I see many things in drawings, spatial terms, distances inside my head.  Everything is neatly measured on graphs, often with colors for emotion.  That’s how I see the issue of quality of life.  Quality life is such a broad ill-defined term tossed about with regard to health or finances in general.  It’s inherent subjectivity makes objective assessments feel vague, everyone holding different values and tolerances.  For me the bottom line in quality of life would be the pure desire to live.  Anything above that line is a movement toward health and anything below a movement toward death.   The line itself-is made of ANHEDONIA.   Moving up from the anhedonic line into quality-of-life is not a step into happiness it is a step in to struggle, possibly a very long struggle, possibly a losing battle.  We might think of anhedonia as a place to rest. The problem with resting in anhedonia is its proximity to the wish to die and the ease of falling or slipping into that territory. 

Drs., the mental health profession, they ask the wrong question.  The truly relevant question is not “do you want to hurt yourself ? Are you thinking of suicide?  The question should be “do you want to live”.  That is where to start a conversation about how a person really feels. 

What shape might the life of a person who has significant anhedonia, who does not recognize or respond to reward, take? Mine seems to have become an exercise in pain avoidance. I recall so many times closing my eyes and seeing myself as a bumper car that bounces off pain. It makes life so random, hitting pain at various angles and ricocheting who knows where, just to repeat that time and again. And then of course I try to avoid the avoidance by avoiding anything I associate with pain. But it doesn’t stop there I go into meta- mode avoid the avoidance I’m avoiding to avoid the pain. After while there are really only two things in the world, avoidance and pain. That doesn’t sound very good and it’s pretty much as bad as it sounds. No direction, lots of anxiety, hyper alert and every decision, appears to me to be some kind of blow, just choices between ways to lose. Sometimes I feel that beat up just by the process of living.
I could buy a house then I’d have a house. If I don’t buy a house I have to continue to live and have my business in rented space. Rented space can be abandoned in a snap. Houses, in any kind of intelligent escape need to be sold and that takes time. Anything that takes time isn’t a proper escape – and I have no idea what I would escape from but I’ve done it many times. Maybe I’m just escaping from feeling trapped.
My dogs are old. I have a home for them more than any other reason. Sometime that reason will be gone. I have to wonder if I’m trying to make a transition by being so concerned that my employee keeps his job. Could I be making him the new reason to keep going? I don’t seem to be able to do hardly anything just for myself. No problem doing for someone or something else -but never for myself.
As you can see I’m depressed again already, it’s Sunday, it’s cold, it’s raining. A little while ago I laid down on my bed and tried to adjust my mind. After that I took the console for the NordicTrack elliptical trainer apart and repaired it. It’s been sitting there for a couple months waiting to get fixed. I’m deciding to feel good about that.

I’m having such a bad time lately, such a very bad time lately. I’m cycling so fast I don’t know if I’m coming or going. This morning I was driving around trying to get various works and errands done. I was perseverating on my latest trip to the Dr. It always feels like I’m spinning my wheels, wasting my time but more importantly like I’m just sinking further and further in. Into some bad bad place I’m never going to be able to get out of. I drive and think and cry because I feel hopeless, then I think some more and I am angry and say things inside my head I never say out loud. In my imagination I rail at the Dr. who doesn’t seem to understand, my rare hypomania is very unlikely to kill me but my depression is entirely threatening. I think about the people who threaten to kill themselves all the time, how I thought they were so full of crap, such a cheap annoying way to seek attention. I wonder if they didn’t spend a lot of time feeling the way I feel now-just more willing to make themselves heard.
I see pleasant old people and imagine they have wonderful memories keeping them warm and families and ties for comfort and a faith that gives them something to look forward to. I have none of these things and usually I can’t even be comfortable right now. A few minutes later I’m saying to myself, what is wrong with you? A terribly redundant question. There is nothing wrong right now. And there is nothing wrong for another 10, 15, 20 minutes, until some other cycle starts.

