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Answers To Curing Anhedonia/numbness/apathy, No. 1


itstrevor

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These psychiatrists believe that SSRIs are most effective for any type of depression, regardless of symptoms, (usually calling me "obsessive" for researching or disregard science backing it up as "just theories,” and that “nobody knows what’s actually going on in the brain" etc.) and often deny that serotonergics make anhedonia worse (I've been with two of this type).


I didnt read the whole thread I think I've done my mental work for the day so Ill throw it up on bookmark. But I don't generally feel sad or angry anymore, and I used to be very aggressive and confrontational but never violent. I was trying to summarize my feeling on SSRIs and how they affect me but it is very difficult so Ill try to make it logic statements

-I feel apathy 80% of the time

-SSRIs made me feel apathy near 100% of the time or slightly drunk/high/altered

-SSRIs had numerous side effects including clamp jaw so much that i cracked a tooth, complete sexual numbing and dsyfunction but for some reason my libido cannot be lowered (only increased... welbutrin was hell). So its like having a ton of desire but never being able to get satisfaction which is the worse combo of sexual symptoms I think. It also had a ton of other side effects

-SSRIs made me feel better and I liked the dead apathy feeling or drunk state a LOT so much that I struggled to quit them because it was so nice to not feel bad and be a zombie, but its like something that makes you feel good but you know its wrong. Even thinking of it now I long for the feeling so badly like a drug addict, I dont drink, smoke, or do drugs (outside of whip cream once in a blue moon and I tried salvia as a spiritual type thing, have it under my desk right next to me, ready at any time, havent touched it in months). But I crave for drugs so badly when I am depressed even when Im not an addict or addictive personality, only tried pan a few times several years ago and hated it, I even straight up wanted to do meth or heroine because the pain and it scares me to think of that because I am vehemently antidrugs and wanted to be a cop. But that dead feeling is so nice because feeling partially dead or mostly dead is horrible. I want to feel completely numb and dead and not think or be whole. This inbetween purgatory of emptiness is torture to the brain that craves stimulation and sensation. I hurt my back really bad recently and the pain was actually nice because I felt something.

Its like when you are drunk or w/e you feel good and dont want to stop but you know if you were sober you would stop and that the ideas that seem good now aren't reality but as the alcohol gains more effect and you continue to drink the reality you know and live in slowly melts away and loses hold til that other voice is ignored or silenced and you make stupid decisions. And that logically you should not be feeling like this because you will be trapped dead forever like a zombie. I felt like SSRIs would keep me an invalid for the rest of my life like a zombie and even though I might be, I wouldnt call it happy, I know what happy is because of salvia reminding me, like... its not even content its like... contented apathy rather than miserable apathy. Like you don't care compeltely so much that you dont care you don't care and you let go of everything instead of not caring but feeling horrible and sick and wanting to be dead. I don't even know if human words have the depth to describe feeling as I've come into so much more depth with my mind and its states in the last few years. Like how is it possible to both feel nothing but then also feeling nothing feels bad, and you crave for a good feeling. I mean I guess its like sad and apathy aren't really the same emotion or I am feeling each emotion about different things or even simultaneously. Maybe its like sad and happy are feelings that can be put on a graph but then apathy is magnitude of said feelings and people who are bipolar is like frequency...
Or emotions are more like colors with hue and saturation is probably best. Saturation is how much of it you feel so less saturation is like apathy so colors are dull and grey, so it doesnt matter if you are happy or sad because like red or blue because apathy makes them both shades of grey, so although it is preferable to have less saturation if you are always sad it doesnt not actually fix the problem that you are sad, it only makes its so apathy completely overtakes it. Instead of lack being sad, you lack being happy.

I have some sadness and crying spells which is very rare but whenever I think about God or Jesus or read the Bible it makes me cry, it didnt used to do this to me before even though I felt it a little and would cry rarely but now it always does like even writing this. I used to feel like crying whenever I had to sing in church so I would never sing but now I think if I went to church I would cry from hearing the singing or serrmon. It makes me feel better too, but crying in public to me I can't do especially if its related to a disease. Don't get me wrong I do not care what others think of me at all in any way shape or form and this was before depression too, but I feel its wrong to cry in public like this, because of a disease, even though I would probably only get approval from family and church for it.

But besides that I feel nothing but physical pain most of the time. Sometimes I feel restless but its not anxiety its like I feel so empty it causes me to be restless and need to fill it with SOMETHING.

. But generally I am just apathetic to everything and most definitely do not enjoy anything. I sit sometimes staring at my computer or laying in bed thinking, what should I do. I don't even know what to do at all. I have no motivation or attraction to anything in any normal amount. And even when there is stimulus like pain, having to pee, hunger, dehydration (Im always dehydrated), bad heartburn, cold (like if I left my window open when its snowing and kicked off my covers and am freezing) etc it doesn't motivate me unless it is really really bad. So its not just lack of motivation, its lack of motivation when stimuli is present that would make a normal person react. I guess thats tied into why I don't shower or brush my teeth ever as well because even with stimuli of filth which I hate (used to be a clean freak wash my hair twice a day sometimes) I don't react.

