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Updated comprehensive anhedonia cure guide

anhedonia emotional numbness anhedonia cure no emotions emotional numbness cure emotional blunting anhedonia cure guide

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#1 Deaden

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Posted 27 September 2017 - 12:00 AM


Hello,

 

So this is an updated guide on how to cure anhedonia/emotional blunting completely and permanently. No I haven’t hit remission as of yet, I am only just now starting on my recovery plan. I believe I figured out the neuroscience of anhedonia/emotional blunting, at least to some degree. For sure today’s conventional antidepressants aren’t a reliable option for this condition. I have been suffering from near complete anhedonia for a bit more than a year now, and do not plan on staying like this for a year longer. One thing for sure is emotional numbing does not consist of irreparable damage to the brain, or there wouldn’t be a few reports here and there from people that said they recovered fully… often if not always not thanks to medication. So here, please tell me what you think. I hope I can help by giving a better understanding to what is at the root of our numbness, and break the simple dopamine deficiency dogma that some still believe in. Don’t hesitate to comment if you have anything to correct from my guide or more information to add on the matter. I’m also interested in MGluR antagonists if that could help? Anything more that would aid in neuroplasticity with the reward center? Anyway can’t wait to become myself again^^ feel the warmth of the air on my skin, getting euphoric on music, having my high motivation back, girls making me weak… so many things I miss. If we could potentially make this thread a place where anhedonics gather to share their experiences and knowledge it would be great. I recommend taking a quick look at the links for better understanding.

 

Okay so as this study below demonstrates, anhedonia consists of abnormal communication (as opposed to inactivity) between the pVMPFC and the brain’s reward center:

>https://www.ncbi.nlm...les/PMC5070048/

 

What is glutamate? —> Glutamate is a chemical that nerve cells use to send signals to other cells. So obviously, glutamatergic neurotransmission plays an important role in brain circuits connectivity, and therefore plays a role in anhedonia/emotional numbing.

 

How excessive glutamate release due to stress can disrupt normal brain circuits functioning:

 

“Exposure to stress also causes an increase in the release of the excitatory amino acid glutamate, which binds to N-methyl-D-aspartate (NMDA) receptors, which are plentiful in mPFC”

>https://academic.oup...-Stress-Induced

“Mounting evidence suggests that acute and chronic stress, especially the stress-induced release of glucocorticoids, induces changes in glutamate neurotransmission in the prefrontal cortex and the hippocampus, thereby influencing some aspects of cognitive processing. In addition, dysfunction of glutamatergic neurotransmission is increasingly considered to be a core feature of stress-related mental illnesses. Recent studies have shed light on the mechanisms by which stress and glucocorticoids affect glutamate transmission, including effects on glutamate release, glutamate receptors and glutamate clearance and metabolism. This new understanding provides insights into normal brain functioning as well as the pathophysiology and potential new treatments of stress-related neuropsychiatric disorders.”

>https://www.ncbi.nlm...les/PMC3645314/

 

Realistically, fixing the disrupted pathways completely is the only way one will achieve full and permanent recovery from anhedonia. Artificially toying with monoamines using antidepressants does not address that problem. So it explains why individuals being treated on the rare ADs that are known to be effective to some extent on anhedonic depression (MAOIs, TCAs, etc…) report going back to baseline as soon as they leave treatment. In theory, we must restore glutamatergic neurotransmission to a normal functioning. This is where neuroplasticity plays a role. 

First we should probably take care of brain inflammation. Inflammation stops energy production in brain cells (why CoQ10 supplementation might help) and slows the firing of neurons. 

There is much information out there on methods to treat inflammation —> some specific diets, physical exercice, meditation, acupuncture (cheap mats can easily be bought online), etc… It’s probably best to also avoid habits that perpetuate inflammation as of eating food high in sugar. I’d recommend doing extensive research on that. Let’s not forget that the only type of brain damage that is actually incurable (at least as of now) takes part in neurodegenerative diseases like Alzheimer’s or Parkinson. Our capacity to put new neurons to birth is a well known fact, so there’s not much to worry about if you read “neurons death” somewhere. 

 

Being on a plan to reduce inflammation should make neuroplasticity easier already. Okay so what we want is our brain to reinforce neuro communication with our reward center which is is associated with pleasure and emotions. Cognitive Behavioral therapy (CBT) can do that, It’s tricky because how can we reinforce emotions and pleasure if we have none? Well… 100% anhedonia is relatively rare, most will be at like 95% baseline with variance in moods so there is something to work with. I do remember in all the dating I did this past year since I became emotionally numb to being able to force myself to feel some type of numbed affection for the girl I was with…and I did notice it slightly becoming more easier to force myself to overtime. Actually just two weeks ago, I felt heartbroken and could get myself to cry after a three months relationship with a beautiful girl ended. Side note: it’s been shown that some individuals suffering from the negative symptoms of schizophrenia do succeed in achieving full remission from CBT. Anyway, It’s possible that I would have benefited much more from CBT if not for one thing. My vagus nerve is most likely irritated:

“Any kind of GI distress can put pressure on the nerve and irritate it, with a hiatal hernia being a frequent culprit. Poor posture along with muscular imbalances can also cause the vagus nerve to misfire, as can excess alcohol or spicy foods. Stress can inflame the nerve, along with fatigue and anxiety.” 

More application to acupuncture: “Regular acupuncture reduces the inflammation that is often at the root of this disorder and calms the irritated nerve”

>http://www.pacificco...ted-vagus-nerve

The vagus nerve is located in the upper part of the neck and It would make complete sense in my case that’s there’s an issue with it as I crack my neck relatively often and have terrible posture when I’m laying in my bed and using my computer. I can stand up perfectly right, but my neck and lower back will still feel uncomfortable for a while. So I guess from now on I’m going to stop cracking my neck and sit in a chair… 

Regardless if you think you have an issue with your vagus nerve or not, VNS should be one of the most beneficial tools we have for aiding to neuroplasticity and restoring normal brain circuits function:

“Importantly, the researchers also found that VNS affected other deeper structures in the brain, many of which have high concentrations of brain cells that release dopamine, a neurotransmitter that helps control the brain’s reward and pleasure centers and also helps regulate emotional responses. This supports a growing consensus in the field that problems in dopamine pathways may be particularly important in treatment-resistant depression, explains Conway. And he said the finding that vagus nerve stimulators influence those pathways may explain why the therapy can help and why, when it works, its effects are not transient. Patients who respond to VNS tend to get better and stay better.”

>https://www.bbrfound...toms-depression

>https://www.ncbi.nlm...les/PMC4615598/

 

There’s multiple way to stimulate the vagus nerve, one being meditation (aka why it’s been said to help with anhedonia on top of its stress and inflammation reducing properties), and there’s more direct methods like shocking the vagus nerve with electrons for stimulation. And good news, there’s an alternative to the high cost ($20,000), invasive surgery of VNS. It is called transcutaneous vagus nerve stimulation—>zapping part of the outer left ear that connects to the vagus nerve, not even it’s way way less expensive than the surgery, but it also comes with far less risk and equal efficiency. I plan on ordering t-VNS from a company named Nervana based in San Diego I know they sell this device, but I haven’t looked much in other sourcing as of yet. There… all this should do it. Oh and by the way, if your “depression” comes with DP symptoms like me, they will go away at the same time as the anhedonia does.


Edited by Deaden, 27 September 2017 - 12:30 AM.

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#2 Stinkorninjor

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Posted 27 September 2017 - 06:45 PM

Oh and by the way, if your depression comes with DP symptoms like me, they will go away at the same time as the anhedonia does.

 

 

Wait a minute... how do you know this? Do you have any reliable data to support this? I understand that this is somewhat uncharted territory but do you at least have a collection of anecdotes, say 10 or so, to support the hypothesis of this?

 

There was a lot of talk about what's what, and how they relate to each other - and yes, glutamate is connected to DP/DR, but so are the opioid systems, and there seems as if there's a significant amount of DP/DR-ers whom respond to Kappa antagonists - how do you know that Anhedonia, DP/DR and Flat affect is THAT interconnected? People do report suffering from them independently, or with only minimal symptoms of one or the other.

 

Are you CERTAIN about this? Because this thread is fairly interesting, but it's also specifically aimed at anhedonia, the inability to feel pleasure - with this in mind, should you really be stating something like this?

 

Are you speaking from your own experience? Do you have DP/DR (as I recall it, you've said that you DON'T identify with that diagnosis, and that you feel that it's almost COMPLETELY INACCURATE - at least a couple of months ago) and have noticed that it goes away when your anhedonia goes away?

Please remember, people report these symptoms independently of each other as well, like how they report anxiety and depression independently, it may not be a universal constant that improvement of all of these symptoms will happen at the same time.

 

 

There's also the fact that some of the anhedonics that will see the thread will also have some form of atypical low-yield form of Schizophrenia (we've got several such people on the forums), and these people may have a different form of anhedonia. (and then we get to the connections to flat affect, if for instance one of the people stricken with anhedonia has low-yield atypical Autism as well, that person may be VOE-fully disappointed when they expect their affect to go up after the relief of anhedonia - it won't, it's a part of their very being, their brains are hard-wired to feel less)

 

You should probably add a small note at the bottom of your post, wherein you specify even more clearly, how you don't see yourself as having any other neuropsychiatric diagnosis prior to Anhedonia - and also your thoughts on Anhedonia, Depression, Flat Affect, and DP/DR - and how they are, or are not, interconnected or distinct. Because the way I read the guide, is that it's aimed at a very specific sort of audience, which you count yourself among, and it really helps to make it clear whom these people are, and even more importantly...

