Posted by King Vultan on August 10, 2004, at 8:27:16
In reply to enjoyment, posted by robot on August 9, 2004, at 22:43:40
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.