I believe most definitions of depression don’t do it justice.  For me it is a pervasive psychic pain, so inhumane that at its worse, I curl up into a tight ball to escape it, but there is no contraction powerful enough to crush it.  Fortunately, I spend only about 3% of my time there, although at some points in my life it has been much more.  Approximately, another 15% of the time the pain mixes so intimately with anxiety, I can’t stop moving, but I can’t accomplish anything either. I can’t sit down I can’t focus, it’s as though my psyche has jumped up and is trying to escape the pain by running and hiding from it inside myself.  As you can see it’s totally an inside job.  At some point I will reach the shuffling stage, where I drag myself around trying to fix everything, on the exterior, I believe is deteriorating or out of control, another 15% of the possibility of enjoying life -vanished.  After a cycle of this or some combination anhedonia is a relief, although it holds no joy or comfort.  It is a step up out of the morass, where I can turn back into the robotic producer of results, provider of services, caretaker, organizer, teacher, all those things that make me look “normal” most of the time.  Normal, take a shower, put on my makeup, dressed up and smile-as normal as I get, but not very rewarding.  Who lives to look good?  At this point, I guess I do, about 65% of the time.  So, if you’re adding we’ve covered 98% of the terrain of my life.  Of course, if that’s all there was, I would only have a depressive type diagnosis, however, my behavior the other 2% of the time, has earned me a bipolar diagnosis. That’s when I’m energized, alarmingly social and behaving in a manner that would shock my mother, to say the least.  In fact, I’ve been known to shock myself.  Although I put myself in some extremely dangerous situations, during these forays into the other world, it’s the anhedonia that’s killing me. Overdosing on nothingness with no hope of escape. More meds please.  Diane

I love technical info:

Acute stress reduces reward
responsiveness: implications for depression

by
Bogdan R, Pizzagalli DA.
Department of Psychology,
Harvard University,
33 Kirkland Street, Cambridge,
MA 02138, USA.
Biol Psychiatry. 2006 Nov 15;60(10):1147-54.
ABSTRACT

“BACKGROUND: Stress, one of the strongest risk factors for depression, has been linked to “anhedonic” behavior and dysfunctional reward-related neural circuitry in preclinical models. METHODS: To test if acute stress reduces reward responsiveness (i.e., the ability to modulate behavior as a function of past reward), a signal-detection task coupled with a differential reinforcement schedule was utilized. Eighty female participants completed the task under both a stress condition, either threat-of-shock (n = 38) or negative performance feedback (n = 42), and a no-stress condition. RESULTS: Stress increased negative affect and anxiety. As hypothesized based on preclinical findings, stress, particularly the threat-of-shock condition, impaired reward responsiveness. Regression analyses indicate that self-report measures of anhedonia predicted stress-induced hedonic deficits even after controlling for anxiety symptoms. CONCLUSIONS: These findings indicate that acute stress reduces reward responsiveness, particularly in individuals with anhedonic symptoms. Stress-induced hedonic deficit is a promising candidate mechanism linking stressful experiences to depression.  http://www.biopsychiatry.com/anhedonia.htm  “If you would just beat the crap out of the ___ who is threatening to shock you, depression would be unnecessary!   Diane

08.13.2009

When I grow up

Remember when you had a dream of what you wanted to be when you grew up.  Someone or something had impressed you-a cowboy, a firemen, a doctor, a nurse.  Dreams are made of inspired energy and inspired energy moves people toward goals.  I never considered what I wanted to be when I grew up.  I was a child with no dreams, no aspirations and goals. Nothing felt exciting or rewarding.  I had few friends, but it didn’t seem important.  I went to school because my mother made me go to school.  I went to church because my mother made me go to church.  But wherever I was there seemed to be nothing for me, nothing that had meaning, value, excitement.  I took piano lessons and I was bored.  I took violin lessons and I was bored. I took clarinet lessons – I was bored.  My mother finally quit bothering me with lessons.  I didn’t feel lonely, because I have never had any particular desire to be around people, except to meet basic needs.  In my world, everything has been nothing forever.  The only way I know there is something different, something much better, on a few occasions, once for a couple hours once for a couple weeks and once for two months I have broken through to the real world where good feelings are available. 