Its like the threshold for reaction, like the uh... decision for the nueron to fire are set extremely high so doing anything including sending the emotions like sadness are also increased so you feel less of it. Or mabye the nuerons DO fire but somehow its weak or lost or the reception of the next neuron is weak. I have no idea just FFT.

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Hi trevor I am Ahsan. I am suffering from anhedonia. My psychiatrist has prescribed me two ssris which are paroxetine 20 mg(1.5 tablets) in the day during 9-10am and risperiodone 1mg(1.5 tablets) during 9-10pm in the night. Recently I have been getting some emotions for the past 2 days. I went to the zoo with my mother and felt some strong emotions of love towards animals and small children. What do you think?

Before taking Paroxetine and Risperiodone, were you emotionally numb? Did you have no emotions? What about motivation/desire/interest to do stuff?

Yes I was emotionally numb. I had no motivations or desire to do anything.

Really? So you couldn't feel ANYTHING? Like no emotions at all? Like you couldn't feel ANYTHING, period? What about enjoying stuff? Could you enjoy anything before taking meds?

It's so painful to live every single day with Anhedonia... you're not living, you are simply existing... and this existence is becoming too painful for me. I can't feel anything, I can't feel any emotions whatsoever, and I can't even enjoy anything. All I do everyday is lay in bed and watch movies... I am a vegetable (thanks to Prozac). I don't understand what's the purpose of continuing this existence, because I'm not even living anymore.

There's a guy named "conundrum" on dr-bob.org he took Prozac, and after he stopped taking it, he developed Anhedonia, and like me, he cannot enjoy anything and has no feelings/emotions at all. 7 years later, it never went away. I don't even know how this guy even made it for THAT long. As I said, no one who has experienced this can even possibly understand what it's like. Please give me Severe Depression ANY DAY... than this state that I'm in.

The sad part is, there is no "treatment" for this.... why I continue this existence is simply beyond me. Unfortunately, this world really is an "evil place". I use to be religious when I was younger, but not anymore. I don't believe in God or any creator or w/e BS... this world exists by pure luck, and whatever happens, happens. Most people (humans) are pathetic anyways.

THIS. I believe mine is not caused by prozac though but a personality disorder i am diagnosed with. And that what I do all day as well when I'm not working - laze around and watch anything and everything. Sometimes I like to read and play video games just to stimulate my mind a bit which it can help bring the tiniest bit of pleasure. Working out can also give me a bit of an endorphin high but it doesn't last long. Hardly worth living this existence just for that... I'm sure prisoners have more enjoyment in their lives than me. It is prison though... prison of the mind.

Myself it has been four years and how I haven't thrown in the towel on life yet is a miracle. Making it to 7 without change would just be the final nail in the coffin for me. I need to FEEL and not be a zombie. I don't even feel much pain. I self harm all the time and it does not really hurt. Earlier Trevor mentioned only being able to feel frustration... well that's what it is for me. I sometimes feel anger that somehow I can't get rid of unless I sleep it off.

You are right that most humans are pathetic. The biggest problem to them is often something so small and fickle. Just wake up and walk in our shoes and you'll see how insignificant their "problems" are. They don't have the courage and strength that anhedonic people have just to wake up and face the world. Really I am not afraid of anything anymore... I haven't felt fear in a long time... not of pain, being homeless, broke or being arrested. In my opinion, those problems are nothing compared to anhedonia.

I can't tribute to much to this thread I'm afraid... I take Citalopram mainly because I have mild 'anxiety.' I put in inverted commas as I'm not really afraid / nervous I just don't like showing my face in public. I feel like a ghost when I walk around people anyway, so I want to walk in the shadows with my face covered. I'm Schizoid PD so I really don't want to be around people at all but of course this to doctors = social anxiety. I also take Tyrosin for metabolism / liibido / stress, (biosynthesis of dopamine, adrenaline noradrenaline and thyroid hormones), L-Tyrosine 500 (for thesysthesis of the neurotransmitters such as norepinephrine, epinephrine and dopamine) and Damiana for general well being.

Finally I take a few laxatives and fiber to speed up / help my digestion as it's terribly slow. Also one of the reasons I take Tyrosin also is for the thyroid hormones ( too little throid so poor regulation of food into energy meaning metabolism is too slow), as I believe that I have Hypothyroidism. Although I have never been diagnosed it is very hard to diagnose. I have however ruled out Celiac disease. My awful digestion is not caused by allergies to wheat. Somebody once told me libido is all in the gut and a slow digestion can cause a poor sex drive. I have all of the following symptoms of Hypothyroidism notably low sex drive and slow digestion: Chronic fatigue, lethargy, slow digestion, low sex drive, brain fog, weight loss and dry skin.

I honestly now believe that my personality disorder is only half the problem. I'm sure it's something physical as well. Embarrassing as it is, constipation and depression are heavily linked. Finally, I would like to point out that how almost everyone with anhedonia writes long passages a lot on the internet. I believe it's because of boredom. We don't enjoy anything so we think and get our thoughts out. Just a theory based on an observation... not necessarily true but I believe it is why we ramble on so much.

