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Complete anhedonia (loss of feelings) as a ME symptom. Anyone else who has it?

Bob

Senior Member
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16,455
Location
England (south coast)
Exogenous depression, on the other hand, can be treated with talk therapy because the root is in some sort of pathological thinking.

A bit off-topic here, but I just want to briefly say something about what SOC said here, because it's a subject that I really care about... Personally, I don't think it's helpful to think of reactive depression as being caused by 'pathological thinking', but I think it's better to think of it as a neurochemical, or psychological, reaction to external stimuli or stress. The mental processes that lead to depression can be at a subconscious or emotional level, and don't necessarily involve conscious thoughts. I know what SOC was getting at though, as talking therapies can help ease reactive depression, and some talking therapies address habitual 'thinking' processes, which can in turn change our attitudes and coping mechanisms that can lead to depression.
 

SOC

Senior Member
Messages
7,849
A bit off-topic here, but I just want to briefly say something about what SOC said here, because it's a subject that I really care about... Personally, I don't think it's helpful to think of reactive depression as being caused by 'pathological thinking', but I think it's better to think of it as a neurochemical, or psychological, reaction to external stimuli or stress. The mental processes that lead to depression can be at a subconscious or emotional level, and don't necessarily involve conscious thoughts. I know what SOC was getting at though, as talking therapies can help ease reactive depression, and talking therapies address habitual 'thinking' processes, which can in turn change our attitudes and coping mechanisms that can lead to depression.

I won't disagree with you here, Bob. Reactive depression could certainly be strictly (or largely) a neurochemical reaction to stress and need pharmacological intervention (or simply time to resolve). Additionally, any number of illnesses can affect neurochemistry and cause so-called depression which benefits from ADs. These are not the result of pathological thinking, either.

I have met people who were raised in toxic environments and have distorted understanding of themselves and the world. They tend to be more classically "depressed" -- sad, disconnected from society, etc. Proper talk therapy does seem to work for them (not that UK-style CBT crap). That isn't to say that the stress of their toxic upbringing didn't also generate a neurochemical imbalance/disorder....

IMO, "depression" is a stupid word for the variety of neurochemical disorders that can arise from any number of sources.
 

taniaaust1

Senior Member
Messages
13,054
Location
Sth Australia
No, actually anhedonia is one of the most identifiable signs of depression. This is another one of those "stupid name" illnesses that leads to incorrect assumptions in perfectly reasonable people. When people hear "depression" they think patients are universally sad. Not true.

Many people with endogenous depression ("depression" caused by neurochemical imbalances) never suffer from inappropriate sadness. The illness is still called "depression". It's not caused by life circumstances or unhealthy thought processes. It's physiological, not psychological. (Sound familiar?) Fortunately, the meds work on the physiological cause of endogenous "depression".

Exogenous depression, on the other hand, can be treated with talk therapy because the root is in some sort of pathological thinking. That isn't to say that a person couldn't have both endogenous and exogenous depression, and need both talk therapy and meds.

It might be well worth your while to try ADs if you have anhedonia. Doubt it will do any good for the ME (contrary to the thinking of innumerable over-paid under-trained MDs), but it might help you feel better.

I thought SOCS post was a good one. It is correct that not all with depression are sad, some have blunted emotions and cant feel throu them due to depression. This symptom can be a sign of depression and is likely in those who are feeling this symptom.

ME can also cause havoc thou with the feelings and body too. I lost my ability to feel fear at one point.. it was like I wasnt producing any adrenaline and no fight or flight response at all while at other times I'd get an adrenaline rush for no reason at all. I once almost got hit by a tram and felt no fear response at all. My whole system was wacked out. There have been times Ive lost my ability to feel temperature eg something hot

currently.. Im loosing at times my ability to feel hunger or thirst, my body isnt producing those signals at times but my emotions are good :)
 

PokerPlayer

Guest
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125
Location
Seattle, Washington
I just think the way redo feels is more related to autistic cognitive dysfunction than any sort of depression.

Anyway, Yes methylation supplements made me cognitive dysfunction worse while making me physically better. EXCEPT hydroxy b12 and fish oil both cleared the brain fog a bit.

