Creative Therapy for Parkinson's

Parkinson’s disease is the second most common neurodegenerative disease in the U.S. It affects more than a million people, and that number is expected to double by 2030. For the last several years, research and testing with dopaminergic drugs has revealed a few surprises.

  • A CEO with minimal artistic experience suddenly uncovers a hidden passion for painting.
  • A sociologist is struck with the inspiration to create intricate necklaces representing the customs of different cultures from around the world.
  • A person with no flair for the written word unexpectedly publishes a book.

The real-life people living these seemingly singular situations have one surprising thing in common: Parkinson's disease.

They are also patients of Rivka Inzelberg, M.D., professor and PD specialist at the Sheba Medical Center, Department of Neurology.

"About two years ago I started to notice that some of my patients were painting, writing books and engaging in other creative pursuits," Inzelberg says.

The Benefits of Dopaminergic Medications Go Beyond the Physical

People who suffer from this disease experience complications, such as an inability to control limb movement, due to the impairment of nerve cells that produce the brain chemical dopamine. The use of dopaminergic drugs has brought interesting results.

Why were so many of Inzelberg's patients suddenly experiencing unexpected surges in creativity?

Her answer, based on research conducted on case studies from around the world: it is all in the medications.

The disease gradually destroys the dopamine-producing nerve cells in a person's brain. This leads to a host of different physical and mental symptoms, including depression, muscle pain and rigidity, tremors, issues with walking and balance, trouble swallowing and blinking.

Most Parkinson's treatments can reduce the tremors and rigidity that make daily tasks difficult for people with the disease. This may also enable them to more easily engage in artistic hobbies that require dexterity.

These treatments work by influencing the levels and functioning of dopamine, a multi-functional neurotransmitter, in a person's brain. Dopamine helps govern everything from voluntary movements to feelings of reward and pleasure.

Specifically Inzelberg's interest was not the physical effects of the treatments.

Her interest lay in the observation that people on certain types of prescriptions, specifically, dopamine precursors (Carbidopa/Levodopa), or dopamine receptor agonists (Mirapex, Parlodel, Requip, Neruopro or Apokyn), not only saw a reduction in their physical symptoms, they also sometimes experienced a spike in their creative drive.

Nevertheless, the effect is not universal.

"The jury is still out on this one," says Diane Breslow, MSW, LCSW, coordinator of the Parkinson's Disease and Movement Disorders Center at Northwestern Memorial Hospital. "These medications might unlock a new or hidden talent. It depends on a lot of things: which medication a person is taking, how artistic they were beforehand, etc."

Creativity: What's dopamine got to do with it?

According to Inzelberg, dopamine replacement therapies may pave the way for amplified creativity because they increase the activity of dopamine in the brain. This increase in activity may lower a person's inhibitions, enhance their level of overall arousal and help them focus on a particular creative pursuit.

The role that these medications play in potentially reducing a person's apprehensions can sometimes leads to dangerously obsessive behaviors. Severe addictions to gambling and sexual activity have been observed in certain individuals who are taking these prescriptions.

Though her recently published study is drawing new attention to the connection between dopamine replacement medications and increased creativity, Inzelberg is not the first to uncover the link.

In a 2012 study, a group of Italian researchers found that receiving dopamine therapy treatments has caused some people to develop new artistic skills (i.e. reading, writing, drawing, painting, etc.). While dopamine has a primary purpose of aiding the transmission of motor commands, it is also involved in the brain’s reward system. It is connected to the feelings of satisfaction or happiness when we experience an accomplishment. It is also connected with artistry and is an area of prominent study.

Not every individual was able to create a high-quality masterpiece, but 78 percent of those whose creativity was unleashed under the influence of the medications pursued more than one artistic avenue (e.g. painting and sculpting). There are seemingly no limits to the types of artistic work in which these patients develop talents; or perhaps many unleash hidden talents that have been long suppressed.

Finding Comfort in Creative Pursuits

The incurable, degenerative nature of PD can make it an extremely difficult ailment to cope with. Sufferers are faced with the daily reality that their ability to perform routine tasks is gradually wearing away and current treatments can only do so much to slow this decline.

Art therapy has long been recognized as an effective way to help people struggling with the limitations of this disease to express themselves and improve their motor functioning, according to Inzelberg. It is also a proven and rewarding approach used in general psychological therapies.

"Some people find their creative ability is freed up," says Breslow. "Art becomes a way for them to regain some of what they have lost with the disease. It enables them to express themselves and hold on to their sense of independence."

She shares some comments, made by Parkinson's sufferers, on how engrossing themselves in artistic pursuits has affected their ability to cope with the disease:

  • "You have control over your art—even though you don't have control over this disease."
  • "Creativity takes your mind off of your disease."
  • "Art has become very soothing for me."

Breslow cautions that, like gambling and other common compulsions, art can become an obsession. If an individual feels so compelled to draw or paint that they neglect to take the time to sleep, eat, or care for themselves, then their creativity is no longer therapeutic and they should see a doctor to help get their unchecked impulse under control.

Most of the time, art can be incredibly beneficial for people with this disease, which is why Breslow says caregivers should encourage creative pursuits in their loved ones struggling with the ailment. Often, motor handicaps can lessen significantly, not to mention the overall feeling of happiness they get when they are busy with their art.

She suggests providing a loved one with a variety of artistic materials and mediums (most people, once they have mastered or thoroughly explored a particular pursuit, such as painting, want to move onto something else). As they create, loved ones might ask about their feelings or what they are trying to express.

Although art therapy will not alter the progression of the disease, Breslow says, "Creative pursuits can enhance a person's quality of life. People are happier when they are engaged in an activity; art is that activity for some people."

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