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


itstrevor

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Fasting Therapy

I was reading this thread since I sometimes have degrees of apathy and lack of emotional responsiveness I think but I can see that I am just in the normal range. There is schizophrenia in the family so I have done much reading around that topic and incidentally as I am a once-keen yoga fan as well, for many years read a lot around that. In both areas of interest I have seen "evidence" of the effectiveness of fasting therapies essentially "re-booting " the body to a better state in mental illness and also problems of lesser emotional nature and indeed physical problems too. It may therefore be of interest here. The articles I read are available on www.yogamag.net archives and also on the Journal of Orthomolecular Medicine archives. NB all fasts of longer than 2/3 days should be medically supervised.

I personally found an old book by Marion Milner "A Life of my Own" very helpful somehow. She undertook a 7 year personal study of what kinds of experience made her happy in order to a)record those daily moments in words that were particularly happy and b)discover rules about the conditions in which happiness occurred. She wanted to "drink life to the dregs and plumb human experience/discover the best way to live ". I was so impressed by the library book I made a long handwritten note of the main points running to 7 A4 pages to keep by me...this was after a very stressfull episode in life full of major changes. Occasionally I use one or two of her techniques which she discovered during the course of her study.

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Another aspect of anhedonia I find particularly troubling is the prior lack of reward for getting anything accomplished. I often feel malaise as though I am ill and almost to the point of having minor CFS. However, when I have to do something strenuous, I have plenty of 'physical' stamina to do it, but then feel no reward, and the attending feeling of how much else I have to do. This leads to a cascade of emotional rebellion to doing anything - since everything feels futile. It's like trying to drive with your brakes on.

Interesting on the fasting. Perhaps the sensory deprivation helps regulate the neurotransmitters allowing them to be more receptive - as Trevor has touched on.

Edited by stillkickin
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Taking a look at the test results from nighthawk I do see the vitamin D deficiency that was noted with me as well. Cortisol is produced with stress (glucocorticoids), so that is not surprising, and actually there has been a lot of work recently showing the link between cortisol/glucocorticoids and the stress/anhedonic/anxiety response. Prolactin is supposed to have anti-libidinal effects, though I am not entirely sure of it's role in this whole web of interacting systems, but I believe it may have something to do with turning off certain reward circuitry to allow for maintenance, though I cannot say for sure.

The key is really to realize that ultimately the anhedonia is a natural response that the brain undergoes to deprive the senses; regulating neurotransmitter systems to become more or less receptive through turning them off for a while. This is one reason that I believe that vitamin D levels are often low in those with this anhedonic syndrome - calcium ion potentials increase firing and when the brain needs to turn off, it would make sense for the body to lower vitamin D because of vitamin D's pivotal role in calcium absorption.

Resentment or rebellion against the symptoms really just prolongs recovery. It sucks, but all you have to do is keep moving through them and try to get your mind on something else and to treat it sort of like a bad acid trip or something, knowing it will eventually end. For me, not knowing that it would end caused me to resent the symptoms and drove me crazy with the prospect that I would never feel right again. Avoid looking too much into anecdotal reports because many people will post about their symptoms that seemingly never end when they are in reality still taking some sort of psychotropic, are under unreasonable stress (such as a death in the family, toxic relationships, and so on) and have a great deal of self-doubt that may perpetuate anxiety spikes and symptoms.

Looking into recovery stories as well as scientific journal articles showing recovery of all of the systems of the brain after drug-induced or stress-induced trauma gave me the hope and self-empowerment I needed to move on from the self-doubt and put away the specter of permanence once and for all. This will not work for everyone, so everyone has to find their own way of moving forward.

It would be interesting to hear if other people with this syndrome are found to have low vitamin D levels

Edited by itstrevor
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I'm also well past deluding myself that this problem will ever go away on it's own, and even doubt it will ever improve in a marked way, in spite of many conventional and out-of-the box attempts at treatment; it's as though the anhedonia, blunted emotions, and apathy have taken root in my brain and personal experience in such a way that this is a life sentence. I think when you just let go and abandon the prospect of "getting better," and embrace the apathy and numbness that is your current reality, it's a lot less work, futility, and negative conditioning to acheive the exact same end.

First off, I am a compassionate and caring person and I would have compassion and such towards depressed people despite knowing that they are inferior biological robots. I feel that not only are others robots, but I am also a robot in a sense as well and I wish to discuss this with people who are supportive and such who might be able to try and convince me otherwise to at least try and make me feel less angry/depressed about myself and such.
Edited by Lioninwinter
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Hello

I am not going to be talking here long but may I respectfully say I just experence your views here as unsupported assertions about what you personally consider important/unimportant. So I don't see how this is going to help people get better. And I do not personally agree with anything you are saying.

