Neuroplastic

Anhedonia, apathy, demotivation, emotional numbness

315 posts in this topic

I'm just really glad that this feeling doesn't involve my kids. For some reason, they don't bother me one bit, I can talk to them fine without feeling like I need to end the conversation. Which is very good, as my daughter is taking a lot of focus with her medical attention, and her own reluctance to live her life. It's like pulling teeth to get her to take her driving exam and study for it, and she's 19. So I'm having to do everything for her and be on top of things with her doctor. I'm going to have to drive to San Fransisco soon to take her to UCSF, and I'm pretty freaked out about driving around that city! I'm several hours north of there in the country. Not at all used to traffic.

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What is the relationship between anhedonia and apathy? Are they separate entities, or is one a subset of the other? A like vs. want thing?

 

Sparrow

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I can't say for sure as I don't know enough about it. But it seems to me that Apathy would be a subset of Anhendonia as there are other symptoms such as what we described as not wanting to be bothered with other people and phone calls. I think that goes a bit beyond apathy.

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I sense these as very different issues. I hesitate to use the term "anhedonia" because it is a psychiatric term and hallmark sign of "depression".

 

Anhedonia is the inability to experience PLEASURE, especially in things that used to be pleasureable.

 

Apathy, to me, is lack of care or concern about things both good and bad. I have difficulty connecting to or anticipating emotion, good or bad. Worry used to be a motivator for me. I rarely worry now, which sounds good in theory, but it's a distinct "just don't give a s*** about anything" and not because I trust that things will work out. The absolute basics get done, usually: eating, feeding the animals, taking drugs necessary to avoid immediate worsening of how I feel. I don't "see" a future, so I'm not motivated to take care of finances, relationships, etc. Most importantly, it's not a conscious choice. I do have to make a very concerted effort and force myself to do things "just in case there is a future". To be clear, I have absolutely no thoughts of harm or SI.

 

Apathy is also distinct from lazy. There IS a lack of motivation (positive or negative) to use as energy. I have had times of laziness and there's probably overlap, but it's the indifference about outcome or consequences that is the hallmark in apathy, IMHO.

 

Interestingly, apathy is something NOT addressed by psychiatry or the current DSM although DSM-V is looking at it. Makes sense, since they've created so much of it iatrogenically. *SIGH*

 

http://www.mcmanweb.com/apathy.html

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I hesitate to refer to Wikipedia, but this page on APATHY and the interactive graph are interesting. Much of the information contained on the page deceives how I feel.

 

http://en.m.wikipedia.org/wiki/Apathy

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Bar that is a good comparison to the two. The differences you suggested make sense to me.

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I'm with Barb. Are we talking about apathy or anhedonia when we talk about this aversion to do things? I'll change the title.

 

For me, the lack of a sense of reward has made me sort of demotivated. It's hard to get started even on things I want to do. For example, I put in a lot of effort to order a rug a year ago, and I want it in my living room, but I can't seem to get going on taking the old rug up, cleaning under it, and putting the new one down.

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I'm with Barb. Are we talking about apathy or anhedonia when we talk about this aversion to do things? I'll change the title.

 

For me, the lack of a sense of reward has made me sort of demotivated. It's hard to get started even on things I want to do. For example, I put in a lot of effort to order a rug a year ago, and I want it in my living room, but I can't seem to get going on taking the old rug up, cleaning under it, and putting the new one down.

 

I vote for change of title to Apathy. I think "Anhedonia" is too wrapped up in the "depression" diagnosis as has been discussed in other threads. Also, apathy encompasses far more than inability to ENJOY or experience PLEASURE. It is also indifference to NEGATIVE things and lack of worry or concern about future.

 

Pharma has alot of drugs to dull and take away emotion. What will they come up with to make people care or infuse emotion and energy??

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Hear hear on the hating talking on the phone and having to make small talk. I think I'm not much of a people person. I only really click with a few people. I think I've always been that way.