I'm so sorry to hear. I don't know what to say, other than it's a living nightmare. I just woke up and asked myself why I continue even living, it is so painful, this simply isn't life.... If I could have the ability to feel and have emotions again, I would probably be the happiest person in the world... but now, I'm fighting for my life...

Did this start when you took Citalopram, or any type of medication? And yes, I have the same problems as you (chroinc fatigue, lethargy, low libido, brain fog and dry skin)... but I took a thyroid test and it says everything is fine...

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Everything makes sense... I do suffer from permanent brain damage, take a look:

http://pssd.forumotion.com/t176-post-ssri-brain-damage

For anyone else who took SSRI's... please take a look.

How do you know it is permanent? The article lists some interesting symptoms but shows no causative validity whatsoever. The symptoms, by the way, are the same symptoms many exhibit during depression. In 20 years people might look back on SSRIs like they were arsenic, but until that happens, maybe want to get a SPECT scan and an MRI if it makes you feel better.

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Everything makes sense... I do suffer from permanent brain damage, take a look:

http://pssd.forumotion.com/t176-post-ssri-brain-damage

For anyone else who took SSRI's... please take a look.

Is there any scientific evidence to back this up?

I don't need scientific evidence to back anything up Trevor. I don't need anyone telling me whether I suffered from brain damage or not, either. I know the person I was before taking Prozac, and the person after I took it. Everything symptom they've mentioned applies to me. People who take SSRI's usually recover with 1-2 years after taking them (recovering from SSRI induced Anhedonia, no emotions), but that wasn't that case for me and some other people.

Everything makes sense... I do suffer from permanent brain damage, take a look:

http://pssd.forumotion.com/t176-post-ssri-brain-damage

For anyone else who took SSRI's... please take a look.

How do you know it is permanent? The article lists some interesting symptoms but shows no causative validity whatsoever. The symptoms, by the way, are the same symptoms many exhibit during depression. In 20 years people might look back on SSRIs like they were arsenic, but until that happens, maybe want to get a SPECT scan and an MRI if it makes you feel better.

I've been contacted by a couple of people on Youtube, talked to people on internet forums, and there's people like me out there (after taking an SSRI, they lost all emotions) and they never came back. When I was depressed, it was feelings of sadness. It's so hard to remember what emotions were like, because it's been practically 4-5 years since I had any emotions. I practically forgot what emotions were, because I've been living in this zombie state for so many years now.

The question is, is there anyone that has ever regained their emotions again after losing them? I think there's people that recovered from anhedonia (lack of pleasure), but haven't found anything about people losing their emotions, and getting them back again.

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Getting back to treatments for anhedonia, there is a melatonin derivative which is being used in other countries for depression, and current studies show that it has noticeable effects with AH..

http://www.ncbi.nlm.nih.gov/pubmed/22959116

Anhedonia and major depression: the role of agomelatine.

Source

Department of Neuroscience and imaging c/o Mental Health Department, Viale Amendola, 47, 66100 Chieti, Italy. digiannantonio@unich.it

Abstract

Anhedonia is a condition in which the capacity to experience pleasure is totally or partially lost. Although anhedonia is a feature of major depressive disorder according to DSM IV criteria for major depression diagnosis, so far it has received relatively little attention. The scale that is most commonly used in the measurement of anhedonia is the Snaith-Hamilton Pleasure Scale (SHAPS), a brief 14-item self-report questionnaire designed to measure hedonic tone and its absence. Two studies have described the efficacy of agomelatine in the treatment of anhedonia: an open-label study and a comparative trial versus the antidepressant venlafaxine XR. In both studies agomelatine significantly reduced anhedonia, as indicated using the SHAPS. This reduction was observed after the first week of treatment (P<0.05) and at different times until the end of the trial. Moreover, in the comparative trial, a significant difference between groups was observed in favor of agomelatine, after 1 (P<0.05), 2 (P<0.01), and 8 weeks (P<0.01). The possible effect of agomelatine on anhedonia may represent a novel area of interest among antidepressant agents and deserves further investigation, with larger samples and double-blind placebo-controlled designs.

Copyright © 2012 Elsevier B.V. and ECNP. All rights reserved.

Edited by stillkickin
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Handsup, anhedonia (lack of pleasure) is related to no emotions. If you cannot feel pleasure, that encompasses pleasurable emotions too, such as getting an emotional release after a cry, feeling head over heels and romantic, or feeling good about something in your life. Anhedonia is really all about feeling flat, empty, zombielike, and apathetic.

I think I saw a post you made on psychobabble not too long ago as well. I am sensing that you are becoming desperate. Be careful because desperation often comes with muddled thinking. Most of the times I reached desperation, it landed me in the ER. Once I overdosed on Ritalin (since it was the only thing so far to make any sort of impact, but I had to continually escalate my dose to achieve the same effects). I also got sent to the ER for overdosing on 300-400mg caffeine (I had purchased anhydrous caffeine online because I noticed a slight mood boost from drinking Pepsi, but after this "experiment" it seems that this mood boost was more a result of the sugar intake than caffeine). There are other times besides these, but ultimately the result was the same: I got myself in big trouble.

