Okay, I will go for amphetamines first. If they bring some help, I'll proceed to examine the CILTEP stack of yours first!
Listen, when you posted to this thread for the first time I kind of ignored it because I still was extremely convinced with the "endogenous opioid deficiency" hypothesis and therefore kind of ignored all the stimulant talk. Now I know better. So here's what I'm curious about now: what exactly was your anhedonia like?
I'm asking this because it's important to know what exacly has amphetamine + CILTEP helped you with. After all, anhedonia can mean many things. Before treatment, what was socializing like? Listening to music? Eating sugary foods? Exercising? How about motivation in general? Did you take any non-stimulant drugs like alcohol, cannabis, opioids etc. when having anhedonia and how did they make you feel? How about the attention deficiency - how exactly did it manifest itself? You mentioned that you like to skip your stack to relax - doesn't the anhedonia intervene with pleasure obtained from relaxing?
A lot of questions, but I'm getting some amphetamine for me soon and I want to know what I'm dealing with. I'll report here when I've tested something.
Whew, I could write all day and maybe not cover all of those questions, but I'll do my best to give you a summary. I've written quite a few essay length posts on here over the past year about my symptoms and how I got here.
First of all, I don't know if you have any history with stimulants, but I sure didn't when I started taking Adderall. It was rough on me. My blood pressure and heart rate shot up. The crash every night, the dry mouth, irritability, and jaw grinding were awful too. The higher my doses got, the more side effects popped out. When I got up to 60mg/day, I often felt socially awkward, and it was hard for me to switch gears. I also had OCD tendencies, cleaning and sorting things when I should have been doing other things.
Also, when I was taking only the stimulant without CILTEP, Adderall worked better than d-amphetamine. However, d-amphetamine + CILTEP works with less side effects for me than Adderall + CILTEP. The only reason I'm not on d-amp + CILTEP now is because my current doctor doesn't seem to fully understand that Adderall isn't less harmful or addicting than d-amp.
What I'm about to describe might not fit into a neat box called anhedonia, and others who have anhedonia may not relate to it. All I know is that it fits better than ADHD-PI:
It could be dysthymia, not necessarily ADHD-PI, there is a huge overlap, i.e. lethargy, loss of motivation, inability to concentrate.
Dysthymia would be a type of depression. I don't think I've ever been depressed for no reason. I'm more of an inattentive mind-wanderer and day dreamer. My thoughts paralyze my production. My impulse to feed my imagination is over-bearing at times. My itchiness to do something else literally affects my whole body and mind... eh, not to say I can't get down from self frustration, but that's the scope of the depressive symptoms.
I can relate to this 100%. Growing up, I was a Winnie the Pooh like crazy. Content, well behaved, smart, but always a day dreamer. In my teens, I started taking pseudoephedrine (mild stimulant) daily for allergies and became a quick witted, though somewhat procrastinating (yet able to get things done at the last moment), social person; graduated Valedictorian.
When I went to college, I no longer needed to take allergy medicine because I wasn't around my family's cats any more. Also, the material got harder, things weren't as intuitive, and I couldn't talk my way out of late assignments like in high school. Things stopped working right, and I failed out of college 3 times over the next 8 years.
Seems as if most doctors can't wrap their head around the fact that I'm not depressed. They look at the college failure and want to give me SSRI's. (Side note: If I'm depressed because of an emotional reason, shouldn't the doctor recommend therapy instead of stuffing me full of drugs? Aren't anti-depressants supposed to be targeted toward people who are depressed for no reason?) I laugh a lot, smile often, and generally lean towards a realistic nature with a touch of optimism. Does that sound like depression at all?
My main symptoms being: lack of motivation, poor memory, inability to maintain concentration on things that aren't "new" (I can research on the internet for hours, but have a ridiculously hard time reading for any length of time about something uninteresting or that I already know about).
This reminds me of all those times where I struggled to explain my ADD-like symptoms, and was told that I just needed to have more motivation. Gee, thanks! You know, I think I'll go around telling depressed people that they just need to be happier, or choking people that they just need to breathe!
It would take me 12 cups of coffee to make it through an 8 hour/day desk job, and I still would struggled to keep from falling asleep at my desk. When I would go home, I would want to watch tv and sleep until the next day. It took so much work to "will" my brain into keeping its attention that I was exhausted from being bored.