I told the doctor again, I believe I have a dopamine problem. I need a medication that kicks some dopamine into operation. I was saying the same thing to another “primary care provider” two years ago. He doesn’t want to give me a med that will do that. He is afraid it will make me hypomanic. He is however happy to give me some more seroquel, on which I gained 35 lbs in two mos. I wonder how happy he thinks I could be at 300 lbs, with diabetes and no hope of ever having a satisfying social life? I’ve never been arrested because I was hypomanic. I don’t believe I’ve ever been seriously hurt, because I was hypomanic. I’ve never hurt anyone else because I was hypomanic. What the hell does he think he’s protecting me from? It seems like he’d rather see me miserable, with my whole life crashed than take a chance I become hypomanic – which I become occasionally anyway. I have made no progress in my 4+ years of treatment.
I can’t do anything about that. But I’m still going to do whatever I can to help myself have some comfort in the rest of my life. It’s time to start concentrating on ways to enhance my dopamine level that don’t require a prescription or…
Angry, angry still angry…

When I begin to feel depressed I also begin to feel desperate and scattered. The last few weeks, I’ve been getting that way so I went to see an EFH (emotional freedom and healing) practitioner, in fact the founder of EFH. That was last Wednesday. I started getting better right away, I bought a bunch of cashmere sweaters and Argyle socks on eBay this week. Spending is a sign I’m getting better-perhaps too much better, but I am getting a lot done. That is the nature of bipolar illness, I’m down, I’m up, I’m rolling, or I’m not. As long as I don’t wander into the kind of “up” that gets me into trouble all will be fine.
I haven’t seen the emotional freedom healer for about six years and I can’t explain why. Last time the results were dramatic. After three healing sessions, I had the only nine-month period-far longer than I have ever had, of feeling good, social and productive.
I had been desperately depressed. I was afraid to lie down because I was afraid I couldn’t get back up. I was terrified I couldn’t take care of my dogs and they would be taken away. I was leaving a parking lot thinking about all this when on the bumper of the car in front of me I saw www.emotionalfreedom.com. Immediately I said to myself and probably out loud “that’s what I need!” A soon as I got home I got on the computer, found the phone number, made the call.

Two weeks ago I got on the computer found the phone number again and made the call. It can take two or three months to get to see my doctor, only a week to see Richard Ross. I guess I’m just a lucky puppymother.

>

Anhedonic babies grow up. I go to sleep thinking and I wake up thinking and all day thoughts drop and swirl through my mind like snowflakes, the only difference, some of them are the same over and over. When I woke up this morning the anhedonic children were in my mind. I started to think, to remember, to link.
Do you ever recall being scared by something just because you couldn’t clearly define what it was-some shadow in the dark-some errie noise? Then there are the more subtle forms of alert, confusion, worry, bewilderment, anxiety… all because you are thrown off base, can’t quite get a grasp on what is happening, what you’re seeing, what you’re hearing-the ‘why’ of the moment. For me it’s like this all day long every day every month every year decade after decade. Everyone around me is acting and reacting in ways I don’t understand, don’t have access to, can only imitate-and I do imitate quite well, well enough to fool everyone except my self. To keep from being ‘found out’, I keep all but a few people at a distance.

Christmas doesn’t really mean anything to me except candy canes and bright lights and endless demands on my very limited energy to make things nice for someone else. I watch this thing called joy, merriment, good will toward all and I have no idea what’s going on. Easter doesn’t really mean any thing to me except jellybeans and Easter bunnies. I’ve always liked the jellybeans, but that bunny, he’s always looked rather ridiculous. I don’t understand why people celebrate birthdays or anniversaries. I do not understand what party in general is about or social or Memorial or funeral and the list goes on. I don’t know why anyone gets excited when a baby is born or would want to have anything in particular to do with one.
The thing that makes this anhedonic state rather sticky, much more confusing, something a psychologist could have fun with for years-are all the stories I have made up and incidents and experiences to which I have attributed value to explain to myself how I got this way, why Everything is Nothing.
Tomorrow-or some time soon I will say more-in this 12 part essay on my personal anhedonic experience.