 

...who they are not.


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#3 Deaden

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Posted 27 September 2017 - 07:10 PM

Anhedonia can come with DP symptoms yes. Every time I've gotten some degree of relief in my anhedonia thanks to substances, my DP symptoms diminished. I've read a few other reports online from people noticing the same thing. Then there's Jahio and Referer on the anhedonia discord... full remission on anhedonia --> no more aphantasia, weird memory, etc... There's a possibility it's due to inflammation in the brain, but I wouldn't bet over it.

 

I'm targeting a specific audience yes, they will recognize themselves.


Edited by Deaden, 27 September 2017 - 07:15 PM.

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#4 jaiho

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Posted 28 September 2017 - 04:05 AM

 

 

how to cure anhedonia/emotional blunting completely and permanently. No I haven’t hit remission as of yet, I am only just now starting on my recovery plan. I believe I figured out the neuroscience of anhedonia/emotional blunting

 

 

There's no cure for anhedonia, only treatment of symptoms. Noone can claim to understand it completely. We dont even know how anti depressant drugs relieve depression and anhedonia, only correlations.

 


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#5 Deaden

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Posted 28 September 2017 - 05:00 AM

 

 

 

how to cure anhedonia/emotional blunting completely and permanently. No I haven’t hit remission as of yet, I am only just now starting on my recovery plan. I believe I figured out the neuroscience of anhedonia/emotional blunting

 

 

There's no cure for anhedonia, only treatment of symptoms. Noone can claim to understand it completely. We dont even know how anti depressant drugs relieve depression and anhedonia, only correlations.

 

Let's stop with the: "we have no idea of how the brain works"

 

Brain imaging has proven that anhedonics have abnormal brain circuits functioning compared to healthy individuals. It's been shown that chronic stress enhances glutamate release, that's what creates a dysfunction in communication between brain regions. This is plenty of information to work with... Okay I guess I kind of implied that I had a "100% guaranteed simple cure guide" and I shouldn't have, but really we need to start getting an understanding on what's going on instead of just relying on psychiatric medications to save us completely; it's not like the odds are looking that great. Do we live for ourselves or what? We have access to some of the most recent studies and research on depression just googling why not take advantage of it? Adaptation is the key to everything...


Edited by Deaden, 28 September 2017 - 05:02 AM.

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#6 hydrus

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Posted 01 November 2017 - 09:42 AM

anecdotally I noticed that killing off pathogenic bacteria or fungi in the intestinal tract caused me to experience a massive worsening of anhedonia. Perhaps due to toxins or due to increased immune stimulation which made me wonder if part of the symptoms I experienced were due to the brain being poisoned with metabolic microbial waste

 

 

https://www.ncbi.nlm...les/PMC2890937/

 

Bacteria produce various toxic agents that may have surprising systemic effects. These agents are ammonia, D-lactate, endogenous bacterial peptidoglycans and others. SIBO is regularly associated with increased serum endotoxin and bacterial compounds stimulating production of (pro)inflammatory cytokines[7,96]. SIBO might be associated with endogenous production of ethanol (probably synthesised by Candida albicans and Saccharomyces cerevisiae). Serum ethanol disappears after successful treatment of SIBO[37].

 

 


Edited by hydrus, 01 November 2017 - 09:49 AM.


#7 Kinesis

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Posted 01 November 2017 - 05:12 PM

It bears repeating that anhedonia is considered one of the hallmarks of clinical depression as defined in the standard DSM.  You do not need to have low mood or melancholy to be diagnosed as clinically depressed.

 

http://www.medicalcr...y/383-5mdd.html

 

The point is that if you are suffering from anhedonia, you don't have a novel condition that has yet to be recognized by medicine, and that there are standard medical treatments for it.  We can and do question the effectiveness of these treatments, but that does not mean the diagnosis is wrong.  Clinical depression is not unique among chronic diseases that way ... treatments for cancer, diabetes, etcetera also notably often leave much to be desired.

 

People experiencing serious anhedonia may have clinical depression and should see a doctor.

 

 


Edited by Kinesis, 01 November 2017 - 06:01 PM.

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#8 Deaden

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Posted 03 November 2017 - 02:39 AM

It bears repeating that anhedonia is considered one of the hallmarks of clinical depression as defined in the standard DSM.  You do not need to have low mood or melancholy to be diagnosed as clinically depressed.

 

http://www.medicalcr...y/383-5mdd.html

 

The point is that if you are suffering from anhedonia, you don't have a novel condition that has yet to be recognized by medicine, and that there are standard medical treatments for it.  We can and do question the effectiveness of these treatments, but that does not mean the diagnosis is wrong.  Clinical depression is not unique among chronic diseases that way ... treatments for cancer, diabetes, etcetera also notably often leave much to be desired.

 

People experiencing serious anhedonia may have clinical depression and should see a doctor.

 

Five or more of the following symptoms must be present nearly every day during a 2-wk period:

Core symptoms (>/= 1 required for diagnosis)

  • Depressed mood most of the day
  • Anhedonia or markedly decreased interest or pleasure in almost all activities

Additional symptoms

 

  • Clinically significant weight loss or increase or decrease in appetite
  • Insomnia or hypersomnia
  • Psychomotor agitation or retardation
  • Fatigue or loss of energy
  • Feelings of worthlessness or excessive or inappropriate guilt
  • Diminished ability to think or concentrate, or indecisiveness
  • Recurrent thoughts of death or suicidal ideation

"5 or more", I only have anhedonia, decrease in appetite (because I do not feel pleasure from eating), diminished ability to concentrate, in the criteria. I am not saying that just to argue against getting this diagnosis, it is just facts. Also, I would say I have higher introspective thinking than average so I am not mistaking on that. Okay so, technically anhedonia is listed as a symptom in depression. A symptom does not equal the condition. When you have a symptom of something, for any disease, there could be a dozens of explanations, it was studied (also in the DSM), that anhedonia can happen in other psychiatric disorders. Now clearly, quite a few people have gotten full blown anhedonia/ emotional numbing solely because of taking SSRIs, or being on anti-psychotics, chronic stress (with anhedonia being a biological effect, not a psychological effect leading to regular depression), chronic inflammatory diseases, dementia, a stroke (depending on the location), schizophrenia, PTSD, DP/DR. The point is, anhedonia is a biological reaction, and no matter what caused it, it affected the functional connectivity of our brain circuits. When I developed depression in my middle teen years, I had all the reasons to as life was pretty bad, it took me less than a year to get out of it. When I developed anhedonia, I just became more and more apathetic even though life was going well. I had no interest in doing anything, but not inability to feel interest itself during my depression. 90% of anhedonics will say they do not feel depressed. So I wonder, if anhedonia is so common why do we have no idea how to treat it? Obviously everyone who complains of emotional numbing should never be put on an SSRI (don't make me argue why). They should be skipped directly to MAOIs, even those don't work that well... Why is it that the usual target of rTMS or deepTMS for major depression is ineffective at relieving anhedonia, but works in different areas such as the orbifrontal cortex? When someone with depression takes an SSRI and becomes numb from it (almost always saying they no longer feel depressed), would that be a switch of depression subtype? Come on...

Honestly, I have about a hundred other arguments that support that it just doesn't make sense to say for anyone that has anhedonia, you have depression. In the literature, anhedonia is depression no matter the biological cause. fMRIs show a clear difference in the affected brain activity for depressed people, and people with anhedonia as the dominant symptom. They will label those anhedonics as having major depression in that case, but when there's a distinct neurobiological difference, experience of living, with so many potential different causes that cause a chain of reaction directly causing anhedonia only, why are we still calling anhedonia depression? What does depression by itself means then? Depression just becomes a word saying you're in in a state that is making you unable to have a good life, and loses its meaning or importance. I say let's start calling anxiety depression, or ADHD??!! The fact and the matter is, anhedonics and depressed people have a clear difference in ratio, and types of treatments they respond from, so it is counter productive to call them the same and this is mostly why I do not like someone calling anhedonia depression. Also most doctors seem clueless in how to treat someone who lost emotions and ability to feel pleasure from life effectively, you would know if you researched this for a year. Also I doubt all the negative experiences on medications online from true anhedonics are just from hypochondriacs, or are the piece of the pie that is just not responding to meds, so that reports online. No, if you look at the ratio of anhedonics, and others with the most usual major depression symptoms, there's a high difference in ratio of success from medications (even the most treatment resistant of depressives, are less than anhedonics and will respond to something at some point). Maths do not lie. Maybe if the emotionally numbed weren't treated with the usual meds used for major depression, there wouldn't be so many hopeless souls that are completely unable to feel pleasure for anything for years and have tried so many, without success. So please, have some critical thinking, or keep on saying anhedonia is depression, you are part of the problem. Before you reject my whole argument, know that I've spent countless hours reading studies and testimonies on anhedonia, major depression, etc, because getting out of this is literally the only thing that matters in my life, physically I cannot truly care for anything else. 