When I'm not on any kind of suppliments/medication, most daily tasks take a monumental amount of "willpower" to do. I'm working twice as hard as the guy next to me to get through the same amount of work, since half of my brainpower is going towards "getting myself motivated" and keeping myself focused. Therefore I burn out before those around me, and it makes me look lazy and unmotivated.
I have a hard time getting out of bed in the morning, and it takes about an hour after waking for the brain fog to go away. Some days (err... a lot of days) I don't really get anything done. I just shuffle around the house until its time to go to work (I work the evening shift). I look at the clock and wonder where the day has gone, because "I was just getting ready to do that really important thing I needed to do..."
Certain tasks come very easily to me (usually involving something new and interesting to me), while most every day tasks are like a giant boulder that I have to struggle and strain against to get it started rolling. Most doctors say it's depression or ADHD, and neither fit that well. Its a type of depression, I suppose. Except I'm not sad, or anxious, or the symptoms that most people equate to depression. And I have absolutely no signs of Hyperactivity, so most people get confused if I say that I have ADHD-Inattentive.
If I take no supplements whatsoever, I have this constant sedated feeling. I don't get frustrated, angry, or anxious. I don't have a sense of urgency, even for important things. Just kind of a dreamy fuzziness to my days. My daydreams tend to grab my focus more than the world around me. At night, I lay down my head and struggle to remember what I did that day, which is usually not that much of anything.
To describe this all another way: Let's say there is a scale of pleasure from -10 (most unpleasant), 0 being neutral, to 10 (let's call it orgasmic bliss).
When I am not on anything at all, I am always stuck at 2. It takes extreme situations to get me to deviate from that. Learning something novel, new, or interesting produces a 3. A really good book, movie or song produces a 4. A good looking woman (haha) produces a 5. Skydiving produced a 6.
Getting in a fight with my family: 0. Getting cut off in traffic: 0. Being insulted by someone: 0. Failing a test: 0. Being broke: 0.
Anyway maybe you can see the pattern, or maybe not. But basically, I'm always content. Never worried, never sad, though I can get quite pensive at times. But never really happy or excited. I mentally know how I "should" feel, but it's not there. It kind of feels like I have a few beers in my system. I feel numb. Content and relaxed, but completely passive and somewhat emotionless.
Being always stuck at 2 has it's advantages in that I always feel pleasant, but the fact that I don't fluctuate causes issues with motivation. If it hurts to get off my butt and do something, and what I have to do is never rewarding in any way, then it is twice as hard to continue doing it. On the other hand, I know that it's going to feel okay if I just sit there and don't do it. Living life where every little task is forced out of the guilt of not doing it makes for a very heavy life, indeed.
On the other hand, with the CILTEP + Adderall stack, my baseline is 0. If I don't do something I know I should be doing, it actually hurts a little bit (depending on how important it is). I actually start to get irritated that I'm not doing it. So it drops into the negatives. But when I get up to go do it, it quickly swings into the positives. Now, since I'm not trying to induce a high, I have tweaked my doses so that hopefully my brain only rewards me in the way that it's supposed to. I don't feel euphoric every time I take out the garbage, I just do it. And when I get done, I wonder why it was so hard to do while not under the influence.
So motivation for me is not inducing euphoria (which actually hinders motivation for me), it is changing my brain so that it can correctly reinforce good behavior with the proper amount of reward.
To answer another of your questions:
No, I don't have any experience with anything besides legal supplements, prescription amphetamines, and alcohol.
Alcohol is a tricky beast to assess, because I mostly drank it right after my ex had cheated on me, several years ago. I don't think it makes me feel like how it makes other people feel. It is mostly physical in it's effects, and leaves most of my emotions and thoughts in their normal state. I know this not only from my own observations, but from other people who tell me this. They have said that even though my speech slurs, I still have all my faculties and make sense even when I've been nearly failing down drunk (which has only been about 5 times in my life).
Now that I only drink one or two beers at most, I know that it really doesn't effect my anhedonia unless I have other supplements in my body.
Sorry for this jumbly mess of a post. If you have made it this far, you have my condolences. I will end it here, and if you have any follow up questions about confusing or conflicting statements I made, or questions I left unanswered, feel free to ask.
Edited by zrbarnes, 05 December 2012 - 06:30 AM.
LongeCity