• Making up stories…
• in vivo adrenalin shootups!…
• No dreams, goals, aspirations… 
• how nothing becomes nothing good…
• “I don’t care”
• the value of anger… 
• one saving grace…
• the hug, the touch, other confusing things… 
• furfaced angels for anhedonia…
• Bipolar connection?…
• sex or not…
• creating reasons to live…
• and other STUFF.

Check it out…

http://www.mental-health-matters.com/index.php?option=com_content&view=article&id=159

The Loss of Joy: Anhedonia            Written by Richard O’Connor, PhD

“Less dramatic than anhedonia but a much more pervasive problem is a condition that doesn’t even have a clinical name; it’s the gradual withdrawal into isolation and indifference that can mark the beginning of depression. Robertson Davies called this condition acedia; it’s akin to the deadly sin of sloth. But it’s not merely laziness, it’s a gradual closing down of the world.”

          A couple years ago I started writing a book on mental illness, my mental illness.
Because I have been somewhat disturbed for as long as I can remember, I started way back.
I’ve taken a few excerpts that reveal states of mind, that I now know as anhedonia. 
It was clearly well developed by the time I was 16 years old.  A number of instances stood out starkly
by virtue of their emptiness in relation to the experiences others were having.  How confusing and unrewarding it must be to be close to me.

       On my 16th birthday Jerry gave me a beautiful diamond engagement ring.  I accepted it.  I liked it but I couldn’t ‘feel’ it, there was no emotion with it.

          He was crying and I could see his pain, but I could only feel a tiny bit of it, just enough to make tears run down my face.  I wanted to give him an explanation.  I looked hard inside myself to find one.  It was almost like staring at a blank wall.  I couldn’t even feel confused, just tired out on the inside-some kind of dull ache.  “Please,” I said, “it’s not about you it’s something wrong with me that I can’t explain.” 

        Other people had feelings, lots of them.  I could see them flash across their faces, they expressed awe, appreciated the beauty around them and talked about their relationships, their connection to other people. Even in the emotionally impoverished environment in which I existed, I could see I was different.  I had anger, fear and pain. 

        I have worked for decades on the anger and fear and pain.  I have overcome much, only to find this nothingness, that this is what I have to look forward to.

Do NOT go to this link if you are easily offended. It is not my fault if you resemble the the subjects studied.  I warned you…http://knowledgeisnecessity.blogspot.com/2009/05/new-imaging-studies-reveal-brains-of.html Diane

Anhedonia
Written by Colin Brennan, medical journalist

Anhedonia is the inability to gain pleasure from enjoyable experiences.

It was first identified in the 19th century, but was largely ignored until the late 1980s in favour of more obvious depressive symptoms such as low mood, poor concentration, tiredness, disturbed appetite and sleep, and suicidal thoughts.

Anhedonia is now recognised as a core symptom of depression and research by the Institute of Psychiatry in London is throwing new light on the links between the brain and depressive illness.

Symptoms of anhedonia
People with anhedonia have an incredibly flat mood. They can’t react properly or feel anything. There is no variation of mood, making it difficult to take things forward.

It is best described by examples. An anhedonic mother gains no joy from playing with her baby, a footballer isn’t excited when he scores the winning goal, a teenager is left unmoved by passing her driving test.

Anhedonia places a great strain on relationships and is usually accompanied by a loss of sex drive.

Anhedonia and depression
Depression affects one in every five people at some time in their lives and is a potentially fatal illness through suicide.

Depression can be triggered by a sad event like a bereavement, by a physical illness or by imbalances in brain chemistry.

Not everybody who has depression has anhedonia. While rare in mild depression, it can be a serious problem for people who are severely depressed.

