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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 24 of 24. This is the beginning of the thread.
Posted by Conundrum on December 29, 2010, at 16:08:59
Its just so unbearable. I have literally no interest in anything. On xmas eve my cousins and I were playing guitar hero, and I thought it would be fun to play my electric guitar while they played the game, so I got it out and tried to play some of the songs.
I forced myself to learn a new song on guitar and I didn't get any good feelings from it. I remember I used to get such excitement from playing music and performing and now I get none. I'm waiting for prozac to kick in, which partially helps. Also I will be starting a job next week, so that should keep me occupied and force me not to dwell on how terrible my "life" has become.I recently failed to respond to adderall and I'm starting to worry that there is no real help for my problem. :(
I lost myself
Posted by rculater on December 29, 2010, at 16:34:55
In reply to Anhedonia is wearing me down., posted by Conundrum on December 29, 2010, at 16:08:59
Are you in Northeren Hemisphere ? UK ?
This weather dont help. I feel for you. Right now I feel so disconnected from this dull world im wondering what the point is.Hope the prozac gives you some response soon.
c u
Posted by Conundrum on December 29, 2010, at 17:31:10
In reply to Re: Anhedonia is wearing me down., posted by rculater on December 29, 2010, at 16:34:55
> Are you in Northeren Hemisphere ? UK ?
> This weather dont help. I feel for you. Right now I feel so disconnected from this dull world im wondering what the point is.
>
> Hope the prozac gives you some response soon.
>
> c uYeh north east U.S. No the weather seems to even make anhedonia worse.
Posted by Phillipa on December 29, 2010, at 19:09:52
In reply to Re: Anhedonia is wearing me down., posted by Conundrum on December 29, 2010, at 17:31:10
For sure in NC and we have snow on the ground???? Only warm weather will help. Phillipa
Posted by Maxime on December 29, 2010, at 21:33:34
In reply to Anhedonia is wearing me down., posted by Conundrum on December 29, 2010, at 16:08:59
I really think that starting a new job will help quite a bit. It will give you something else to focus on. I do understand how awful you are feeling and I think you are very courageous to start a new job. Let us know how it goes.
Posted by floatingbridge on December 30, 2010, at 0:37:36
In reply to Anhedonia is wearing me down., posted by Conundrum on December 29, 2010, at 16:08:59
It's been a long time. I'm sorry. Hope the prozac kicks in soon and Maxie is on about the job.
(((Best)))
Posted by roscopeeco on December 30, 2010, at 4:24:05
In reply to Anhedonia is wearing me down., posted by Conundrum on December 29, 2010, at 16:08:59
> Its just so unbearable. I have literally no interest in anything. On xmas eve my cousins and I were playing guitar hero, and I thought it would be fun to play my electric guitar while they played the game, so I got it out and tried to play some of the songs.
> I forced myself to learn a new song on guitar and I didn't get any good feelings from it. I remember I used to get such excitement from playing music and performing and now I get none. I'm waiting for prozac to kick in, which partially helps. Also I will be starting a job next week, so that should keep me occupied and force me not to dwell on how terrible my "life" has become.
>
> I recently failed to respond to adderall and I'm starting to worry that there is no real help for my problem. :(
>
> I lost myselfWe can all relate. Will you please let me know about your prozac trial. I am interested in this med if my current med doesn't work. My father responded well to prozac so has my stepmother.
Best Wishes,
Jesse
Posted by linkadge on December 30, 2010, at 7:32:39
In reply to Re: Anhedonia is wearing me down., posted by roscopeeco on December 30, 2010, at 4:24:05
Serotonergics never really helped me with winter depression. For me, something about the lack of sunlight and lack of ability to go outside all the time seems need some sort of catecholaminergic boost.
I live in ontario (no not way up there, but long winters nonetheless).Suprisingly, strong coffee is great for a boost for me, when all else has seemingly failed.
I still go running, I just pack up very tight. It helps a lot. Once you get going, you actually find yourself too hot, dispite the temp. Your body still releases PEA, regardless of what season it is.
Good luck finding a crack in your case.
Linkadge
Posted by SLS on December 30, 2010, at 7:58:58
In reply to Anhedonia is wearing me down., posted by Conundrum on December 29, 2010, at 16:08:59
> Its just so unbearable. I have literally no interest in anything.