How do you do with alcohol? When I was super foggy I could drink 3 drinks or so and feel nothing, but by the 4th drink I would get a significant change in brain chemistry and I would get enjoyment out of talking to people, and I would actually feel less brain fog. So, you could do that once a week or so just to take a break from the fogginess if possible.

Also, using benzodiazepans can possibly cut down the brain fog if used every once in a while (but not daily). So you could give that a shot.
 

Bob

Senior Member
Messages
16,455
Location
England (south coast)
ME can also cause havoc thou with the feelings and body too. I lost my ability to feel fear at one point.. it was like I wasnt producing any adrenaline and no fight or flight response at all while at other times I'd get an adrenaline rush for no reason at all.

Yes, I'm pretty certain that i've had fluctuating endocrine system as well, including fluctuating thyroid hormones.
My thyroid went clinically low, and then back to normal in about a year.
Then, after that settled down, other hormones seemed to be fluctuating.
My mood was fluctuating between mild depression and a very motivated mood for a while, which I put down to fluctuating hormones or brain chemicals because I'd never had that before.
And then, after that, I think I then had fluctuating histamine levels because I suddenly had a randomly fluctuating allergic reaction, with itchy ears, nose and throat etc.

It seems like it must be a dysfunction of the pituitary gland or hypothalamus, which regulate all of our hormones and endocrine system.
 

hurtingallthetimet

Senior Member
Messages
612
hello not sure if this is what you are talking about but i stay exhuasted and alot of time in a daze this was before the strong pain medicatoins alos so i know its not it causing the daze feeling...

i do suffer from depression and anxiety and always have that and i am sensitive to everythign most of time noise...lights..people..traffic and cry pretty much every day...guess more i type it doesnt really sound alot like what you had menitoned..i hope you get alot of good ansewers..these illness have some many extra things that come along it seems...
take care
 

Hip

Senior Member
Messages
17,824
Anhedonia and emotional flatness (blunted affect) are two major symptoms I suffer from, and for me are the worse symptoms that I have.

There is a difference between anhedonia and emotional flatness (blunted affect), although they are related and often arise together.

Anhedonia is defined as a lack of sense of pleasure or reward from life's normal activities. The reward circuits of the brain are inactive in anhedonia, so the experience of pleasure and reward on completing tasks is absent.

So normally, whereas you might have felt satisfaction and reward after doing something as simple as tidying your desk, cleaning the bathroom, or going for a walk, you find with anhedonia that the sense of reward is absent or only weakly present when you complete the task. You just get the most awful feeling of mental vacuum instead. Metaphorically it feels like working hard from Monday to Friday, only to find that your boss pays you nothing at the end of the week. But that metaphor does not really fully capture to horrendous sense of vacuum and meaningless emptiness delivered by severe anhedonia.

Severe anhedonia will bring on thoughts of suicide very quickly, as I have observed in myself. A long time ago, I had quite bad clinical depression for a couple of years, but never once did the thought of suicide even occur to me during that entire depressed period. But when I got severe anhedonia, even though I only had mild depression (if at all), I just was hoping every day that I would drop down dead. It's hard to explain to someone if you haven't experienced anhedonia; anhedonia seems like all you reasons for living have been taken away.

Anhedonia is further divided into two subtypes: consummatory anhedonia, which is where you don’t feel much reward or satisfaction on completing a normally enjoyable activity; and anticipatory anhedonia, which is where you don’t get any good feelings when you look forward to doing an activity that is normally enjoyable.

Emotional flatness (blunted affect) is slightly different to anhedonia. In emotional flatness, the normal emotional responses (love, sadness, compassion, surprise, guilt, shame, anger, joy, etc) are weak or absent. So for example, if you watch an emotional drama on TV, you tend to experience the drama in a cold, often cynical way, as you don't really engage with the emotions in the story.

With my emotional flatness symptoms, I find the same thing happens when I speak to say an old girlfriend that I have remained friendly with. Usually in these circumstances, a normal person will often feel quite a few emotions as a result of talking about say old times. But when you have emotional flatness, you just can't tune into this type of conversation.

