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is there any med that helps for apathy, emotional numbness and anhedonia?


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I am struggling with emotional blunting, lack of motivation, no pleasure from anything or interest in engaging with anybody/anything.  Google tells me this is classic "anhedonia".  Also have some classic depression symptoms I guess; fatigue, suicidal thoughts, no confidence, etc.... but no real 'sad' feeling.

 

The emotional blunting and feeling numb (no ups or downs) is what is the killer.  Has anyone found a treatment or medication that is good for this?    I'm not even getting enjoyment from food or exercise like I used to.  :huh:

 

 

 

My thinking is really disordered so sorry for the jumbled post. 

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Note: I'm not a doctor, but this is a pet issue of mine so maybe I can help. Also, typing on my phone, so it might be hard to read.

So okay.

Apathy is such a bitch, and it seems like one of the least talked about symptoms. That may be because of how easy it is to assume that listlessness is just 'part of depression' and dismiss it.

SSRI-Induced Indifference is a real thing, and it's a big fucking deal, but it doesn't have much hard research to pin down its specifics, at least not yet. Before I realized that SSRIs caused it, I trialed at least a dozen medications and just thought it was how I was 'supposed' to feel. (Indifferent instead of sad.)

The first recommendation for patients with SSRI-Induced Indifference is switching from an SSRI (like prozac, celexa, paxil, and zoloft) to an SNRI (like cymbalta, pristiq, effexor, and fetzima) in the hope that the additional norepinephrine shift will overcome the apathy.

In my case, this worked almost perfectly. I've had success with several different SNRIs and the difference has been like night and day. Things like soft bedsheets and being hugged feel good again, and I'm aware of pleasure again. I want to interact and talk again, and can get up and do the basic activities of daily living without a fight.

Secondly, if SNRIs don't help enough, I've known folks who got great benefit from adding wellbutrin or abilify because of how activating both tend to be. Like every other headcandy we take, everyone's reaction and drug requirements are going to be different.

Lastly, Nootropics (focus drugs like provigil, nuvigil, adderall, and ritalin) are another possible option due to their stimulant effects. Unfortunately for folks with anxiety or anger issues, these meds can potentially make those symptoms worse.

Pester your doctor.

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Apathy is such a bitch, and it seems like one of the least talked about symptoms. That may be because of how easy it is to assume that listlessness is just 'part of depression' and dismiss it.

Secondly, if SNRIs don't help enough, I've known folks who got great benefit from adding wellbutrin or abilify because of how activating both tend to be. Like every other headcandy we take, everyone's reaction and drug requirements are going to be different.

Lastly, Nootropics (focus drugs like provigil, nuvigil, adderall, and ritalin) are another possible option due to their stimulant effects. Unfortunately for folks with anxiety or anger issues, these meds can potentially make those symptoms worse.

Pester your doctor.

I agree the apathy is one of the least recognised symptoms I think.... and I notice if you mention it to professionals the advice seems to be along the lines of "pull yourself together", "fake it till you make it", etc.  The assumption is if you just TRY things (exercise, new hobbies, etc) then you will feel better for having done something more than sit around on your butt all day......... but in my experience that isn't the case at all.  Earlier in the year I tried a few new things and gave up after a few attempts because I felt no pleasure and the fact that I didn't feel anything actually made me despair. 

 

Abilify keeps coming up in discussions on this site. The idea of taking an AAP scares the crap out of me, but I'm getting to the stage I would try a lot of crazy stuff. I mean I have been reading up about ECT for goodness sake. 

 

Seeing a pdoc for the first time soon and I hope s/he will take me seriously when I explain I do not want to go down the SSRI/SNRI again, I've tried enough to know they just don't work for me.  I can only imagine their reaction if I ask about psychostimulants on a first appointment.  :huh:

Edited by crazyguy
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Apathy is my worst symptom, and I agree it is an absolute bitch. Abilify is the ONLY med that has ever touched my apathy and gives me at least some semblance of an interest in life. Nothing else has ever helped me. YMMV.


Wellbutrin shifted my anhedonia (it's the first MAOI I've ever tried). Hope thw pdoc helps.

 

Wellbutrin is not an MAOI.

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Apathy is such a bitch, and it seems like one of the least talked about symptoms. That may be because of how easy it is to assume that listlessness is just 'part of depression' and dismiss it.

Secondly, if SNRIs don't help enough, I've known folks who got great benefit from adding wellbutrin or abilify because of how activating both tend to be. Like every other headcandy we take, everyone's reaction and drug requirements are going to be different.

Lastly, Nootropics (focus drugs like provigil, nuvigil, adderall, and ritalin) are another possible option due to their stimulant effects. Unfortunately for folks with anxiety or anger issues, these meds can potentially make those symptoms worse.

Pester your doctor.

I agree the apathy is one of the least recognised symptoms I think.... and I notice if you mention it to professionals the advice seems to be along the lines of "pull yourself together", "fake it till you make it", etc.  The assumption is if you just TRY things (exercise, new hobbies, etc) then you will feel better for having done something more than sit around on your butt all day......... but in my experience that isn't the case at all.  Earlier in the year I tried a few new things and gave up after a few attempts because I felt no pleasure and the fact that I didn't feel anything actually made me despair. 

 

Abilify keeps coming up in discussions on this site. The idea of taking an AAP scares the crap out of me, but I'm getting to the stage I would try a lot of crazy stuff. I mean I have been reading up about ECT for goodness sake. 

 

Seeing a pdoc for the first time soon and I hope s/he will take me seriously when I explain I do not want to go down the SSRI/SNRI again, I've tried enough to know they just don't work for me.  I can only imagine their reaction if I ask about psychostimulants on a first appointment.  :huh:

 

 

Same probs. I realize that no matter how many times I do an activity, its not making me want to go out and repeat it. I know I got to pull myself together, but how? lol!