Amotivation and anhedonia often occur comorbidly and may be linked. The thing you need to watch out for is the emergence of anger, hostility, irritability, and anxiety. When anger and anxiety go together with anhedonia, the risk of suicide increases significantly.
I do think there is hope for you. Have you ever combined Lamictal with Trileptal?
- Scott
Posted by linkadge on December 30, 2010, at 8:27:58
In reply to Re: Anhedonia is wearing me down. » Conundrum, posted by SLS on December 30, 2010, at 7:58:58
Is conundrum bipolar? Why/is he taking trileptal (?)
Linkadge
Posted by linkadge on December 30, 2010, at 8:30:23
In reply to Re: Anhedonia is wearing me down. » Conundrum, posted by SLS on December 30, 2010, at 7:58:58
>When anger and anxiety go together with >anhedonia, the risk of suicide increases >significantly.
Statistically speaking.
Linkadge
Posted by Conundrum on December 30, 2010, at 10:14:35
In reply to Re: Anhedonia is wearing me down. » Conundrum, posted by SLS on December 30, 2010, at 7:58:58
> Amotivation and anhedonia often occur comorbidly and may be linked. The thing you need to watch out for is the emergence of anger, hostility, irritability, and anxiety. When anger and anxiety go together with anhedonia, the risk of suicide increases significantly.
>
> I do think there is hope for you. Have you ever combined Lamictal with Trileptal?
>
>
> - ScottHi, thanks for your concern, I haven't felt to irritable or anxious, just down. Today a little better since I woke up earlier and I know I have more than 4 hours of day light left, and it is pretty bright today. I'll go for a walk in a bit. I have been having some trouble sleeping, and I know that hasn't helped. Perhaps I'll start taking my b vitamins and prozac in the morning.
Never tried trileptal, but i have tried lamictal, and it did provide a boost for a day once I got to about 400 mg but then pooped out and didn't work at 450mg. My pdoc thinks I have have some mood instability, since most drugs that raise my mood, only do so for a couple days and then stop. I'm not convinced at all though. When I told my family and girlfriend about it, no one thought that dx fit either. Anything is possible though. Another reason she believes I might BP is that after taking prozac and feeling pretty good for 4.5 years on it, I stopped and started to have some strange thoughts and feelings, such as beliefs in 9/11 conspiracy theories, and became really religious and started reading the bible, but also believe in numerology and astrology. It was a pretty intense two years after stopping prozac. During those 2 years I was taking ginkgo to help with my memory, which became awful after stopping prozac. I didn't see any improvement after two years on ginkgo so i stopped it, and then those paranoid and religious feelings stopped, and I returned to my more logical self. Its been 5 years since then and I've never had anything like that happen again. So while I could see how that could make a doctor suspicious, I tend to blame that whole period on a dopaminergic rebound from stopping prozac, since prozac suppresses dopamine, and also some interaction with ginkgo.
Maybe it is bipolar, but it seems like it would be very long cycles. Depressed as a young teen, felt good on prozac for 4.5 years, weird for 2 years after stopping, and anhedonic for 5 years after that. If those are cycles, then they are some pretty long cycles. Also two of those phases can be tied to being on and withdrawal from a psychotropic med. I tend to blame the drug not a soft BP, but maybe I am misguided.
Posted by Conundrum on December 30, 2010, at 10:17:18
In reply to Re: Anhedonia is wearing me down., posted by linkadge on December 30, 2010, at 7:32:39
Thanks for everyone's support. It is a hard time of year to get through, but the days have already started becoming longer, and soon it will be spring again! I say all of us enter the lottery and if one person wins, they buy everyone a place in costa rica, or some place like that!
Posted by Conundrum on December 30, 2010, at 10:31:37
In reply to Re: Anhedonia is wearing me down., posted by linkadge on December 30, 2010, at 8:27:58
> Is conundrum bipolar? Why/is he taking trileptal (?)
>
> LinkadgeMy pdoc thinks so. I actually talk about it in my reply to SLS. I had tried lamictal with no success. I'm hoping if low dose prozac increases my motivation for awhile I can say to her "Look it is holding my mood, now don't be scared and add on a TCA!"
