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


itstrevor

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Does my response to flouxetine and licorice mean I have multiple problems in my body that needs to be addressed? Fluoxetine is a SSRI and licorice root is for adrenal fatigue yet both had success temporarily.

Regarding the brain as a non-linear, dynamical system at some steady state - steady states being depressed, "happy", and everything imaginable in between - and considering that (AFAIK) there are currently over 60 identified neurotransmitters, each subject to complex rules, global and local feedback regulation - perturbation of any neurotransmitter could change the steady state, regardless if that neurotransmitter is at an abstract "ideal" level or supposedly "deficient".

Moreover, though a change in the level of any single neurotransmitter might lift someone from depressed to "happy", (all else being equal) it provides no evidence whether those neurotransmitter levels were a proximate or an ultimate factor in the depression.

To reduce this to the simplest analogy possible, think of a washing machine that's running off-balance (a bad steady state). You can kick it in the front (prozac), side (licorice), or back (olanzipine), and all of those actions might rebalance the load inside. It doesn't mean the machine had a kicking deficiency - that perturbation (kick) just changed the steady state. Of course, some perturbations won't do anything, and some will exacerbate the imbalance.

I'm saying I don't think that there is strong evidence that there are multiple things "wrong" with your neurochemistry (...though there might be anyway).

My last psychiatrist tended to agree with this abstraction, but... she could have been humoring me.

Feel free to disregard. I just think the linear "chemical imbalance" concept is not supported by the data that's been explained to me by my MDs.

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In March of 2012 I induced anhedonia through the frequent use of master-bation and porn daily. One night I was master-bating while simultaneously looking at porn and the moment I ejaculated everything turned off. The ability to feel emotions, pleasure, orgasm, and libido disappeared. At first I thought I physically damaged my penis because I never heard of anhedonia before nor thought it was a psychological issue as I was not depressed. I eventually went to go see my doctor and told her my story. In response she had me take a hormone panel and my prolactin was above normal. She wanted me to take another blood test to confirm my prolactin levels being abnormal.

As I waited for the blood test results I went to see an urologist and was told everything looked fine down there. I have had multiple blood tests confirming my prolacin levels are above normal. The highest level of prolactin to be considered normal is 16 and mine are in the 20s. Unfortunately, doctors don’t usually prescribe medication to lower prolactin levels unless they are much higher. In January of 2013 I began taking fish oil and noticed my emotions coming back. I began to feel a euphoric happiness all the time. However, I could feel emotion again but still had sexual anhedonia. For example, I still did not have any libido and couldn’t feel pleasure from master-bating or ejaculating. All of this lasted for about six months till august of 2013 where I became depressed and had full blown anhedonia again. As a result, my doctor prescribed bupropion for me, but I suddenly began developing manic symptoms. I felt like I had unlimited energy for two days and didn’t sleep for forty eight hours as I felt I didn’t require sleep anymore. Moreover, I was forced to stop the medicine due to mood swings.

My doctor then prescribed me Fluoxetine and a mood stabilizer called olanzapine. After a week of being on the medication my emotions came back, but I still had sexual anhedonia. Unfortunately, after another week I began relapsing again. In response my doctor increased the dosage from 20 mg to 40 mg. The same event occurred my emotions came back for a week and went away the next week. I then began to take licorice root, which is used for adrenal fatigue. Due to some claims of it curing anhedonia I began taking it. Surprisingly it worked and my emotions came back, but then disappeared after a few weeks. My doctor has now prescribed me a new antidepressant called Brintellix. I have been taking for twelve days now and it has rid me of depression, but hasn’t don’t anything for anhedonia yet. However, my doctor told me it would take two weeks to start seeing any results and up to 4-6 weeks for full benefits.

I have recently been doing a lot of research on the effects of master-bation and porn. Apparently, when watching porn and master-bating simultaneously it is very stimulating to dopamine receptors. As a result, the dopamine receptors become desensitized from frequent master-bation and porn. If your dopamine receptors are desensitized they can’t utilize dopamine properly. In response, I have begun taking supplements like uridine, cdp choline, and inositol that are suppose to increase dopamine receptor density. It has only been two weeks, since I have begun taking these supplements and I have not noticed anything yet. However, I don’t know long it takes for these supplements to increase dopamine receptors so I must be patient.

What is your guy’s opinion on my story?

Does my response to flouxetine and licorice mean I have multiple problems in my body that needs to be addressed? Fluoxetine is a SSRI and licorice root is for adrenal fatigue yet both had success temporarily.

