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Dr. Bob is Robert Hsiung, MD,
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Posted by kaylabear on April 11, 2010, at 21:44:47
In reply to Any med that made you gain interest in people?, posted by Economist on April 10, 2010, at 15:02:48
There are differences in axix II and axis I depressions. A narcissistic decompensation is usually indicated by boredom, feelings of futility, and lack of interest as opposed to feelings of worthlessness and guilt that often go along with a more neurotic depression.
Basically if a person doesn't feel "sadness" with depression, it might be beneficial to look into axis II conditions. Medications wouldn't be as helpful if that is the case. Psychoanalytic or psychodynamic therapy would be your best bet. In contrast, today's psychiatrists normally don't screen for this and seem content with years of medication trials for people who do not benefit.
It sucks either way, but sometimes the search for medication after medication is a distraction or an aspect of psychological denial/lack of insight which keeps people from getting more appropriate treatment...And I think everyone deserves effective treatments...to feel serenity, to have a more fullfilling life.
Posted by conundrum on April 11, 2010, at 21:45:35
In reply to Re: Any med that made you gain interest in people? » mike0388, posted by floatingbridge on April 11, 2010, at 21:35:31
Its funny cuz I would say I have anhedonia but i still like to party sometimes. However I couldn't do it every weekend and there is nothing wrong with that. Most people wouldn't like that. Especially as you get older.
As far as caring about peoples lives i think thats an odd thing to be talking about at a party. Don't you usually joke and talk about light hearted stuff? Last thing I want to talk about is work or something like that.
Posted by kaylabear on April 11, 2010, at 21:54:10
In reply to Any med that made you gain interest in people?, posted by Economist on April 10, 2010, at 15:02:48
Forgot to answer your question directly - Effexor would be my #1 choice (guess) for the symptoms you described.
Posted by Economist on April 11, 2010, at 22:28:10
In reply to Re: Any med that made you gain interest in people? » Economist, posted by conundrum on April 11, 2010, at 20:20:44
For the past two years I have been accepting every invitation to go out, partly in an attempt to show that my anhedonia is not a result of not "having a life". I can be active with different social plans every weekend, and yet none of this will stir a pleasant emotional response in me. When I'm out and people ask if I'm having fun, the pressure is obviously to say "yes" because a long explanation about not being able to have fun due to anhedonia is just extremely repetitive and burdensome for the whole group to hear. But actually, I've decided that beginning next week I will refuse invitations to go out because it is less stressful for me not to show up than to show up and have to act the entire day. I'm going to be my natural anhedonic self from now on, away from the view of others so they won't have to frustrate themselves with trying to "cheer me up". My friends and family need to understand and accept that anhedonia is simply a part of my life now, and there's nothing that can be done about it.
Regarding schizophrenia -- I have annual periods where I start hallucinating and having delusions of grandeur and persecution, followed by a visit to the hospital whenever someone notices my behavior is off. The first time this ever happened, I was diagnosed schizophrenia. However subsequent doctors have told me I am too high-functioning to be schizophrenic -- my memory is extremely sharp, I groom myself well, and I don't have the speech or thought disturbances normally associated with schizophrenia. Still, I personally agree with the first diagnosis. I may not have the cognitive problems but I sure as hell have the negative symptoms -- anhedonia being the worst of them.
Posted by Economist on April 11, 2010, at 22:37:58
In reply to Re: Any med that made you gain interest in people?, posted by conundrum on April 11, 2010, at 21:45:35
"As far as caring about peoples lives i think thats an odd thing to be talking about at a party. Don't you usually joke and talk about light hearted stuff?"
Usually the first thing you do ask ask what they've been up to since you last saw them. Then you proceed with the joking and light-hearted stuff. I have no instinct to do either one.
There has never been a moment since 2008 (after my first psychotic episode happened) where I wanted to go out to meet my friends.