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I would almost report you for hate speech. I dont understand how you can intercalate intelligent observations with complete nonsense in such fashion. If i had to diagnose you over the internet, which of course can not be done, id say schizotypal personality disorder with strong magical thinking and odd beliefs components.

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I have experienced better mood when exposed to sunlight on my skin. Im sure the brightness has a similar effect as well. To address the 'permanence' issue with anhedonia, I used to think that as well. Since starting wellbutrin I have got much relief.


"It would be interesting to hear if other people with this syndrome are found to have low vitamin D levels"

Edited by earwaxxer
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I recently tested as low in vitamin-D as well (calcidiol/choleocalciferol = 29 ng/ml), which isn't near the lowest I've read about in anecdotal reports of low vitamin-D and psychological/neurological problems.

Spending time each day under the powerful summer sun with lots of exposed skin doesn't make any difference in zombieness/anhedonia for me. Nor does long-term supplementing with 10000iu/daily of D3. I think if anything, for me, sunlight exposure and vitamin-D plays a role in metabolism and circadian rhythm more than anything. For instance, supplementing with D-3 late in the day can really make my usual poor-quality sleep even worse, and actually induce insomnia which I otherwise never have.

Interestingly, the inverse is true in that long-stretches of cloudy days turns me from feeling absolutely nothing to feeling a little bit depressed. I'm sure I'd end up like Layne Staley if I lived in Seattle.

Vitamin-D is of course an important hormone, just like the rest of them, and all the hormones have a way of getting out of whack in any chronic disease (which I would classify long-term anhedonia as). Not only does it have affects on sleep/wake cycle, but as already explained by Trevor, neurological effects as well (in addition to other things).

Edited by Dichotohmy
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jaiho, cowabunga!

sad_girl06, thanks for endocrinological feedback regarding nighthawk.

Dichotomy, inflammations are interesting also is cortisol. Though being stressed out as crap I respond somewhat well to SSRI which is said to increase cortisol. Also Mirtazapine was really bad here in the long run. I guess for some there's a subjective "feeling" of stress while actually stresshormones could be considered too low. I don't know what's norepinephrine is considered to be but norepinephrine without SSRI really turned things evil.

itstrevor, good insights as always.

okish, probably a good read. However I am a firm believer of learning the hard way. So to say with the "depression" gone people selfesteem enough to make up ones own mind about what's good for oneself.

For me it seems to have been "lack of dopamine". Obvious by taking the effect of Selegiline and Wellbutrin into account.

As for excersise I have been recommended doing that 30 minutes a day. Not that too hard with selegilne combined with low amounts caffine and/or possibly low doses of nicotine however I've been a bit decadent lately and developed a sense for alcohol instead.

If it's true one gets some kind of endorphine release by excersise and dopamine potentially potentiates opioid-response as Trevor pointed out that's a real good reason to keep on doing that.

But again thanks to the antidopaminergic effect SSRIs have had by themselves it's hard to be driven enough without something like selegiline.

Edited by General_Failure
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Earwaxxer. there is more to an uplift via sunlight than Vitamin D; First, there is a known boost to beta endorphins from sunlight (that is why people can actually get addicted to sun bathing). Secondly, sunlight boosts nitric oxide production and this too can lift depression. And then there is the blue light effect on the brain, and of course, the vitamin D boost.

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Hi everyone. itstrevor thank you SO much for starting this thread. My therapist talked about ANHEDONIA for the first time yesterday and I realise I have suffered from it as far back as I can remember (I'm 59). I'm on various antidepressants (was on fluoxetine and it's VERY interesting to know that can actually make ANHEDONIA even worse). I have never really enjoyed anything or had any feelings whatsoever. The awful thing is that it seems there isn't a huge amount that can help (although I've only read a few of the posts). It ALMOST makes me want to cry but the tears never come. I wish you all luck with finding some relief

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mille01 - wow - for sure the fluoxetine and what I would call a "flattening" phenomena (cutting off the top and bottom of the emotional spectrum). I guess over time I just got used to it, and accepted not being depressed as a trade off for having attenuated joy. I can also relate to “the tears never come”, and others have related the same.

What’s interesting is that I have worked in the psychiatric field as an RN off and on for 30 years, but only sought tx. for my own depression in the past 10 yrs or so, when it became intolerable (suicidal etc.). I remember a client many years back complain of “not being able to cry” after being on Prozac. I really couldn’t understand it then. Now I can.