It is extremely difficult keeping these impulsive thoughts at bay, since you are constantly in a flat mental state, much as if your inner self is in a prison and cannot escape. I find that the times when I encounter breakdowns the most is after a failed experiment, because it becomes very discouraging. What keeps me going is the hope I have that I will get better. If my Parnate trial fails, that will be a big blow, since it would essentially mean that my "depressed" state cannot be modeled by classic interpretations of depression involving monoamine neurotransmitters. It would mean that a response to any antidepressant would be unlikely, since I would have already tried raising all of the monoamines with no success. It would mean that I would have to move on to uncharted territory and deal with more complex theories involving glutamate and opioids, unsure if there is even a suitable med to fix the problem. All I am saying is you are not alone, and you still have options on the table.

Now I have heard of agomelatine, and my pdoc mentioned it during our last meeting. It improves sleep quality due to its agonism of melatonin receptors, and increases dopamine/norepinephrine release due to 5ht2c antagonism. Now I wonder if this release is only increased in the prefrontal cortex? Remember my discussion earlier about raising dopamine and norepinephrine in the prefrontal cortex - this can be done with NRI antidepressants and Abilify already, and so far I have not had a response to them, meaning my issue is most likely elsewhere. But perhaps it also increases release elsewhere? And perhaps others in this thread are experiencing more of a frontal lobe syndrome? It does not appear that I am, at least. I am wondering really how powerful agomelatine is compared to other meds. At this point I am beginning to lose hope in the weaker meds, since I have had absolutely no response to them. That's one reason why I feel so compelled to try the "big guns" MAOIs.

-EDIT

Yeah I just read that 5ht2c antagonism not only increases dopamine/norepinephrine release in the prefrontal cortex but also in other limbic structures of the brain. I'm not sure by how much, though (obviously not that much, since we don't tend to think of these types of meds as addictive or abusable). It also appears that 5ht2c antagonism actually decreases 5ht2c receptor density, which is desired.

Perhaps Handsup could use a serotonin reuptake enchancer and also a 5ht2c antagonist? Some people have also reported success with cyproheptadine which is also a 5ht2c antagonist (also a 5ht2a antagonist).

I think that we can essentially do the same thing as agomelatine with something like cyproheptadine+melatonin pills

Edited by itstrevor
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Trevor, of course I am getting desperate, there is no doubt about it. I honestly can't even function in life. As you know, there's no point in doing anything if there isn't a reward (this comes to anything in general). Everyone takes emotions/feelings for granted in life. Just existing with anhedonia is so painful... you just want to be alive, have fun, spend time with friends, and enjoy life. All I do is eat, watch movies, and sleep... and this isn't life. I just have no desire to do anything and it's driving me mentally insane. I honestly feel like a vegetable that simply can't do anything. At the same time, I also feel like I can't even concentrate properly or make decisions. Thinking about stuff is mentally exhausting... I'm not sure if you experience the same thing (about mental exhaustion). I know you are going through the same exact thing, I don't mean to imply that I'm the only person suffering from this... but like anyone else suffering from anhedonia, I just want to live and enjoy life, but that has been taken away from us.... like our souls have been taken away from us.

I have spoken to someone on the Social Anxiety forums, and he said taking Zoloft (150 mg) and Abilify (5 mg) and he now feels emotion/empathy (before he was anhedonic and felt absolutely no emotion at all.) This whole "5 HT2C receptor antagonists" is simply too complicated for me to understand, I don't believe I'm smart enough to even comprehend all this stuff... as for Pepsi/Coke... like you, I felt just a bit better. It wasn't happiness of course, but it was "better"

Now, the problem is, is that I'm not sure if the best option is to wait it out (and hope our emotions/ability to enjoy stuff) is back, or if we try a crap load of drugs... you see, I'm not liking for a "high", but I want genuine human emotions back. Do you think it's possible to regain genuine human emotion with drugs? I just feel paralyzed...

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Everything makes sense... I do suffer from permanent brain damage, take a look:

http://pssd.forumotion.com/t176-post-ssri-brain-damage

For anyone else who took SSRI's... please take a look.

Is there any scientific evidence to back this up?

Well it definitely is something that has been on the radar recently. some titles of papers on the issue:

Tardive dysphoria: the role of long term antidepressant use in-inducing chronic depression.

perturbational effects of antidepressants suggest monoaminergic homeostasis in major depression

Do antidepressant and antianxiety drugs increase chronicity in affective disorders?

Especially the second study is interesting. The authors performed a meta-analysis on discontinuation studies that evaluate the longitudinal course of patients that were enrolled in placebo controlled clinical trials of SSRI antidepressants. They found that the chance of relapse/recurrence of major depression was greater in patients who discontinued medication than those who discontinued placebo.