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Wellbutrin is a good med. It helps me a lot. I was going through a mixed episode which went into anhedonia, and Wellbutrin kicked me out of it. I also take Ritalin. 

 

Wellbutrin is NOT an MAOI, its an atypical antidepressant and works way different than TCA's, SSRI's, SNRI's or MAOI's. 

 

Don't be afraid of antipsychotics. Abilify was great for me at a low dose, it helped my negative symptoms and such, and when combined with an antidepressant its extremely useful. I've even seen commercials for it saying Abilify is a good add-on to an AD. It's a bit different than most AAP's, and can be said to have its own category, but I've heard a lot of positives of it. I ended up with akathasia at 10mg and it was too activating for me. This isn't the case for everyone, I am activated easily (I sound like I'm talking about a robot!) and get akathasia from many AP's and AAP's. I currently take artane for it. It helps.

 

There are a lot of options out there. Don't give up!

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Abilify is pretty good stuff. I had very few side effects, and it did what it was supposed to do. I hope it works if you're giving up on everything else, there's a good chance it will.

Good luck.

 

^I agree.

 

 

Lastly, Nootropics (focus drugs like provigil, nuvigil, adderall, and ritalin) are another possible option due to their stimulant effects. Unfortunately for folks with anxiety or anger issues, these meds can potentially make those symptoms worse.

 

I am on provigil, and while it helps keep me awake and gives me more energy, it does not give me anxiety.  Actually I think I'd be more anxious without it because I know how much it helps me.  But YMMV ... works different for everyone. 

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well I will have to wait for the psych appointment anyway.  here in the UK Wellbutrin is only licensed as a quit-smoking aid and not for depression, so I don't know if they would go for that.  However it is on my list of things I would consider trying as I have heard good things about it. 

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Apathy is my worst symptom, and I agree it is an absolute bitch. Abilify is the ONLY med that has ever touched my apathy and gives me at least some semblance of an interest in life. Nothing else has ever helped me. YMMV.

Wellbutrin shifted my anhedonia (it's the first MAOI I've ever tried). Hope thw pdoc helps.

 

Wellbutrin is not an MAOI.

Oops, thanks.

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I am struggling with emotional blunting, lack of motivation, no pleasure from anything or interest in engaging with anybody/anything.  Google tells me this is classic "anhedonia".  Also have some classic depression symptoms I guess; fatigue, suicidal thoughts, no confidence, etc.... but no real 'sad' feeling.

 

The emotional blunting and feeling numb (no ups or downs) is what is the killer.  Has anyone found a treatment or medication that is good for this?    I'm not even getting enjoyment from food or exercise like I used to.  :huh:

 

 

 

My thinking is really disordered so sorry for the jumbled post. 

 

Welbutrin or Abilify (at low doses). If anxiety isn't a major issue with you, Welbutrin may work wonders.

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I am struggling with emotional blunting, lack of motivation, no pleasure from anything or interest in engaging with anybody/anything.  Google tells me this is classic "anhedonia".  Also have some classic depression symptoms I guess; fatigue, suicidal thoughts, no confidence, etc.... but no real 'sad' feeling.

 

The emotional blunting and feeling numb (no ups or downs) is what is the killer.  Has anyone found a treatment or medication that is good for this?    I'm not even getting enjoyment from food or exercise like I used to.  :huh:

 

 

 

My thinking is really disordered so sorry for the jumbled post.

It's like you read my mind (and mine's jumbled too) and then wrote that. The funny thing is I don't feel depressed at all. I feel ... nothing. The worst part for me is the apathy and lack of motivation, as it's going to cause real problems for me if I don't start getting stuff done. But then I'll nonchalantly think, "No worries, I'll just kill myself." It's like that's preferable to dealing with anything.
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It's like you read my mind (and mine's jumbled too) and then wrote that. The funny thing is I don't feel depressed at all. I feel ... nothing. The worst part for me is the apathy and lack of motivation, as it's going to cause real problems for me if I don't start getting stuff done. But then I'll nonchalantly think, "No worries, I'll just kill myself." It's like that's preferable to dealing with anything.

 

yeah I know what you mean, it is a really distorted way of thinking and clearly caused by the depression.  How we fix it though I don't know. 

 

I decided to stop taking my antidepressant to see if that improved the emotional numbness.   I feel slightly better but I haven't been off it a full week yet..... maybe the mood crash will come soon. 

 

A little research on Wellbutrin suggests it might be worth a try, the problem being it isn't licensed for depression in this country.  I will have to ask my doctor about the options when I see them.  Right now I'm thinking MAOI, Wellbutrin, Clomipramine, Stimulants, etc.  My mind is jumbled with ideas and I don't know which are good or bad.  All I know is I don't want another SSRI and probably not APP like abilify either. 

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yeah I know what you mean, it is a really distorted way of thinking and clearly caused by the depression.  How we fix it though I don't know. 

 

I decided to stop taking my antidepressant to see if that improved the emotional numbness.   I feel slightly better but I haven't been off it a full week yet..... maybe the mood crash will come soon. 

 

A little research on Wellbutrin suggests it might be worth a try, the problem being it isn't licensed for depression in this country.  I will have to ask my doctor about the options when I see them.  Right now I'm thinking MAOI, Wellbutrin, Clomipramine, Stimulants, etc.  My mind is jumbled with ideas and I don't know which are good or bad.  All I know is I don't want another SSRI and probably not APP like abilify either.

Wellbutrin is what my pdoc is holding in reserve. I couldn't sleep on it the first time I took it. Made me even crazier as a result. But that was long time ago and I have no sleep troubles now (just the opposite ATM), so I'm willing to give it another spin.
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