Emotional flatness is not at all the same as autism, incidentally. Contrary to popular belief, people with an Asperger's bent may not necessarily be people-oriented, but often posses and express extremely strong emotions towards the non-human things that interest them (like abstract academic subjects, engineering hobbies, and so forth). I have a touch of Asperger's, and know how much love I had for many abstract academic subjects; now that love and rapport I had for these abstract subjects has mostly vanished, along with the love and rapport I used to have for my friends.

Note that "blunted affect" is defined as the lack of emotional reactivity to emotional stimuli; a very similar concept is "affective flattening" which is defined as the lack of emotional expression in an individual.

Another closely related condition is lack of motivation (aboulia):

Lack of motivation (aboulia) results in a reduced inclination to start or engage in tasks. Lack of motivation differs from anhedonia. In aboulia, you don't tend to intellectually initiate into tasks and purposeful activity; in anhedonia, you don't get the feeling of reward or satisfaction on completion of a task a reward which is the psychic payoff we all need to receive when we have done something useful.

Supplements I have found helpful in reducing the anhedonia / emotional flatness symptoms are:


Anti-Anhedonia Supplements:

EGCG (green tea extract) 1000 mg daily, boosts mood, motivation and mental focus (this is probably the best anti-anhedonia supplement I have found; however, there is a comedown for a few days when you stop taking it, so best to taper off slowly).
Colostrum powder 8 grams (= 2 heaped teaspoons) twice daily on an empty stomach
Hydrogen rich water drinking several glasses throughout the day
Manganese 5 mg daily
Vinpocetine 10 mg daily
Horny goat weed (Epimedium) herb 3000 mg daily
Bacopa monnieri herb 1000 mg twice daily
Acetyl-L-carnitine 500 mg twice daily
Choline bitartrate 500 mg + vitamin B5 500 mg twice daily
He shou wu (Polygonum multiflorum) 500 mg twice daily
Korean ginseng 500 mg twice daily

Vinpocetine and horny goat weed seem to work for sexual anhedonia too. Treating and reducing brain inflammation will also significantly lower anhedonia, I find. For me the two most effective anhedonia treatments in the above list are colostrum and hydrogen rich water.

Low doses (10 to 20 mg daily) of tricyclic antidepressants such as amitriptyline or imipramine are useful for anhedonia. A useful anti-anhedonia drug is amisulpride. I detail my experiences with amisulpride here. Amantadine 25 to 50 mg daily I find good as well.

More recently, an antidepressant drug called agomelatine (which is structurally similar to the hormone melatonin), has been shown effective for treating anhedonia. Several studies have demonstrated agomelatine's anti-anhedonia effects. Refs: 1 2 3

Unfortunately agomelatine is quite expensive, around $60 for 28 x 25 mg tablets. However, it's often stated that sublingual agomelatine is 8 times more effective than oral, so to save money, you can crush each tablet into powder, and use just ⅛ of the tablet sublingually each night (agomelatine is taken before bed). This may be equivalent to a 25 mg tablet taken orally.

Phosphatidylserine seems to make my anhedonia worse, in doses higher than around 200 mg.

If taking high dose EGCG for some time, it may be worth taking some folinic acid, as EGCG has an anti-folate action: it inhibits the enzyme dihydrofolate reductase (DHFR). Folinic acid is used to correct for DHFR deficiency.


Treatments For Emotional Flatness:

Supplements that I have found help return some emotional strength and responsiveness to the mind include the following list. The general rule with these supplements is that they boost emotions for a few hours, but I find if you take them every day, they stop working. So they are best used occasionally, to remind yourself the fact that emotions exist. It is easy to forget that emotions exist, when you have blunted affect.