Do you guys know of any medications that increase dopamine receptors?

Having read some of your previous posts I think you may actually be suffering from bipolar disorder/manic depression, This is generally considered a biological disturbance of mood tha is therefire probaby unrelated to your ************* . Do you have any family members that have mental health issues? this would also point to bipolar disorder. ALso you said somewhere you are currently in your low twenties and recenty your symptoms started. This also points to bipolar disorder.

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In March of 2012 I induced anhedonia through the frequent use of master-bation and porn daily. One night I was master-bating while simultaneously looking at porn and the moment I ejaculated everything turned off. The ability to feel emotions, pleasure, orgasm, and libido disappeared. At first I thought I physically damaged my penis because I never heard of anhedonia before nor thought it was a psychological issue as I was not depressed. I eventually went to go see my doctor and told her my story. In response she had me take a hormone panel and my prolactin was above normal. She wanted me to take another blood test to confirm my prolactin levels being abnormal.

As I waited for the blood test results I went to see an urologist and was told everything looked fine down there. I have had multiple blood tests confirming my prolacin levels are above normal. The highest level of prolactin to be considered normal is 16 and mine are in the 20s. Unfortunately, doctors don’t usually prescribe medication to lower prolactin levels unless they are much higher. In January of 2013 I began taking fish oil and noticed my emotions coming back. I began to feel a euphoric happiness all the time. However, I could feel emotion again but still had sexual anhedonia. For example, I still did not have any libido and couldn’t feel pleasure from master-bating or ejaculating. All of this lasted for about six months till august of 2013 where I became depressed and had full blown anhedonia again. As a result, my doctor prescribed bupropion for me, but I suddenly began developing manic symptoms. I felt like I had unlimited energy for two days and didn’t sleep for forty eight hours as I felt I didn’t require sleep anymore. Moreover, I was forced to stop the medicine due to mood swings.

My doctor then prescribed me Fluoxetine and a mood stabilizer called olanzapine. After a week of being on the medication my emotions came back, but I still had sexual anhedonia. Unfortunately, after another week I began relapsing again. In response my doctor increased the dosage from 20 mg to 40 mg. The same event occurred my emotions came back for a week and went away the next week. I then began to take licorice root, which is used for adrenal fatigue. Due to some claims of it curing anhedonia I began taking it. Surprisingly it worked and my emotions came back, but then disappeared after a few weeks. My doctor has now prescribed me a new antidepressant called Brintellix. I have been taking for twelve days now and it has rid me of depression, but hasn’t don’t anything for anhedonia yet. However, my doctor told me it would take two weeks to start seeing any results and up to 4-6 weeks for full benefits.

I have recently been doing a lot of research on the effects of master-bation and porn. Apparently, when watching porn and master-bating simultaneously it is very stimulating to dopamine receptors. As a result, the dopamine receptors become desensitized from frequent master-bation and porn. If your dopamine receptors are desensitized they can’t utilize dopamine properly. In response, I have begun taking supplements like uridine, cdp choline, and inositol that are suppose to increase dopamine receptor density. It has only been two weeks, since I have begun taking these supplements and I have not noticed anything yet. However, I don’t know long it takes for these supplements to increase dopamine receptors so I must be patient.

What is your guy’s opinion on my story?

Does my response to flouxetine and licorice mean I have multiple problems in my body that needs to be addressed? Fluoxetine is a SSRI and licorice root is for adrenal fatigue yet both had success temporarily.

Do you guys know of any medications that increase dopamine receptors?

Having read some of your previous posts I think you may actually be suffering from bipolar disorder/manic depression, This is generally considered a biological disturbance of mood tha is therefire probaby unrelated to your ************* . Do you have any family members that have mental health issues? this would also point to bipolar disorder. ALso you said somewhere you are currently in your low twenties and recenty your symptoms started. This also points to bipolar disorder.

Yes my family has had a history of depression. This has been going on for two years now though. I didn't start taking antidepressant's until the fall of 2013 though.

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Published recently in Cell. I put it here because it's a theme in this thread for people to assume anhedonia is a dopamine problem, and the reward system is not functioning optimally. Specific anhedonia does not support a global "chemical imbalance" of dopamine, but malfunction in some precursor to the reward system.