The authors argue that, although short term treatment using ssri’s raises the concentration of serotonin in the synaptic cleft, the brain might actually over time adapt to this disruption of homeostasis by a variety of neuroplastic processes, leaving patients with functional and/or structural changes to the serotonergic architecture that actually predispose them to prolonged, severe and treatment resistant depression, once treatment is ceased. Tardive dypshoria is postulated to occur especially in those who start treatment at a young age, for prolonged periods of time, becasue the plasticity of the brain is greatest before adulthood.

However, The authors also note that stopping SSRI use results in a slow recovery of normal functioning. However they note that this process may take several years.

Actually, considering that practically ALL antidepressants (i.e. ssri's, MAOI's etc.) work by in some way raising the availability of different types of monoamines in the central nervous system, it might very well be that similar neuroplastic changes might results in paradoxical long term effects that actually worsen function of patients that use other types of antidepressent medication as well.

Unfortunately, there is not much scientific data on this because pharmaceutical companies are only required to provide evidence of the short term efficacy and side effects profile of their products. Hopefully this will change now that some scientists are actually aware of and possibly actually studying this phenomenon

However, it should be kept in mind that the papers i mention here are actually for the most part viewpoint papers, much like a lot of the papers itstrevor mentions in his posts. These papers mostly represent the expert opinion of the authors. There could be possible alternative explanations to the meta-analysis in the second paper and untill there is more data on this phenomenon strong conlcusions such as those drawn by the autohors I cite in my post are definetely not warranted. So consider the phenomenon of 'tardive dysphoria' as a hypothesis for which there is a lot of anecdotal evidence, rather than a scientific fact.

Edited by sc2
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Everything makes sense... I do suffer from permanent brain damage, take a look:

http://pssd.forumotion.com/t176-post-ssri-brain-damage

For anyone else who took SSRI's... please take a look.

Is there any scientific evidence to back this up?

I don't need scientific evidence to back anything up Trevor. I don't need anyone telling me whether I suffered from brain damage or not, either. I know the person I was before taking Prozac, and the person after I took it. Everything symptom they've mentioned applies to me. People who take SSRI's usually recover with 1-2 years after taking them (recovering from SSRI induced Anhedonia, no emotions), but that wasn't that case for me and some other people.

Everything makes sense... I do suffer from permanent brain damage, take a look:

http://pssd.forumotion.com/t176-post-ssri-brain-damage

For anyone else who took SSRI's... please take a look.

How do you know it is permanent? The article lists some interesting symptoms but shows no causative validity whatsoever. The symptoms, by the way, are the same symptoms many exhibit during depression. In 20 years people might look back on SSRIs like they were arsenic, but until that happens, maybe want to get a SPECT scan and an MRI if it makes you feel better.

I've been contacted by a couple of people on Youtube, talked to people on internet forums, and there's people like me out there (after taking an SSRI, they lost all emotions) and they never came back. When I was depressed, it was feelings of sadness. It's so hard to remember what emotions were like, because it's been practically 4-5 years since I had any emotions. I practically forgot what emotions were, because I've been living in this zombie state for so many years now.

The question is, is there anyone that has ever regained their emotions again after losing them? I think there's people that recovered from anhedonia (lack of pleasure), but haven't found anything about people losing their emotions, and getting them back again.

This is some data I looked into many years ago.

http://www.freepatentsonline.com/y2006/0217394.html

It's actually about Iatrogenic Anhedonia. But I don't see why SSRI can't cause Tardive or post effects. Post Sexual SSRI disorder seems to be quite documented. That might be due to the L-arginin to Nitric Oxid conversation process or it might be due to some dopaminergic messup. However I don't know if it's "game over". Dopaminergic receptors could upreglate if it's about that. The HPA axis could adjust itself or if not there might be some drugs to put it right. What about Cabergoline ? It decreases prolactine and happens do be an agonist of Dopamine D2 receptors. It seems to me that D2 is very implicated in anhedonia. Take for instance Abilify which help some. Or Amisulprid at low doses which are indicated for "dysthymia". I wouldnt go for those neuroleptics if I suspected some sort of hyperprolactinemia. Avoiding stimulant might be helpful. Excersise. Vitamin B , especially B12. B8 (Inositol) seems to work good for OCD and anxiety btw). D vitamin (2000 IE a day shouldnt be dangerous but I am not 100 %) or else like someone wrote Cod liver oil which contains D vitamin.

I take it as this was a result of Pre-Prozac medication ? Did Prozac make anything better? IF that's the case Valdoxane(Agomelatine) which is also an HT-2c antagonist without Serotoninreuptakeinhibitator might help.

prefrontal cortex is very much involved in depression and especially in that type (if it's not ADD or ADHD)

which is associated with mood regulation. That is if one having hypofrontalism (ventromedial I think) the prefrontal cortex is to weak to be having control over the Amygdala (which is the center of fear). That in turn leads to stress and stress breaks down the brain. (Hippocampus and possibly even PFC).

I believe there's things you might try. And if it doesnt work , and if it's a comfort you should know that your'e not alone with this.