 

At the same time, when I'm feeling well I have a much higher tolerance for doing things I don't like.

 

I do think it's related to anhedonia... when you are feeling good you see everything in a more positive light.

 

The lack of motivation is HUGE for me when I'm not well. I can gauge how well I am, for example, by my waxing and waning desire to have a dog. Or really, do anything. When I'm not well, everything is too much trouble. In a way that is how I felt when I was depressed before meds, but somehow it was easier to spiral out of it... I know it's withdrawal anhedonia when nothing will pull me out. Nothing makes me laugh, nothing pleases me that normally does (sun, food, chocolate, trees)... I think to myself "my desire box is broken".

 

Luckily, that is one of the main things that has improved... it seems to be the first thing to lift when I'm on an upswing, before the anxiety and insomnia.

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A few weeks ago I was able to get up, walk the dog, study, meditate, etc. Now I can just about get out of bed. I have no desire to do anything. Couldn't be bothered walking the dog, not really interested enough to really engage with my study's, even though a few weeks ago I was fascinated!

 

I suspect it's either because I've been holding for some time now, which allows the drug to "settle in" more and exert its "therapeutic effect". Or it's because I caused instability by moving the dose forward. Either way, it's a PITA!

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The few remedies I tried, such as Cayenne, Curcumin, Ginger and the Sepia Homeopathy has helped with this some. I've been doing some light yard work and a few other things that I wouldn't have done before. I do feel a bit more motivated. Oh, and Coconut Oil. It's good for metabolism and thyroid function. I put a couple of tablespoons in some yogurt.

 

Edited to add that if I were in the midst of physical symptoms like brain zaps, jerks and other w/d body symptoms, I wouldn't take the fire element remedies that I mentioned. It might be too stimulating to the CNS. However, it doesn't effect me at all, not like coffee does.

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I think I posted some version of this somewhere, but here it is again:

 

Antidepressant Apathy Syndrome

 

http://www.redorbit.com/news/health/333128/antidepressant_apathy_syndrome/

 

" Levy et al. (1998) and Marin (1990) have made great strides to distinguish depression and apathy as two unique disorders. There is increasing evidence suggesting that apathy may also be a late- occurring complication of SSRI treatment separate from the original diagnosis (Garland & Baerg, 2001; Hoehn-Saric, et al., 1990,1991). Hoehn-Saric et al. (1990) initially reported SSRI-induced apathy in a case report of patients with depression and anxiety disorder. More recently, Garland and Baerg (2001) reported five cases of AAS among young people. It is important to note that before clinicians were aware that SSRIs could potentially induce apathy, it was rarely reported (Walkup & Labellarte, 2001). Furthermore, patients fighting anxiety or depression may ignore the insidious onset of apathy until most of their original symptoms are gone. At this late stage in treatment, apathy may be misdiagnosed as a relapse of the primary condition or considered treatment “poop out” (i.e., loss of efficacy). Distinguishing AAS from relapse and “poop out” has clinical implications regarding treatment and management strategies (Barnhart et al., 2004; Marangell et al., 2002)."

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Shanti I have had that. It never lasted a terribly long time, but while in the thick of it I only wanted to watch re-runs of Law & Order and old Westerns :lol: I swear.

 

And yes, I did not want to talk and there were times I actually couldn't talk. I was physically able, but I had to force myself to speak. That scared my daughter and I had to explain it to her.

 

The good news is that it does pass.

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I don't know if I'm ok being alone or if SS/NRIs just made me feel ok with being alone. I feel the aloneness and loneliness and *stillness* inside my head now and it's AWFUL. Today was a day of feeling every second tick by. And, of course, *everyone else* is busy doing something interesting and purposeful or so my mind imagines. It's frightening that I cant remember what I've done for the last 11 years since I worked last. Aside from the nonsense i mentioned earlier, it's a blur.