'Dissociation between Musical and Monetary Reward Responses in Specific Musical Anhedonia'

Healthy people with specific musical anhedonia are identified
These individuals do not find music pleasurable, but enjoy other rewarding stimuli
They show normal autonomic responses to monetary reward, but not to pleasant music
Specific anhedonia reflect the existence of different access to the reward system


Abstract:

Music has been present in all human cultures since prehistory [1,2], although it is not associated with any apparent biological advantages (such as food, sex, etc.) or utility value (such as money). Nevertheless, music is ranked among the highest sources of pleasure [3], and its important role in our society and culture has led to the assumption that the ability of music to induce pleasure is universal. However, this assumption has never been empirically tested. In the present report, we identified a group of healthy individuals without depression or generalized anhedonia who showed reduced behavioral pleasure ratings and no autonomic responses to pleasurable music, despite having normal musical perception capacities. These persons showed preserved behavioral and physiological responses to monetary reward, indicating that the low sensitivity to music was not due to a global hypofunction of the reward network. These results point to the existence of specific musical anhedonia and suggest that there may be individual differences in access to the reward system.

http://www.cell.com/current-biology/abstract/S0960-9822%2814%2900133-X

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i found this post tonight after running into the word "anhedonic" while searching for a cure for many of the same symptoms you all have.

i have been fighting fatigue, disinterest, loss of libido, loss of interest, inability to feel ... for about 2.5 years now.

i will say that i'm winning, despite having spent the past week in bed, because i do have feelings again - good and bad ones; i have some sex drive and some interest in sex and possibly meeting someone and falling in love again; and i even went to the gym a few times in the past month. those are just a few of my successes.

my battle started with a ruptured appendix, went septic, almost died but after 3 weeks in intensive care my "systems" began to work again.

i have a theory, and you all may think i'm totally whacked, that a lot of modern medicines destroy important "stuff" in our guts. all those antibiotics they gave me to **** the infections that were ******* me, i think, killed some that my body used to "speak" to my brain.

when i got back to work, from bed, i would read financial reports, comprehend them fine, but could not make a decision whether to buy, sell, or hold a stock. my "gut check" was missing.

my palate had changed. i couldn't put a glass of red alcohol to my lips. i craved yogurt.

my doc put me on a low dose of buproprion, atenolol, and modafinil. i think these are helping enough that i'm not going to give them up.

over time i've rebuilt some of the 46 percent muscle loss i experienced (and all the weight i lost) and have managed to pull off some pretty cool things with a modicum of feeling.

hang in there folks and check in with your gut.

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Reelwell, that doesnt sound too crazy. I wish more doctors were interested in Looking into these things. My stool is never solid i wonder if i have gut issues. Now that i think of it, close to when my anhedonia started I was on a 2 day course of anti biotic.

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I wouldn't dismiss it, but also statistical noise happens. Post hoc ergo propter hoc is what's kept a lot of parents from immunizing their children.

That being said, google "fluoroquinolone antibiotics depression". Apparently carries a risk of damaging the CNS (and inducing potential psychiatric effects).

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Okay so here's my update for 3/7/2014:

I'm currently on 15mg of Sertraline (Zoloft). I know that I have been avoiding SSRIs for so long because they blunt mood and my main goal has been to remove the blunting, but after my experiment with Tranylcypromine (Parnate) I had such severe anxiety that I was hospitalized with catecholamine levels 3x normal, then was taken off of the drug very quickly for safety reasons, had the worst withdrawal I have ever experienced, and put on Zoloft just to function. It was a necessity.

Again, my new approach is to remove anything that could possibly perpetuate the anhedonia/numbness, then wait it out. I've had my go with everything from NRIs, Stimulants, ECT, you name it. I am pretty confident things will get back to normal if I accept the situation (which is hard to do because, like everybody else, I have a lot of reserved anger about the situation) and kind of take a third person observer view of the whole thing and an "it is what it is" stance. So the SSRI is just temporary so that I can remove the anxiety, then slowly taper off of it while maintaining a non-anxiety state.

So far I have had no noticeable withdrawals or return of anxiety, and have even taken 5mg Ritalin once a week without any major problems (which is a very conservative dose, but I really shouldn't even be doing that and probably won't be in the future). I can feel the anhedonia stuff wax and wane. Sometimes I am totally blunted, and other times I am feeling a bit better. I am confident that things will return to normal given enough time and acceptance. The proof is in the fact that the brain has been shown to return to equilibrium after drug abusers use drugs and countless firsthand accounts of people feeling more like themselves after doing a proper taper of their antidepressants and staying abstinent from psychotropics and too much stress.

