• Ryan Reynolds is speaking out about his father’s life with Parkinson’s disease nine years after his death.
• Reynolds says he hopes to raise awareness of some of the early signs and symptoms of the disease, including less common psychological and cognitive problems.
• Reynolds’ father experienced hallucinations and delusions, which are part of a spectrum of symptoms due to psychosis.

Actor Ryan Reynolds is opening up about his father’s journey with Parkinson’s disease and the painful effects it had on his family in hopes of raising awareness about some of the lesser-known symptoms of the disease.

In an intimate interview with People, Reynolds described the cognitive symptoms, including hallucinations and delusions that his father experienced while living with Parkinson’s.

He also addressed how the diagnosis affected him and his family and the persistent stigma that exists around Parkinson’s even to this day.

Reynolds has recently partnered with the educational campaign More to Parkinson’s to raise awareness and offer families and caretakers additional resources.

“It’s a moving story, and it’s a story that many families experience because the onset of Parkinson’s is so insidious,” David Charles, MD, a Professor and Vice-Chair of Neurology at Vanderbilt Medical Center, told Healthline.

“The symptoms that precede the motor symptoms and the things that we see in a person with Parkinson’s when we examine them have sometimes been present for years beforehand, but we’re not really able to conclude that they are related to a future diagnosis of Parkinson’s,” said Charles.

The differences between hallucinations and delusions

It has been nine years since Reynold’s father, James Chester Reynolds, died at the age of seventy-four after living with Parkinson’s disease for almost two decades. He’s now ready to talk about the challenges and complex inter-family dynamics wrought by the disease.

Parkinson’s disease is a progressive neurological disorder that affects both movement and cognition. While some are likely familiar with the motor-related symptoms of Parkinson’s, like tremors and slow movement, the cognitive symptoms are, perhaps, not as widely known. And that’s precisely what Reynolds addresses in his interview.

“At the time, I just thought, ‘My dad’s losing his mind.’ My father was really slipping down a rabbit hole where he was struggling to differentiate between reality and fiction,” Reynolds’ told People. He describes both hallucinations and delusions that his father experienced. Collectively, these symptoms, which exist on a spectrum of severity, are known as Parkinson’s psychosis.

Between 20% and 40% of people with Parkinson’s experience some form of psychosis during the early stages of the disease. As the disease progresses into later stages, up to 70% experience psychosis.

“These symptoms fall under the non-movement symptom category. They are common and can be more troublesome and disabling at times than the movement symptoms,” Emile Moukheiber, MD, an Assistant Professor of neurology at Johns Hopkins University School of Medicine, told Healthline.

Hallucinations and delusions are not synonymous and have unique characteristics.

• Hallucinations are when an individual sees, hears, or even smells something that is not actually there. Hallucinations may not be alarming to the person experiencing them.
• Delusions are signs of an alternative or irrational view of reality. Delusions may generally include paranoia or more specific delusions such as Capgras delusions, in which an individual believes that a friend or family member has been replaced by an impostor.

Moukheiber explains that psychosis can manifest in different forms, from shadowy figures to fully formed individuals able to converse.

However, cognitive issues may not be extreme either. The person with Parkinson’s may just seem “off” or different in an abstract way.

“Some people feel just like that person has changed, whether it’s a change in personality or a consequence of some behavioral issue,” said Charles.

How to identify early Parkinson’s disease symptoms

There are several “classic” signs and symptoms of Parkinson’s disease. However, there is no simple test to identify it, which means that a doctor can only diagnose based on a multitude of factors, including physical symptoms, medical history, and a neurological assessment.

Early symptoms of Parkinson’s disease include:

• Decreased or loss of sense of smell (anosmia)
• Constipation
• Small, cramped handwriting
• Voice changes
• Stooped posture

“These symptoms can sometimes precede the movement symptoms classic of Parkinson’s by a decade or more. Others include increased anxiety and depressive symptoms that had not been present in younger years,” said Moukheiber.

As the disease progresses, movement-related symptoms will begin to appear, which are more obvious to observers. These include:

• Tremors
• Slow movement
• Stiffness in the arms, legs, and trunk
• Balance and stability problems that lead to falls

The stigma of Parkinson’s

In his conversation with People, Reynolds describes the secrecy around his father’s diagnosis:

“He said the word ‘Parkinson’s’ maybe three times as far as I knew — and one of them wasn’t to me. There was a ton of denial, a ton of hiding,” Reynold’s said.

His experience is not a unique one, but instead an all-too-common thread between families, friends, and even co-workers of people with Parkinson’s.

“I’ve had patients who did everything they could to hide their symptoms from others,” said Charles. “One person comes to mind who only told his spouse. Did not tell his children. Did not tell his coworkers. With each visit, one after the other, it was more and more apparent that he was literally carrying the weight of the world on his shoulders, trying to hide.”

Michael S. Okun, MD, a board certified neurologist and co-founder and co-director of Norman Fixel Institute for Neurological Diseases, told Healthline that there’s more work to do with both healthcare providers and families alike to address the issue of stigma.

“We need to be teaching clinicians and healthcare teams to have deeper and more meaningful discussions to uncover stigma and to help folks live well with the disease. When we hear stories like Ryan’s father, it emphasizes how real the ‘hidden’ phenomenon is,” he said.

The bottom line

Ryan Reynolds has spoken out about his late father’s Parkinson’s disease journey and the effects it had on him and his family.

While the disease is most commonly associated with motor problems, including tremors and slow movement, there are also psychological and cognitive symptoms. Reynolds’ father experienced hallucinations and delusions, known as psychosis.

Early symptoms of Parkinson’s include constipation, loss of smell, and stooped posture.

Stigma still persists around Parkinson’s disease, with many individuals hiding their symptoms and diagnosis from those around them.