Late Night

Here I am yet again in the wee small hours of the morning, looking at the clock and thinking, go to bed! And yet, for some unknown reason, I’m not, going to bed that is. In truth, the reason isn’t totally unknown, although the mechanics around it remain mysterious. At the heart of it is also the reason that I find this disease that I live with every day, both frustrating and fascinating. It’s this little something called dopamine. Thanks to our Parkinson’s disease poster boy and spokesman, Michael J. Fox, dopamine isn’t quite as unfamiliar to folks as it was ten years ago. So if you know a little bit about dopamine and Parkinson’s disease you probably think of dopamine as related to things having to do with movement, which is, of course the most outwardly visible part of the disease. Things like tremor, balance problems, a fun little thing called “freezing” stuff like that. But dopamine is also integral to the proper functioning of the reward center of the brain and is associated with reward seeking behaviors; and the firing of dopaminergic neurons is a motivational substance as a consequence of reward-anticipation.

What does that mean? Well, in a research study in which rats were depleted of dopamine by up to 99 percent in the nucleus accumbens and neostriatum (don’t ask me to translate that part), researchers found that as a result of this large reduction in dopamine, the rats would no longer eat by their own volition. The researchers then force fed the rats food and noted whether they had the proper facial expressions indicating whether they liked or disliked it. The researchers of this study concluded that the reduction in dopamine did not reduce the rat’s pleasure in consuming the food, only the desire to actually eat. I need to repeat that, as much for me as for you – the reduction in dopamine did not reduce the rat’s pleasure in consuming the food, only the desire to actually eat. Pretty interesting isn’t it?

Let’s get back to the “it’s really, really late and I should be going – should have already gone – to bed, but I’m not” part. Because whether it’s eating or sleeping or whatever, the things that get you to do the things you should do, namely the anticipation of the reward, whether the reward is food, or the satisfaction of crossing off of your to-do list something you’d rather not do, or that luxurious feeling of sinking into bed at the end of the day, don’t work for me anymore. I know it sounds crazy, even to me and I live with the damn thing, have lived with it for over a decade now. So when I say I’m having sleep issues, people naturally assume that I mean that I can’t sleep. But, lately at least, I can sleep just fine. When, that is, I actually manage to get myself to bed. When I go to bed, I fall asleep in mere seconds. It’s not getting to sleep that’s the issue; it’s getting my butt to bed.

Back to me staring at the clock; I look at the clock and think, “go get ready for bed,” and some amount of time later, maybe it’s fifteen minutes, maybe it’s two hours, I find myself looking at the clock again and I’m still doing whatever it is that I was doing when I first thought I should get ready for bed. It’s as if there’s a big old chasm, something close to the width across the Grand Canyon, between what I should do, and what I do do. Now, imagine trying to explain that to a boss, or a spouse, or the judge at an SSI hearing. Toss on top of that other fun features that come as the result of a large depletion of dopamine, things like fatigue, and I think you get the picture.

But, not to worry, I won’t leave you on that depressing note. Because my theory, and I haven’t researched this enough yet to know if it has been properly tested by the folks in white lab coats, is that doing things I like to do, increases the amount of dopamine in my system, or at least amplifies the available dopamine somehow, and thus changes my brain chemistry enough to get me to do the things I love to do as well as the other stuff. Why is this good news? Because what is the thing that I like to do just about best of all?

Write.