I know people who have had the zombie effect for years and gotten better, so what makes me any different? I'm probably healthier than they are, and have less stress to boot. I know that the receptors will return to baseline. Proof of this is in the fact that the first time I took Abilify, I had tremors, but the second time, the tremors dissipated, proving that dopamine receptor sensitivity changes accordingly. It should come back to normal, and the numbness is a sign of healing, sort of like the body shutting down emotions to replenish it's "stores" of feelings. That's my opinion anyways.

Antidepressants can eliminate problems that perpetuate anhedonia, then once those problems are gone, slowly wean and maintain the effect. ECT might trigger remission, but it's sort of finicky, might only tease you by working for a few days, and can have a lot of side effects for some people. I won't be trying that again I am pretty sure.

I have found eating whatever I am craving to be useful. Like listening closely to what your body is telling you it wants. Sometimes it's strawberries, sometimes it's something with a lot of sodium, sometimes it's something starchy, sometimes it's something with a lot of protein, etc.

I really don't think that selegiline will do much to help to be honest but let us know your experience.

Edited by itstrevor
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Hi: I am new to this forum, and new to this topic.

But I am not new to anhedonia! It was the principle feature of my own depression for many years, and continues to be on and off.

Contra itstrevor's initial contribution, it has not been my experience that anhedonia is distinct from depression, but is part of the range of possible experiences. The same day I am feeling "anhedonic" can be the same day I fly into panic over some little thing that happens, or become enraged over some small slight. The pleasurelessness of anhedonia lies, for me, at one extreme end of a spectrum of emotional responses.

Yes, I often had "windows"-- periods when i felt normal, and the world seemed a happy place, or a place of possibility. These windows were always deceptive-- I'd try to hold onto these good feelings, but without success.

As to treatment, once I attacked my depression as a whole, most of my symptoms, including my anhedonia, tended to lift. The treatment was the conventional triad of medication, lifestyle changes, and commitment to therapy.

A good therapist is key for a lot of people. I am skeptical about the therapy industry, and I have a bad feeling that there are a lot of folks practicing as therapists who have no business doing so. I was fortunate to find a tremendously gifted guy. Not everyone is so fortunate.

Best of luck to all who are struggling with this!

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Blackdogpie,

I'm happy reading that a therapist helped you. Could you tell us what is his/her type of therapy? Gestalt, Psychoanalysis (Freud, Lacan, Klein), Ericksonian, etc???

Itstrevor,

We know chemistry is important, however the structure of the neural network is also important. Due to this, I think other resources should be tried.

I'm on Ericksonian, which did not cured me, but helped somehow. Now, I will try I kind of "adapted meditation" for non religious people. Some material can be found here: http://www.juniperpath.org/

A read that you tried therapy, but unfortunately most therapists fail miserably. Thus have tried other alternatives? (Fasting, meditation, sports, etc)

I'm planning to begin with low-dose naltrexone in the next week. If it helps me, I will post results here.

However, I'm afraid of Selegiline, since I fear it can brings panic attacks back. (I read that you had a serious event with it).

Regards.

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ItsTrevor,

I want to apologize due to my "repeated" questions. Reading early posts of yours, I found that all of them were previously answered. The only one I didn't find was about Naltrexone.

Fortunately, this topic is amazingly huge with lots of information. However I don't have time to read more than one or two pages when I'm not busy. Thus, it will take a while for me to be updated.

Regards!

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Okay, on about 11mg of sertraline - still no withdrawals or anxiety whatsoever and a gradual dose/time related reduction in anhedonia. I can't really complain much about my mental state and hardly ever think about the anhedonia issue anymore. More updates to come, but I'm pretty confident now that anhedonia isn't permanent.

Also, I'm going to be launching an electric car business and signed up for a contest - if anyone wants to help me out by voting for me in the contest (after all, I have done my best to help you) pm me!

Edited by itstrevor
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I once again started to augmented 5-HTP (I tend to forget to take them in periods). This is the third day and it again convinces me that the Clomipramine is too low (and too high as I rather switch them to something with less sideeffects and similiar effect).

As I've written "anxiousness" may be sneaky. When the serotinergic drugs I become extremely sensitive and nervous to the point I am almost get paralyzed. I get afraid of other opinions. I also tend to get agitated.It could be "atypical depression" but I suspect that a sensitive limbic system could be brought on by psychosocial factors like "reverse parenting". It doesn't change much but may be worth pondering on for a while.

Nice cat Lauryn, mine was also reading books. You know you have to read faster when they start browsing.