Posted by Economist on April 11, 2010, at 22:56:35
In reply to Re: Any med that made you gain interest in people?, posted by kaylabear on April 11, 2010, at 21:44:47
For the record, at the request of my mother, I do see a talk-therapist now. Very pointless though, as I have no thoughts in mind and find nothing interesting to talk about. There is nothing for the therapist to work on because my feelings simply don't exist. I have no desire, no guilt, no anger, no sadness. I am simply waiting for the therapist to run out of questions. Not that I would have anything more interesting to do if I weren't sitting in her office answering questions. So it doesn't matter to me either way if we spend the entire hour just sitting in silence. I am just using up my insurance benefits so she can have business.
Posted by mike0388 on April 11, 2010, at 23:02:41
In reply to Re: Any med that made you gain interest in people? » kaylabear, posted by Economist on April 11, 2010, at 22:56:35
I think your trying to tell your doctor you have no problems, just lack of interest, but only you know your problems.
Posted by floatingbridge on April 12, 2010, at 0:21:16
In reply to Re: Any med that made you gain interest in people?, posted by mike0388 on April 11, 2010, at 23:02:41
Would declining invites create isolation which might, in the long run, not serve you very well? That it is stressful indicates some feeling register. Not that I have an answer...
Maybe a different therapist-- one to intellectually engage you?Best to you.
Posted by kaylabear on April 12, 2010, at 0:56:55
In reply to Re: Any med that made you gain interest in people? » kaylabear, posted by Economist on April 11, 2010, at 22:56:35
Economist,
What is the orientation of your therapist, if you don't mind if I ask?
It sounds like you have a lot of pain trapped deep inside. I am sorry you are having such a difficult time getting well. :(
Posted by Economist on April 12, 2010, at 1:28:27
In reply to Re: Any med that made you gain interest in people?, posted by mike0388 on April 11, 2010, at 23:02:41
"I think your trying to tell your doctor you have no problems, just lack of interest, but only you know your problems."
My only problem actually is my lack of interest. But what kind of talk-therapy fixes that? If I have no interest in life I have no interest in life. No amount of talking will make me interested in it again.
Posted by Economist on April 12, 2010, at 1:52:27
In reply to Re: Any med that made you gain interest in people?, posted by floatingbridge on April 12, 2010, at 0:21:16
> Would declining invites create isolation which might, in the long run, not serve you very well? That it is stressful indicates some feeling register. Not that I have an answer...
>
>
> Maybe a different therapist-- one to intellectually engage you?
>
> Best to you.Hi, thanks, floatingbridge. You're right, stress is an indication of feeling, I suppose. I am stressed because I am not feeling any interest in my friends and family, and there is some desire to hide this from them so they won't take it the wrong way or take it too harshly on themselves. I am also stressed because my lack of interest (boredom) does not go away no matter what I do.
If I sat at home by myself I would be stressed anyway because of the persistent boredom, but going out to meet friends would be an extra stress in addition to the baseline stress, because then I'd have to put effort into masking the persistent boredom, which requires energy and deliberate planning. So in the end, staying at home exerts slightly less energy and less stress.
Kind of an annoying condition, really.
Nothing is intellectually engaging either, unfortunately.
Posted by Economist on April 12, 2010, at 1:58:47
In reply to Re: Any med that made you gain interest in people? » Economist, posted by kaylabear on April 12, 2010, at 0:56:55
> Economist,
>
> What is the orientation of your therapist, if you don't mind if I ask?
>
> It sounds like you have a lot of pain trapped deep inside. I am sorry you are having such a difficult time getting well. :(
I'm not sure I understand what you mean by orientation.But yeah, persistent boredom and anhedonia is actually quite painful. "Painfully bored", "bored to death", and "so bored I could scratch my eyes out" are phrases for a reason. :/ Now imagine having that feeling for 16 hours a day, every day...for two years...that never goes away...no matter WHAT you do...
Anhedonia at its worst.
