Mental Health Getting off kratom? - a psychological dilemma: detailed discussion of mental illness

[candidsurprise]

So I know most people here view kratom as a milder drug, and the general perception is that it's easier to come off than almost any other drug. I agree fully that it is a mild drug in comparison to the major ones that I used to use, but my case is a lot more complicated and I will try to explain how. I have been suffering with severe MDD (Major 'Depressive' Disorder) for 5 or 6 years now, but the word 'depression' does not encapsulate what I experience. It is better described as follows: I experience subtle catatonic symptoms where I become basically bed bound for many hours at a time and I hardly eat or wash during these periods. I feel like the world around me has become grey and frightening, and when I wake up I feel this crushing feeling on my body. I have this constant feeling of inner tension and attacks of painful intrusive thoughts that are impossible to dismiss or eliminate in the moment. My movements slow down and I become hunched over. But the main and most brutal symptom of my illness is severe anhedonia. What this basically means is that I become completely unable to experience any pleasure at all. This means that if I try to listen to music, I can last 20 seconds before it actually causes me pain and frustration. If I try to socialise, rather than connection to others my mood plummets even more and I feel an intense craving to withdraw to a dark room. This applies to all activities and This is unbearable to deal with for long periods of time without relief. Even though this illness is quite uncommon, I am sure that many of you know what I mean by it.

So now I'll come to kratom - red strains of kratom are the only thing that I have found to improve my anhedonia symptoms by at least 30%, besides some other harder drugs. This means that I experience moments of enjoyment in certain things, so for example the right strain of kratom has allowed me to have a dating and sex life, it has allowed me to somewhat enjoy the World Cup (I used to love football), and it allows me to kinda sorta enjoy doing a few hobbies such as reading and academic interests. The improvement to my life in these areas has been a lifesaver for me, and I probably would have committed suicide a couple of years ago without it. I cannot explain in words what it feels like to go from that anhedonic state to having some enjoyment in life. It has also stopped me from taking hard drugs, along with improving my insomnia.

However, kratom is starting to cause me significant side effects. It is causing me significant dehydration, which sticks around no matter how much water I drink. This has ruined my skin amongst other consequences of dehydration. I also feel intense dysphoria and suicidal ideation if I skip a day, and the intensity of this is even worse than before my illness, so I take it every day. Luckily the same dose still works, I don't experience a substantial increase in tolerance. It has also reduced my testosterone levels. It also slightly destabilises my mood - as the dose wears off, I feel a bit dysphoric. Sometimes it makes me irritable. It also causes me to be excessively focused on specific tasks, which affects my ability to structure my day. To sum it up I am basically completely psychologically addicted to this substance that is causing me problems.

So the question is: should I come off kratom and go back to that unbearable state that I was in, whilst hoping that I can find an alternative treatment that works as well as kratom? Or should I accept the side effects of kratom for now and be grateful for the improvement in my core symptoms. I would love to hear your thoughts and experiences, and any advice that you may have. I should note that I have come off kratom a couple of times and could not mentally cope with the consequences of that, so I returned to it.

 

[candidsurprise]

A few comments on my experiences with other ways of treating anhedonic MDD:

No psychiatric medication that I have tried has improved this symptom by more than ~15% - so they work a little bit, but nowhere near enough. However certain meds have helped significantly with anxiety and mood. The problem is that these are peripheral symptoms of my condition and not the core ones. Psychological therapy does help with some of the symptoms such as self perception, but it doesn't touch my core illness symptoms - i.e. anhedonia, avolition, anergia; and this is pretty much expected since anhedonia is viewed by the medical community as as more biological issue within the brain (so called 'endogenous depression'). I recognise that it is possible that some kind of treatment combination could work to treat my symptoms very effectively, but it seems like an unlikely thing to me. I don't have access to a good psychiatrist and I have tried a lot of meds already.