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I haven't quite figured out how to live with this nothingness of anhedonia. Everyday is the exact same and I cannot feel any emotions at all. How do I live like this. It's been two years and three months and I just try to get through the day and waste time to get through another day. There are no feelings associated with anything and life seems very pointless. How do you live without being able to feel love, joy, happiness or even fear or sadness. This mundane existence is getting to me. At times I just want to end it all. Like everyday. Is there any advice in how to keep surviving? I can taste food. So I try to get as much out of that as possible.

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I may be a bit twisted and it could be due to this state of derealization (or if that's actually anhedonia as everything looks flat and there's nothing in everything) BUT I found some interesting way of thinking in Zen and Taoism. I would call it the "nothingness pride". Christianity seems more about to reach out and improve but what is there to improve when all seems like nothing or indifferent. Zen and taoism seems more about adapting that "reaching out". That sort "of" thinking may be an effect rather than cause as well as I don't believe in books in general. I found Zen by accident in a martial art book.

A dissociative state could be described as Unreal reality or real unreality and so on. I believe dissociation is involved in Borderline Personality Disorder and maybe that's why Dialectical Behaviour Therapy may help as it has borrowed some or many thoughts from those eastern way of "thinking".

Haven't been up to reading or contemplating anything of that anymore as I see it too playful and it's hard to be serious doing that. And it's a step away from western logic.

It may have helped me to cope. Antidepressives has also been helpful and possibly excersising (one usually has to force oneself in the beginning) as it may be hard to get away from anxiety and general low mood in general. Digging into the past doesn't seem helpful as in thinking what it was like.Just not thinking about it.

As I believe in matter over mind one it's not enough just trying to change thinking pattern. I know this sounds contradictional as I suspect that Zen/Taoism thinking was helpful a period.

However it was really bad before starting Fluoxetine (don't know how I managed to survive ). I walked around 4-5 years with a severe depression constantly bombarded with suicidal "feelings" and thoughts. In hindsight I should have ask for antidepressives earlier. I had some decent years after despite having a somewhat reduced hedonic capacity and still being in this "unreal reality". The problem with Fluoxetine was that after I while I got too apathic taking them. We augmented with DopaminergicRI Wellbutrin which worked for 5 days regarding focus and at least SOCIAL anhedonia then I got allergic and had to quit.I believe my anhedonia is mostly iatrogenic (drug-induced) here but despite the severity caused by Mirtazapine I notice some improvement in other aspects.

I can't speak for everyone but there's worse things to have than anhedonia and I would considered this one sever as there's not even enjoyment when listening to music. My few past interests has disappeared and so on. But I think I like Carbs or sugar (yay!!) that's why I keep it out of sight ..

If "sugarfood" (including grains) is the one and only thing one lives for I don't recommend Mirtazapine as it forced me into paleodiet. I've a person that had a problem with weighing to little if anything before it and now I have to have discipline to not to gain weight. Fluoxetine had me gaining some good 5 kgs or so which was ok as I ate like I did before.

Well Sorry for repeating myself and mentioning drugs that MAY increase anhedonia but I don't see any other way to treat those other things which may be comorbid. Anhedonia is bad enough in itself that's why.

This is also a bit of a repetation of what I've written before and it's a pity as the thread is quite long. I don't know how much people is able to read and as the question is how to keep surviving this is what constantly at least made me keep on living or perhaps existing and I am rather objective about this and sure that everyone with this at least is able to treat themself to the degree that all is not bad and still have anhedonia (maybe to a certain degree though).

Maybe there's even worse kinds of (anticipatorical) anhedonia. I saw a video where some scientists had removed the Dopaminehydroxylase ( I think) in rats. They starved to death. They didn't move 30 cm to get their food. IF i don't remember wrong they were overeating when they were almost mouthfeeded. That could indicate that it's about "anticipatoric anhedonia" which is consisting with "wanting". As Vieno pointed out already in the beginning at the thread there's still signs of intact "liking" which is why Ibogaine and Salvia (careful use) could be interesting so to reset mu-opioid receptors.

Edited by General_Failure
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General_Failure,

I would try low-dose Naltrexone (LDN) before Ibogaine or Salvia, because it is much more safe. When LDN is used, the opioid receptors are blocked for only short periods of time in the night, what leads to a subsequent upregulation. Thus, as time passes, opioid system works progressively better.

Once opioid systems are involved in many important biological processes, LDN has many utilities. The most common are treating cancer, depression, and multiple sclerosis.

Best regards.