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I just posted a topic about my recent relapse in the physical conditions, such as body zaps. It may due to taking the Cayenne and Curcumin, as they are stimulating. I'm going to stop taking them and see how my symptoms improve but it's really a bummer, as it was helping me with the apathy and anhedonia.

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These posts have been moved to "Anhedonia or emotional anesthesia: When all is flat and colourless" under Symptoms and self-care.

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These posts have been moved to "Anhedonia or emotional anesthesia: When all is flat and colourless" under Symptoms and self-care.

 

Jemima,

 

This was originally Anhedonia but we decided to separate it out to differentiate Apathy from Anhedonia. (Approx 2 weeks ago)

 

Perhaps a thread entitled Apathy / Demotivation would be less confusing? Apathy is not part of "depression" or addressed by Psychiatry whereas anhedonia is usually equated with depression.

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Sorry, I wasn't aware of that. I moved the posts back.

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Sorry, I wasn't aware of that. I moved the posts back.

 

Thank you!

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Did those of you with this problem find your motivation returned after you got off the ADs?

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I experienced it - and am still experiencing it - during withdrawal. I'm a bit over a year from a too-fast taper off of Lexapro which ended in mid-December of 2011. According to what I've read, feelings of pleasure and interest in life are the very last to be restored after a bad withdrawal.

 

I've thought about this a lot and I suppose it makes sense that feelings of fear, sadness, and anger would come back first, especially fear, which helps us to survive.

 

Over the past several months, I've had some episodes of pleasure but at the present time they're fading in and out, the old windows and waves pattern. But at least I know I'm still capable of feeling pleasure and in time that capacity will be back to normal.

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This is from an old post by Alto in another thread. I've always found it reassuring (Emphasis mine):

 

...Emotional resonance does seem to be coming back, faintly. Charly G. said emotions were the last to come back. A knowledgeable doctor recently told me this, too.In all the years (6 now) that I've been reading people's experiences with withdrawal syndrome, of all the awful symptoms, the emotional anesthesia seems to frighten people the most. It's so not-human.(I prefer to call it emotional anesthesia, implying an iatrogenic condition, rather than anhedonia, which is supposed to be a symptom of garden-variety depression. Hah! I'd go for anhedonia any day over emotional anesthesia.)Yet, if you look at what these drugs do when you're taking them, it's a predictable residue of their action....it does get better....
This is the thread if you'd like to read more:http://survivingantidepressants.org/index.php?app=forums&module=post&section=post&do=reply_post&f=8&t=510&qpid=7381Dunno why these two are separate. Edited by Altostrata
name changed by request

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"...the emotional anesthesia seems to frighten people the most. It's so not-human."

 

Exactly.

 

It is so difficult to maintain hope or motivation without positive reinforcement of some kind.

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"...the emotional anesthesia seems to frighten people the most. It's so not-human."

 

Exactly.

 

It is so difficult to maintain hope or motivation without positive reinforcement of some kind.

 

It's like having not will to live or survive. Emotional anesthesia seems to take that away, doesn't it? It's like the antithesis of life. Fight or flight? What's that? I'll just hang here and see what happens. Oh, what's that? Danger? Really? I'll just hang here and see what happens in the middle of the danger. That's how emotional anesthesia seems to me.

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"...the emotional anesthesia seems to frighten people the most. It's so not-human."

Exactly.

 

It is so difficult to maintain hope or motivation without positive reinforcement of some kind.

 

It's like having not will to live or survive. Emotional anesthesia seems to take that away, doesn't it? It's like the antithesis of life. Fight or flight? What's that? I'll just hang here and see what happens. Oh, what's that? Danger? Really? I'll just hang here and see what happens in the middle of the danger. That's how emotional anesthesia seems to me.

 

Yes, exactly (again). No will or energy to fight or flee. Frozen, waiting to see what my fate is.