 

[Lil'LinaptkSix]

Hi.
If you do decide to come off kratom please taper the dose til 1/2 or 1/4 gram a couple times a day for a few days befor droppning it. Do not suddenly stop it as this could bring withdrawals that may exacerbate the situation.
What other meds are you on and how did you get them? What I mean is were they prescribed by primary care provider, other doctor or are you self medicating?
I see a huge trend towards what you are going through and others globally including myself. As I used to feel almost super human, be able to take on anything and had a fairly optomistic outlook; I now feel like I am a waste of space and basically have little worth.
Have you had these depressive states for many years or have they fairly recently begun?
After becoming almost "paralyzed" mentally and unwilling to leave my place of "safety" I gave in to therapy with a psycologist. Over the last couple months I seem to be gaining back a bit of my former optimism and this is through basic talk therapy. Just unloading my deepest dark traumas and getting feedback while building somewhat of a support structure along the way.
BL has been a huge part of my ability to stay "afloat" but there came a time where I felt I could not carry anymore "weight" and sought out help through the social system to try to unload some old baggage because I need the room to make any headway and deal with some traumas/loss I can see coming in the future.
My therapist wants to start with EMDR therapy this week and I am going to give it a try as I am willing to try anything (sans meds) to try to get some of the weight off of me. It is crippling.
To boot I have applied several times to most all businesse around this dead ass town as working and working hard has always been a big help in my self-confidence... but sadly where I am is like a ghost town and not getting any callbacks or positive interviews has just added to my feeling of becomingba ghost myself and roaming to and fro in a state of limbo of sorts.
Is there access to maybe a psycologist for you? I mean spilling my guts here I have done for years yet it seems that talking to someone in person about what is going on may be having a more effective impact on my mental state so far. This may not last and may backfire at some point but as stated I am willing to try anything to regain some ground that has been lost in the last few years.
I only hope the best for you and the rest of us who are going through these crisis and also that whatever all that is going on in our environs that may be adding to or causing this influx of anxiety/depression/trauma gets flipped so that we all get a chance to heal.

 

[Basteel]

So I know most people here view kratom as a milder drug, and the general perception is that it's easier to come off than almost any other drug. I agree fully that it is a mild drug in comparison to the major ones that I used to use, but my case is a lot more complicated and I will try to explain how. I have been suffering with severe MDD (Major 'Depressive' Disorder) for 5 or 6 years now, but the word 'depression' does not encapsulate what I experience. It is better described as follows: I experience subtle catatonic symptoms where I become basically bed bound for many hours at a time and I hardly eat or wash during these periods. I feel like the world around me has become grey and frightening, and when I wake up I feel this crushing feeling on my body. I have this constant feeling of inner tension and attacks of painful intrusive thoughts that are impossible to dismiss or eliminate in the moment. My movements slow down and I become hunched over. But the main and most brutal symptom of my illness is severe anhedonia. What this basically means is that I become completely unable to experience any pleasure at all. This means that if I try to listen to music, I can last 20 seconds before it actually causes me pain and frustration. If I try to socialise, rather than connection to others my mood plummets even more and I feel an intense craving to withdraw to a dark room. This applies to all activities and This is unbearable to deal with for long periods of time without relief. Even though this illness is quite uncommon, I am sure that many of you know what I mean by it.

So now I'll come to kratom - red strains of kratom are the only thing that I have found to improve my anhedonia symptoms by at least 30%, besides some other harder drugs. This means that I experience moments of enjoyment in certain things, so for example the right strain of kratom has allowed me to have a dating and sex life, it has allowed me to somewhat enjoy the World Cup (I used to love football), and it allows me to kinda sorta enjoy doing a few hobbies such as reading and academic interests. The improvement to my life in these areas has been a lifesaver for me, and I probably would have committed suicide a couple of years ago without it. I cannot explain in words what it feels like to go from that anhedonic state to having some enjoyment in life. It has also stopped me from taking hard drugs, along with improving my insomnia.

However, kratom is starting to cause me significant side effects. It is causing me significant dehydration, which sticks around no matter how much water I drink. This has ruined my skin amongst other consequences of dehydration. I also feel intense dysphoria and suicidal ideation if I skip a day, and the intensity of this is even worse than before my illness, so I take it every day. Luckily the same dose still works, I don't experience a substantial increase in tolerance. It has also reduced my testosterone levels. It also slightly destabilises my mood - as the dose wears off, I feel a bit dysphoric. Sometimes it makes me irritable. It also causes me to be excessively focused on specific tasks, which affects my ability to structure my day. To sum it up I am basically completely psychologically addicted to this substance that is causing me problems.

So the question is: should I come off kratom and go back to that unbearable state that I was in, whilst hoping that I can find an alternative treatment that works as well as kratom? Or should I accept the side effects of kratom for now and be grateful for the improvement in my core symptoms. I would love to hear your thoughts and experiences, and any advice that you may have. I should note that I have come off kratom a couple of times and could not mentally cope with the consequences of that, so I returned to it.