 

You can check out those links, it doesn't go in the neuroscience of apathy, so it shouldn't take too much effort:

>https://www.google.c...umbness&f=false

>http://neuro.psychia...76/jnp.10.3.314


Edited by Deaden, 03 November 2017 - 02:54 AM.

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#9 Deaden

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Posted 03 November 2017 - 03:18 AM

Quoting someone: "As the medical community defines depression, anhedonia is included. But what does that really teach us about depression as a disease? Or about its manifestations? Or what that means for treatment? Nothing at all. The labels don't teach us anything. I am saying we need to actually understand psychiatric symptoms better and create distinctions that actually mean something."


Edited by Deaden, 03 November 2017 - 03:20 AM.

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#10 Kinesis

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Posted 03 November 2017 - 03:40 PM

It bears repeating that anhedonia is considered one of the hallmarks of clinical depression as defined in the standard DSM. You do not need to have low mood or melancholy to be diagnosed as clinically depressed.

http://www.medicalcr...y/383-5mdd.html

The point is that if you are suffering from anhedonia, you don't have a novel condition that has yet to be recognized by medicine, and that there are standard medical treatments for it. We can and do question the effectiveness of these treatments, but that does not mean the diagnosis is wrong. Clinical depression is not unique among chronic diseases that way ... treatments for cancer, diabetes, etcetera also notably often leave much to be desired.

People experiencing serious anhedonia may have clinical depression and should see a doctor.


Five or more of the following symptoms must be present nearly every day during a 2-wk period:
Core symptoms (>/= 1 required for diagnosis)
  • Depressed mood most of the day
  • Anhedonia or markedly decreased interest or pleasure in almost all activities
Additional symptoms
  • Clinically significant weight loss or increase or decrease in appetite
  • Insomnia or hypersomnia
  • Psychomotor agitation or retardation
  • Fatigue or loss of energy
  • Feelings of worthlessness or excessive or inappropriate guilt
  • Diminished ability to think or concentrate, or indecisiveness
  • Recurrent thoughts of death or suicidal ideation
"5 or more", I only have anhedonia, decrease in appetite (because I do not feel pleasure from eating), diminished ability to concentrate, in the criteria. I am not saying that just to argue against getting this diagnosis, it is just facts.


The DSM material is a copy/paste from the link I cited, so there’s nothing new there. You say you "only" have anhedonia, but there are some serious problems with that. First, you admit to having a decrease in appetite, but then just dismiss it as a side effect of anhedonia. Nothing in the DSM, however, requires that one symptom cannot be a consequence of another.

Second, and much more important, you are not everybody else. You are not prescribing for just yourself. You’ve come onto Longecity and posted:

Updated comprehensive anhedonia cure guide

So this is an updated guide on how to cure anhedonia/emotional blunting completely and permanently. No I haven’t hit remission as of yet...


You claim you have discovered the cure for anhedonia. So we can add at least one more mental symptom to the list ... delusions. Seriously? If you have discovered the cure for anhedonia, you should be speaking at international medical conferences, heading up a major research institution, going on tours to promote your new book. Yet in the same breath you admit you haven’t even cured your own anhedonia.

You go on to say
 

"Okay so, technically anhedonia is listed as a symptom in depression. A symptom does not equal the condition."


Likewise, the symptom of anhedonia does not equal the condition. Yet you purport to cure it as if it were.
 

"When you have a symptom of something, for any disease, there could be a dozens of explanations, it was studied (also in the DSM), that anhedonia can happen in other psychiatric disorders."


This is very important, because it underscores my point that people experiencing anhedonia should consult a doctor, not merely self-diagnose and experiment with advice from someone on the internet who has not examined them yet claims to know how to cure them.
 

"Now clearly, quite a few people have gotten full blown anhedonia/ emotional numbing solely because of taking SSRIs, or being on anti-psychotics, chronic stress (with anhedonia being a biological effect, not a psychological effect leading to regular depression), chronic inflammatory diseases, dementia, a stroke (depending on the location), schizophrenia, PTSD, DP/DR. The point is, anhedonia is a biological reaction, and no matter what caused it, it affected the functional connectivity of our brain circuits. When I developed depression in my middle teen years, I had all the reasons to as life was pretty bad, it took me less than a year to get out of it. When I developed anhedonia, I just became more and more apathetic even though life was going well. I had no interest in doing anything, but not inability to feel interest itself during my depression. 90% of anhedonics will say they do not feel depressed."


This shows that despite your having acknowledged that anhedonia is a symptom of clinical depression, your rhetoric still embeds the mind set that they are separate and distinct. When you "developed depression" this... then when you "developed anhedonia", that...

When you say that "90% of anhedonics will say they do not feel depressed" you’re still in denial that anhedonia itself is a symptom of depression. In other words, you’re still stuck on conflating the lay use of the word "depressed" with the meaning used in the medical field.

And we still have the problem of extrapolating your personal experience to a general recommendation for any and all who suffer from anhedonia.

And okay, so standard treatments are not always effective, and sometimes lead to side effects. But isn’t this true of many chronic diseases? Medical treatment is not always effective for cancer either, and often leads to serious side effects, but would you tell someone who thinks they have cancer to avoid seeing a doctor and experiment with self treatment instead?
 

Quoting someone: "As the medical community defines depression, anhedonia is included. But what does that really teach us about depression as a disease? Or about its manifestations? Or what that means for treatment? Nothing at all. The labels don't teach us anything. I am saying we need to actually understand psychiatric symptoms better and create distinctions that actually mean something."


Who is "we"? No one has claimed that that the psychiatric field has a cure. Far as we know, only you claim to have that. That there is widespread, intense, ongoing research into depression and all of its manifestations is an obvious acknowledgment that much work remains to be done. Yet we do know that many people do in fact respond to treatments commonly prescribed by doctors. What you are doing here boils down to reinforcing the misconception that if you don’t feel sad or melancholy that you don’t have clinical depression and therefore that there’s no point in seeing a doctor, when instead you could be helping to overcome it.
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#11 Deaden

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Posted 03 November 2017 - 11:02 PM

I am disappointed, how could you miss my entire point so heavily? Not feeling motivated enough right now to keep on arguing with someone with such low critical thinking. Maybe I will be some other time. 

 

By the way, I might have seen about ten doctors and none helped. Surprisingly, I'm far from the only one with this experience. One thing I will agree with you though, I shouldn't have implied I had a guaranteed guide to cure anhedonia, but a proposal for a treatment plan. No I am not cured as of yet, working on it. I wanted to wait until I was to make this post but since it takes time, I figured I would share some things I know that anhedonics may chose to apply for them meanwhile.


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#12 vere

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Posted 06 November 2017 - 08:43 AM

I have to respond to Kinesis because I cannot stand this kind of ideology, and this kind of dangerous misunderstanding of mental health conditions is at the very core of the field of psychiatry.


Anhedonia is a standalone condition from depression. The neuropathological origins of anhedonia are separate from those of depression. They can also be comorbid. Just like anxiety and depression. This isn't even up for debate. If you are using the DSM as a benchmark of mental health conditions, you are part of the problem that is perpetuated by psychiatry.


Yes, anhedonia can be a symptom of depression. But depression can exist without anhedonia, and anhedonia can exist without depression. Either one could precede the other. An inability to enjoy or feel anything anymore could make you lose hope and become depressed. Being depressed can wind up making you feel like nothing matters anymore and lose interest in things you used to enjoy.


A symptom, at face value, can overlap with any number of conditions. That does not mean that the ORIGIN of the symptoms are the same. Fatigue is a symptom of many conditions but the origin of it is vastly different across the board. Anhedonia and depression can produce similar symptoms, impact peoples' lives in similar ways, but for entirely different reasons. By only taking their symptoms at face value without viewing them contextually, you misunderstand the entire point.


Instead, read some medical papers on the conditions that actually discuss the underlying pathologies of the disorders. Just as one instance, you can read this study that shows weakened pVMPFC connectivity with reward-related brain regions is uniquely associated with anhedonia. This paper is on point with the fact that "complex psychiatric disorders such as MDD need to be more fully characterized by identifying potentially distinct neurobiological mechanisms associated with individual symptom clusters."


Someday, "symptoms" that were previously lumped under depression will undeniably be proven as having neurobiologically unique pathologies that are separable from depression. Anhedonia is for certain, one of these prominently incorrectly generalized conditions.


But, we don't even have to get this technical and specific to figure this stuff out. It's obvious enough if you take the time to listen to people and understand, there are people that have depression without anhedonia, and people who have anhedonia without depression. That in itself should tell you the two are separable and distinct. I primarily have anhedonia and emotional numbness, and I often have no symptoms of textbook depression. Any symptoms of depression I have are usually caused by the emotional numbness and anhedonia -- I cannot cry, feel anything with any depth, care about anything that should matter, and that makes everything hopeless and pointless. It is not the distress of depression that takes the joy out of activities that were once enjoyable, as is the case for many primarily depressed people with symptoms that could also overlap with anhedonia at face value.


If you need more convincing, just ask yourself why there are so many anhedonic "depressed" individuals who are labeled "treatment resistant depression." The article I linked here discusses this as well, saying that “anhedonia is a predictor of poor treatment response in MDD.” The reason for this is obvious: because many of these people are probably individuals that have been persistently misclassified as depressed patients. They did not FAIL depression medication (that phrasing makes it seem as though the patient's lack of response to a medicine renders them incurable). The reality of it is that these medications are not meant to address neurobiological origins of anhedonia and should never be expected to WORK on someone with this condition -- they are improperly prescribed to anhedonic individuals and then these individuals are consequently written off as untreatable.