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Hi everyone, I took Prozac for 6 months in 2009 and ever since, I lost my emotions COMPLETELY. I was 15 at the time...

 

""I consider myself to have been recovered after 6 to 7 years. However, the emotional recovery takes almost twice as long. It's only now that I feel I am becoming whole again and that's more than I could ever asked for.""

 

When he said emotional recovery, did he mean the ability to REGAIN emotions? I want to feel human again.... I literally feel DEAD. Please tell me it's possible to recover? It's 2013 and I don't have my emotions :(

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""I consider myself to have been recovered after 6 to 7 years. However, the emotional recovery takes almost twice as long. It's only now that I feel I am becoming whole again and that's more than I could ever asked for."

 

Hi everyone. I took Prozac when I was 15 (in 2009) and I lost my emotions.... completely. Ever since, I have not felt ANYTHING. It's so hard to continue like this. I fear this is permanent.... I hope I do recover... I want to feel excitement/joy/happiness.... even sadness would make go crazy (in a good way) it means I can feel again.

 

It's 2013, and nothing has improved. Anyone else still suffering after 5+ years?

 

 

When Charles mentioned about emotional recovery, did he mean REGAINING emotions? Please let me know, because I want to feel human again.

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You're referring to Charly G. here http://survivingantidepressants.org/index.php?/topic/1351-charly-g-recovered-from-prozac-withdrawal/ ?

 

Charly is on Facebook, you might ask him the details.

 

He's a musician and has gone back to a normal life, leaving withdrawal syndrome behind him.

 

I can tell you personally, it does get better.

 

(I merged our two similar topics on anhedonia, apathy, demotivation together.)

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You're referring to Charles G. here http://survivingantidepressants.org/index.php?/topic/1351-charly-g-recovered-from-prozac-withdrawal/ ?Charly is on Facebook, you might ask him the details.He's a musician and has gone back to a normal life, leaving withdrawal syndrome behind him.I can tell you personally, it does get better.(I merged our two similar topics on anhedonia, apathy, demotivation together.)

Thank you. I'm hoping that's the case, how long did it take for you to recover? This suffering is simply inhumane. I never thought in a million years THIS was even POSSIBLE. Edited by Altostrata
changed name to protect privacy

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My emotional anesthesia took a few years to noticeably lighten -- it also stopped bothering me so much -- then continued to get better.

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My emotional anesthesia took a few years to noticeably lighten -- it also stopped bothering me so much -- then continued to get better.

 

Thanks for replying.

 

Have you fully recovered from emotional anesthesia? To be honest, I almost forgot what it's like to feel or have emotions... it's almost as if I never had them in my life, but I know I did. There was something magical/exciting about life before, and I can't explain it. The feeling of excitement was amazing... it was something I can't even describe. I had goals/dreams/desires in lie, now, I don't even understand why I'd want to do anything anymore, or even leave my house for that matter.

 

I just want to feel human again... if there's only one thing I want in life, it's to feel emotions/feelings. When I recover (i'm hoping I do), I will be the HAPPIEST HUMAN BEING in the face of the Earth.

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I'm 62 and menopausal, so it's hard to tell how much of my present state is due to aging.

 

I can't say I'm 100% recovered yet, but it gets better all the time.

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Alto, what improvements have you seen?

 

do you have the strong free floating anxiety and inner restkesness?

 

Do you have anhedonia still or does it come and go?

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I had intense free-floating anxiety. Not so much akathisia.

 

I had depersonalization for quite a while and that gradually went away. One day I realized I was present.

 

The emotional anesthesia gradually lifted. I can't recall if there were windows because the changes were so subtle.

 

I can't say I still have anhedonia. My emotions still seem a little muffled.

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and you have seen improvements in your free floating anxiety? its by far my worst symptom...dare I ask....has it gone?

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Yes, it has gone away. I only occasionally feel weird, like last week when I was coming down with a cold. I felt a tenseness for a night.

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