Posted by JohnX2 on April 5, 2002, at 2:20:27
In reply to A few questions for Dr. Kramer, posted by Anna Laura on April 4, 2002, at 1:41:40
> Second question:
>
> I'm wondering why i went fom extreme hypearousal/vigilance, "vivid" sense of reality down to hypoarousal/dream-like-mental state and mental confusion/numbed anxiety.
> Is there a neurobiological mechanism underlying the above mental states?
> Is there a reason why anhedonia got worse throghout the years? (May be dopamine deficency?).
>This is conjecture, take it with a grain of salt..
I believe that your assertion may be correct. I also feel that this may be related to a dysfunction in the hypothalamus-pituitary-adrenal (HPA) gland workings. Specifically a hypofunctional system. This may occur after prolonged trauma (which would hyperstimulate the
HPA) reaches an exhaustion phase. At this point your body's thermostat may get stuck on "low". Your adrenals are underproducing glucocorticoids and adrenaline, etc. This may cause you to feel very fatigued and anhedonia/detached. Prior to this your HPA may have been hyperactive, producing too much adrenaline, "fight-or-flight" chemicals and making you anxious, psyhotic feelings, heart racing, high blood pressure etc.>
> Sorry, one more question: could the emotional/sensory numbing i suffer from
> somehow related to PTDS? I'm asking you this 'cause when i was psychotic years ago i experienced a state of hyperarousal, constant terror, high blood pressure, and high heart rate which lasted for many months with virtually no breaks.Emotional/sensory numbing is a classic symptom of PTSD.
> After that state subsided anhedonia took its place (it's like i experienced a reversed state). Could that endogenous shock be similar to PTDS, neurobiologically speaking? And if it was so, could be the endogenous opiate system play a role?
> I've read that extreme, prolonged shock triggers anhedonia via the opiate system.
>There have been studies that indicate that the opiate system may be involved in the "emotional blunting" felt after trauma.
Zoloft is a primary medicine prescribed for PTSD related symptoms. Zyprexa is a useful adjunct for disassociative symptoms. Some people think that the opioid antagonist Naltrexone may help to relieve emotional numbing/depersonalization/derelialization. I believe that Lamictal has also been used successfully to treat these symptoms.
Many times PTSD and atypical depression symptoms that you are describing also seem to be indicators of bipolar symptoms. People with PTSD often times have "non-textbook" symptoms of other disorders.
Take care.
John> O.K., enough with questions. Sorry if i've been so long. I thank you again for your patience and support.
>
> Sincerely,
>
> Anna Laura
poster:JohnX2
thread:101755
URL: http://www.dr-bob.org/babble/20020402/msgs/101940.html