Suddenly, ketamine comes along and everyone's mystified how it miraculously helps many people with "treatment resistant depression." The answer to this is obvious as well - it's one of the first major mainstream treatments that actually had a glutamatergic mechanism that significantly and instantly addresses the origin of anhedonia in the mPFC.


At some point, you have to ask yourself why depression medications don't address anhedonia. It's not because the depression medications "leave something to be desired." It's because the medications fundamentally are not designed with the underlying neurobiology of anhedonia in mind.


You cannot compare this with something like cancer or diabetes that is more easily united as one condition by physical, observable symptoms. Mental health symptoms are much more easily misunderstood because they are not as concrete. Because these conditions are often only defineable by subjective interpretation of another person's mental experience, they are also subject to being misconstrued by the misinterpretations of horrible people that are not very empathetic or understanding of what goes on in other peoples' brains.


With conditions like cancer or diabetes, the diagnoses are obviously much more clear cut. And so it is clear that the shortcomings of the treatments for these disorders are for other reasons - not because the diagnosis is wrong (i.e. not yet discovering an ideal solution to treat the problem, progress being slow in the medical system due to red tape and needing to go through safety/testing for years, etc.) Whereas the inadequacy of the medications prescribed for anhedonia are due to a misunderstanding of the origin of the condition altogether as a "symptom of depression," in which the depression needs to be "fixed first" for the anhedonia to go away.


The problem with people who think like you about this stuff (almost every psychiatrist thinks this way) is that you are being overly pedantic about this instead of using some common sense. In the end, the DSM does not matter - what treatments you respond to will reveal the actual neurochemical origins of what is going on in your brain and that is the only thing that matters and should unite conditions as falling under a specific diagnosis.


You think that our brains care and respect the DSM outlines? You think those are any way of properly understanding these conditions? Some old white guy who understands nothing about what it feels like to have depression or anhedonia or any of these mental conditions wrote it on a paper years ago, and it's somehow the unquestionable authority now that governs all of psychiatry. I'm not even going to attempt to measure myself by some inaccurate standard, because it’s a disservice and insult to peoples’ actual complex mental conditions. The DSM is hardly worthy of being toilet paper.


Psychiatry will never acknowledge the fact that their diagnoses are not accurate, and so they prescribe based on the medications available for each of these categories, stuffing you under one that sounds most like you (a poor fit, at best.) Instead, they should be only paying attention to the mechanisms of their medicines and how you respond to them, how they change how you feel, to try to deduce the neurochemical origin(s) of your condition(s). At that point, we can come to understand the separate diagnoses that exist on this basis. In mental health, the treatment is a better diagnostic tool than the misinterpretation of your symptoms by a soulless psychiatrist according to an ancient rule book. Let people speak for themselves on what they feel the heart of their condition is, because they know themselves and are the authority on what applies to them.


If you have anhedonia, doctors just cannot help you right now. What Kinesis said about consulting a doctor and not self-diagnosing and experimenting is a joke. People like to play make believe doctors can help you because, I don’t know why, it helps them sleep at night? Anyone who has been through the hell that is psychiatry with a condition like this knows that, at this point in time, you are far better off and safer trying supplements and medications on your own to find ones that work for your condition, so long as you are willing to take the responsibility upon yourself to do your research well -- and it is not at all difficult to exceed the knowledge of your average psychiatrist.


Psychiatrists are dangerous and they will only lump you under a category that doesn't really fit you and play russian roulette with which medication at their disposal that they can try on you next. I would never recommend seeing one, I have been through many psychiatrists as well, and like Deaden says, this is not an uncommon experience. All of them have made me worse, all of them I regret seeing, none of them understood my condition and placed assumptions on me based on the closest fit DSM diagnosis which was "depression" instead of truly understanding the heart of my issue as anhedonia and an inability to feel emotions.


All of the standard medications commonly prescribed for depression - and I'm including ones that they will off-label prescribe for depression that "treat" other conditions like anti-psychotics, stimulants, and mood stabilizers - have mechanisms that neurologically end up numbing you even more. By aiming to suppress negative emotions or extreme moods, they suppress all emotions.


I also agree with what Deaden said earlier in this topic. Let’s stop pretending we don’t know the origins of anhedonia in the brain. Psychiatrist have this hands-off attitude about medications where they pretend that no one understands why they work and how they will affect people. They treat medications like some whimsical fanciful thing that might magically work for some people and not others - which is just blatantly a lie that covers up for their laziness and inability to keep up with any research on the brain and mental health conditions despite all of the research, studies, information, and anecdotal evidence out there. And that because even psychiatry doesn’t know why or how these work, you, the patient, can’t possibly know. Only “experts” have the authority to know this stuff.


If I could go back, I would have never seen a psychiatrist. And I wouldn't recommend to anyone with my type of condition to see a psychiatrist, unless you are using them to get some sort of medication or treatment that you have researched to be right for yourself. But never to blindly gamble with the medication they will prescribe you without even understanding the neurological origin of your problem and the mechanisms you respond to. I had a psychiatrist who told me SSRIs couldn't be bad because even bananas have serotonin in them, and another who looked at me with a blank, dead stare when I started discussing glutamate (a trained psychiatrist could not discuss the mechanisms of the mood stabilizer she was more than happy to prescribe improperly for my already, flatline-stabilized mood) - this is completely “normal” and (for some fucked up reason) accepted behavior for the morons who worship the DSM and are given the reigns on their patients' mental health.


Side effects are things like headache, nausea, and diarrhea. They are unintended effects that are unrelated to the intended mechanism of the medication, that are inherent cross-system results of affecting neurotransmitters. Emotional numbness is not a "side effect" and don't let anyone tell you that. The problem is not that "we have good medications for depression that, oops, accidentally might cause emotional flatness also!" But that we have medications for depression that are intended to control excessive emotions being improperly prescribed to people who already can't feel a normal range of emotions, numbing them. Compounded on top of my natural, initial anhedonic condition is a bunch of neurochemical changes artifically induced by improperly prescribed medications because I was lumped simply under "depression."


How about people on these forums try to make some actual progress and help people by trying to define these conditions by the actual neurological mechanisms behind them and not by the DSM's generic bulleted list of rigid symptoms with no context? The information is out there, and while psychiatrists may ignore it in favor of repeatedly, beyond all evidence, prescribing their beloved monoamine antidepressants, that doesn't mean we have to. There already is substantial medical evidence for a lot of this stuff but it's going to take years for the medical system to even acknowledge it, let alone actually get to the point where it can help people.



I think it was an overstatement on Deaden's part to say that this is the official cure guide for anhedonia, and he has acknowledged that, but it should be obvious Deaden's intent was not to speak for everyone and steamroll over depressed people who also have anhedonia. It was to help others like himself, who will know who they are when they read what he's said.


Before I get attacked on this as well, I want to be clear and say that I’m not seeking to even unify the diagnosis of anhedonia, even though I’ve generalized anhedonia in my post a bit for the sake of simplicity in discussing this, without getting caught up on details that are inconsequential to the point I am trying to make. I think anhedonic individuals could also be diverse in the origin of their condition and that needs to be considered. But what I am saying is that if we go by the treatments we respond to, we can define ourselves by the actual underlying mechanisms instead of broad terms like these.


People like Deaden aren’t harming other people by trying to draw conclusions or make theories about treatments that might work with individuals experiencing anhedonia based on medical papers we’ve read, our own experiences, and anecdotal evidence from others. The intent is to share these theories from others who are experiencing anhedonia, others who have had similar responses to treatments, and see if through a collective experience we can come to some understanding about our conditions.


I got the same kind of crap for trying to post about a treatment that could be potentially helpful to consider for others like myself. Even if you write disclaimers so you don’t get attacked on things that are beside the point you are trying to make, you will still get crapped on by people who think they are spreading god's word by pointing out irrelevant fallacies in your post (according to their poor understanding) and in doing so, are missing the point entirely. It’s this kind of thing that made me stop wanting to even post on these forums.


If this topic had been about discussing anhedonia vs. depression and whether or not they are distinct conditions, Kinesis’s post would have been a warranted offering of his opinion (although still, in my argument, completely misinformed and dangerous.) But derailing a topic like this is only serves to discourage a discussion that is meant for the people who this might actually be revelant to. I haven’t been able to care enough to add some actual meaningful discussion to this topic and I hope I can contribute in the near future, because there should be somewhere on these forums where a collective effort is being made to figure out treatments for anhedonic individuals. But when I see crap like this (which seems to happen all the time on these forums) I have to step in and reply because the least I can do is shut people like this down for obstructing valid and needed discussions like this.

 


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#13 jaiho

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Posted 06 November 2017 - 11:40 AM

Anhedonia and general distress show dissociable ventromedial prefrontal cortex connectivity in major depressive disorder.

You forget that MDD causes various breakdowns of brain chemistry and most commonly, the reward circuitry, leading to Anhedonia.

