Posted by robot on August 11, 2004, at 22:10:05
In reply to Re: enjoyment » robot, posted by King Vultan on August 10, 2004, at 8:27:16
Im SO GLAD you responded. Its a relief to hear from someone who has experienced some of the same things.
So many depression-sufferers seem to either have multiple diagnoses, or depression symptoms I dont quite relate too. I dont really have relationship problems. i dont cry for no reason. Im not really 'sad' except because of the lack of enjoyment/desire. And even when Ive ben motivated over the past few years, it never lasts, I think because my brain's reward system is screwed up. So that problem has finally crushed my motivation. I dont have emotional disruptions--I usually have no emotions (unless boredom and hopelessness are emotions :-)
Im a very 'cerebral' type person (my therapist says its schizo disconnection from my body)--im historically pretty introverted, a bookworm, not really socially successful. But I used to have pleasure in being with people as well as pursuing my own interests.
The more I think about it, I suspect that my anhedonia has pretty deep roots--maybe I was destined to develop it. It was partially brought about by intense loneliness in my college years as well as a religious belief system that was oppressive to me. But once the depression/anhedonia came, the anhedonia only worsened over the years and I think was the symptom that made the depression chronic. Then the symptoms just reenforced themselves.How can you be motivated if you have no pleasure in the present or future? How can you develop relationships if your ability/desire to be with people rises and falls without rhyme or reason? How can you be creative if everything you see is grey and meaningless?
It just used to be more interesting to be inside of myself.
While I believed that through will and spiritual searching I could overcome and triumph, I had brief periods during which I felt very well. Then it would pass. And I would think I was doing somehting wrong. Eventually all the pain and uncertainty took its toll and those periods stopped happening. Still I tried to beat it.
Its like being tortured and, finally, broken. Now even if I feel slightly okay I cannot trust it and it brings on anxiety about it leaving. Things I used to enjoy are so colored with dissapointment that I cant bring myself to pursuit them again. One thing Ive always been able to enjoy is food--especially chocolate and ice cream :-)
I think my problem lies in the dopamine system too, and maybe norepinephrine. How the 2 sites below explain the various neurotransmitter deficiencies makes me think so. I wish I knew more about it.http://drugfreeoptions.com/display.php?r=good_stuff
http://www.crossroadsinstitute.org/neurotransmit.html
Ive been on Lexapro (ssri) for 5 months, and I just started Wellbutrin a few weeks ago. It works on dopamine, and many experts say norepinephrine too. Im curious why your doc gave you an MAOI. Are they more effective for some types of depression?
Thanks again for responding, I hope we can talk some more.
> Every so often, I run across someone who has a story that reminds me so much of my own. I really know where you're coming from and do sympathize profoundly. I have/had many of the same issues as you do, and central to all of them seems to be a profound anhedonia, or lack of enjoyment and pleasure. It's been so long since I've had a true feeling of enjoyment that I can't even remember what it feels like.
>
> I've been under treatment for dysthymia/depression for over ten years now and have only recently begun to realize that I am not fundamentally depressed to begin with, but rather, it is the chronic lack of enjoyment that has induced the depression and apathy which I have suffered for such a long time. I hope you will keep in mind that my mindset was once very, very similar to yours in its pessimistic outlook, and that I have managed to turn things around to some extent in the last couple years and get at least half way back to where I want to be. In my case, this has involved learning as much as I can about psychopharmacology and giving my doctor an enormous amount of input as to my own treatment. After trying no less than ten drugs in the last two years, I've come to the firm conclusion that my anhedonia, which in the past has been just as profound and crippling as yours is, is fundamentally being caused by a lack of dopamine.
>
> With that in mind, I am going to be starting the MAOI Parnate in a couple weeks, as I am just finishing tapering off the other MAOI still available in the US, Nardil. My own hypothesis is that many people who have a central anhedonia problem, such as you seem to, may be suffering from a dysfunctional dopamine system more than anything else. I'm curious as to what ADs you've tried, as some of the common ones actually deplete dopamine, unfortunately.
>
> As for your concerns about the semi-manic/euphoric feelings you've also experienced, while it's been a long time since I've felt anything like that, I actually have experienced the same thing at distant points in the past, this after the onset of my depression/anhedonia. In my case, this seemed to coincide with periods of intense mental or emotional effort. I am hoping that the right antidepressant will allow me to achieve a sense of well being without undue effort and also to experience the excitement and enthusiasm that has been so profoundly lacking in my life for so long, and perhaps even a bit of euphoria every now and then.
>
> Todd
poster:robot
thread:375818
URL: http://www.dr-bob.org/babble/20040811/msgs/376658.html