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I have read a few pages here concerning anhedonia and would have to say I can commiserate. I have suffered from MDD (since 1996) and anxiety and PTSD (since 2006). I believe my own bouts of anhedonia have been within the past couple of years. I isolate often, have no friends, no real passion to speak of (scuba diving had a great effect but is too social). I have quit my last three jobs by just walking out which will probably hurt me in future career endeavors.

It seems like, as with many of the post on this topic, we have been on many meds (paxil, zoloft, lexapro, buspar, klonopin, depakote, abilify, and presently mirtazapine and effexor). Over the past year or two I am beginning to think that my brain chemistry has been adversely affected by all of these medications. Not to mention over the years I spent much time self medicating with mainly alcohol but dabbled in garden shrub, illegal drug, lsd, and mdma.

To not think we are in stage 1 neurobiological experimentation would be naive. Does anyone know of studies that show what the long term effects are on the brains chemistry? After looking at many posts on here I am seeing trends that seem deeply concerning but am not a scientist or a researcher.

I am wondering if the "chicken or the egg" question doesn't apply here. Which came first, the overuse of medications that were initally intended for short term use or the anhedonia that now seems to be a real byproduct of such overuse. Will using dopaime agonists rectify this, or will it be another epidemic of sorts. I am currently hoping to come off of medication all together with a psychs help and see if I can "feel" again. This has been something I have been contemplating but as many of you know the side effects are no joke. I recently came across another forum that discusses life after AD's and such. Guess what I've gathered? These people, after years of "experimenting" and being lab rats like I have done, they complain of similar issues to this topic. Anhedonia, depression, anxiety, and I've noticed a trend where people talk about the trauma assocated with the withdraws, the changing of AD's the mind and body being warped after all of years of medicating and suicidal ideations and in some cases failed attempts (I've personally have had 3 or 4).

With all this said, I just want everyone to know I am right there with you, but also want to let people know every action has an equal and opposite reaction. Please consider if the cure is in a pill and consider where it has taken you so far...

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as far as being 'ambitious' umm no, i think its impossible to be ambitious and anhedonic at the sme time..ambitious people find reward in the things they are seeking out..a person that is truly anhedonic eventually gets to the point where they only do things that they HAVE to do, work, eat, sleep etc etc..they will not be seeking things out on a regular basis imo..

Not true... Absolutely you you can be ambitious and anhedonic at the same time. Ambition is the drive to seek more and more success (more and more pleasure), it is the drive/desire to experience pleasure. Anhedonia prevents you from experiencing pleasure, but it doesn't stop you from wanting it. To the contrary, the more you can't feel it, the more you want it. I have read rat studies, rats who have less dopamine receptors aka less ability to enjoy the food are the ones who worked the hardest for more of it. I am the most ambitious person I have ever met in my entire life and the also the most anhedonic person I have ever met. I have full blown anhedonia, to the point where I don't even have windows anymore. Also note that ambition and motivation are not the same thing. I am extremely ambitious yet have almost zero motivation. It is a very distressing state but don't think it's impossible. Every little thing I do feels like climbing a mountain. You wouldn't believe how hard I have to force myself just to complete the most simple tasks of day to day living. That a person could be as ambitious as me yet have as little motivation as I have is the epitome of irony.

Edited by IWantToFeelAlive
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Yeah so what everyone is saying pretty much iterates my point that anhedonia usually lifts within a few months when left alone in the absence of excessive stress, emotional trauma, and psychotropic substances. Abstinence, slow comfortable weaning, stress reduction, and acceptance are key to make healing faster.

I am currently on less than 10mg of sertraline and am planning to be off of it within a month. So far no rebound anxiety and not even a single brain zap. The lower the amount of sertraline I am on, the more I feel the dose kicking in and leaving (probably because there is less of the drug to buffer and even out the effect). To mediate this I space my very low dose out throughout the day into several doses and this works fine for the most part. I keep getting tempted to just cut it all together out of impatience and to "get it over with" (especially because it makes me feel tired and blunted), but I realize that this is like landing a plane and I can't rush it otherwise turbulence will set me back and would be potentially dangerous. I have to be careful and patient.

I'm still keeping a mood chart/graph. I think irritability has a lot to do with sudden fluctuations in the drug/neurotransmitters in the system (the body gets upset when suddenly things drop). I felt more comfortable when things were evened out (like a capacitor evens out a "noisy" signal).

I found a pretty good analogy to the three states I have experienced throughout all of this:

ANXIETY is when you think you are going to die

ANHEDONIA is when you don't care if you die

DEPRESSION is when you want to die

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