Then there is the constant watching of people doing what is called having fun and not understanding why, even when I am participating I’m just watching, because “fun” is just a subjective feeling that I don’t have. I’ve tried all kinds of sports, adventurers, moves, changes, experiences and diversions. Most of them were okay, and most of them I have no particular interest in repeating.  Sometimes a line from a song runs through my head, “57 channels and nothing’s on”,  “57 channels and nothing’s on”,  “57 channels and nothing’s on”.  It is hard to have this condition, but I can imagine it must be so much more devastating to have been normal, to have been able to participate and lost it.
Diane

08.09.2009

THE WORLD IS FLAT

Welcome!  This whole site is devoted to anhedonia.  I believe it is the most undertreated and the most fatal symptom of mental illness.  So let’s start with a comprehensive definition, pieced together from various sources. 

Anhedonia

From Wikipedia, the free encyclopedia

In psychology, anhedonia (< Greek αν- an-, without + ηδονή hēdonē, pleasure) is an inability to experience pleasure from normally pleasurable life events such as eating, exercise, and social or sexual interaction.

Anhedonia is recognized as one of the key symptoms of the mood disorder depression according to both the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM IV) and the International Statistical Classification of Diseases and Related Health Problems (ICD). Other than anhedonia, the DSM considers only depressed mood to be a key symptom.[citation needed] The ICD lists both depressed mood and fatigue or loss of energy as the other key symptoms. Anhedonia is also seen in schizophrenia, schizoaffective disorder, schizoid personality disorder and other mental disorders.

a few steps closer we find:

“A more complete understanding of anhedonia comes from an expanded definition, taking into account the full breadth of the spectrum.  I would say that anhedonia is not only the inability to experience pleasure, it is the inability to experience any positive feeling whatsoever.  It may seem like a slight distinction, but it is crucial to understanding both the experience of the patient, and the impact that this particular symptom has upon the patient.
In the most severe cases, patients are unable to experience anything positive: no pleasure, no satisfaction, no fulfillment, no sense of accomplishment, no sense of worth, no sense of meaningfulness.  Just nothing.  
Many positive experiences have little, if anything, to do with pleasure…  
I realize that different people may define “pleasure” in different ways.  The point is not to get hung up on what is and what is not pleasure.  The point is that anhedonia, in its most severe form, involves the loss of all positive feelings.  In other words, it involves the complete loss of any kind of positive reinforcement.
One consequence of this, is that the person with anhedonia cannot do anything to make himself or herself feel better.  This can lead to a sense of hopelessness and/or helplessness.  It also can lead to problems in relationships.  Other people do not understand why the patient is acting the way she or he is acting.  The patient knows that others do not understand, which adds to the experience of alienation…  
Thus, we come to understand why anhedonia is one of the core symptoms of depression. ”    -from an excellent article. Read more here  http://scienceblogs.com/corpuscallosum/2007/03/basic_concepts_anhedonia.php

 I’ve stolen a few poignant subjective expressions of anhedonia:

“I make jewelry and used to love it, but now can’t complete anything and am in such a mess with my beads I don’t think I’ll ever get them straightened out. I’ve gained 40 pounds, don’t care about my appearance, can’t clean the house, etc etc. I feel I have all the symptoms of depression, plus I can’t feel any excitement about seeing loved ones, can’t think of anything, or anywhere I want to be but in my bedroom.”

and           sarah Says:

“it’s very hard to live with anhedonia…i can’t go on like this,my life is broken.
i just want to know the reason , maybe i could go through it .
why i can’t enjoy what i do,every single minute , every experience , every situation , every relation , every new things , every crowd between friends and so and so
while all of the others smile and laugh as if something totaly excited…
why am i strange like that?”

and     Plil said:

…”I can’t actually feel angry, but there’s no denying the burning resentment I now have toward my peers in college. Everybody but me is having a good time, and my friends assume that I’m gay because I don’t respond when women flirt with me. I just go to class/work and go home. Nothing else is worth the effort.”

and one from my own experience:   Diane said;

“I had developed no real affinity for the planet or its inhabitants.  The push to really be involved was minimal.  I just wanted to feel safe and get through the day.  I would have to call myself self-centered, if I had even been able to be interested in myself.”

For some of us, the world is indeed flat.  So talk to me! How is it for you? Does anything help?

Hit the COMMENT link in the lower right hand corner and tell me all about it> Diane


 

 

 

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