 

Other conditions can cause Anhedonia, so and overall analysis of symptoms is important to determine if its MDD or not. But going by Deaden's symptoms, it is likely MDD (As he explains on discord)

 

Also, important to note that almost all depression treatments also treat Anhedonia, even SSRIs though they usually need augmentations to treat Anhedonia sufficiently.

 

 


Edited by jaiho, 06 November 2017 - 11:49 AM.

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#14 Deaden

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Posted 06 November 2017 - 12:15 PM

I cannot take this anymore, another one blindly defending that anhedonia=depression using irrelevant arguments. I would counter the statement you're making, but unless I spend a high amount of time proving from A to Z that your reasoning lacks sense, which I don't have the motivation for right now, you would still come up with things that are maybe 10% relevant to this situation and think you're onto something. Well, to be honest, you probably won't admit you're wrong regardless. I am beyond convinced my anhedonia was not caused by depression, if I would be otherwise then It'd be false and not account to the true reality of things. 

 

Anyone that tries to against Vere's post, either did not read it in its entirety, cannot make sense of it, or just can't handle being wrong (bruh). In Jahio's case, low ability to reason critically I believe. I am impressed with how well he put it all in words, and I 100% agree with everything he said.


Edited by Deaden, 06 November 2017 - 12:17 PM.

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#15 Galaxyshock

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Posted 06 November 2017 - 12:58 PM

Has anyone tried low dose amisulpride for anhedonia? It's an antipsychotic yes, but in low doses it's pro-dopaminergic by blocking presynaptic d2 receptors. Amisulpride is interestingly also GHB-receptor agonist, which is an excitatory receptor increasing release of glutamate and dopamine. It's used in these low-doses for dysthymia in some countries.

 

I'm considering this especially for motivational anhedonia.



#16 Deaden

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Posted 06 November 2017 - 12:59 PM

Me and Vere have an unfortunate faith... Got our life ruined by a condition that is so poorly understood, doctors not helping so we do our best to adapt and certainly do it better than most people would, yet if all this wasn't enough, this world is full of morons that believe in things that are really irrelevant to our situation and making recovery way harder than it should be if we lived in a less imperfect society that could utilize information better or did not let ego get in the way...

 

I think Vere will get out someday though, and sooner than someone who would be at his place and had lesser intelligence. At least our anhedonia did not take our ability to think critically... 

 

If you want to argue against what I said, first try to counter each one of Vere's point trying to make more sense than he does. Oh... you can't. If you try it will only make more sense in your mind, but not to the reality.

 

Smh. Our life is shit <--> we do not get recognition <--> no matter how well we try to adapt, people on the lower spectrum of intelligence interfere with our recovery <--> STILL will get argued against by poor rationalization even if we prove our point OR best case scenario apparently, the person shuts up instead of admitting he was wrong, or deciding to help.

 

Downvote my post because I criticized you or seemed mighty, I do not care. If you were a better human you would understand where I am coming from, let your ego aside and apologize to us. Of course that won't happen because apparently some can't/don't want to think deeper than anhedonia=depression because they read that loss of pleasure was part of the DSM when it's really not relevant to our situation.

 

 


Edited by Deaden, 06 November 2017 - 01:55 PM.

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#17 hydrus

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Posted 06 November 2017 - 01:51 PM

IMO anhedonia is strongly linked to the dopaminergic system. I think the numbness that is often described while taking SSRIs/SNRIs is due to increased serotonin lowering dopaminergic activity.

Edited by hydrus, 06 November 2017 - 01:53 PM.


#18 Kinesis

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Posted 09 November 2017 - 07:46 PM

I have to respond to Kinesis because I cannot stand this kind of ideology, and this kind of dangerous misunderstanding of mental health conditions is at the very core of the field of psychiatry.am saying is that if we go by the treatments we respond to, we can define ourselves by the actual underlying mechanisms instead of broad terms like these...

It's not ideology, it's semantics.  It has to do with the different meanings of words in different contexts.  In the medical field the word "depression" doesn't mean the same thing as it does in ordinary conversation.  That's why I cited the DSM ... it gives the medical field's working definition of "clinical depression".  Agree or disagree, it is what it is.



#19 vere

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Posted 09 November 2017 - 11:37 PM

Thanks for your support, Deaden. 

 

Anhedonia and general distress show dissociable ventromedial prefrontal cortex connectivity in major depressive disorder.

You forget that MDD causes various breakdowns of brain chemistry and most commonly, the reward circuitry, leading to Anhedonia.

 

Other conditions can cause Anhedonia, so and overall analysis of symptoms is important to determine if its MDD or not. But going by Deaden's symptoms, it is likely MDD (As he explains on discord)

 

Also, important to note that almost all depression treatments also treat Anhedonia, even SSRIs though they usually need augmentations to treat Anhedonia sufficiently.

 

 
Yes, depression can lead to breakdowns of reward circuitry as well, causing anhedonia. That does not mean it is the same condition, and that the treatment is the same. You can have one disorder that causes another, and they are still separate disorders. You've misunderstood my argument if you think this is against what I believe.
 
I am saying that even though depression can be a cause of developing anhedonia, that it should be classified separate disorder because it has a separate neurological mechanism in the brain that can function on its own without having to be entangled with depression.
 
You could even argue that depression almost always leads to some degree of co-morbid anhedonia and I wouldn't disagree. I think that is often where the confusion comes in, because they can be so intertwined in this way. But I would disagree that the mechanism of the dysfunction that causes anhedonia ONLY is possible in the brain when co-present with some other form of disorder. Anhedonia can exist on its own.
 
Disruptions in reward circuitry can happen without depression. A lack of properly functioning reward circuitry can lead you into becoming depressed as well. This is true in my case. 
 
Drug abuse can lead to anhedonia without depression.
 
Chronic stress can cause anhedonia without depression.
 
You could just have a natural dysfunction of your reward circuitry. Be pre-disposed to it genetically, environmentally, whatever.
 
The point I am making is, you are thinking of this way too rigidly and aren't respecting the complexity of these disorders by saying anhedonia can only exist as a part of depression. 
 
Again, my argument is that we really should relate to each other based on what kinds of treatments we respond to, because we can infer the source of each of our problems and relate to each other based on that. Labels are so rigid while the brain is so complex. We try to fit ourselves into these strict terms as if there is only one way the brain can be when it is "depressed" or "anhedonic", that there is a single pathology for all of depression, or all of anhedonia. When you reduce someone's condition to this level, the treatment is going to be wrong. In my case, I was reduced to depression because all the DSM can understand is "anhedonia is a part of depression, you can not be anhedonic without being depressed." And that kind of treatment is dangerous and can make people like me a lot worse.
 
I'd need a little more convincing that "most depression treatments also treat anhedonia." I would think that there are some medications or combinations of medications intended for depression that also affect neurotransmitters in a way that helps anhedonia. But definitely not the majority. And that does not mean the two problems are of the same origin. 
 
 

 

 

It's not ideology, it's semantics.  It has to do with the different meanings of words in different contexts.  In the medical field the word "depression" doesn't mean the same thing as it does in ordinary conversation.  That's why I cited the DSM ... it gives the medical field's working definition of "clinical depression".  Agree or disagree, it is what it is.

 

 

The ideology I am referring to is that anhedonia should be treated as a part of depression, and that anhedonia can not be a standalone condition. That is what I am referring to.

 

It's not about semantics. I am not using the word depression colloquially. My argument isn't that depression "just means you're sad."

 

Just because something is currently the standard, set by an "authority" on the subject, does not mean it is to be just blindly trusted and never questioned as an untouchable truth. Do we not amend the Constitution upon the realization that the document wasn't perfect or right when it was first written?

 

Take a disease like multiple sclerosis. Years ago the criteria were even more strict with regards to what qualifies as "having" the disease. Upon new scientific realizations, it turns out there are tons of people that probably had the disease but the "working medical definition"  at the time said they did not. Does that mean they did not have MS? No, it means the way that we defined them was wrong. 

 

So what exactly makes you think that the working definition of depression is so accurate as of now? These kinds of things are constantly being revised. I have a feeling that if the medical field's definition of depression were something completely absurd, you'd still buy into it.

 

Maybe your beliefs on this topic align with the current standard set by the DSM, which is fair, as long as you can defend what your beliefs are grounded in. But it seems like the only argument you have on this subject is "The DSM says anhedonia is a part of depression." And somehow that entitles you to be able to go around and match up peoples' beliefs against what the DSM says and prove them "wrong."

 

If you really don't have another reason other than the DSM says so, you're not giving this enough thought to be a valid participant, much less initiator, of this debate.

 

 

Has anyone tried low dose amisulpride for anhedonia? It's an antipsychotic yes, but in low doses it's pro-dopaminergic by blocking presynaptic d2 receptors. Amisulpride is interestingly also GHB-receptor agonist, which is an excitatory receptor increasing release of glutamate and dopamine. It's used in these low-doses for dysthymia in some countries.

 

I'm considering this especially for motivational anhedonia.

 

 
From reading a little bit about it in the past, my impression of it is that it seems to work pretty well for anhedonia. I haven't tried it, but I did consider it for a while and I am curious about it and how it pans out after long term use. 
 