Allicin 1,000 mg daily (6 x 180 mg allicin capsules taken once daily) seems to have a good emotion boosting effect. Allicin is a garlic extract. This is one of the few supplements that seems to work long-term for ameliorating emotional flatness.
Terminalia arjuna herb 6 grams — takes about 5 hours to kick in, but then boosts emotions for the rest of the day.
Myrrh essential oil 10 drops mixed in 30 ml of a carrier oil (like baby oil), and rubbed on the skin of the body, where is it is slowly absorbed transdermally (not be taken by pregnant women).
Royal jelly 1500 mg + vitamin B5 500 mg seems to bring my emotions back online quite strongly, but temporarily (it only lasts for 3 or 4 hours).
Green coffee bean (50% chlorogenic acid) 2000 mg produces a strong cathartic and loving emotional response within a few hours of taking it. May not get repeat effects if the chlorogenic acid is taken every day.
He shou wu (Polygonum multiflorum) 3 grams
Carnosine 1000 mg
Glutamine powder 2 heaped teaspoons (12 grams)
Choline bitartrate 500 mg + vitamin B5 500 mg
Vinpocetine 10 to 20 mg
Bacopa monnieri herb 2 grams
Bael fruit powder (bilva powder) 3 grams

Fludrocortisone (Florinef) 0.1 mg, a drug for treating adrenal insufficiency and POTS, I found has a profound emotional boosting effect; in particular, it boosts your emotional emotional empathy (and a study showed this to be the case in BPD 1). Unfortunately I found this emotional boosting effect only appears when you first take fludrocortisone, and like with many of the supplements above, it disappears with repeat use.



Emotional flatness can occur several months after using benzodiazepines.

I hope you will find some benefit from these.
 
Last edited:

redo

Senior Member
Messages
874
The thread has gone a bit OT, but to weigh in about the causes of feelings they are all a result of neurotransmitters acting in the brain, whether it be because someone is stinging one, whether it's endogenous condition, or whether it's 'pathological thinking' as a result of a 'pathological situation'. But, to go back to the topic.

I just think the way redo feels is more related to autistic cognitive dysfunction than any sort of depression.

Anyway, Yes methylation supplements made me cognitive dysfunction worse while making me physically better. EXCEPT hydroxy b12 and fish oil both cleared the brain fog a bit.

How do you do with alcohol? When I was super foggy I could drink 3 drinks or so and feel nothing, but by the 4th drink I would get a significant change in brain chemistry and I would get enjoyment out of talking to people, and I would actually feel less brain fog. So, you could do that once a week or so just to take a break from the fogginess if possible.

Also, using benzodiazepans can possibly cut down the brain fog if used every once in a while (but not daily). So you could give that a shot.

Yes PokerPlayer, the emotional flatness I (or we) are experiencing is totally different with a depression. I haven't used substances in the past, but the flatness doesn't respond to powerful substances. I feel nothing, when given a powerful opiate, I feel nothing when given substances known to give a massive stimuli to the dopamine system. I don't feel anything despite getting artificial stimuli..

I don't know of any depressed person, who has a perfectly well psyche, who don't respond at all to opiates/dopamine releasing substance, who's full of great plans for the future. Those are not any of the characteristics of being depressed. And add to that, don't feel heat/cold, hunger/fullness.

And like PP says, it's much more related to autistic peoples (lack of) feelings, although I think most of them feel more than us.

I haven't drunk alcohol in almost a decade, because of the disease. But when I did, in the beginning of the disease (and this is not related to the not feeling symptom), my brain fog was actually better when I had a hangover. The day after drinking.


Anhedonia and emotional flatness (blunted affect) are two major symptoms I suffer from, and for me are the worse symptoms that I have.
(...)
Supplements I have found helpful in reducing the anhedonia / emotional flatness symptoms are:

Treatments For Emotional Flatness:

Royal jelly 1500 mg + vitamin B5 500 mg seems to bring my emotions back online quite strongly, but temporarily.
Myrrh essential oil 10 drops mixed in 30 ml of a carrier oil, and rubbed on the skin of the body, where is it is slowly absorbed transdermally.

+1 for the post Hip. The treatments you have listed for emotional flatness, is that something you've found through trial and error, or is it something else? I Googled royal jelly, and I saw it mentioned together with methylation several places.
 

Hip

Senior Member
Messages
17,824
+1 for the post Hip. The treatments you have listed for emotional flatness, is that something you've found through trial and error, or is it something else? I Googled royal jelly, and I saw it mentioned together with methylation several places.