Anhedonia can continue after depression, but usually it goes away at the same time.

Antidepressant medicines only partially deal with anhedonia symptoms.

Watching the brain in action
There have been various studies to try to identify the specific areas of the brain involved with anhedonia and depression.

An imaging technique called functional magnetic resonance imaging (fMRI) is used to scan the brain at work.

For example, as you talk, you use the brain cells in the front part of your brain. The increase in neural activity means there is an increased need for oxygen in this area.

Oxygen is delivered by the haemoglobin, which carries oxygen in the blood to all the cells of the body.

The fMRI scan picks up the difference in the magnetic properties of oxygenated and deoxygenated haemoglobin as the oxygen is delivered to the active area of the brain.

This means scientists can see changes in the brain as they happen. Not only can the activity of the brain be recorded when the person moves or signals the answer to a question by pressing a button, it can also be observed when the brain is active during thinking or planning.

Studies on depression and anhedonia
Some differences in the brains of depressives have already been observed. For example, in comparison with healthy volunteers, depressives have:

smaller hippocampi (the area that deals with emotion)
larger white matter lesions
differences in brain metabolism.
One study found that when depressed people were shown film clips designed to cause passing sadness, they activated areas of the brain that were not involved in the reaction of a group of healthy controls. The investigators suggested that this activation might disconnect the limbic system, which is linked to both rage and pleasure, from the normal prioritisation of emotional importance.

In 2005 the Institute of Psychiatry in London used fMRI to compare 12 people with anhedonia and depression to 12 healthy individuals. They identified three areas of the brain that worked differently:

ventromedial prefrontal cortex – the front part of the brain associated with empathy and regulation of negative emotions
ventral striatum – the area of the brain that signals reward
amygdala – almond shaped area of the brain associated with mood and ‘forgetting’ fears (memory of recent events).
All three are involved in the brain’s reaction to sad and happy stimuli.

In those people with anhedonia, the prefrontal cortex had to work harder to register happiness, and there was less activity in the amygdala and striatum.

The study’s authors believe this lack of activity may be what causes the prefrontal cortex not to process happy (rewarding) experiences. In effect, the reward system of the brain breaks down, resulting in anhedonia.

It’s hoped the findings of these studies will eventually lead to new treatments that could target specific regions of brain – either with existing drugs that can be shown to work, or with new medicines or psychological treatments.

Living with anhedonia
Lizzie Gardiner, a writer and single mother from South London, spoke to NetDoctor about how depression and anhedonia affected her life.

After several short bouts of the illness in her teenage years, Lizzie was hit by a major depression at the age of 31. It was brought on by a series of events: the break-up of her marriage, a move from one end of the country to another, bad health, financial problems and the threat of eviction.

Driven by the need to keep the lives of her two children as normal as possible, antidepressants and psychological treatment helped Lizzie through. She didn’t know about anhedonia then, but has since taken part in the Institute of Psychiatry’s research.

Lizzie’s anhedonia took many forms and partly remains with her. She still can’t gain pleasure from her own achievements or see that her children are a credit to her as well as to themselves.

One of her darkest moments was when she sat down to listen to Elgar’s Enigma variations. To her horror, she felt unmoved by the music she had always loved.

Lizzie has learned to live with her symptoms, and says being given information and reassurance helped when she was depressed. ‘Up to now it has been an invisible illness,’ she said.

‘If the research can show physical evidence that depression is caused by changes in the brain, it will be immensely helpful in removing the stigma that is attached to it.’
http://organizedwisdom.com/Anhedonia&url=www.netdoctor.co.uk/special_reports/
depression/anhedonia.htm

Donations are very welcome!

50% of donations go to NAMI (The National Alliance on Mental Illness). 50% of donations go toward my Brain Transplant…
It shouldn’t be too hard to find one;
there are a lot of people running around who obviously are NOT using theirs…thank you!

Please head on over to the HOME page and talk to me! Diane