Posted by Economist on April 12, 2010, at 2:23:55
In reply to Re: Any med that made you gain interest in people? » Economist, posted by evenintherain on April 11, 2010, at 13:17:55
"i also try to go out and see people once a week or so, because in the past it helped with depression. But it hasn't helped at all for the past 6 months or so, it just makes me more aware that there is something wrong. I still like my friends and want to show support for them, but I find the time spent with them is very unsatisfying (and sometimes unbearable) and makes me sad. Maybe it is some extreme form of anhedonia and maybe it is actually Causing social phobia?"
Yes, I know exactly what you mean by time spent with friends being unbearable and unsatisfying. I believe this is extreme anhedonia. For me, my decision to decline invites from now on is not due to phobia, as I am not fearful of people. In fact, if they didn't mind me just sitting at their parties and not dancing, not laughing, not looking at people, and not responding to questions, I would continue to go. But as you can imagine, a well-dressed girl sitting like this at a party will just be an incredible distraction to everyone. People will either come over and ask what's wrong/if someone just died, or they will think I am being an a-hole/weirdo/begging for attention. Either situation will cause stress upon the party. So my avoidance of people now is not due to fear but rather of concern for their well-being.
Posted by manic666 on April 12, 2010, at 3:45:53
In reply to Re: Any med that made you gain interest in people? » evenintherain, posted by Economist on April 12, 2010, at 2:23:55
where the hell do you live beverlly hills //a party every weekend wow.//in the situation you say your in an dont like //if me i would be hammered 10 minutes after walking through the door just to get by.//your not telling me your friends see you as a bubbly party goer// the condistion you are discribeing would make you the talk of the party an stand out like a beacon,, or you deserve an oscar for you acting
Posted by Economist on April 12, 2010, at 4:43:51
In reply to Re: Any med that made you gain interest in people?, posted by manic666 on April 12, 2010, at 3:45:53
> where the hell do you live beverlly hills //a party every weekend wow.//in the situation you say your in an dont like //if me i would be hammered 10 minutes after walking through the door just to get by.//your not telling me your friends see you as a bubbly party goer// the condistion you are discribeing would make you the talk of the party an stand out like a beacon,, or you deserve an oscar for you acting
I live in New York City. It's not really that difficult to find parties and social events every weekend here. In fact, going to a party every weekend is somewhat expected in Manhattan for people my age.
So far, there have only been three or four times when people asked if something might be wrong with me. This is out of probably 80 or so social meetings within the past two years. So, I can play it off extremely well most of the time. Friends are unaware of the stress it causes me to act normal so they continue to ask me out. They do still see me as someone who likes to meet people and dance. It's how I grew up. It's who I should have been right now.
Posted by SLS on April 12, 2010, at 8:08:13
In reply to Re: Any med that made you gain interest in people?, posted by kaylabear on April 11, 2010, at 21:44:47
> Basically if a person doesn't feel "sadness" with depression, it might be beneficial to look into axis II conditions.
You may be right to some degree. However, the diagnosis of Axis I depression requires at least one of two features. One is sadness and the other is lack of interest.
- Scott
Posted by SLS on April 12, 2010, at 8:23:37
In reply to Re: Any med that made you gain interest in people? » manic666, posted by Economist on April 12, 2010, at 4:43:51
How do you spend your free time?
In what ways does your current condition differ from dysthymia? Perhaps you have a bipolar disorder with comorbid dysthymia. I know of one person with this condition. Have you ever been screened for schizoaffective disorder?
I experience boredom only when my depression begins to remit. Otherwise, I am too vegetative to be bored. When I enter this less severe depressive state, I no longer want to do nothing, yet there is nothing that I want to do.
- Scott
Posted by Economist on April 12, 2010, at 13:37:55
In reply to Re: Any med that made you gain interest in people? » Economist, posted by SLS on April 12, 2010, at 8:23:37
I spend my free time reading and re-reading archives from Psycho-babble and schizophrenia.com. I don't find it very enjoyable, but it holds my interest because there is some chance of discovering a medication that might help me be rid of the boredom/anhedonia. But I imagine that once I have tried every single useless medication and augmentation, and once I have finished reading all the archives, I will have to spend my free time lying down or sitting on a park bench enduring the boredom until evening comes, when I can just fall asleep and be at peace in unconsciousness for a brief 8 hours.
