorter inhales, longer exhales (stimulates the vagus nerve)
Avoid long breath holds (since breath holding can worsen autonomic symptoms)
Inhale for 3 seconds → exhale for 6 seconds, 1–3 minutes.
Hydration + electrolytes
This supports blood pressure stability, which directly stabilizes emotions.
Heat/cold regulation
PD can impair temperature regulation. A comfortable thermal input (warm blanket, cool cloth on forehead) can calm the system quickly.
Body-Based Regulation
Because PD is a body-first disorder for many, physical regulation works better than cognitive methods alone. These stimulate the parasympathetic (calming) system and reduce limbic (emotional brain) activation.
Gentle rocking in a chair
Weighted blankets or a weighted lap pad
Hand massage or foot massage
Slow rhythmic movement
Walking at a comfortable pace
Warm showers or warm baths
Gentle stretching or Tai Chi
Reduce Sensory Overload
The PD brain becomes more sensitive to sensory input. Reducing sensory overload prevents the emotional system from spiking unexpectedly.
dimmer lighting
softer colors
avoiding chaotic stores or restaurants
lowering TV/radio volume
using noise-canceling headphones
Emotional Safety Strategies
How care care partners can communicate to help give cues of safety:
Speaking in a calm, slow tone
Gentle eye contact (not intense)
Short, clear sentences
Reassurance without being patronizing
Predictable and consistent responses
Avoiding “rapid-fire” questions
Allowing silence
Address Fatigue (the #1 trigger of dysregulation)
Fatigue in PD is neurological, not just physical. Once fatigue hits, emotional dysregulation skyrockets. Think of fatigue management as emotional regulation management.
schedule rest periods daily
avoid back-to-back demands
use “energy budgeting” (see link in resources)
nap earlier in the day if possible
plan appointments earlier when the nervous system is fresh
have a consistent sleep/wake time
warm bath before bed
limit screens before bed
treat nighttime dystonia or bladder issues
Sleep in a cool, dark room
Use Cognitive Tools after the body is regulated
In PD, emotional reasoning skills are harder to access when the nervous system is dysregulated. Trying these too early often backfires. So the sequence is: Regulate the body, THEN use these cognitive strategies:
gentle reframing (Original Thought: “I can’t handle this.” / Reframe: “This feels hard right now, and I can take it one step at a time.”)
grounding statements (“I am having a moment right now. It will pass.”)
orientation (“You’re here, you’re safe, we’re okay”)
problem-solving
Medication Adjustments
Dopamine fluctuations can cause emotional swings. Working with your neurologist to help tune medication timing and type may reduce dysregulation. Several PD medications affect:
anxiety
impulse control
mood
sleep
autonomic function
Support the Gut–Brain Axis
Because PD heavily affects the enteric (gut) nervous system, stabilizing digestion stabilizes emotions. Gut discomfort often causes emotional spikes in PD.
regular meals
fiber + hydration
probiotics (with support from physician)
magnesium glycinate (with support from physician)
Care partner Co-Regulation
A care partner's tone, pace, and emotional stability helps regulate their partner with PD. Those with PD can “borrow” the care partner’s nervous system cues.
slow your breathing
lower your voice
get physically close but not overwhelming
offer a hand
model calmness
Resources:
Conti M, Garasto E, Bovenzi R, Ferrari V, Mercuri NB, Di Giuliano F, Cerroni R, Pierantozzi M, Schirinzi T, Stefani A, Rocchi C. Insular and limbic abnormal functional connectivity in early-stage Parkinson's disease patients with autonomic dysfunction. Cereb Cortex. 2024 Jul 3;34(7):bhae270. doi: 10.1093/cercor/bhae270. PMID: 38967041; PMCID: PMC11909796.
Helvaci Çelik FG, Aktaş YE, Kiraz S, Şeker D, Hocaoğlu Ç. The Relationship between Emotional Expression, Difficulty in Emotion Regulation and Anhedonia in Parkinson's Disease. Neurocase. 2025 Aug;31(3):112-118. doi: 10.1080/13554794.2025.2467910. Epub 2025 Feb 20. PMID: 39980234.
Delaveau P, Salgado-Pineda P, Witjas T, Micallef-Roll J, Fakra E, Azulay JP, Blin O. Dopaminergic modulation of amygdala activity during emotion recognition in patients with Parkinson disease. J Clin Psychopharmacol. 2009 Dec;29(6):548-54. doi: 10.1097/JCP.0b013e3181bf1c5f. PMID: 19910719.