I think this is where the differentiation between anhedonia and emotional numbness comes in. In my personal experience, though I don't mean to speak for everyone, dopaminergics seem to help with "wanting" to do something and pursuing it, but they don't seem to help me feel any more emotional depth or connection to things I should care about (and used to.) In other words, I still feel flat, though I might be slightly more motivated. Only glutamatergic medications have helped me feel again. This is why I personally haven't pursued dopaminergic medicines for my condition but I do think something like this would help motivational anhedonia.
 
From what I've read, most peoples' aversion to amisulpride seems to be because it increase prolactin at even low doses, and prolactin can in general be supressive to dopamine. I am not sure how big of a deal this is though, or if you could take something to counterbalance this, and if the pros would outweigh the cons.
 
 

 

IMO anhedonia is strongly linked to the dopaminergic system. I think the numbness that is often described while taking SSRIs/SNRIs is due to increased serotonin lowering dopaminergic activity.

 

I think that's true too, that anhedonia is a dopaminergic problem - but that there is probably a lot more to the story in fixing this problem than simply affecting dopamine. The SSRI numbness definitely is a widespread problem (probably worse in individuals who already trended towards anhedonic prior to taking them.) For many, myself included, it seems to last past taking SSRIs and SNRIs as well. While taking them, it makes sense that serotonin would be supressive to dopamine. And I think beyond that, the lasting numbness after stopping seems to be because they tend to downregulate key receptors that would otherwise keep serotonin in check and promote dopamine. I also think SSRIs are involved with worsening not just anhedonia, but emotional flatness as well. My theory is that SSRIs downregulate 5HT2A receptors, which have a strong link to glutamate release and glutamatergic receptors like mGluR 2/3 in the mPFC.


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#20 Kinesis

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Posted 10 November 2017 - 06:36 PM

It's not ideology, it's semantics. It has to do with the different meanings of words in different contexts. In the medical field the word "depression" doesn't mean the same thing as it does in ordinary conversation. That's why I cited the DSM ... it gives the medical field's working definition of "clinical depression". Agree or disagree, it is what it is.


The ideology I am referring to is that anhedonia should be treated as a part of depression, and that anhedonia can not be a standalone condition. That is what I am referring to.

It's not about semantics. I am not using the word depression colloquially. My argument isn't that depression "just means you're sad."

Just because something is currently the standard, set by an "authority" on the subject, does not mean it is to be just blindly trusted and never questioned as an untouchable truth. Do we not amend the Constitution upon the realization that the document wasn't perfect or right when it was first written?

Take a disease like multiple sclerosis. Years ago the criteria were even more strict with regards to what qualifies as "having" the disease. Upon new scientific realizations, it turns out there are tons of people that probably had the disease but the "working medical definition" at the time said they did not. Does that mean they did not have MS? No, it means the way that we defined them was wrong.

So what exactly makes you think that the working definition of depression is so accurate as of now? These kinds of things are constantly being revised. I have a feeling that if the medical field's definition of depression were something completely absurd, you'd still buy into it.

Maybe your beliefs on this topic align with the current standard set by the DSM, which is fair, as long as you can defend what your beliefs are grounded in. But it seems like the only argument you have on this subject is "The DSM says anhedonia is a part of depression." And somehow that entitles you to be able to go around and match up peoples' beliefs against what the DSM says and prove them "wrong."

If you really don't have another reason other than the DSM says so, you're not giving this enough thought to be a valid participant, much less initiator, of this debate.


Let's try to separate opinion from fact. The difference between our arguments about the DSM is that you're talking about what should be, and I'm talking about what is. I've posted what the DSM says, but haven't expressed an opinion on whether I agree with it. The ideology, the belief that it should be different, is yours.

What opinions have I expressed? The opinion that people suffering from severe anhedonia should see a doctor. That OP's claim to know how to "cure anhedonia/emotional blunting completely and permanently" was over the top.

But no opinion on the merits of the DSM. Maybe it will help clarify the difference if I give one. For what it's worth, not a fan. To be fair, psychiatrists and researchers have problems with it too; there are intense and ongoing efforts to improve understanding and treatment. It doesn't really describe a single pathological "disease", but rather a messy collection of syndromes whose only common connection is that an equally messy collection of treatments work for them some of the time. It tries to draw bright lines in a fuzzy world. But that's just my opinion.

Something I strongly disagree with ... calling a treatment an "antidepressant" as if the diagnosis defines it ... the whole thing is circular, because "depression" as suggested above winds up just being whatever may respond to "antidepressant" treatment. In practice what happens if you go to see a doctor and based on his training and experience he thinks a certain treatment will work, and if that treatment is called "antidepressant", then the diagnosis is tailored to fit the treatment. That's how inadequate I think the medical "depression" paradigm is. It effectively defines a disease by what treats it, names the treatment for the disease, names the disease for the treatment, and round and round we go. How it got on that track is history. The only reason it's survived this long is that it often works.

This leads to a derivative opinion, that as it is defined, clinical "depression" is a big enough enough tent that insisting that people who suffer from anhedonia have something separate and distinct from it isn't helpful and may even be counterproductive. It gives more credit than is due ... as if "depression" as medically defined were really a unique coherent pathology. Whether it should be defined that way is a separate question. Whether we think it should doesn't alter the fact that it is.
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#21 Deaden

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Posted 11 November 2017 - 06:19 AM

No, thank you!

 

Honestly, almost all you wrote I had came up with myself, you make perfect sense on everything and I'm glad you're able to put it all in words so well. It feels relieving to find someone else with anhedonia that comes so close to my understanding and Charles Carriere's of things, and actually even better, teaches me stuff (like about Mgur2/3 receptors and antagonists). I also know of a few others non depressed anhedonics that feel strongly about anhedonia not being depression, although not knowing much about the neurobiology behind all this.This past year, I read hundreds of testimonies from people trying various drugs/supplements for their numbness, it only became clearer and clearer that there isn't any relevant prescribed pharmacological option for our condition at this time. Like Vere said, it is about meds not being meant to address the issue, let's stop with the "treatment resistant" Also, I tried four different ADs, with little to not success (including an MAOI, supposedly the most powerful class of anti depressant?), but I'm done. I do not plan on trying another fifty random drugs during the rest of my life and ultimately never truly getting better (Jaiho much?). People like us cannot rely on today's psychiatry, it is just the unfortunate truth. 

 

I should be surprised some are still not getting it after Vere's post, but after arguing over the subject for hours with Jaiho (still saying anhedonia=depression after Vere's second comment btw), and some guy nicknamed "Under" on discord, I lost faith in some reasoning deeper than what they read in the DSM, or what some random doctor told them. Doctors are not all knowing entities, have some independent thinking for Christ sake. I am not saying you should never trust them, but no matter their authority, if they do not serve you appropriately, then their medical degree means absolutely nothing. By the way, there is mental health professionals/ articles out there arguing that anhedonia can come independently of depression. Also, I was able to make two psychiatrists agree with me that I did not have depression exchanging on the subject (not counting the one that faked his approval out of laziness/dishonesty) Although sucks that all they knew about was dopaminergic medication for my case. The rest of doctors I've seen were incapable of critical thinking, could not get over their ego because -I am the patient and they are the professional- Then, there is this girl from this support group on facebook, that got refused a depression diagnosis and medication because anhedonia was the only symptom she showed. Clearly, not all mental health professionals are in perfect agreement so there goes your blind faith in doctors. For myself, I rather follow facts, or people that studied the subject more extensively. Following some peoples logic, if the DSM one day decides that depression is some special type of brain tumor, then no questioning is needed. Of course this is an over exaggerated example, but still perfectly relatable to this situation expect here it isn't as obvious to start to question if the general medical community can help people like us. Did you know? We used to think schizophrenia was an early onset and with rapid cognitive deterioration type of dementia.

 

It's interesting how some will be so desperate to defend their argument. Notably Jaiho and Under on discord. Jaiho will be telling me that the reason I get overly short of breath and light/hotheaded from any small amount of exercise (came around when my anhedonia started), it is because I am "unconsciously anxious", and will keep on insisting with that even after I tell him (should not have to), that just a year ago, I would be going to the gym six times a week with absolutely no problem, and that now I will get short of breath from just walking up a small hill not even realizing I am making physical effort. Just from that, you should lose all credibility, but I keep on arguing with you because it is just mind blowing for me how anyone could be so close minded (don't worry though, you're really not the only one that has been making irrelevant statements like these when I complain about my issues). Also we have Under, telling me I am depressed  "you also wake up early and have guilty thoughts I know it", so... I tell him I don't, and I'll be accused of lying when in fact I'm really not... Oh and, they are being totally serious and not just trying to mess with me

 

I just read Kinesis new post. First off, I don't know why you use the word "opinion", when you came here shoving to my face that anhedonia is depression like you are spreading god's word. Second, you are still missing the point. Clearly yes, I got a bit excited with my post, but was it really necessary to point it out, and not once, but twice already after I admitted to having made an overstatement? And as Vere said, the main goal was to try and find a better alternative of what we are given by today's psychiatry. You are being clueless when saying that it is counter productive to make a distinction of anhedonia from depression, it is the exact opposite. I'm putting you in the trashcan of people who can't reason, not going to keep on wasting my time arguing on why you're absolutely wrong, when even after Vere's post that is highly up to the reality of our situation, you are still not getting it.