"I no longer want to do nothing, yet there is nothing that I want to do" -- yes, that describes my state very well. I imagine this is what purgatory must feel like. Extremely uncomfortable and joyless, half alive and half dead. I suppose this could be dysthymia. The diagnosis doesn't matter so much to me, only the treatment.
Posted by floatingbridge on April 12, 2010, at 13:42:34
In reply to Re: Any med that made you gain interest in people? » SLS, posted by Economist on April 12, 2010, at 13:37:55
This hasn't been my experience of dysthymia, and though I was surprisingly diagnosed with concomitant anhedonia, I've always had (cr*ppy) feelings.
this brings my tally up to 4 cents
(depression, ptsd)
> "I no longer want to do nothing, yet there is nothing that I want to do" -- yes, that describes my state very well. I imagine this is what purgatory must feel like. Extremely uncomfortable and joyless, half alive and half dead. I suppose this could be dysthymia. The diagnosis doesn't matter so much to me, only the treatment.
Posted by manic666 on April 12, 2010, at 13:52:36
In reply to Re: Any med that made you gain interest in people? » SLS, posted by Economist on April 12, 2010, at 13:37:55
could be your just a toally different person that you used to be//you no like ? im not really into this sh*t anymore, and are in limbo as you struggle to be this new person//i had a hard time comming to terms with a new life i had to take// drunk most the time , up for anything, women ,ect ect, // i still am not over it but suffer guilt from my old life //plus it would have killed me//i think you may well be board with the old you, but dont no the real one yet. does that make sence to you// if not im on the wrong track sorry, im a loony with imotions
Posted by SLS on April 12, 2010, at 14:55:33
In reply to Re: Any med that made you gain interest in people? » SLS, posted by Economist on April 12, 2010, at 13:37:55
> The diagnosis doesn't matter so much to me, only the treatment.
I hope you find what you need to enjoy life again.
- Scott
Posted by floatingbridge on April 12, 2010, at 16:12:28
In reply to Re: Any med that made you gain interest in people? » Economist, posted by SLS on April 12, 2010, at 14:55:33
Yes.
> > The diagnosis doesn't matter so much to me, only the treatment.
>
> I hope you find what you need to enjoy life again.
>
>
> - Scott
Posted by Economist on April 12, 2010, at 16:27:26
In reply to Re: Any med that made you gain interest in people? » SLS, posted by floatingbridge on April 12, 2010, at 16:12:28
Posted by conundrum on April 12, 2010, at 17:20:20
In reply to Re: Any med that made you gain interest in people? » SLS, posted by Economist on April 12, 2010, at 13:37:55
That describes me as well. Have you considered ever trying a low dose of prozac. Like take a half of a 10 mg pill every other day. It kinda helps with motivation. It doesn't make you bounce of the walls or super excited, but it atleast you feel like doing things.
For me it increases motivation more than pleasure which it only slightly increases. Its sort of impossible to increase one without slightly increasing the other.
Just to be sure, this wasn't caused by SSRIs for you it came out of the blue?
This link describes how I feel, althought it didn't come on slowly. It started exactly 3-4 weeks after stopping prozac.http://www.psychotropical.com/Patient_information_Mental_anaemia.shtml
Posted by conundrum on April 12, 2010, at 17:30:00
In reply to Re: Any med that made you gain interest in people? » conundrum, posted by Economist on April 11, 2010, at 22:37:58
Well don't they say psychosis and schizophrenia are caused by high dopamine? I never understood how that manifested in the negative symptoms. Perhaps the drugs you are trying that increase dopamine could be making things worse?
Have you tried APs on their own at a theraputic dose for schizophrenia?
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