chronic illness, dopamine and parkinsons, parkinson's disease, Parkinson's Health

The Importance of Dopamine in Creative Expression: By Dr. De Leon

“We of the craft are all crazy. Some affected by gaiety others by melancholy but all are more or less touched.” ~Lord Byron

As you all know, I have had some major health issues setbacks lately which have curtailed my involvement in various activities including my bi-monthly blog writings. Main reason for this has been lack of creativity along with a lack of mental drive to get anything done. Of course having blood pressures fluctuate in a drop of a hat from 95/60 laying down to 200/95 sitting and even higher standing or mild activity such as dressing or bathing causing blindness a couple of times along with a TIA (mini stroke) did not help much either, which scared the living daylights out of me being a neurologist and all.

As I laid around mindlessly watching T.V. trying to stay calm and avoid any major excitement (difficult in my life at times it seems like), I caught some scenes of the movie -“A Beautiful Mind” perhaps many of you will remember this movie which won many awards for Russell Crowe’s portrayal of a brilliant mathematician (John Forbes Nash Jr.) who struggled with lifelong mental illness in the form of schizophrenia.

Following a stream of semi-consciousness, I began thinking about my own patients with mental illness over the years including those with Parkinson’s disease and the apparent connection of great intelligence, creativity and mental disease.  From ancient times of the Greeks important people like Aristotle thought that creativity came from the gods and the muses (the 9 daughters of Zeus). These were the mythical personifications of the arts and sciences.Image result for pietà michelangelo

One thing is clear to me and to many others who have studied this subject is the direct correlation of dopamine and intelligence. After all we know that this is the chemical responsible for learning and reward system. A study by psychologist J. Phillippe Rushton discovered that creativity was highly correlated with a high intelligence and traits of abnormal personality – schizotypal. Those who had a condition with known dopamine involvement particularly those with excess dopamine such as bipolar or schizophrenia (like Nash) were found in literature to be extremely brilliant and creative individuals. In my experience this has also been true, all of whom hated being on “treatment” which suppressed their dopamine because it ‘stifled’ their creativity and their originality causing them more often than not to go off their meds time and time again. We have example after example of great literary minds and artist who had significant neurological deficits who were quite prolific despite their disease. I believe, that this is greatly in part to the excess of dopamine circulating in their brains. People like Earnest Hemingway, Michelangelo, Virginia Wolf, Sylvia Plath, even Robin Williams.The Old Man and the Sea

Pondering about the subject of creativity it dawn on me that since I had stopped intake of my Rytary (Levodopa replacement), I had lost my spunk, mental acuity, including writing creativity, and worst again stopped bring interested in reading my favorite novels which everyone in my family noticed…this I believe is due to fact that reading a novel with complex story line requires a great deal of concentration and recollection which use up large amounts of dopamine.

Incidentally, as an aside reading is what I needed the most to regulate my blood pressure because studies have shown that simply emerging oneself in a favorite fictional book especially if already read and enjoyed can quiet the heart rate and lower blood pressure several points within a few minutes- so take out those favorite fictional novels out to Keep your brain and heart healthy!

However, since I began to feel the effect of lack of dopamine in my body after more than a week without it, I took my first dose again last night and behold I woke up with a brain full of ideas and ready to tackle the world once more, read, write and be creative. ( I won’t be going off my levodopa anytime soon again) Confirming that dopamine is the key substance needed to thrive in life and be creative. So in reality, this question of artistic expression in Parkinson is truly a simple one. Parkinson’s appears to be responsible for our new talents indirectly just as those with frontal lobe dementia due to excess of dopamine either by design of disease itself as in the case of FTD or by external supplementation in PD. Perhaps some of us have already been gifted with latent artistic talents that have been dormant for years unexpressed due to insufficient stimulation of our own muse. This would explain why people who undergo DBS no longer have the same creative expression as seen before the procedure because by design the operation is meant to reduce amounts of external dopamine required so people no longer have that boost to surpass the threshold into the creative realm.

Since a study of more than one million people in Sweden found a direct correlation between creative occupations and mental illnesses. This may be an area for further development as a way of doing vocational rehab for those of us with Parkinson’s disease who were forced to abandon our previous occupations. Something to ponder. As I continue to regain my own mental stability –recalling the day I first took levodopa, as a day when everything came completely into complete mental focus.

This weekend I will be relaxing with some dark chocolate curled up to a good book, maybe even enjoy some poetry!

 

Sources:

https://en.m.wikipedia.org/wiki/Creativity_and_mental_illness

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4041074/

 

 

parkinsons health and beauty tips

Health & Beauty Tips #12: Creativity & Parkinson’s Disease by Dr. De Leon

Health & Beauty Tips #11 Living a Full Life with PD by Dr. De Leon

“Creativity involves breaking out of established patterns in order to look at things in a different way!” -Edward de Bono

The biggest challenged we all face in living with this illness is the disconnection that occurs gradually between our of minds and our bodies! How do you survive? Much less thrive in a world designed for the abled not the disabled?  When each one of us still has dreams, ambitions, goals, families to raise, jobs and careers to pursue?

The answer lies perhaps in the brains ability to cope and form new connections from one neuron to another bypassing old defective ones! This is accomplished by the gift many have discovered after starting treatment with L- dopa and dopamine agonists.