I

Edited by General_Failure
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Trevor, of course I am getting desperate, there is no doubt about it. I honestly can't even function in life. As you know, there's no point in doing anything if there isn't a reward (this comes to anything in general). Everyone takes emotions/feelings for granted in life. Just existing with anhedonia is so painful... you just want to be alive, have fun, spend time with friends, and enjoy life. All I do is eat, watch movies, and sleep... and this isn't life. I just have no desire to do anything and it's driving me mentally insane. I honestly feel like a vegetable that simply can't do anything. At the same time, I also feel like I can't even concentrate properly or make decisions. Thinking about stuff is mentally exhausting... I'm not sure if you experience the same thing (about mental exhaustion). I know you are going through the same exact thing, I don't mean to imply that I'm the only person suffering from this... but like anyone else suffering from anhedonia, I just want to live and enjoy life, but that has been taken away from us.... like our souls have been taken away from us.

I have spoken to someone on the Social Anxiety forums, and he said taking Zoloft (150 mg) and Abilify (5 mg) and he now feels emotion/empathy (before he was anhedonic and felt absolutely no emotion at all.) This whole "5 HT2C receptor antagonists" is simply too complicated for me to understand, I don't believe I'm smart enough to even comprehend all this stuff... as for Pepsi/Coke... like you, I felt just a bit better. It wasn't happiness of course, but it was "better"

Now, the problem is, is that I'm not sure if the best option is to wait it out (and hope our emotions/ability to enjoy stuff) is back, or if we try a crap load of drugs... you see, I'm not liking for a "high", but I want genuine human emotions back. Do you think it's possible to regain genuine human emotion with drugs? I just feel paralyzed...

Hey handsup,

Like i mentioned in the previous post, there is all the reason to believe that eventually you will recover, as have many people on the paxilprogress forums. People there came back from some pretty severe and long lasting periods of anhedonia. If I might give a suggestion it would be to seek specialized, psychological care in a mood clinic or such. You'd be surprised how much they can help you. Don't get caught up in the idea that your anhedonia is something that is beyond help and that you will have to always suffer from it.

My personal belief is that time will heal you, even if it really is a physical thing. Even if not, there are a lot of treatments out there that could help ultimately alleviate your symptoms, such as ECT or deep brain stimulation. Especially ECT is HIGHLY effective in treating even the most severe caeses. To illustrate, ECT has a remission rate, which means full recovery, of 70% in patients with severe melancholic depression. That means patients who are so sick that they cannoy carry out basic self care activities like going to the toilet or feeding themselves anymore. These patients would die from hunger if left unattended and are often so mentally slow that they do not have the capability to move or speak anymore. They will actually spend 99% of time in a state of catatonic muteness experiencing overwhelming panic. Deep brain stimulation is a technique that particularly alleviates anhedonia, by directly stimulating the pleasure centre. Results from clinical trials illustrate that in the same group of patients, patients would suddenly develop motivation to go on vacations and could actually taste food again.

But in the end I think that the best long term effects might be gained if healign occurs naturally. That is why I think you should seek specialized care. Anhedonia is a hallamrk feature of depression and psycholgoical treatment with for instance CBT has specific modules to adress this issue. so that is where I would start. If it turns out that it doesnt work i would move up the ladder of more radical treatments

Edited by sc2
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Hi sc2, thank you so much for taking your time to help me.


You mentioned people on Paxil Progress that have long lasting periods of anhedonia, how long are we talking here? There's a guy named wade, he took AD since he was 12, and he still has problems feeling any emotions (which unfortunately, doesn't seem to be surprising..) the thing is, I was placed on Prozac when I was 15 (when I was still a teen/kid and was still growing) so that's why I fear it is permanent. Seriously, a few members on the Paxil Progress forums are BLINDLY optimistic and delusional... kinda makes me want to puke. There advice would be perfect for someone who actually has emotions/feelings... not for someone who is anhedonic. I've been this way since 2009, so its safe to say that it's permanent. (i wish it wasn't... i just feel crippled)

The second last post you just made... I can't even understand what the heck you wrote because my concentration is damn bad. When it comes to this whole "H2 Atagonist blah blah" I can't even understand what that means. I'm not so bright when it comes to that kinda stuff... unfortunately. But to answer your question, no, Prozac did nothing other than ruin my life (I have anhedonia thanks to prozac).

As for CBT - my mom and my GP want to try therapy (CBT), but I would feel bad (well not feel... but you get the idea) that she would be wasting money on me (since i'm anhedonic). But, I'm curious, if this is an issue with the brain, how can therapy help with anhedonia? (i don't mean this in a rude way) because i don't feel depressed (how can I, i don't have emotions) but I guess I'm in shock that I might not have a normal life... didn't know this could happen to me. I guess everyone with anhedonia feels this way.

As for ECT - if there's anything that'll permanently screw you up, it just might be ECT. I'm too scared to try ECT... I mean... the whole ECT thing isn't pretty at all... but I'm interested in DBS (as long as their isn't pain or anything) the thing is, I don't want my parents dumping money on me...