If you haven’t explored NSRI’s or wellbutrin they might be a good go. The wellbutrin was a game changer for me. Completely turned my life around. To such an extent that I feel a bit foreign to life and have to relearn how to do some things (friendships, relationship with work etc.)

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Millie01 - it looks like desvenvaflaxine is an SNRI and agomelatin is in the same class as wellbutrin (Bupropion). I guess you may already be taking something very similar to bupropion. Its worth a shot to discuss it with your therapist anyway. The mind is a tricky thing to treat. I wish I had tried different drugs a long time ago, I wouldnt have waisted so many years being so depressed.

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Jaiho, are you still having good results with moclobemide? Ive read good things about this med having a good side effects profile and when it works it seems to work good sometimes for a long time. I really cant afford to take ssris and be more numb with less sex drive. Ive read moclobemide sometimes increase libido, do you have this effect? Im seeing my pdoc tomorrow, will discuss moclobemide. He knows i cant take ssris.

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@earwaxxer, Wellbutrin is NOT in the same class as Agomelatine. Agomelatine is a HT-2c antagonist with Melatonergic M1 and M2 agonism. HT-2c antagonism should increase Norepinephrine and Dopamine in prefrontal cortex but the distribution isn't general though some of the Dopamine may be distributed to nearly located parts in the brain( Stephen M Stahl, Neuroscientific Basis and Practical Applications Rev 4)

Wellbutrin is a NDRI, Norepinephrine Dopamine Reuptake inhibitor which would guarantee a more widespread effect.

I've taken them both and Wellbutrin actually did something (social anhedonia)though being quite anxiogenic when perhaps Agomelatines effect could be a bit like Fluoxetine(sort of activating) as that SSRI also has an HT-2c antagonism(NDDI).

In defence of Agomelatine that drug at least has a study saying it may work for anhedonia. If it do so I suppose it's rather about the lack of sideeffect SSRI's tend to induce than some magic related to the melatonergic system.

Edited by General_Failure
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Interesting topic. I think I may have anhedonia.. I don't often feel depressed since I've been on meds, but I don't feel like me. I didn't even think about the music thing until reading it here, but I have all my radio station s programmed to talk stations bc yeah I just don't like any music anymore. I don't really experience deep emotions for those close to me either. This topic has really made me look back at the past few months and analyze how I've been feeling. I have had some moments when I've experienced something positive.. one thing I remember in particular was a fall cinnamon like smell at the store one day, but it was very "window like". I perked up for a minute at the smell, but then felt flat again shortly thereafter.

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yeah this is ridiculous..relationships are basically pointless for me anymore..i met a woman a few weeks back and we've hung out a few times but i dont register enjoyment out of any of it...tried the flirting and kissing aspect but it felt forced and like an act...even sex isnt enjoyable and really hasnt been for a very long time...

i can take welbutrin or yohimbe and it will help me anticipate sex but still no pleasure..plus, both of those meds give me erectile dysfunction problems..

anhedonia is just a life destroyer..

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I would almost report you for hate speech. I dont understand how you can intercalate intelligent observations with complete nonsense in such fashion. If i had to diagnose you over the internet, which of course can not be done, id say schizotypal personality disorder with strong magical thinking and odd beliefs components.

I have every reason to believe that happy people with nice lives are the better people and that people such as itstrevor are the better people.

Here is a link to a new and more brief convincing post I made in this topic that explains this:

http://www.depressionforums.org/forums/topic/104959-be-a-hero-with-depression/

Edited by MattMVS7
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I also don't believe in G-D!. I also don't believe in http://lavistachurchofchrist.org/LVanswers/2010/04-29.html

Matthew 13:12. The point is to FEEEEEL good at any price. Never mind if someone else is paying for it. If your'e consistently feeling good you are per definition a good person.

This of course brings with it that person feeling bad must be a bad person. You are what you feel. For instance if your'e feeling bad by getting raped by a unscrupulous hedonist that's what you should feel and at the same time that rapist would be a good person as while he's feeling better he's also becoming a better person. I hope you understand sarcasm.

Seriously, I propose someone clear this thread from sadists. If people like Matt is allowed to keep on spewing his manure I am out.

Edited by General_Failure
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Ok - back to the topic... KateKate expressed the phenomena much like I am experiencing things right now in my life. I get an occasional and brief (some seconds) feeling of love, or what I would call 'joy'. This is superimposed on a background of ‘OK-ness’. Big improvement for me though. As far as the sexual and intimate stuff, I am currently not active and I don’t believe that I would be very consistent either functionally or emotionally. Fortunately, in our relationship there is no pressure for that these days. That’s another hurdle to cross. One step at time….

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