The emotional flatness treatments were found both by Googling, and then trying the supplements out to see if they actually work. I've listed the ones that worked for me.

You have to use a bit of lateral thinking when Googling, using search phrases like: herbs emotions. As is well known, myrrh is an old biblical herb, and has a reputation in herbalist circles for boosting emotions. Myrrh contains sesquiterpenes, which apparently act to bring oxygen to the hypothalamus and pituitary glands (which are involved in emotional dynamics). You can take myrrh orally, but it is a little harsh on the stomach, so I prefer transdermal application. Myrrh essential oil smells really nice.

Royal jelly I find works well when you first take it, but you seem to build up tolerance to it very quickly, so the next day it doesn't work half as well. So I find you need to take a break for a few days before you use it again.

I think it is best to treat anhedonia and emotional flatness simultaneously, as they are quite similar and overlap to some degree.

For anhedonia, try acetyl-L-carnitine, vinpocetine and imipramine together.

If you want to lower brain inflammation, try the anti-inflammatory treatments listed on my website. A lot of my severe anhedonia symptoms improved once I employed anti-inflammatory treatments. Brain inflammation is increasing recognized as a cause of mental symptoms.

Note that in general, anhedonia and emotional flatness are one of the hardest mental symptoms to treat. Doctors generally have nothing to offer patients with such conditions. So you will be hard pressed to find any drugs that work for these symptoms.


I can definitely relate to your complete lack of enjoying food. When I had severe anhedonia, it was almost weird to eat, as there was no feeling of contentment or satisfaction after eating or drinking. With the anti-inflammatory treatments recommended, I overcame this severe anhedonia, and now I can enjoy food again, and enjoy drinking a decaf coffee again.
 

xrayspex

Senior Member
Messages
1,111
Location
u.s.a.
I can relate to this, I have been struggling with whatever for over 20 years and emotional bluntness seems worse with age w/cfs stuff.

I feel worse on b vitamins and fish oil. I have sjogrens too and seems fish oil supposed to be good for that. I had some dental issues and dry eye stuff flare lately so was forcing self to try to tolerate cod liver oil tsp day and occasional tincture of st johns wort--both of those things seem to always worsen the depressive flat like symptoms. I cannot figure out what the mechanism is there, but with fish oil have tried it over and over again and same thing. maybe i just need practically a homeopathic dose. I am curious if anyone knows why fish oil could make mood and brain feel foggier and sometimes just intolerable mood of yuck, don't know how to describe. I did wonder if maybe it blocks the minute dose of pain meds I take for spinal pain, wonder if fish oil an undiscoverd opiate antagonist like LDN or something

so frustrating you try to do one thing to help one symptom and then worsen another

btw tried LDN for 6 mos and made mood worse, its why went off of it

anyway, I dont think my natural personality was dysthymic, I think something happened to brain as result of whatever this chronic fatigue and pain is. some days and moments still good other ones feel vry antisocial and like crawling out of skin.
 

shannah

Senior Member
Messages
1,429
I can relate to this as well. As a matter of interest, those with Lyme/Co-infections often talk about these things.

Checking out your site Hip, that's quite the extensive collection of information you've assembled. Good for you. I've never seen some of these symptoms talked about before though I've looked for some of them. Not to hijack this thread, but an example would be this paragraph complete with links to pictures.

"After 2 or 3 years, an additional skin symptom appears: namely the color of the skin on the upper chest area becomes a little red/pink, and the skin texture in this area gets quite thick and oily (or waxy) in feel; this upper chest symptoms is called a heliotrope rash. New moles with a rough texture may appear on the skin; see this picture that I took of one. These type of moles are called dysplastic nevi."

http://chronicsorethroat.wordpress.com/
 

taniaaust1

Senior Member
Messages
13,054
Location
Sth Australia
I am curious if anyone knows why fish oil could make mood and brain feel foggier and sometimes just intolerable mood of yuck, don't know how to describe. I did wonder if maybe it blocks the minute dose of pain meds I take for spinal pain, wonder if fish oil an undiscoverd opiate antagonist like LDN or something

so frustrating you try to do one thing to help one symptom and then worsen another