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Hey all, [[[ exercise is as effective as antidepressants ]]]

I've been following this thread for a while and finding its development very both interesting and disturbing. It seems to have started out with the premise that drugs were the solution but gradually moved into a quagmire of doubt. Alot of effort has been expended on an area in which we have little control. I however can not disparage you all from investing your time in this way as I too know the severity of the problems which drive you to look for answers.

Taking a different approach to treatment: Has anyone else tried using neurofeedback as an alterative to the pharmacological approach. I would think it would appeal to anyone technically minded and who wishes to gain a far higher level of control over their treatment. I started it when doing psychotherapy, had a quantitative EEG (QEEG) done and was pleased to finally have some hard evidence as to my psychophysiology. The down side is that it is an investiment of time learning the field and then actually doing the training, money and the every present risk of it just not working.

To add my two cents to the mix I'll just report on my experience with drugs:

Agomelatine 25mg nocte: Two weeks; two days of start up side effects which completely disappeared, helped with sleep, no noticable antidepressant effect.

Agomelatine 50mg nocte: Two weeks; did not notice any new side effects, no noticable antidepressant effect, discontinued due to lack off efficacy and cost!

Comment: Clinical data + anecdotal evidence suggests that it kicks in faster than other ADs hence my short trial period.

Modafinil: Increase in energy, increase in creativity, insomnia, discontinued due to insomnia.

Comment: Inconclusive clinical evidence as to its effeciacy in augmenting an AD.

Sertraline: I'm now 4.5 weeks in, no blunting of emotion (it was already flat though). It has decreased negative affect somewhat, without increasing positive affect.

Comment: I will look to augment this with a second AD preferable a TCA (I would go for a MAOI but it is of course contraindicated!) such as Imipramine.

Clip

Also exercise has been the best thing I have done through out all this, don't under rate it.

Edited by Clip
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Hi sc2, thank you so much for taking your time to help me.

You mentioned people on Paxil Progress that have long lasting periods of anhedonia, how long are we talking here? There's a guy named wade, he took AD since he was 12, and he still has problems feeling any emotions (which unfortunately, doesn't seem to be surprising..) the thing is, I was placed on Prozac when I was 15 (when I was still a teen/kid and was still growing) so that's why I fear it is permanent. Seriously, a few members on the Paxil Progress forums are BLINDLY optimistic and delusional... kinda makes me want to puke. There advice would be perfect for someone who actually has emotions/feelings... not for someone who is anhedonic. I've been this way since 2009, so its safe to say that it's permanent. (i wish it wasn't... i just feel crippled)

The second last post you just made... I can't even understand what the heck you wrote because my concentration is damn bad. When it comes to this whole "H2 Atagonist blah blah" I can't even understand what that means. I'm not so bright when it comes to that kinda stuff... unfortunately. But to answer your question, no, Prozac did nothing other than ruin my life (I have anhedonia thanks to prozac).

As for CBT - my mom and my GP want to try therapy (CBT), but I would feel bad (well not feel... but you get the idea) that she would be wasting money on me (since i'm anhedonic). But, I'm curious, if this is an issue with the brain, how can therapy help with anhedonia? (i don't mean this in a rude way) because i don't feel depressed (how can I, i don't have emotions) but I guess I'm in shock that I might not have a normal life... didn't know this could happen to me. I guess everyone with anhedonia feels this way.

As for ECT - if there's anything that'll permanently screw you up, it just might be ECT. I'm too scared to try ECT... I mean... the whole ECT thing isn't pretty at all... but I'm interested in DBS (as long as their isn't pain or anything) the thing is, I don't want my parents dumping money on me...

I doubt CBT would help. It's usually goaloriented. That means one needs to have some form of motivation and suffering from Reward deficiency is not like a carrot. Sometimes doing things without having motivation might help. Working out at the gym has become a bit of a habit of mine but at first one has to push oneself. The thing about sports is probably the endorphines. It's said that's dopamine is involved in the "wanting" and opioid activity is involved in "liking". Some studies claims that Anhedonic people might actually appreciate the thing causing the "opioid-release" when it's happening. One tends to forget what if anything actually did give some kind of reward. Socializing might help (if one is not social anhedonic as well), it's just that the "wanting" and the memories of potential "likeable" activities is blocked. Opiods have showed great results when it comes to treat depression the problem is of course tolerance/depedency. Some studies claims that aerobic excersises might be more beneficial for depression but I can't stand them with some exception.

I think someone earlier wrote about this before. That is that liking can be separable from wanting.

It's not like I believe hitting the gym actually helps against anhedonia, if it had had I would have been "cured" 15 or 16 years ago. It's more like helping putting up in this misery called life.

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Hey all, [[[ exercise is as effective as antidepressants ]]]

I've been following this thread for a while and finding its development very both interesting and disturbing. It seems to have started out with the premise that drugs were the solution but gradually moved into a quagmire of doubt. Alot of effort has been expended on an area in which we have little control. I however can not disparage you all from investing your time in this way as I too know the severity of the problems which drive you to look for answers.