I was thinking about trying it, but not so sure now

 

[Mjäll]

Have you had lowered testosterone confirmed? If so, what doses of kratom and for how long? (These questions are for my own curiosity, not intended as a guidance)

As for alternatives, my thought goes to weed immediately since you don't mention having tried and dismissed weed. It's been a great crutch for me with my depressive symptoms, while not as heavy of a baggage as an opioid habit (which kratom is). <edited out misleading information -SMod>

Other than that, substances like psychedelics might be another approach. Depression is often correlated with unprocessed emotions which therapy can help deal with, whether chemically facilitated or not.

Is there any actual evidence that anhedonia in particilar is endogenic and :"biological"? Oftentimes the medical community makes assumptions out of fear and prestige (conformism) just like any humans anywhere.

 

[Neuroborean]

have you tried calamus root?
in my experience is as good or better than kratom as an anti-depressant, my experience with kratom is that it CAUSES anhedonia when you're dependent on it... bad bad shit. I'm kicking it (3rd time in a year due to lack of motivation and lack of "brightness" in my life lately).

 

[Senior Moderator]

Have you had lowered testosterone confirmed? If so, what doses of kratom and for how long? (These questions are for my own curiosity, not intended as a guidance)

As for alternatives, my thought goes to weed immediately since you don't mention having tried and dismissed weed. It's been a great crutch for me with my depressive symptoms, while not as heavy of a baggage as an opioid habit (which kratom is).

Other than that, substances like psychedelics might be another approach. Depression is often correlated with unprocessed emotions which therapy can help deal with, whether chemically facilitated or not.

Is there any actual evidence that anhedonia in particilar is endogenic and :"biological"? Oftentimes the medical community makes assumptions out of fear and prestige (conformism) just like any humans anywhere.

Please be very careful when suggesting using drugs as "treatment" for any mental illness, as certain substances such as weed and psychedelics can exacerbate or induce mental illness in some people.

Certain psychedelics can be used to treat depression, PTSD, and other mental illnesses, yes, and this is a fascinating and exciting area of modern psychology that is being heavily researched and trialled. BUT it must be done in a controlled environment, with a trained clinician and in a clinical setting. You can't just recommend that someone go and take LSD and trip and expect to feel better, for example. Sure, this does help some people, but for others it can be disastrous.

So please be mindful of what you say in The Dark Side, as we take such things quite seriously in here.

 

[xtcgrrrl]

have you tried calamus root?
in my experience is as good or better than kratom as an anti-depressant, my experience with kratom is that it CAUSES anhedonia when you're dependent on it... bad bad shit. I'm kicking it (3rd time in a year due to lack of motivation and lack of "brightness" in my life lately).

WebMD lists calamus root as “likely unsafe” when taken by mouth, just FYI

 

[Neuroborean]

WebMD lists calamus root as “likely unsafe” when taken by mouth, just FYI

nah, it's not "likely unsafe", it's quite unsafe if you take more than you can take (I guess it's personal and depends on the batch) but you can take it very safely titrating up. If you take more than you can handle you end up vomiting violently, but that's not what happent to me, anytime.
Maybe it's because they did a study long time ago, and they saw that one of it (hundreds..) substances, asarone it's likely carcinogenic in absurd quantities, on its own and in rats. It's too much of a leap to jump to say it's dangerous for humans, once in a while and in normal quantities.
One must consider that rats/mouses are not physiologically able to puke so they just cannot expel toxic substances by that route, which makes some studies quite stupid, if one tries to "humanize" them.

I've always had a good, mild and rewarding experience with it. No side effects.

 

[candidsurprise]

What do you mean by causes anhedonia, as in you start to feel anhedonia whilst on kratom, or when kratom wears off/the next day anhedonia is worse?

have you tried calamus root?
in my experience is as good or better than kratom as an anti-depressant, my experience with kratom is that it CAUSES anhedonia when you're dependent on it... bad bad shit. I'm kicking it (3rd time in a year due to lack of motivation and lack of "brightness" in my life lately

 

[Neuroborean]

What do you mean by causes anhedonia, as in you start to feel anhedonia whilst on kratom, or when kratom wears off/the next day anhedonia is worse?

I mean that, like every other substance that hits dopamine, if you use it 24/7, once you are dependent on it, your dopamine receptors/release tend to compensate that over-activation and then they down-regulate.
Down regulation of dopamine can be the cause of anhedonia, and it's the case for me, very markedly in the withdrawal (that I'm on now, by the way) but also during the use dependence phase, overtime.