 

What is this world I'm living in? I have one of the worst psychiatric conditions to live with, the majority of the medical community is clueless on how to treat people like me (fault of the DSM), I feel forced to argue against people telling me I have depression because they are part of the problem, and I can't even get the recognition I am due for the constant battle I've been fighting, living and doing my best to make the best decisions I can so that I get my right to feel alive back. I do not wish to have this for ten years like a lot of people that decide they're just going to take the word of doctors at first degree. No. I shall not let anyone decide if my life will be wasted or not. Man... this must all be karma from my ex's.

 

"Lol" anyway... my plans are to first hopefully figure out why I have been intolerant to exercise, have no sense of time, am severely dissociated from any of my memories, get very and abnormally confused on alcohol, psychoactive drugs (that I tried to get temporary relief on my anhedonia). My best guess is that I have some issue with oxygenation, but I don't know. These may suggest an underlying issue and have an indirect link to my incapacity of feeling pleasure and emotions. I need doctors for that, some testing is needed. All I got till now was a EKG of my heart and was told it was fine, well then why can't I exercise give me an explanation?? Sigh. Also, I need to rule out dementia... You may criticize me on that, but honestly need a clear explication for my ghostlike memory because it is scary and makes CBT impossible. These may just be DP symptoms, but I need to be certain of it. I do believe CBT is part of the few relevant options to cure anhedonia, but it is much trickier, harder, and takes more time and consistency than CBT for depression. So apart from that, I have hope in deep or repetitive TMS, those specifically act on functional connectivity, aka glutamate which is the core of the issue in most anhedonics. As of now, I am still not sure of what should be the target for this procedure, but I haven't really researched it extensively, and perhaps we can help each other in figuring that out? Ideally, one would get an fMRI before getting TMS, so that there's noway doctors will decide to miss the spot. For sure I shouldn't get TMS at the usual location for major depression, I have quite enough evidence that it wouldn't be effective. Actually, I know of two people saying TMS made their apathy worse or induced it, this only just confirms more the fact that TMS can help us anhedonics, but the right location is needed. Also, I have some hope in partial kappa agonists, lamictal, and the Mgur2/3 acting drugs Vere mentioned to me in private messaging. Hopefully it works for him, and then I'll probably give it a try myself. Multiple things may cause apathy, but if mine was solely caused by the neurobiological toxicity of chronic stress which is the best sense making answer I have right now (although I have a hard time connecting it to the rest), then we probably respond to very similar things. The brain does not work like a computer where we can run multiple different softwares. We don't have different brain areas for reward, and I'm theorizing that glutamate connectivity got altered in similar locations. The brain is complex, but much like the universe, our understanding of it can only gets progressively better. There will be a time when nothing of it will be a mystery, we will be able to make a perfect link of everything, and there will be a general agreement on the best treatments for every human psychiatric disorder there is. When we reach that point, I have a hard time believing that over generalized labels will still be a thing... symptoms will have a more important role that is for sure. This would especially benefit emotionally numbed individuals.


Edited by Deaden, 11 November 2017 - 07:11 AM.

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#22 jaiho

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Posted 11 November 2017 - 06:32 AM

 

 

What is this world I'm living in? I have one of the worst psychiatric conditions to live with, the majority of the medical community is clueless on how to treat people like me (fault of the DSM)

 

This is factually incorrect.

The medical community *do* know how to treat it, and its done often in treatment resistant patients.

dTMS, DBS, MAOIs, Ketamine. The list goes on.

 

Theres also psychological therapies which you mentioned for depression, CBT being one. And also http://www.cell.com/...(17)30065-2.pdf

mGlu2/3 Receptor Antagonists as Novel Antidepressants

 

It's weird people here are so confused on the matter. You're mentioning depression treatments such as CBT, TMS while claiming you dont have depression.


Edited by jaiho, 11 November 2017 - 06:59 AM.

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#23 Deaden

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Posted 11 November 2017 - 08:19 AM

You are seriously exhausting. Out of context, again.



#24 Deaden

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Posted 12 November 2017 - 12:35 AM

"If you need more convincing, just ask yourself why there are so many anhedonic "depressed" individuals who are labeled "treatment resistant depression." The article I linked here discusses this as well, saying that “anhedonia is a predictor of poor treatment response in MDD.” The reason for this is obvious: because many of these people are probably individuals that have been persistently misclassified as depressed patients. They did not FAIL depression medication (that phrasing makes it seem as though the patient's lack of response to a medicine renders them incurable). The reality of it is that these medications are not meant to address neurobiological origins of anhedonia and should never be expected to WORK on someone with this condition -- they are improperly prescribed to anhedonic individuals and then these individuals are consequently written off as untreatable."

 

Now, TMS often fails to treat anhedonic patients because they keep hitting the usual target for major depression. MAOIs are not a reliable option. DBS, yeah only when I am really really really desperate. Ketamine works short term only, but you won't hear that from doctors, only maybe something like "ketamine is a miracle of pschiatry". I said the majority of the medical community by the way, if you're telling me most doctors know how to treat anhedonic patients you are beyond delusional. A small minority might have a clue.

 

Edited by Deaden, 12 November 2017 - 12:36 AM.

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#25 hydrus

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Posted 12 November 2017 - 11:14 AM

anyone here cured their anhedonia and left a detailed description of their treatment and experience?



#26 Londonscouser

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Posted 12 November 2017 - 10:26 PM

Just for the record, (and I've personally stated this is several posts in 2015-2016), I don't think I am clinically depressed, however I do suffer from anhedonia, a lack of emotions and an inability to connect to others. When I say I suffer from anhedonia, I mean that I don't enjoy socialising, gaming, eating, reading...so many activities that I used to derive pleasure from for at least 18 years of my life.

 

My symptom arose as a result of smoking cannabis everyday for years, and still persist to this day, although I have never quit longer for 5 months. That being said, there was a marked improvement in my symptoms during my period of abstinence. If I could quantify the improvement, I would say something like 20%.

 

I have also noticed that my form of anhedonia does not correlate with my motivation. When I was 'normal' (never had a negative symptoms before I started smoking daily), I was quite apathetic towards my future, had no aspirations whatsoever, barely studied. I lived in the moment, enjoying my time playing sports and socialising.

 

However after several years of being anhedonic (which greatly inhibits my capacity to be social), I gained a lot of motivation and ambition that I never had before... Since I've been anhedonic (since 2012), I've completed a Bachelor's degree in a specific subject (attaining the best possible grade), and than my motivation increased considerably in the summer of 2016, in which I decided to pursue a Master's degree in a completely unrelated discipline, with 0 background knowledge, and now I've been working for 1 month in my first ever job, which happens to pay rather well.

 

Anyways, I find this thread really interesting, so I'd like to thank Deaden for starting it. I haven't  been on longecity in a long time but I certainly will keep an eye on this thread.

 

 



#27 Deaden

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Posted 13 November 2017 - 09:48 AM

Just for the record, (and I've personally stated this is several posts in 2015-2016), I don't think I am clinically depressed, however I do suffer from anhedonia, a lack of emotions and an inability to connect to others. When I say I suffer from anhedonia, I mean that I don't enjoy socialising, gaming, eating, reading...so many activities that I used to derive pleasure from for at least 18 years of my life.

 

My symptom arose as a result of smoking cannabis everyday for years, and still persist to this day, although I have never quit longer for 5 months. That being said, there was a marked improvement in my symptoms during my period of abstinence. If I could quantify the improvement, I would say something like 20%.

 

I have also noticed that my form of anhedonia does not correlate with my motivation. When I was 'normal' (never had a negative symptoms before I started smoking daily), I was quite apathetic towards my future, had no aspirations whatsoever, barely studied. I lived in the moment, enjoying my time playing sports and socialising.

 

However after several years of being anhedonic (which greatly inhibits my capacity to be social), I gained a lot of motivation and ambition that I never had before... Since I've been anhedonic (since 2012), I've completed a Bachelor's degree in a specific subject (attaining the best possible grade), and than my motivation increased considerably in the summer of 2016, in which I decided to pursue a Master's degree in a completely unrelated discipline, with 0 background knowledge, and now I've been working for 1 month in my first ever job, which happens to pay rather well.

 

Anyways, I find this thread really interesting, so I'd like to thank Deaden for starting it. I haven't  been on longecity in a long time but I certainly will keep an eye on this thread.

Yes... addiction to certain drugs may blunt the reward response overtime. I mean, why haven't you stopped using something that takes off all your humanity? What is anything in this world worth if you cannot feel pleasure and emotions from anything? Like... I did nothing to deserve this, well nobody deserves anhedonia, but personally I had no way of guessing I was doing anything wrong and that would completely ruin my mental health. 

