Anhedonia: the worst manifestation of treatment-resistant depression?

[FoolsGold]

Hi everyone,

This is my first time posting and I'm not sure what to expect. I guess I should tell you a bit about me before I pose some questions that I would really appreciate feedback on.

I'm 48 (male) and battle treatment-resistant depression, generalised anxiety disorder and an alcohol use problem; all since I was in my early teens. It's been a very tough road navigating treatments (anti-depressants, anxiolytics, stimulants, anti-psychotics, mood stabilisers, ECT, TMS, CBT, interpersonal therapy, medications to address my alcohol use, etc.) and the devastating effects my condition has had on relationships. My anxiety is well-controlled with a non-benzodiazepine medication at the moment, but I expect to develop tolerance to it as has been my experience in the past. I eventually found a SNRI anti-depressant 11 years ago that prevents me from living in a crippling abyss of depression, but I'm left with persistent anhedonia that I now recognise has been the long-standing reason for my inability to define a direction for my life.

With some unfortunate exceptions, I'm grateful for my privileged access to excellent medical professionals in Australia and in the US. I'm looking forward to consulting a psychiatrist who specialises in the treatment of mood disorders, anhedonia in particular, and would really like to hear about others' experience with anhedonia.

Anhedonia is the (relative) inability to experience pleasure. Although not always present, is it the worst possible symptom of treatment-resistant depression? I think that it is.

How can anhedonia be successfully treated? I was prescribed a selective dopamine receptor agonist, a good idea and supported for the treatment of anhedonia by a small number of clinical studies, but the risk of unpredictable "sleep-attacks" makes driving too dangerous and so I won't take it.

How do you cope with anhedonia? In the long-term, it's paralysing for me and makes me periodically suicidal.

Life without pleasure is very difficult to sustain. Is there any hope?

[white knight]

Hi welcome

Im sorry no one has replied. Likely no one has the knowledge of such a condition

Try using the search tab

Some threads on depression might be related eg search for

depression the timing of motivation

TonyWK

[Youre1]

I understand what you're going through, I also cannot find pleasure in anything anymore, life seems pointless and it upsets me deeply when I see people having fun, particularly over the festive season. So you're not alone. I have tried multiple different treatments over 12 years living with this dreadful condition. I'm your age and male, it makes me feel pointless to live and I call it just an existence. I used to mask these feelings with alcohol to try and get away, even temporarily. After my 3rd intake into hospital for alcohol detox, I have now been totally alcohol free for over 2 years. I would recommend that as the first step. The first few months without alcohol as a self medicating masking agent was difficult, but I just took it one day at a time. Now I don't think about drinking at all. My blood tests have improved and my blood pressure and liver function has returned to normal. I still have really bad days, on those days I chose to sleep. I sleep a lot as I'm unable to work. This is a good escape measure, much better than drinking. There is no single one cure but at least it can be better managed to make the suffering a little more bearable. I hope that this advice works for you.

[geoff]

Hello FoolsGold, for me, anhedonia is part of depression or any mental disorder where no enjoyment can be found in anything that we used to find pleasure in doing and certainly excludes any pretend enjoyment.

I'm not saying that once the mental disorder has been overcome that your life will now return to what you had previously enjoyed, simply because these may have contributed to forming any negative thoughts attributed to what was happening.

To be able to find any joy in life is to completely change who the person you are, that is, not continue on with what you have been doing but do a complete circle and concentrate on other aspects in your life, that is, areas that you never thought you would be able to do, that's what I have done.

We'd like to hear back from if possible.

Geoff.