This is what makes our Journey with Parkinson’s disease so very interesting.  When we are tested to our limits , we must find a way to rise above our circumstances despite our not so cooperative or disabled bodies to live and be happy!
We have all heard the old adage;   “necessity is the mother of invention or innovation!” When the roads between the neurons are obstructed or no longer functioning to full “speed” or “capacity” we feel the need to find another mean of  arriving at the same destination in a place where we feel valued, unique and useful! After all being able to express ourselves in a singular fashion is what differentiates us from the rest of the animal world.

So, thank goodness that for a great number of us that have PD the principal treatment with dopamine replacement has created a much debated phenomenon- artistic expression.
Recently, there has been a great deal of talk and interest in this new phenomenon known as “artistic expressivity” in Parkinson patients.  There is a great debate among experts as to the origin because it is not entirely clear if this is de novo expression  or simply a surge of dormant innate talent. Although there are several theories one thing is for sure -all the increase in artistic phenomenology appears to be related to the intake of dopamine both L-Dopa and dopamine agonists. There have been reports of de novo sculptures and painters who previously had no experience or training prior to onset of disease as well as reports of increase desire to create and express themselves through whichever means possible whether that be through music, writing, humor or painting.

One theory proposes that this occurs due to a  sudden release from social inhibitions due to the effect of the dopamine or because dopamine is not only involved in motor control but in “pleasure and reward center” being able to achieve a new goal and have a new purpose may have its own unique drive!

Others opine that simply adding the medication allows them to become more artistically sensitive because they experience a greater desire to create when the dosage of dopamine increases.

In my profession, I always had to be logical and concise in my diagnosis and decision making but the inherent drive to always look at the bigger picture and take a holistic approach to life and medicine was always present. I have always loved color and admired great works of art even if I never considered myself as being “artistic.” However, interestingly about the time I began to develop Parkinson symptoms I noticed I became much more bolder in my color schemes both in my home and office. At the time, I was building a new office which I helped to design. Turned out to be not just colorful, but uniquely bold. It was designed around my Parkinson patient’s and other patients needs in mind but not lacking any flair of personality and air of museum!  Needless to say doctors offices around here have never been the same ever since. I started a trend- Before I sold my office, we even considered highlighting it in architects digest. But, since I was so ill all the décor was taken off before we could take pictures! My patients and drug reps and others used to comment on the décor and were always surprised to find out it was all my design. They even started suggesting that I have a separate desk for interior designing consultations…

So for me, I think it brings out the innate talents to the surface that somehow you once were to afraid to express!

No matter the reason  for the increase in artistic expressivity, I agree with the experts,  that the therapeutic value is immeasurable. This form of helping the brain cope with substantial losses has already been explored in other neurologic diseases like (vascular) dementias and strokes. Similarly, this type of “art therapy’  could hold great benefit to Parkinson patients helping them circumnavigate the motor problems or deficits. Thanks to the external stimuli the once impaired motor skills ( e.g. not able to button shirt or feed oneself) consumed by tremors, or rigidity or severe bradykenesia can become normal or almost normal when engaging in this type of therapy -like painting or sculpting. Allowing patients to perform fine motor skills not otherwise able to achieve in their normal activities. But the greatest benefit derived from allowing one to express itself artistically is the psychological and physiological well being that brings forth to all patients with Parkinson. Furthermore, being able to create makes people happy and provides hope while temporarily allowing one to forget about one’s own disabilities.

Because I have seen the value of “art therapy” in other neurological disease, I firmly believe that opening oneself to this type of expression is not only psychologically beneficial. But, I firmly believe this may be the key to longevity and perhaps slowing down the disease process by the building of new connections – recruiting unused brain to take over the function of those parts no longer functioning well! This is just my theory- but for years we thought NOTHING could be done for STROKE patients until we discovered the power of rehab and although the infarcted (dead) brain usually does not recover a great deal of recovery goes on physically on an individual basis. We already know exercise seems to help the Parkinson patient- I think of art therapy and artistic expression as mental exercise!

So, go ahead don’t be shy start a new painting,  music or writing class or whatever else makes you happy and allows you to use your fine motor skills! Engage your kids, grandkids…the more the merrier!

Remember, being Happy It’s all a matter of perspective……
Is the glass half empty or half full?… a dear sweet friend of mine, who also had Parkinson’s disease, …. thought me- WHO CARES?!!! just BE HAPPY YOU HAVE A GLASS WITH SOMETHING IN IT!!!!

As doctor Gene Cohen would say;  “art is like chocolate for the brain” and if chocolate has similar characteristics to dopamine-the essential deficient chemical in Parkinson patients then by all means let us continue expressing ourselves artistically to continue battling this chronic illness avoiding spiritual, mental and moral decay and find a greater quality of living  for us and our loved ones!

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Dr. M. De Leon is a retired movement disorder specialist, PPAC member and research advocate for PDF; Texas state assistant director for PAN (Parkinson’s Action Network). You can learn more about her work at http://www.facebook.com/defeatparkinsons101 you can also learn more about Parkinson’s disease at http://www.pdf.org or at www.wemove.org

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