Dr. Leland Heller, writes Biological Unhappiness * How Can I be Sure I Won’t Get Serotonin Syndrome? – Dr. Leland Heller is a family physician who has treated thousands of patients with the Borderline Personality Disorder. BPD is a medical disorder and that this and other Biological Unhappiness disorders are treatable with medication first and then by retraining the brain * Biological Unhappiness * BiologicalUnhappiness.com.

“There’s no guarantee on anything in life. Approximately 10 people per year are killed by vending machines falling down on them. You can be killed or maimed every time you drive a car. The computer you’re using can explode. Bad weather, earthquakes, lightning and terrorists can kill. The electricity in your home can cause a fatal fire in your house. Your car can explode. You can be killed by lightning hitting your telephone line.”

[Then there is MY reality...  expressed so well by the Doctor.   Diane]

“Being depressed increases the risk of a heart attack by 600%. There are more suicides per year than the combination of homicide and automobile accidents combined. Anxiety dramatically increases the risk of immune system disease, cancer, heart attacks, strokes, high blood pressure and others.

There is no absolute prevention of risk. What we do with everything in life is make an attempt to balance the risks versus the benefits.

I would not be concerned if any of my loved ones took BuSpar (buspirone) and Prozac…”

via

Dysthymia and cyclothymia: historical

origins and contemporary development

by

Brieger P, Marneros A

Psychiatric Hospital,

Martin Luther University,

Halle-Wittenberg, Germany.

peter.brieger@medizin.uni-halle.de

J Affect Disord 1997 Sep; 45(3):117-26

ABSTRACT

The aim of this article is to review and put in their historical context today’s data, methodologies and concepts concerning subaffective disorders. The historic roots of dysthymic and cyclothymic disorders–part of the subaffective spectrum–are essentially Greek, but the first use of the word ‘dysthymia’ in psychiatry was by C.F. Flemming in 1844. E. Hecker introduced the term ‘cyclothymia’ in 1877. K.L. Kahlbaum (1882) further developed the concepts of hyperthymia, cyclothymia and dysthymia–with possible subthreshold symptomatology–in 1882. After Kraepelin’s rubric of ‘manic-depressive insanity’, the term ‘dysthymia’ was widely forgotten, and ‘cyclothymia’ became ill defined. Nowadays the latter term is used in three, partially contradictory, senses: (1) a synonym for bipolar disorder (K. Schneider), (2) a temperament (E. Kretschmer) and (3) a subaffective disorder (DSM-IV, ICD-10). A renaissance of subaffective disorders began with the development of DSM-III. Therapeutically important research has focused on dysthymic disorder and its relationship to major depressive disorder, while cyclothymic disorder is relatively neglected; nonetheless, operationalized as a subaffective dimension or temperament, cyclothymia appears to be a likely precursor or ingredient of the construct of bipolar II disorder.

via Dysthymia.

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.

Anhedonia refers to the reduced ability to experience pleasure, and has been studied in different neuropsychi- atric disorders. Anhedonia is nevertheless considered as a core feature of major depressive disorder, according to DSM-IV criteria for major depression and the definition of melancholic subtype, and regarding its capacity to predict antidepressant response. Behavioral, electrophysiological, hemodynamic, and interview-based measures and self- reports have been used to assess anhedonia, but the most interesting findings concern neuropharmacological and neuroanatomical studies. The analyses of anhedonic non- clinical subjects, nonanhedonic depressed patients, and depressed patients with various levels of anhedonia seem to favor the hypothesis that the severity of anhedonia is associated with a deficit of activity of the ventral striatum (including the nucleus accumbens) and an excess of activ- ity of ventral region of the prefrontal cortex (including the ventromedial prefrontal cortex and the orbitofrontal cor- tex), with a pivotal, but not exclusive, role of dopamine. © 2008, LLS SAS Dialogues Clin Neurosci. 2008;10:291-299.

via The Core of Depression-27.

I want my Dopamine-and I want it NOW!
If you can read and understand this:
“The nucleus accumbens receives projections from midbrain regions (such as the ventral tegmental area), from regions involved in emo- tion (such as the amygdala, orbitofrontal cortex, and medial prefrontal cortex), from motor regions (such as the dorsal caudate and globus pallidus), and from regions involved in memory (such as the hippocampus).” Just click the link and enjoy the rest of this lengthy, educational and facinatimng article. Diane

Help!! My Brain is Shrinking!

