When the Urge Won’t Let Go: My Journey through Parkinson’s, Dopamine, and Compulsive Behaviors

Understanding Impulsive and Compulsive Behaviors (ICBs)

Before I learned the term ICB, I was living it. Experts define ICBs as irresistible urges to engage in activities that feel rewarding but can become excessive or harmful. These can include pathological gambling, compulsive shopping, binge eating, hyper sexuality, or punding (repetitive, purposeless tasks). In Parkinson ’s disease, ICBs are not a character flaw — they are an unintended side effect of dopamine-replacement medication. In fact, a large study found about 17% of patients on dopamine agonists develop an ICB, compared to roughly 7% on other Parkinson’s drugs.

ICBs happen because dopamine medications flood parts of the brain’s reward system. Dopamine normally helps control movement, but it also drives pleasure and motivation. Medications that mimic dopamine can overstimulate areas that govern impulse control. This rewires the brain’s reward circuit: what starts as a pleasant escape can evolve into an uncontrollable obsession. For me, gaming became less a choice and more a neurological need. I’d plan my whole day around it, skip meals, and ignore calls.

Before we dive in, a quick heads‑up: later on my wife Hayley will chime in with her caregiver’s perspective—so keep reading!

When a Game Becomes a Trap

I have loved video games ever since I was young. When I was first diagnosed with Parkinson’s, I remember being afraid of impulse control disorders (ICDs) – stories of people gambling away their savings or losing control over simple things like shopping or drinking. I never imagined I would end up experiencing one myself. But over the past few months, I’ve felt like I’m trapped inside a game. It’s been just over two days since I finally asked my wife for help, after realizing I couldn’t even put my phone down and go to sleep.

About a month ago, I downloaded a “time tap” mobile game on my phone. In this game, you tap the screen at predetermined times to get rewards. It had many different themes – a zoo, a carnival, a coffee shop, a clan war game – and I didn’t realize how addictive it could be. I had been trying to quit for two weeks and I was not able. I would delete the game, thinking I had kicked the habit, only to re-download it a few hours later. Soon, everything except the game began to seem unimportant, and completing the daily quests became my whole focus. One of my greatest fears about Parkinson’s – losing control – started to consume my life as I obsessed over getting my rewards.

I kept wondering: where did my urge to resist go?

☕ If you’re finding this story meaningful, buy me a Ko‑fi to keep these real‑life Parkinson’s journeys coming.

I later learned this was part of the dopamine effect of gaming. Every tap released a quick burst of dopamine – our brain’s pleasure chemical – flooding my reward system. This rush made me feel happy for a moment, but over time my brain needed more and more gaming to feel the same satisfaction. Normal activities just didn’t give me that hit anymore.

As I played more, I started to feel like a character from a movie who couldn’t escape the digital world. I was only stuck in a small video game, but it quickly turned into a very embarrassing situation. I felt ashamed of myself for not being able to stop. It seemed so childish that something so simple could have such a hold on me. I knew I was hurting myself, but I just couldn’t stop. All I wanted was my freedom back. I felt helpless to get it on my own.

How It Started: The Game That Took Over

When I finally quit playing, I spent a couple of days dealing with withdrawal symptoms. I felt jittery and anxious, almost like I was coming off a medication cold turkey. The main thing that made me call Hayley was realizing I was putting myself in danger. I had been playing so many hours that my risk of falling – already high with Parkinson’s – was increasing.

Even physically, I could see the damage. Playing so much made my tremors worse and triggered more dyskinesia (involuntary movements). My anxiety spiked and I wasn’t sleeping well – all things that made me more likely to fall. I felt shaky both physically and emotionally. I noticed my confidence slipping as I fell behind on my daily exercises and walks. This only made me feel more guilty and frustrated. Whenever I tried to focus on anything – even simple tasks around the house – I had to keep glancing at my phone, worried it might be time to play again. I couldn't concentrate for more than a few minutes without feeling that pull to play. It was awful.

I felt emotionally distressed because I couldn’t stop. My self-care was slipping—my hygiene was deteriorating, and I began to notice signs like body odor I hadn’t experienced before. But it went beyond that. I was falling behind on my daily walks and skipping exercise altogether. I wasn’t publishing videos, which only deepened my guilt and sense of failure. It began to feel like I was teetering on the edge of a breakdown. Even when I tried to focus on work, I couldn’t concentrate for more than five minutes without needing to check my phone—just to see if it was time to tap again, even when I knew the timer still had an hour to go. It was awful. I was unraveling, and I knew it.

