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Dichotohmy

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  1. Congratulations on sucessfully treating your anhedonia, but your shadowy allegory isn't much help for those with a biophysical brain disorder as opposed to comorbid thought-disordered anxiety (conquering the latter seems to be the point of your riddle).
  2. Even though I do get extremely ephemeral, 2-30 second windows of pleasure and emotion at times, I'm completely used to anhedonic symptoms and legitimately untroubled by them anymore. The windows are not strong enough to make me wish that such an alternative to the anhedonic normal would last forever - and quite frankly, I've reconciled that (for me) there's no psychiatric drug or psychosocial solution to this problem anyway - so I don't mind doing nothing about a "problem" I can't even do anything about at the present time. I might be different in that I'm convinced this is just a symptom of a more pervasive biophysical disorder, for which I do actively look for answers to. In the mean time, I've grown to appreciate the robotic objectivity and freedom from the burden of stupid human foibles that anhedonia has given me.
  3. Anhedonia doesn't make me suicidal, but I'd absolutely say that anhedonia has fundamentally changed my metaphysical outlook over the years to a monoist, aspiritual one where the notion of suicide being intrinsically wrong or bad is flat out ridiculous to me. I don't believe in the notion of free will, either, so potential guilt over suicide isn't something that crosses my mind. I think for a lot of people, suicidal ideation is so troubling because they carry moral convictions that suicide is a sin or is a waste of a future that is open ended. Instead, I find it comforting that if things ever become really, really destitute for me, I have the means, method, and zero qualms about opting out of life.
  4. I would say that anxiety over personal circumstances is a a prime cause of people opting out of life. I would therefore say that if you do have anxiety, you probably don't have the kind of anhedonia I know, or at the least, you have some sort of depressive disorder with anhedonic features.
  5. Over the past two weeks, I've been seeing improvements in anhedonia, emotional amnesia, brain fog, and the like by a dramatic increase in REM sleep. That's right, REM sleep, the stage of sleep, which ordinarilly occupies about 20% of an adult's time asleep, that is vilified in the pathology of depression as a scourge of rumination, anxiety, guilt, and just happening way too much. The fact is, REM sleep happens way too little in my baseline, probably about 5% on most nights. I'm doubtful I have also increased non-REM deep sleep, but hypothesize I've swapped stage N2 and N1 sleep for REM. Antidepressant drugs, especially irreversible MAOIs, squash REM sleep. Lots of other things, like alcohol, cannibas, and many other supplements squash REM sleep as well. All of these drugs have been disasterous and inefficacious for my sleep quality and, not surprisingly, my anhedonic symptoms as well. There seems to be little to no scientific evidence for the importance of REM sleep. Humans deprived of REM sleep don't drown themselves in a forced-swim test like rodents do - but that's probably because it's unethical to do forced-swim tests on human participants. I would wager that there is a subest of depressed people that do benefit from REM suppression, but I can say with certainty, as a person with pure anhedonic symptoms and nothing in common with depression or depressed persons beyond the vagueness of the diagnostic criteria, that I need REM sleep badly and I might just get better if I can keep up with the dreaming.
  6. On the surface, pretty damn well with no insomnia, no obvious sleep disorders, excess or disturbing dreaming, or anything tangibly wrong really. In reality, my sleep quality is god awful, fragmented, and non-refreshing. I definitely don't have a problem with dreaming too much, and very rarely have a dream that is a reflection of some sort of inner unresolved pathos that I haven't been able to convert. Instead, my dreams are about mundane things and mostly boring. I also don't ruminate very much in my waking life because, in addition to anhedonia sapping the positive, I don't experience any negative or anxious emotional charge to feed into and sustain that sort of thing.
  7. Indeed, it's impossible to appreciate this fact unless you experience it. I'd also put out the psycho-babble argument that the ability to feel positive emotions from anticipation is a big driving factor in knowing and feeling that pleasure once it happens. In this sense, anticipatory anhedonia is double suck compared to consummatory. On the other hand, let's go full circle to the loss of ability to connect emotionally with thoughts and...
  8. In RLS, there doesn't seem to be a similar loss of dopaminergic functioning in the substantia negra, and in fact, might not be any altered dopamine functioning in this area of the brain's movement center: http://www.ncbi.nlm.nih.gov/pubmed/19467991 However, if you have a bonafied iron deficiency, with iron being a cofactor in the synthesis of dopamine (plus a contributer or cause of RLS), which might contribute to loss of dopaminergic activity in the ventral striatum and limbic areas, which is pretty solidly implicated in the pathology of anhedonia. I have RLS as well, and I'm really on the cusp of being iron-deficiency anemic according to tests.
  9. Yep, it's pretty common knowledge that psychological factors can result in somatization and it's worth mentioning in order to balance the discussion. The take away is that the brain-body connection is still extremely mysterious and poorly understood, so if one doesn't respond to traditional interventions - with the inflammatory etiology of depression being a relatively new concept that has only garnered serious research over the last 10-20 years it seems, you might just need to dig high and low if you don't respond to traditional interventions.