This is a wild thought which I dont know at all so may not even be a possibility?.. but maybe you are getting mercury from the fish oil? or have too much mercury in your body and the fish oil adds to it??
 

xrayspex

Senior Member
Messages
1,111
Location
u.s.a.
I did wonder about that tania, anything is possible.
I searched around on forums last nite and did find one where a lot of people expressed having trouble with cod liver oil like me, realized maybe its also the epa 3 i need to stay away from and do the 6's as ok on eve primrose oil. but not sure if get same benefits from primrose as fish oil. but a bunch of people at a meds forum said they got depressed on fish oil every time. could be the changs in brain those epas induce, and there is research that shows certain epas fish oils can make arthritis worse i saw on wiki so really its all still experimental and individual.

sorry if hijacked a bit... i should start an oil thread.
 
Messages
60
Hi Bob
I feel the same as the others but as i am going through menopause too i wonder if my crying feeling helpless is a result of low seratonin? i also have trouble with my appetite or should isay lack of one
 

Bob

Senior Member
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16,455
Location
England (south coast)
Hi Bob
I feel the same as the others but as i am going through menopause too i wonder if my crying feeling helpless is a result of low seratonin? i also have trouble with my appetite or should isay lack of one

Hi flower,
I'm sorry, I know very little about the menopause (haven't had mine yet :confused: ;)) so I'm probably the wrong person to ask.
If my understanding is correct, your hormones are all over the place with the menopause.
It is very possible that depression could run concurrently with the monopause.
Anti-depressants can help people get through a rough patch in their lives, so they could be helpful to you if you are feeling emotionally low.
Feeling helpless, and crying for no good reason, are signs of depression.
It would be worth talking to a doctor about.
In my experience you have to actually tell the doctor that you want anti-depressants, if you think they might help, or they don't think about it.
A lack of appetite can be a sign of depression, but it could be related to lots of other things too, such as the menopause (possibly?).
Good luck with getting some answers.
Bob
 

Beyond

Juice Me Up, Scotty!!!
Messages
1,122
Location
Murcia, Spain
Hip Very good list, however those are a lot of supplements only for anhedonia. Maybe one day when I actually gain money :D

I have also lost a lot of the feelings that made my life somewhat enjoyable. Having also some degree of Asperger´s even my passion for say videogames has almost vanished. It felt weird to read what you wrote about autistics and having emotions for abstracts, as I have always felt as some videogames "had a place in my heart". I still have some interest in spirituality, conspiracies, truth, herbs and things are getting better, but its a tough road. I want to try a good extract of Fo Ti, but I am currently in a trial of Cordyceps, Reishi and Jiaogulan for my bad sleep and adrenal fatigue which are more important than the hell of my mind and psyche, although knock on wood as the latter two are said to be good with that as well. I like horny goat for "stiffness"! LOL
 

Enid

Senior Member
Messages
3,309
Location
UK
Exploring that a little Redo - yes I was aware of it off and on and suspect some brain damage in the area involved. It is indeed a great relief when normal responses return again. Just don't worry - actually more compassionate than those about me - so one up. !
 

LaurieL

Senior Member
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447
Location
Midwest
I haven't read all the threads, but so much sounds familiar at one time for me. I have not seen oxytocin mentioned here. You may want to look into this.
 
Messages
17
I am experiencing the exact same blunted affect. I have very little emotions and feelings. T.V. shows and movies do not give me good or bad feelings, nor close friends and family. Honestly, at this point I wish I had at least some negative emotions. Having no emotions or feelings feels very dehumanizing and zombie-esque.
 

peggy-sue

Senior Member
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Location
Scotland
I feel the anhedonia being described by the OP is slightly different to the one I know from my experiences with clinical depression, which are described very accurately by this quote from Hip.

"anhedonia seems like all you reasons for living have been taken away"

- where suicide is very close and you spend all your time wishing you could just hurry up and die.

I can't feel sad when I have depression, I don't feel anything - not pain, hunger, cold or heat. No happiness, no sadness, just an unending nothingness.