I do not know if serotonergic meds are bad in this kind of environment, I can't speak for everyone, but I also do not respond to psychostimulants, with the exception of 2 bags of caffinated tea steeped in one mug, then followed by another mug of the same. Totally disgusting. I've tried budeprion SR, methylphenidate IR, mixed amphetamine IR, coffee, caffeine pills, and adrafinil. The only DA pharmaceutical to have any kind of response was abilify, which stopped after 2 days of making me do things with no pleasure. This tells me that 1) I am treatment resistant, 2) newer drugs that hit less targets, like abilify which only increases DA in one brain region are too "clean" for me and 3) I might be so depleted of catecholamines that short acting stimulants have no effect noticable effect. You can't get blood from a stone as they say.
I actually think the reason I do well on such a low dose of prozac is because it increase norepinephrine in the PFC via 5 HT2C antagonism and some 5 HT1A agonism. Higher doses just make me feel flat again. The feeling I get from low dose prozac is similar to the feeling I had for the few days remeron was working.
I wonder if the fact that prozac can decrease dopamine in the nucleus accumbens and that I felt so good on it as a teen, indicate that increasing dopamine is not necessary? Who knows. I'd really like to try a TCA, but I'd have to lose the mood instability dx to try that.
Posted by linkadge on December 30, 2010, at 16:14:41
In reply to Re: Anhedonia is wearing me down. » linkadge, posted by Conundrum on December 30, 2010, at 10:31:37
Hmm,
Thats quite the conundrum, Conundrum. I havn't had much sucess (personally) with restarting SSRIs. Initially, they were somewhat usefull, but after stopping and restarting over the years, they seem to have stopped working entirely.
My last trial with prozac was a disaster - total sensory overload - increased sensitivity to light, sound, insomnia and worsening of cognition etc.
I think when the medications stop working, nutritional approaches still can help (not to sound like one of "those" people). Sometimes there are biochemical imbalances that go far beyond what standard medications can tweak - structural problems perhaps, that have resulted from years of depression's toll.
I definately feel better off meds at the moment, with the exception of occasional use of clonazepam.Over the hollidays I've been sleeping like 16 hours a day, but I'm not fighting it. I think my brain is gaining something positive from it.
Linkadge
Posted by rculater on December 30, 2010, at 16:43:19
In reply to Re: Anhedonia is wearing me down., posted by linkadge on December 30, 2010, at 16:14:41
> Hmm,
>
> Thats quite the conundrum, Conundrum. I havn't had much sucess (personally) with restarting SSRIs. Initially, they were somewhat usefull, but after stopping and restarting over the years, they seem to have stopped working entirely.
>
> My last trial with prozac was a disaster - total sensory overload - increased sensitivity to light, sound, insomnia and worsening of cognition etc.
>
> I think when the medications stop working, nutritional approaches still can help (not to sound like one of "those" people). Sometimes there are biochemical imbalances that go far beyond what standard medications can tweak - structural problems perhaps, that have resulted from years of depression's toll.
>
>
> I definately feel better off meds at the moment, with the exception of occasional use of clonazepam.
>
> Over the hollidays I've been sleeping like 16 hours a day, but I'm not fighting it. I think my brain is gaining something positive from it.
>
>
> Linkage
>
>
>
>
>
>
>
> Have you thought about ot have you tried MAOIs ?Ive given up on SSRIs for the same reason you describe and can only see MAOIs as a next last resort option.
Posted by linkadge on December 30, 2010, at 16:56:49
In reply to Re: Anhedonia is wearing me down. » linkadge, posted by rculater on December 30, 2010, at 16:43:19
>Ive given up on SSRIs for the same reason you >describe and can only see MAOIs as a next last >resort option.
Well, I also try not to think of it in the linear fashon that psychiatry presents it as. i.e. SSRI --> TCA --> MAOI --> ECT.
About 5 years ago, one doctor was really pushing for ECT. I said no, I'd like to do a medication washout and see what happens. So I did a month long med washout followed by melatonin monotherapy.
Sure enough, I felt much better than I did - spontanious remission? Who knows. Sometimes the meds make me feel much worse. Psychiatry likes to make all these predictions regarding depression, but the truth of the matter is that depression is very unpredictable and you don't always have to go down the garden path - depression treatment flowchart / algorigthm.
Linkadge
Posted by conundrum on December 30, 2010, at 18:47:10
In reply to Re: Anhedonia is wearing me down., posted by linkadge on December 30, 2010, at 16:14:41
> Hmm,
>
> Thats quite the conundrum, Conundrum. I havn't had much sucess (personally) with restarting SSRIs. Initially, they were somewhat usefull, but after stopping and restarting over the years, they seem to have stopped working entirely.
