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Re: You and I, we just don't want to get better

Posted by Twinleaf on April 28, 2013, at 14:53:47

In reply to You and I, we just don't want to get better, posted by Phil on April 28, 2013, at 9:13:13

You are expressing what many people feel who have been struggling for a long time with depression. Many people on these boards have wondered whether anhedonia and an inability to use time in a satisfying and goal-directed way are a part of having a depressive illnesses, a result of medication, or both.

While I do think both causes are real, I tend to focus more on the medications, as it is an area where one has more choices. I think the SSRIs and related drugs are the ones which tend to cause anhedonia and lack of motivation by far the most. If they are an important part of successful, or at least helpful, treatment, I think it is very important to try to balance them with medications and treatments which increase the presence of dopamine in the prefrontal areas. It's my understanding, admittedly incomplete, that dopamine in those areas is vital for a sense of meaning in life, hopefulness (even in the presence of difficulties), and goal-directed activities. I'd really like to know what other posters' views are on this topic.

I thought the "not wanting to get well" excuse got retired 50 years ago, along with other discredited Freudian ideas like penis envy! (this is from someone with a wonderful, very helpful contemporary psychoanalyst).

 

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URL: http://www.dr-bob.org/babble/social/20130409/msgs/1042817.html