Difficulties Experiencing Simple Pleasures May Be Caused By Smaller Brains

An area of the brain is smaller in those with anhedonia, or an inability to enjoy simple pleasures as much as the average person.

Yet another biological link between mental illnesses like depression and schizophrenia and brain physiology has been discovered by scientists at the Douglas Mental Health University Institute in Montreal.

Anhedonia, or the inability to experience simple pleasures as strongly as the average person, is a symptom of illnesses such as depression. It also may be because of a smaller area of the brain in which pleasures are processed. Douglas researchers have discovered that patients who suffer from anhedonia also have smaller area of the brain called the anterior caudate. This area of the brain, located in the center regions, is responsible for pleasure and reward.

According to MRI scans of patients with varying degrees of anhedonia, those who suffered the most from this ailment processed pleasurable images, such as a beautiful waterfall, in the part of the brain responsible for cognition rather than in the anterior caudate. The twenty-nine patients chosen for the study had no previously diagnosed mental illness. Their degrees of anhedonia were measured by a questionnaire that contained questions such as “I genegenerally agree that making love is an intense pleasure” that were rated on a scale from “strongly disagree” to “strongly agree”, with those choosing “strongly disagree” on such questions to be considered highly anhedonic.

“The hypothesis is that because they don’t feel pleasure as high as other people, when they analyze positive information, they have to process it at a more cognitive level,” explained lead author Philippe-Olivier Harvey to the Montreal Gazette. “So there is a genuine lack of pleasure and they have to compensate for this by an overactivation of this (cognitive) region of the brain.”

In those who enjoyed pleasure normally, this cognitive area of the brain, located just behind the forehead, was not active.

These findings are significant for advocates of the biological connections of various mental illnesses. It also will make treatment of some forms of depression and schizophrenia easier as a simple MRI scan can tell physicians why the patient is having a difficult time feeling pleasure and adjust treatment accordingly.

“It has been well established that anhedonia is a key symptom of major depression and schizophrenia,” said Douglas researcher Martin Lepage. “We chose to study this core symptom in hopes of finding a vulnerability marker to better diagnose these mental illnesses.”

via Anhedonia – Difficulties Experiencing Simple Pleasures May Be Caused By Smaller Brains.;

What exactly do I do about my subjective distress, the extreme distress I have not been able to convey to the Dr.? I do exactly what I’ve always done, I do IT myself, and I do IT my way without regard for “the rules.” I got online to find out where I could buy medication I would like to try without a prescription. That would usually mean Canada or Mexico. I set my $59 to Mexico, I hope I get something in return, something other than a talcum powder capsule. Does that sound desperate? Then you’re beginning to get the idea. But it’s always complicated, always- always complicate. The medication I am currently taking needs to be washed out, that is discontinued for two weeks prior to starting the MAOI (monoamine oxidase inhibitor), to avoid possible serious hypertensive reactions. That would not be such a big deal except, right now, I feel okay and whenever I feel okay, the last thing I want to do is rock the boat. When and if that med arrives, I won’t dare take it until I start to dive again. It’s never been very long to that point in recent history, no matter what I’m taking. Of course, when I get to that point, two weeks with no medications and another two or three weeks climb to a therapeutic blood level will really be screwed-and what if it doesn’t work? Sometimes I feel like an angry victim of my biochemistry.
This is not the first time I’ve gone the do it myself route. Last time, by the time I ordered the medication the doctor had prescribed it. That was the Metformin. It is supposed to be protecting my brain. I’m really very fortunate to have the Dr. I have. He is not a psychiatrist, he is an internist, with many years of experience, who specializes in brain disorders – dementia, Alzheimer’s and who has written a book on bipolar disorder. When I’m depressed, I think I’m an especially big pain in the ass in my doctor’s mind, and he doesn’t like me. I think he’s going to tell me he will not work with me anymore, but of course he doesn’t. If in fact, if I’m hurting anyone, I’m hurting myself, not him. When I am not depressed, I know he likes me. He would probably consider me more interesting than anything else. Everything is colored like that when I’m depressed.
Today my anxiety is low. I look out at the plan for the day, and I’m just a little bit afraid I can’t do it. Other days I’m terrified and the more urgent it is that I get out the door, the more difficult it is.
I am better this week, much better. One of the barometers by which I gauge my mental state is the condition of my bedroom. It is the one area I will let entirely fall apart while I’m trying to juggle everything else. It is one place where I can just shut the door and it is like shutting the door on the condition of my mind. The bedroom has been a deteriorating mess for the past couple months, until the day before yesterday, when I spontaneously spent hours cleaning and arranging it. Now I can leave the door open, now it is okay to look inside my mind, like you are doing right now.