  10. Yep, my ability to fantasize, and my whole imagination really, was probably one of the first things to go when I started developing anhedonia. By that logic, I'd expect it to be one of the last things to come back as the windows of anhedonia relief I've enjoyed don't feature a return of fantasy or whimsy.
  11. I'd say if you still care about being a good person, or you have the emotional capacity to even care about that, you're doing pretty well when it comes to anhedonia. I'd also say that CBT/mindfulness are completely useless for this problem unless anhedonia is causing you some sort of distress, with organic stress being something that will worsen anhedonia and other depressive symptoms. Others have also posted this, but it's also true in my case, that my inner voice is so emotionally neutral, I consider children starving in Africa with the same gravity as making a decision at the supermarket. In real life instances - high-siding off my motorcycle in traffic and somehow walking away nearly unscathed feels as emotionally significant as paying my monthly internet bill. What I'm trying to say is that the worse side of the anhedonia spectrum includes complete apathy, alexithymia, and emotional loss, so be glad if you don't make it there because you might still have the human capacity to benefit from psychological therapy. Otherwise, welcome to the club!
  12. In re: to some of the posts here. Yes, cytokines released as an inflammatory response (like due to any inflammation from something as bad as rheumatoid arthritis to something less bad like IBS) outside of the brain can cross the BBB in certain cases and make it into the brain. In other cases, the CNS can trigger inflammation in the brain due to signals from the body. Probably the best example of that latter point would be the relationship between the vagus nerve, gut inflammation, and consequent neuroinflammation. The systematic review literature I posted earlier mentions these things, but I admit, it's a lot of reading and biological terminology and concepts to get down if you want to really understand this subject. Brain inflammation can absolutely be a cause of 24/7 brain fog. I have 24/7 brain fog that is like a bonafied altered, slightly hallucinatory consciousness when it gets bad. Personally, anti-inflammatory supplements like curcumin and omega-3 fish oil don't do much for me outside of being a subtle part of a regimen. On the other hand, 600-800mg of Ibuprofen does produce noticeable positive effects on my mood, cognition, and physical ailments. In some cases, ibuprofen can be slightly euphoric for me like an opiate. I'm looking into immune modulation or suppression, because in my case, I'm almost 100% confident my physical, mental, and cognitive issues - are the result of a wacked-out immune-inflammatory response. In my case, my pure depressive symptoms are anhedonia, almost complete emotional loss, numbed mood and alexithymia.
  13. Sickness behavior, or major-depressive-like symptoms as a result of an immune response which releases pro-inflammatory cytokine, is an under-appreciated clue towards the etiology of depression IMO. Pro-inflammatory cytokines can interfere with the tryptophan cycle, cross the BBB from systemic inflammatory conditions, wreak havoc on the HPA axis, and even induce anhedonia in previously healthy individuals. Note: this sort of sickness behavior responce doesn't happen in all cases of depression (IE determined through post-mortem brain study or via blood testing). This concept is highly worth looking into if you're like me and are a non-responder to psychological OR psychiatric treatments (IE treatment resistant). The bottom line seems to be we want to upregulate anti-inflammatory cytokines, or otherwise quell the auto-immune response that induces sickness behavior in the first place. How to go about accomplishing that bottom line is the hard part. http://www.jneuroinflammation.com/content/10/1/43 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2919277/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3025604/
  14. I have decades of exerpience with MJ, and I'm a medical user. My experience is that MJ has no discernible long-term effect at all, which is to say I don't notice any cumulative building, either positive or negative, and that the only effects I notice are acute. In every case, MJ worsens my cognitive abilities, but increases my ability to be introspective and ability to think laterally. Every strain of MJ I've ever tried increases my ADHD symptoms significantly, yet can induce hyperfocus just the same and can also help greatly with filtering out irrelevant environmental stimuli. Cannabindiol-rich strains help a lot with muscle, joint, brain, and other inflammation, but the effect only lasts around an hour. CBD/THC strains (like pure indicas) slow things down for me and increase my apathy markedly. THC-rich strains greatly improve my apetite and the pleasure of eating, which is good because I am underweight and normally have a weak hunger drive. All in all, MJ is far from a primary treatment and is only really useful as an adjunt. I am not prone to anxiety, which is probably why I tolerate all strains. I think there's a lot of medicinal potential in low-THC/high-CBD strains like Valentine-X and Charolette's Web, especially in regards to depression that is caused by an inflammatory and physiological mechanism, but as a whole, MJ is best combined with stronger treatments.
  15. What's your dosage? Are you going by the suggested 500mg BID? I've been thinking about trying Sarcosine for months, because I strongly suspect glutaminergic hypoactivity is part of the puzzle. Hence why I consistenly felt better while withdrawaling from heavy alcohol use. Glutamine balance is probably the take away message for why NMDA antagonists like ketamine work for some, and why and indirect agonist of NDMA, like sarcosine, is useful for others.
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