 

So you say anhedonia made you gain "a lot of motivation and ambition", hmm that's very weird, first time I hear that. Usually very low motivation is a direct effect of a dysfunctional reward system, it is a pleasure/emotional response. Maybe you only have consummatory anhedonia, and not anticipatory? Some only have one of both. Personally, I used to be a highly motivated person, could motivate myself out of anything and loved life. All I needed was my music and could easily make myself hypomanic... I really would spend almost all my time either studying or doing sports. Was an action oriented individual, and always pushing myself. I loved it, but I think with time it became unhealthy though... it became hard to keep up, but I ignored the stress till my brain just couldn't go on anymore and went haywire. No way I was suppose to know that could happen. Chronic stress is what I believe caused this, but doesn't really explain the rest of my handicaps and need to do some testing... Anyway now, I am unable to feel and am just a shell of the person I used to be. I would and will do everything to feel alive again, as right now it is out of my power. There is absolutely no point for me to just push trough the years living life like nothing is wrong and continue with my goals. First off, I don't have the physical and mental energy for that, I am just as useless as a car without gas. And second, even if I succeed, it would just be absolutely meaningless as I won't feel any pleasure or emotion from it. Regardless, my memory is awful I have way too big of a handicap to compete with other people, and well am unable to have any interest in it anyway. I would write ten paragraphs on how anhedonia is destroying every single aspect of my life, but I'm not a big fan of unproductive self defeating post. I am thankful to have a family that helps me financially, although sometimes I wish they could be more comprehensive I guess...

 

You need to quit your addiction, you're lucky the solution is likewise as simple as this. Since you can feel motivation, why not use that to stop cannabis all together? When you feel emotions and pleasure, everything in life is worth it, but with anhedonia everything is meaningless. There's a big contrast, you have no reason to keep on smoking. There is drugs/supplements out there that help with marijuana withdrawal, research them. Also... normally anhedonia also takes off cravings of addiction, since those are a dopamine response and we have none coming out. Well... something is off with you since you can feel motivation, it may not be as serious. Hmmm... you can still try anhedonia treatments, we probably respond to the same things.


Edited by Deaden, 13 November 2017 - 09:52 AM.


#28 Londonscouser

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Posted 13 November 2017 - 12:00 PM

 

Just for the record, (and I've personally stated this is several posts in 2015-2016), I don't think I am clinically depressed, however I do suffer from anhedonia, a lack of emotions and an inability to connect to others. When I say I suffer from anhedonia, I mean that I don't enjoy socialising, gaming, eating, reading...so many activities that I used to derive pleasure from for at least 18 years of my life.

 

My symptom arose as a result of smoking cannabis everyday for years, and still persist to this day, although I have never quit longer for 5 months. That being said, there was a marked improvement in my symptoms during my period of abstinence. If I could quantify the improvement, I would say something like 20%.

 

I have also noticed that my form of anhedonia does not correlate with my motivation. When I was 'normal' (never had a negative symptoms before I started smoking daily), I was quite apathetic towards my future, had no aspirations whatsoever, barely studied. I lived in the moment, enjoying my time playing sports and socialising.

 

However after several years of being anhedonic (which greatly inhibits my capacity to be social), I gained a lot of motivation and ambition that I never had before... Since I've been anhedonic (since 2012), I've completed a Bachelor's degree in a specific subject (attaining the best possible grade), and than my motivation increased considerably in the summer of 2016, in which I decided to pursue a Master's degree in a completely unrelated discipline, with 0 background knowledge, and now I've been working for 1 month in my first ever job, which happens to pay rather well.

 

Anyways, I find this thread really interesting, so I'd like to thank Deaden for starting it. I haven't  been on longecity in a long time but I certainly will keep an eye on this thread.

Yes... addiction to certain drugs may blunt the reward response overtime. I mean, why haven't you stopped using something that takes off all your humanity? What is anything in this world worth if you cannot feel pleasure and emotions from anything? Like... I did nothing to deserve this, well nobody deserves anhedonia, but personally I had no way of guessing I was doing anything wrong and that would completely ruin my mental health. 

 

So you say anhedonia made you gain "a lot of motivation and ambition", hmm that's very weird, first time I hear that. Usually very low motivation is a direct effect of a dysfunctional reward system, it is a pleasure/emotional response. Maybe you only have consummatory anhedonia, and not anticipatory? Some only have one of both. Personally, I used to be a highly motivated person, could motivate myself out of anything and loved life. All I needed was my music and could easily make myself hypomanic... I really would spend almost all my time either studying or doing sports. Was an action oriented individual, and always pushing myself. I loved it, but I think with time it became unhealthy though... it became hard to keep up, but I ignored the stress till my brain just couldn't go on anymore and went haywire. No way I was suppose to know that could happen. Chronic stress is what I believe caused this, but doesn't really explain the rest of my handicaps and need to do some testing... Anyway now, I am unable to feel and am just a shell of the person I used to be. I would and will do everything to feel alive again, as right now it is out of my power. There is absolutely no point for me to just push trough the years living life like nothing is wrong and continue with my goals. First off, I don't have the physical and mental energy for that, I am just as useless as a car without gas. And second, even if I succeed, it would just be absolutely meaningless as I won't feel any pleasure or emotion from it. Regardless, my memory is awful I have way too big of a handicap to compete with other people, and well am unable to have any interest in it anyway. I would write ten paragraphs on how anhedonia is destroying every single aspect of my life, but I'm not a big fan of unproductive self defeating post. I am thankful to have a family that helps me financially, although sometimes I wish they could be more comprehensive I guess...

 

You need to quit your addiction, you're lucky the solution is likewise as simple as this. Since you can feel motivation, why not use that to stop cannabis all together? When you feel emotions and pleasure, everything in life is worth it, but with anhedonia everything is meaningless. There's a big contrast, you have no reason to keep on smoking. There is drugs/supplements out there that help with marijuana withdrawal, research them. Also... normally anhedonia also takes off cravings of addiction, since those are a dopamine response and we have none coming out. Well... something is off with you since you can feel motivation, it may not be as serious. Hmmm... you can still try anhedonia treatments, we probably respond to the same things.

 

 

Erm..well it started with friends. In my area of London, everybody smokes, and most people smoke daily. All of my very close friends smoke. So it started of as a social thing, and progressed towards me smoking daily even without them.

 

It took me a while to figure out the cannabis was having a profound negative effect on my mental health. At the time I thought if I managed to quit, I would be normal within a few weeks. Of course that never happened.

 

I also spent 4 years (2013-2017) at university. Well guess what...everybody smoked there as well...I couldn't find ways around it. Obviously it is all my fault and I do take full responsibility.

 

I wouldn't necessarily say that the anhedonia gave me motivation/ambition...I think its somewhat independent.

 

I think my motivation/ambition comes from me wanting to be better than my peers. I feel like money makes the world go round, and I also realised that it would be impossible for me to buy and own a house in London unless I got myself into a very good career. Also, being financially comfortable is attractive to the opposite sex. Also, have a career and a certain skill set gives me a purpose in life, a sense of direction and something I know would please my family if not myself.

 

Since I've started working 3-4 weeks ago, I have quit, and I have no intentions of ever smoking weed again. It just bothers me that I don't have the ability to laugh with my colleagues, or get to know them on a personal level, or crack jokes, or tap into their wavelengths. I feel like there is a barrier around me and I can't break it down.

 

Like you though, I am a shell of my former self, have basically lost myself and fear that I will never ever enjoy life in the future as I used to for many many years. I am only thankful that I had a great childhood, and that is what keeps me going.



#29 Deaden

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Posted 13 November 2017 - 01:24 PM

I have a hard time believing one can be motivated with full blown anhedonia. Motivation requires pleasure. I had the same mindset as you, and still do to be honest, except when I have "motivating thoughts" no energy, no dopamine comes out and it's like I'm always swimming against the current. I still do stuff because I have to and (also?) believe there's no meaning in life if you are average, but can't say I am motivated since I can't get my brain to care emotionally about anything. Socially, I can act completely normal without much effort expect with people that are not my age or don't share similar interests. So right now, almost everything I do aims in trying to get out of anhedonia. Once I make it. then I can continue with my life, and feel the beauty and meaning of this world once again. It won't be easy and most likely going to take a while. Good luck with quitting your addiction, do not fail.


Edited by Deaden, 13 November 2017 - 01:28 PM.


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#30 Londonscouser

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Posted 13 November 2017 - 03:45 PM

I have a hard time believing one can be motivated with full blown anhedonia. Motivation requires pleasure. I had the same mindset as you, and still do to be honest, except when I have "motivating thoughts" no energy, no dopamine comes out and it's like I'm always swimming against the current. I still do stuff because I have to and (also?) believe there's no meaning in life if you are average, but can't say I am motivated since I can't get my brain to care emotionally about anything. Socially, I can act completely normal without much effort expect with people that are not my age or don't share similar interests. So right now, almost everything I do aims in trying to get out of anhedonia. Once I make it. then I can continue with my life, and feel the beauty and meaning of this world once again. It won't be easy and most likely going to take a while. Good luck with quitting your addiction, do not fail.

 

I  have probably about 80-90% anhedonia. I do laugh a few times a year, but it is very rare. I haven't been able to cry for years, even though i try my hardest. I feel like if i am able to cry, it would be a great release for me.

 

I never felt rewarded after completing and achieving very good results in both my degrees.

 

Socially I can 'act' normal as well, but it feels very fake, and I hate the fact that it is not natural. 

 

If it helps, I've read about multiple people who acquired anhedonia via stress, and after 2-3 years, it went into remission. I'm yet to hear about anybody who smoked through teenage years while the brain was developing, and recovering.

 

Anyways, I won't fail, even if it takes me 4-5 years to feel normal. If i'm still like this after that long, I will try out ibogaine, or other similar substances that may aid me in the long-term. 

 

This is truly no way to live, and I would have killed myself a long time ago, except for I can't because it would destroy my mother who has tried her best to give me a good life. I wish you well in your journey to remission my friend.







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