Anhedonia

John Martz | March 12th, 2007

Anhedonia is a blog full of cartoons by Bart Vliegen. This piece that invites the reader to construct a rock song out of its list of cliche words, and which looks like it comes straight of a Moleskine sketchbok, stood out as a personal favourite.

via Anhedonia « Drawn! The Illustration and Cartooning Blog.

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…

“THE HEDONISTIC IMPERATIVE

A B S T R A C T

This manifesto outlines a strategy to eradicate suffering in all sentient life. The abolitionist project is ambitious, implausible, but technically feasible. It is defended here on ethical utilitarian grounds. Genetic engineering and nanotechnology allow Homo sapiens to discard the legacy-wetware of our evolutionary past. Our post-human successors will rewrite the vertebrate genome, redesign the global ecosystem, and abolish suffering throughout the living world.

Why does suffering exist? The metabolic pathways of pain and malaise evolved only because they served the inclusive fitness of our genes in the ancestral environment. Their ugliness can be replaced by a new motivational system based entirely on gradients of well-being. Life-long happiness of an intensity now physiologically unimaginable can become the heritable norm of mental health. A sketch is offered of when, and why, this major evolutionary transition in the history of life is likely to occur. Possible objections, both practical and moral, are raised and then rebutted.

Contemporary images of opiate-addled junkies, and the lever-pressing frenzies of intra-cranially self-stimulating rats, are deceptive. Such stereotypes stigmatise, and falsely discredit, the only remedy for the world’s horrors and everyday discontents that is biologically realistic. For it is misleading to contrast social and intellectual development with perpetual happiness. There need be no such trade-off. Thus states of “dopamine-overdrive” can actually enhanceexploratory and goal-directed activity. Hyper-dopaminergic states can also increase the range and diversity of actions an organism finds rewarding. Our descendants may live in a civilisation of serenely well-motivated “high-achievers”, animated by gradients of bliss. Their productivity may far eclipse our own.

        Two hundred years ago, before the development of potent synthetic pain-killers or surgical anaesthetics, the notion that “physical” pain could be banished from most people’s lives would have seemed no less bizarre. Most of us in the developed world now take its daily absence for granted. The prospect that what we describe as “mental” pain, too, could one day be superseded is equally counter-intuitive. The technical option of its abolition turns its deliberate retention into an issue of political policy and ethical choice. ”

OKaaaaaay every one has an opinion…        I’m entertained, are you entertained?  There appeared to be more where this came from.   I will read it some day when I am in an alternate mood state.  I offer it now in the name of diversity, perhaps to illustrate the down side of diversity.   Diane

via   The Hedonistic Imperative – Abstract.;

An endogenous opiate mechanism seems to be involved in stress-induced anhedonia

by Zurita A, Murua S, Molina V

Departamento de Farmacologia, Universidad Nacional de Cordoba, Argentina.

Eur J Pharmacol 1996 Mar 28; 299(1-3):1-7

ABSTRACT

This study assessed the effect of an uncontrollable stressor on the preference for a palatable solution (sucrose 1%), and on the preference for a context associated with a single administration of D-amphetamine (3 mg/kg i.p.) by means of the conditioning place preference test. We also evaluated the effect of prior naloxone (2 mg/kg, i.p.) administration on the influence of this stressful stimulus in both tests. Animals previously submitted to a 120-min–but not 60-min–restraint period showed a selective reduction in the preference for sucrose intake as compared to unstressed animals. Similarly, an identical restraint exposure elicited a diminished preference for the place previously paired with amphetamine. Both stress-induced effects were blocked by prior naloxone administration. These data demonstrate that a highly aversive experience decreased the reinforcing efficacy of sucrose and amphetamine, suggesting that uncontrollable stress may lead to an impaired capacity to experience pleasure, which could resemble the anhedonia observed in clinical depression. Furthermore, an endogenous opiate mechanism activated by stress seems to be involved in stress-induced anhedonia since naloxone normalized the reduction of the rewarding induced by both reinforcers.  Depression, stress, and anhedonia : the opioid connection.

To read more go here:  http://opioids.com/depression/index.html

Don’t read more if you are already depressed.    Diane