Taking a different approach to treatment: Has anyone else tried using neurofeedback as an alterative to the pharmacological approach. I would think it would appeal to anyone technically minded and who wishes to gain a far higher level of control over their treatment. I started it when doing psychotherapy, had a quantitative EEG (QEEG) done and was pleased to finally have some hard evidence as to my psychophysiology. The down side is that it is an investiment of time learning the field and then actually doing the training, money and the every present risk of it just not working.

To add my two cents to the mix I'll just report on my experience with drugs:

Agomelatine 25mg nocte: Two weeks; two days of start up side effects which completely disappeared, helped with sleep, no noticable antidepressant effect.

Agomelatine 50mg nocte: Two weeks; did not notice any new side effects, no noticable antidepressant effect, discontinued due to lack off efficacy and cost!

Comment: Clinical data + anecdotal evidence suggests that it kicks in faster than other ADs hence my short trial period.

Modafinil: Increase in energy, increase in creativity, insomnia, discontinued due to insomnia.

Comment: Inconclusive clinical evidence as to its effeciacy in augmenting an AD.

Sertraline: I'm now 4.5 weeks in, no blunting of emotion (it was already flat though). It has decreased negative affect somewhat, without increasing positive affect.

Comment: I will look to augment this with a second AD preferable a TCA (I would go for a MAOI but it is of course contraindicated!) such as Imipramine.

Clip

Also exercise has been the best thing I have done through out all this, don't under rate it.

Something that might helped me slightly when I was on Prozac was Wellbutrinaugmentation. It did not work as well as Concerta but it helped me with at least Social anhedonia and probably increased my focus somewhat. I got allergic and had to stop. I think it may increase anxiety slightly. Another augmention I tried was Buspirone. I think it might have made me to want to do some things occasionaly which I wouldnt have with only Fluoxetine and that Clonazepam I was on. If nothing else it might counteract some SSRI-sideeffects. Thanks for your Agomelatine report. I suspect it works on a particular subset of depression which I have the honor to be induced with.

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Maybe could approach the pdoc and ask for something like Adderall or Vyvanse. They will typically give a dopamine drop. For me, it has felt like God was sitting in my lap for about a day. Then they have just made me irritable and given a boxed in feeling, but, who knows, they may kick off some progress to refresh the brain with emotions.

I recently had a doc suggest Provigil (Modafinil), but when I looked up the generic cost (about $450/30 pills) it seems totally unrealistic. I would consider a sample pack to see if it would indicate or garden shrub out possibilities, but am not going to feed the pharmaceutical industry.

Edited by ufecart
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Something that might helped me slightly when I was on Prozac was Wellbutrinaugmentation.

I have had countless docs sugest wellbutrin as the "antidote" for SSRIs, when I was on them. It never worked for me, just anohter drug with its own side effect profile to make things a bit worse.

Edited by ufecart
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As for CBT - my mom and my GP want to try therapy (CBT), but I would feel bad (well not feel... but you get the idea) that she would be wasting money on me (since i'm anhedonic). But, I'm curious, if this is an issue with the brain, how can therapy help with anhedonia? (i don't mean this in a rude way) because i don't feel depressed (how can I, i don't have emotions) but I guess I'm in shock that I might not have a normal life... didn't know this could happen to me. I guess everyone with anhedonia feels this way.

As for ECT - if there's anything that'll permanently screw you up, it just might be ECT. I'm too scared to try ECT... I mean... the whole ECT thing isn't pretty at all... but I'm interested in DBS (as long as their isn't pain or anything) the thing is, I don't want my parents dumping money on me...

REBT is a cousin to CBT. IMO it makes more sense, but you have to have a fairly obsessive personality to do either of these. I had a doc who does TMS offer that. According to him, it is just as, if not more effective than DBS. In either event - costly, very costly without any sort of guarantee or even any very encouraging results, overall. What nixed the idea for me was when in the pdcos office and he took an urgent patient call – they wanted to get a dose adjustment on their Lamictal. He ended up saying that patient had had the TMS and it was often still necessary to have the meds afterward – so about 12K and then still need meds. No thanks.

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I had a boron test as part of blood workup. It turned out I had no boron - 0 detectable. The doc put me on 30 mg boron tablets. Think they have to be from a doc, as that is a really high dose. They first one felt like a lightning bold hitting my brain. After that, not much. Tried them for about a month and then discontinued.

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Was on Synthroid for hypothyroidism. Have two docs that have recommend dropping the dose of Synthroid down and adding T3. Waiting for endocrinologist to see what he says. Pdoc says T3 can lift someone out of greatest depression/lack of feeling.

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B12 injections have worked better than anything. Relayed that to a doc recently and he said it was a placebo response. I said that was fine, but found it interesting that out of all the meds tried my mind decided to convey the placebo response to B12 injections and nothing else. Things that make you go hmmm….

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May want to check adrenal functions, including cortisol and ACTH. If the pituitary is not talking to the adrenals this can be a big problem and may have a doc prescribing a cortisol shot. Could have an endo check for empty sella syndrome. Alternatively, could have pregnonline and dhea levels checked, as well as testosterone end estrogen panels and see if may have a hormone deficiency. Perhaps pregnonline would then be suggested.

Edited by ufecart
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