Regaining Control, One Tap at a Time

I’m so thankful to have my wife, Hayley, as a caregiver. She noticed how much I was struggling and how my mood and health were changing. When I told her I couldn’t stop playing and that I felt trapped, she didn’t scold or judge me. Instead, she helped me put the phone away and supported me through those first difficult days of quitting. I truly would have been lost without her gentle guidance, love, and support.

This experience has been a wake-up call. I had never heard much about impulse control disorders from others living with Parkinson’s, so I had no idea how common or serious this could be. Only afterward did I learn how dopamine-related medications can trigger compulsive behaviors like mine.

If you or someone you love is dealing with a similar struggle, know that you are not alone. It might feel weird to talk about being trapped by something that seems harmless, but reaching out – to family, friends, or your doctor – can make a world of difference. Talking about it and finding support has been an important step for me in moving forward.

Moving Forward With Hope

Today, I still enjoy video games. They’re part of who I am. But now they live in balance, not in control. Setting those time limits and finding new interests turned gaming back into a treat instead of a trap.

It wasn’t easy, and it didn’t happen overnight. It took my acknowledging the problem, trusting my care team, and committing to change. Sometimes I stumble; sometimes the urge still creeps in if I’m tired or stressed. But now I have a plan: I’ll call my wife, go for a short walk, or do breathing exercises until it passes.

ICBs don’t define me. Parkinson’s disease doesn’t define me. I learned that I am more than a patient or a diagnosis. I’m a person with strength and a life story. We’re all navigating Parkinson’s together, sharing lessons and breaking taboos. The more openly we talk about these challenges, the stronger we become as a community.

If you see yourself in this story, remember: you can take back control. It might take time. It might feel messy. But there is absolutely hope. Stay aware, be honest with yourself and your doctor, and lean on your loved ones. Recovery is possible — you are not alone in this journey.

A Caregiver’s View: When Love Meets a Hidden Struggle

As David’s caregiver, I’ve learned that Parkinson’s disease doesn’t just affect the person diagnosed—it impacts both of us in ways I never imagined. At first, I simply noticed subtle changes: he stopped exercising, wasn’t engaging in conversations, and seemed glued to his phone. I thought maybe it was fatigue or a flare-up. But when he no longer asked how I was doing, when he retreated further into himself, I knew something was wrong.

When David finally admitted he was stuck in a compulsive gaming loop, everything clicked. These weren’t just quirks or mood shifts.

They were signs of impulse control disorders (ICBs)—a known but often misunderstood side effect of dopamine agonists used to manage Parkinson’s. As a caregiver, watching him struggle with what looked like a simple habit, but was really an addiction, broke my heart. I learned terms like punding, where repetitive tasks feel urgent and rewarding but serve no purpose.

And I realized this wasn’t a character flaw—it was a neurological consequence of treatment.

This experience taught me the importance of being observant and asking questions, gently but firmly: “What are you doing on your phone?” “Is something bothering you?” Recognizing compulsive behaviors early can make a difference. We’ve since set phone check-ins and restructured routines to support his recovery. But more than anything, I’ve learned that Parkinson’s support isn’t just about medications—it’s about empathy, boundaries, and love.

If you're a caregiver, trust your instincts. Know the signs of behavioral changes, and don’t be afraid to talk about them. With honesty, cognitive behavioral therapy, and professional guidance, these challenges can be managed. You're not alone in this. And neither are they.

 

Frequently Asked Questions

1. What are Impulsive and Compulsive Behaviors (ICBs) in Parkinson’s?

They are strong, often irresistible urges to repeatedly do something that feels rewarding but can become excessive or risky. Examples include gambling, shopping binges, over-eating, or repetitive “punding” tasks (like endless gaming or sorting). These behaviors occur because certain Parkinson’s medications can overstimulate the brain’s reward circuits.

2. Which Parkinson’s medications are most likely to trigger ICBs? 

Dopamine agonists (such as pramipexole, ropinirole, and others) carry the highest risk. They directly stimulate dopamine receptors related to reward. Studies find about 17% of patients on these drugs develop an ICB. Levodopa (the classic Parkinson’s drug) has a lower individual risk, but higher overall dopamine dosing (or using multiple drugs) can still raise the chance of ICBs.

