..read case studies of people with anhedonia, their lives basically shrink over time ..
well when it comes to drug addicts and long term dopamine damage, ive read enough and talked to enough addicts to realize there is a loss of pleasure after using drugs for long periods..it does var from person to person, some may great recoveries..l some neuro-scientists like James Fallon believe that the dopamine or hedonic system was malfunctioning in addicts long before drugs were ever taken, hence the reason people started taking drugs in the first place..what he said makes sense..
I felt what I eventually realized was anhedonia at about the time I went through puberty. I always felt that something was "missing," something that other people "got." None of the drugs I did as a teenager did anything for me--I got high, of course, but nothing changed the way I felt at a fundamental level. Then, at 18, I discovered both heroin and IV drug user simultaneously, and everything changed. I truly felt like I had finally discovered the magic of the universe, so I chased that feeling from 1971 to 1993. I actually continued to chase it off and on up to the present time. Eventually I saw a very good psychiatrist in a dual-diagnosis treatment center who diagnosed me with dysthymia, which I may have spelled wrong. It's a lifelong form of unipolar depression that tends to begin in childhood or puberty and remains throughout a person's life, and its primary symptom is anhedonia. Eventually treating myself with IV heroin created consequences in my life that were greater than remaining somewhat flat, even with medication. Currently I'm on Suboxone maintenance, and have been for about 10 years. I'm also on Effexxor, and have been 'stable' on that for about 15. Since I've been sober (I consider being on maintenance not to affect my sobriety, since without either it or methadone I would never remain sober at all) for about 10 years and have tapered my Sub down from a start of 8-16 mg to less than 1 mg daily for the past three. I can tell the anhedonia has come back, but I'm not sure if I'm just going to accept it rather than change meds. I also have a lot of other health problems that limit my quality of life, and other than increase my Sub somewhat, if my doctor will go for it, or alternately get off it and see what that does, I'm just not sure what to do. The only things that I've found in recovery work that has been helpful is like herbavore talked about, going deep inside, which is something I'm doing with deep meditation, but it takes a long, long time to reap real benefits, and exercise. Anyone who has been on stimulants, or other drugs that alter your brain chemistry--which is all of them--is going to have altered brain chemistry for at least 5 years. The experts do say, that if you were normal when you started using stimulants, you should be able to get some decent increase in mood in about 6 months with exercise. When nothing feels good, the last thing anyone wants to do is exercise, but it does help. Can I do it every day? Hell no! But I know it helps when I get up and go at it. Some days, all I can do is lay in bed and and try not to think about killing myself, and hope that I feel better tomorrow. And today is one of those days for me...