All Wilson disease patients need to take some type of medication therapy to remove excess dietary copper every day, for life. In some cases, WD patients may benefit from additional forms of therapy to help control emotional or physical symptoms or regain lost movement or speech. These other forms of therapy may be needed only for a short time while other patients may benefit from longer term therapy.

Physical Therapy

Physical therapy restores function for individuals who have neuromuscular or skeletal problems like

dystonia, arthritis, osteoporosis, joint and muscle pain, or balance or coordination issues. Therapeutic treatment may include:

• Training in mobility, gait stability, posture and positioning
• Exercise programs to increase muscle function, coordination, balance and endurance
• Joint and soft tissue mobilization to increase range-of-motion
• Pain management

Occupational Therapy

Occupational therapy assists individuals with adapting to their social and physical environment.

Therapists help improve function through:

• Education and training in areas such as dressing, bathing, eating and grooming
• Activities to help maintain memory, orientation and cognitive integration
• Adaptive techniques or equipment to overcome physical disabilities
• Upper body strengthening and fine motor coordination exercises
• Exercises to reduce the effects of arthritis or other conditions to maintain normal upper body joint movement

Speech-Language Pathology

Speech therapy addresses communication as well as difficulty with swallowing and eating.

Treatment plans are designed for individual needs, such as:

• Recovery of speech, language and memory skills
• Verbal and non-verbal communication, including programs for the hearing impaired
• Oral muscle functioning and strength required for speaking and swallowing
• Appropriate diet recommendations to minimize choking and aspiration of food into the lungs

Psychiatric Care and Counseling

People with Wilson disease may experience a range of psychological disorders over their lifetimes. Depression is the most common and may happen at a rate that’s more than double that of the general population, according to preliminary results from the WDA Patient Registry Study.

The Effect of Mental Health, Neurological Disease, and Liver Disease on Quality of Life in Patients With Wilson Disease (PDF)

Depression is a common, but serious mood disorder. It can cause severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working. If some of these symptoms are experienced almost every day for at least two weeks, depression could be the cause:

• Persistent sad, anxious, or “empty” mood
• Feelings of hopelessness, or pessimism
• Irritability
• Feelings of guilt, worthlessness, or helplessness
• Loss of interest or pleasure in hobbies and activities
• Decreased energy or fatigue
• Moving or talking more slowly
• Feeling restless or having trouble sitting still
• Difficulty concentrating, remembering, or making decisions
• Difficulty sleeping, early-morning awakening, or oversleeping
• Appetite and/or weight changes
• Thoughts of death or suicide, or suicide attempts
• Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment

If depression is suspected, get in touch with your personal physician or a mental health professional for an evaluation.

(Adapted from the National Institute of Mental Health)

During their lifetimes, WD patients may also have higher levels of stress and anxiety, bipolar disorder and suicidal ideation than the general population. These psychological disorders do not seem to be related to how severe a patient’s liver or neurological symptoms are. If you are suffering unusual or persistent behavioral or psychological symptoms, be sure to reach out to your doctor or appropriate health professional.