3. How do I know if I or a loved one has an ICB?

 Look for warning signs such as:

• Devoting long hours to one activity (gaming, shopping, etc.) at the expense of daily life.

•  Secretive or defensive behavior about that activity.

• Unexplained financial problems (credit card charges, debts) or hiding spending.

• Notable changes in mood or relationships when restricted from the activity.

• Taking more Parkinson’s medication than prescribed.

• You can also take a quick screening tool called the QUIP (Questionnaire for Impulsive-Compulsive Disorders) used by neurologists to flag risky behaviors.

4. Can I stop or change my medication on my own to fix this?

No. Never abruptly stop or change Parkinson’s medication without your doctor. Doing so can cause serious withdrawal effects and make your motor symptoms worse. Always consult your neurologist or Parkinson’s nurse. They may gradually adjust your dose or switch medications in a controlled way.

5. What treatments help manage ICBs?

1. Medication review: Under medical supervision, your doctor may lower the dopamine agonist dose or switch to levodopa or other therapies. This often helps reduce the compulsive urge.

2. Cognitive Behavioral Therapy (CBT): Working with a therapist can help you recognize triggers for the behavior and develop coping strategies. Research suggests CBT can be beneficial for ICBs in Parkinson’s.

3. Structure & Support: Set firm routines and limits (for example, scheduled game time). Involve family or friends to help monitor and encourage healthy habits. Finding new hobbies or group activities (like art class or walking clubs) can replace the compulsion with positive experiences.

6. Is punding the same as a gaming compulsion?

Punding is a term for rigid, repetitive behaviors (sorting objects, collecting, disassembling things) that serve no clear purpose. When video gaming becomes an endless, mechanical activity (e.g. playing 10-16 hours a day, resetting levels constantly), it is essentially a form of punding. Both involve a loss of control over the behavior, rather than a planned or finite pastime.

7. How can caregivers help spot and address ICBs? 

Caregivers often notice changes first. Keep lines of communication open: gently express concern (for example, “I’m worried about how much you’re playing lately.”) or ask questions about new habits. If you see warning signs, encourage your loved one to discuss them with their doctor. Support their appointments, help them track medication use, and suggest alternatives or downtime activities. Remember, you’re not blaming them — you’re helping them recognize a medical issue so they can get support.

Support Our Work

If you’ve found this guide helpful and believe in spreading gentle, accessible healing options for Parkinson’s — consider supporting our ongoing research, writing, and community work. Even small gestures make a big difference.

☕ Buy us a Ko-fi — to help us keep sharing meaningful, science-backed content for caregivers and individuals navigating Parkinson’s.

Thank you for being part of this journey.

For Caregivers: Walking the Line between Love and Limits

If you're caring for someone with Parkinson’s who’s showing signs of impulse control issues, know that you’re not alone — and it’s not their fault. As Hayley, my partner, learned through our journey, these behaviors are often side effects of the medication, not a reflection of the person you love. Set clear financial boundaries, watch for subtle changes in mood or habits, and talk openly — without blame. Early conversations and compassionate honesty can make a huge difference. Don’t hesitate to involve a neurologist or therapist, and most importantly, take care of yourself too. Caregiving is hard. You matter too.

Medical Disclaimer

This blog post is for informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult your physician or a qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay seeking it because of something you have read here.

Sources

1. Parkinson’s Foundation (US) – Impulse Control Disorders A comprehensive guide to understanding how impulse control disorders (ICDs) relate to dopamine therapy and how to manage them effectively.

2. Parkinson’s UK – Impulsive and Compulsive Behaviors Explore real-life stories, treatment advice, and support for patients and caregivers dealing with compulsive behaviors in Parkinson’s.

3. American Parkinson Disease Association (APDA) – ICBs Overview An in-depth overview of impulsive and compulsive behavior risks tied to Parkinson’s medications and what to watch out for.

4. NIH – Study on Dopamine Agonists & ICBs Peer-reviewed research on the neurological mechanisms behind dopamine agonists and their link to behavioral addiction patterns in Parkinson’s.

5. QUIP Screening Tool – University of Pennsylvania A downloadable questionnaire to help patients and clinicians detect early signs of impulse control disorders in Parkinson’s