What is it like dating on dopamine?
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What is it like dating on dopamine?
Drug treatments for a chronic health condition can cause unexpected compulsive behavior, which means dating on dopamine can be challenging. Pete Langman describes how it took the strength of will from both himself and his partner to take back control.
Relationships. You know how they go. After the first flush of sexual attraction and the romance fade, real life tends to rear its ugly head. And few things are as ugly as a chronic condition.
Weβd all like to think that were our partner to be diagnosed with something like Parkinsonβs it would make no difference, but the truth is another matter. Pragmatism tends to prevail, and when circumstances change, we reassess: often on costβbenefit lines. While many chronic conditions are only minimally disruptive in the early stages, fear of the future is real:Β no one wants to be a carer; no one wants to be cared for.
There are different pressures on those whose diagnosis quickly becomes divorce, however. Our society routinely shames people for having conditions such as Parkinsonβs, while appearing to believe thatΒ disabled or chronically ill people simply ought not to have sex. This can make meeting new people problematic.
When first βon the marketβ, so to speak, I wouldnβt mention Parkinsonβs until the first date β putting it in my online profile meant I rarely had one. One potential match responded to my online confession with the words, βYouβre joking, right?β Needless to say, the conversation ended there. We are damaged goods. As one friend of mine put it, his new girlfriendβs ex is βutterly mystified and disgusted that anybody would choose someone with Parkinsonβs as a partnerβ.

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But there are other problems waiting to sabotage our personal lives.
An unexpected diagnosis can make life feel more precious, and this can lead to new attitudes, new behaviors, even personality changes. Sometimes weβre so focused on reducing our symptoms to a level that is βnormalβ that we discount any potential side effects our therapy causes. And these side effects are not always physical.
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Dating with dopamine and dangerous compulsions
Those with Parkinsonβs, and especially young-onset Parkinsonβs, are commonly prescribed a family of drugs called dopamine agonists, which are known to cause compulsive behavior. Once considered βrareβ, recent studies have estimated that these symptoms are far more common. Ask anyone with young-onset Parkinsonβs, and theyβll laugh before suggesting 90 percent as a conservative estimate. But why the disparity?
The most common compulsions are sex, shopping, and gambling. For some, these compulsions get severely out of hand. Where are the figures? Well, imagine that in a few months youβve lost thousands of pounds gambling, bought three sports cars, or had sex with 40 different partners, even though you are married. Or that your behavior has led to your being imprisoned. Would you broadcast the fact?
Itβs worse for women than men, I suspect. Think how quickly people would rush to judge a 35-year-old woman who admitted, as she did in confidence to me, that βmy knickers lost their elastic. Despite being in a relationshipΒ I became promiscuous. Mainly with strangers β both sexes, I didnβt care!β
βI cannot count the times when I stepped outside of myself and wondered what the hell I thought I was doing.β
Another woman I spoke to initially experienced βminor compulsive behaviour in arts and craftsβ but this turned into βtens of thousands lost in gamblingβ, so itβs no wonder she felt an almost daily βmeltdown of self-loathing and despairβ, and even thoughts of suicide.
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The irony is that I heard about this problem on the day I was diagnosed, though not from my consultant. As I got into my car clutching a bag of medication, I heard an advert on Radio 4 for a βPanoramaβ special on how some drugs prescribed for Parkinsonβs were causing compulsive gambling. In the absence of a burgeoning poker habit, however, I put this discovery to the back of my mind.
The agonists, however, had different ideas.

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It was a while before I realized what they were up to; long before I became wise to them. I spiraled off into a haze of sexual hedonism, often finding myself knocking on a strangerβs door at 2.30 am after countless hours spent on multiple websites. Logging on. Checking for messages. Closing. Opening. Checking for messages. Logging off. Telling myself thatβs it for tonight. Logging on again. Checking for messages. Logging off. Logging on again, and again. I cannot count the times when I stepped outside of myself and wondered what the hell I thought I was doing, before stepping back in and getting on with it.
But it wasnβt just the drugs β as an ex-lover put it when dating on dopamine I was looking for βproof of life, vitality, virilityβ. She saw βfear and fragility tooβ, as this disease that gradually erases identity led me to grasp experience in both hands, βas if to store up sensation for a future that may not have itβ.

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The dopamine chemical that controls us
This is perhaps where neurochemistry and psychology interact: the point where we lose control of the chemicals that control us. One such chemical is dopamine.
Dopamine is remarkable. It makes us feel good. Itβs released when we drink alcohol and eat chocolate, and when we engage in risky behavior. But itβs a chicken-and-egg drug, as it also appears to promote risky behavior. Furthermore, itβs a vital part of the chain of command between brain and limbs. Dopamine deficiency hits our bodies hard. It occurs when the cells that manufacture dopamine throw in the towel. It is Parkinsonβs.
The gold-standard Parkinsonβs therapy is L-DOPA. Effectively a dopamine fertilizer, L-DOPA works well for a few years, then starts to lose its bite. Hence the use of dopamine agonists, which work by pretending to be dopamine, stimulating the receptor cells.

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Unfortunately, while our natural dopamine comes in several flavors, the agonists arenβt very discerning. They hang out on synapsal corners looking for trouble. They donβt have to wait long before a tempting receptor cell shimmies past. Unfortunately, agonists canβt seem to resist them.
The pernicious effects of these agonists build slowly, so theyβre hard to spot in yourself, even when youβre in the full flush of compulsion. Once awoken, the need for sex, shopping, gambling or gluttony takes over your whole being. For some of us, it takes a crisis to bring clarity. And after the crisis comes recrimination as you find yourself addicted to addiction. It takes time to reduce the dosage and for the compulsion to become controllable. And what you gain on the swings of control, you lose on the symptomatic roundabouts.
It took me 18 months to wrest control back from the drugs. My appetites remain. I always had appetites, but agonists compel action; they make a body need. And those needs can never really be sated, because compulsion comes in the form of a pill.
Itβs not easy, but I have the upper hand. I no longer date, or even βdateβ. The age-old metaphor of βfightingβ Parkinsonβs is, in my experience, both wrong-headed and damaging, but when it comes to taking on the dopamine agonists, thatβs exactly what it is: a fight to control yourself. I now have a partner who understands and has had the strength of will to outlast the chemical hold, though it was a close-run thing. While the agonists still have their moments, they lack the resolve-sapping stamina of old.
The final word will be mine, not theirs.

Dr. Pete Langman
Dr. Pete Langman is a writer, editor, educator, academic, ex-professional guitarist and extremely amateur cricketer. He was diagnosed with Young Onset Parkinsonβs in 2008.
Caption:
This is where neurochemistry and psychology interact: the point where we lose control of the chemicals that control us. One such chemical is dopamine. Dopamine is remarkable. It makes us feel good. Itβs released when we drink alcohol and eat chocolate, and when we engage in risky behavior.