>
> My last trial with prozac was a disaster - total sensory overload - increased sensitivity to light, sound, insomnia and worsening of cognition etc.
>
> I think when the medications stop working, nutritional approaches still can help (not to sound like one of "those" people). Sometimes there are biochemical imbalances that go far beyond what standard medications can tweak - structural problems perhaps, that have resulted from years of depression's toll.
>
>
> I definately feel better off meds at the moment, with the exception of occasional use of clonazepam.
>
> Over the hollidays I've been sleeping like 16 hours a day, but I'm not fighting it. I think my brain is gaining something positive from it.
>
>
> Linkadge
>I have a similar thing going on. The first time I took prozac when i was 16, I didn't feel like I was "on" something. I started to just feel better. When I stopped in 2003 for a few weeks I started to feel anhedonic and nervous so I went back on and it just made me spaced out and totally fuzzy and disconnected. When I recently tried lexapro it was similarly spacey and I only went up to 10mgs. I now can tolerate 2.5 mg of prozac, it helps with motivation, but I still get sexual dysfunction, headaches, and sometimes the runs. So it seems that taking SSRIs has cause my brain and body to become super sensitive to them.
So 2.5 mg prozac is about as much as I can do. Perhaps with an NRI though one could go higher. I did not find the problems as bad on pristiq. So perhaps it is a lack of balance in the 5HT/NE ratio.
I look forward to add some vitamins and omega 3s back to my diet now that I will be working. I can force my self to take supplements, eating well is harder, cuz I just don't care anymore. The first 2.5 years off prozac I ate as well as I knew how, and then I stopped taking ginkgo and about a month later the anhedonia just got worse. It is as if the organic meats and dark veggies, low carbs, no soda etc, had no effect, but stopping ginkgo biloba extract had all the effect in the world. Gingko Biloba in that presentation is essentiatlly a drug.
Lately I've become more inclined to believe that some of my problems are genetic(going back 3 generations) and nutrition while it sounds nice just isn't enough. I wish it were, because I kind of hate these drugs and for about 7 years refused to take them and tried everything else first. The increase in motivation the last couple times with low dose prozac, just goes to show that a drug can do a lot that nutrients can't.
I could be dead wrong, but I don't think I'm barking up the wrong tree. I hoping once I get some motivation back, I'll be eating more healthfully, cuz right now I don't give a damn about what I eat, as long as it is easy to make.
Posted by Economist on December 30, 2010, at 21:59:35
In reply to Anhedonia is wearing me down., posted by Conundrum on December 29, 2010, at 16:08:59
We'll find treatment for this, some day, I hope.
Posted by Alexanderfromdenmark on December 31, 2010, at 10:41:09
In reply to Anhedonia is wearing me down., posted by Conundrum on December 29, 2010, at 16:08:59
Well as you know I'm here and I'm just about as Anhedonic you can get. In 2 hours I'm going out to friends and I'm going to get completely wasted. Happy new year.
Posted by Conundrum on December 31, 2010, at 16:11:08
In reply to Re: Anhedonia is wearing me down., posted by Alexanderfromdenmark on December 31, 2010, at 10:41:09
> Well as you know I'm here and I'm just about as Anhedonic you can get. In 2 hours I'm going out to friends and I'm going to get completely wasted. Happy new year.
"I wanna live, breathe, I wanna be part of the human race."
Posted by floatingbridge on December 31, 2010, at 16:23:15
In reply to Re: Anhedonia is wearing me down., posted by Conundrum on December 31, 2010, at 16:11:08
Does alcohol provide temporary euphoria?
May this next year be good to you.
fb
Posted by Conundrum on December 31, 2010, at 16:53:57
In reply to Re: Anhedonia is wearing me down. » Conundrum, posted by floatingbridge on December 31, 2010, at 16:23:15
> Does alcohol provide temporary euphoria?
>
> May this next year be good to you.
>
> fbNo, it doesn't. I think it was Alexander that was gonna drink tonight. But thanks I sure hope this year is better.
Posted by floatingbridge on December 31, 2010, at 17:01:50
In reply to Re: Anhedonia is wearing me down., posted by Conundrum on December 31, 2010, at 16:11:08
Apologies. Funny, it didn't quite sound like you. I sometimes think of a quote from Susan Hayward, playing a woman on death row, "I want to live." ( 50's film of same name.)
Still, the new year wish doesn't need retraction. Best to you.
This is the end of the thread.
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