So to your questions, both could be the case, if you depend too much on it.

 

[plumbus-nine]

Did you ever try ketamine for its anti-depressant properties? It works even in therapy resistant cases, as should this new combo of detxromethorphan+bupropion (called Auvelity or something alike). It should work well for anhedonia and be non-addictive if used as proposed.

 

[Senior Moderator]

Did you ever try ketamine for its anti-depressant properties? It works even in therapy resistant cases, as should this new combo of detxromethorphan+bupropion (called Auvelity or something alike). It should work well for anhedonia and be non-addictive if used as proposed.

This is an excellent suggestion as there is a lot of solid research on ketamine as an alternative for treatment-resistant depression. However it is very important to note that using ketamine for depression must be done so ONLY under the supervision of a qualified practitioner e.g. a doctor, psychiatrist etc, who has been trained in using ketamine in this way. You can't simply buy street ketamine, use some recreationally and expect to feel better. (I mean, some people might feel better from this method, sure. But there are way too many variables if ketamine is used in a recreational setting in people with mental illness. It could actually exacerbate the mental illness or worse, induce new problems).

 

[candidsurprise]

Do you know if there's any evidence that kratom itself can cause an hedonic disorder whilst you are currently dependant on it? I mean it is not as simple as dopamine downregulating, THC acts on dopamine (as does the SSRI sertraline) and there was a study released by UCL (University College London) a couple of months back which found that there was no correlation between daily cannabis use and anhedonia. In fact the cannabis users had less anhedonia than the control subjects. If there was some scientific evidence that kratom does or does not cause anhedonia then this would probably crystallise my decision about what to do.

Down regulation of dopamine can be the cause of anhedonia, and it's the case for me, very markedly in the withdrawal (that I'm on now, by the way) but also during the use dependence phase, overtime.

So to your questions, both could be the case, if you depend too much on it

 

[candidsurprise]

Did you ever try ketamine for its anti-depressant properties? It works even in therapy resistant cases, as should this new combo of detxromethorphan+bupropion (called Auvelity or something alike). It should work well for anhedonia and be non-addictive if used as proposed.

Yes I've used it once per week and it helped a little bit, I noticed that my disorder would deteriorate if I stopped doing it for a few weeks. It only improves my symptoms by 15% or so though

 

[JackARoe]

Do you know if there's any evidence that kratom itself can cause an hedonic disorder whilst you are currently dependant on it? I mean it is not as simple as dopamine downregulating, THC acts on dopamine (as does the SSRI sertraline) and there was a study released by UCL (University College London) a couple of months back which found that there was no correlation between daily cannabis use and anhedonia. In fact the cannabis users had less anhedonia than the control subjects. If there was some scientific evidence that kratom does or does not cause anhedonia then this would probably crystallise my decision about what to do.

The problem with anhedonia is it is subjective. I don't think we can prove something causes it for sure. I had anhedonia once after a methadone kick and it lasted about 3 weeks. I have never had it from kratom or anything else really. I mean there is certainly the boredom that comes with an opiate type kick so I have had that. However I will say this, whenever I did kick opiates in the past I would take a psychedelic about one month post kick and that always awoke my spirit a bit. The statement being that vision creates power. Not saying that is necessary especially when one is not experienced.

I will say, if a person doesn't need kratom then stay away. If it is a step up then go for it. Some of us have come from much deeper addictions so like for me I don't get too many side effects. For me kratom causes some anxiety in me that seems to die down after it leaves my system. So I too can get some weird effects. Nothing too worrysome though. Been using on and off since 2006.

One last suggestion, if a person does utilize it don't take it every few hours. Space it out. That has helped me a lot.

Also mixing a bunch of meds can cause its own issues.

 

[Neuroborean]

Do you know if there's any evidence that kratom itself can cause an hedonic disorder whilst you are currently dependant on it? I mean it is not as simple as dopamine downregulating, THC acts on dopamine (as does the SSRI sertraline) and there was a study released by UCL (University College London) a couple of months back which found that there was no correlation between daily cannabis use and anhedonia. In fact the cannabis users had less anhedonia than the control subjects. If there was some scientific evidence that kratom does or does not cause anhedonia then this would probably crystallise my decision about what to do.

I mean,
as you say, it's not that simple as saying, doing something around dopamine agonism causes anhedonia,
I think it's not as simple as that, kratom acts on adrenergic receptors, mu-opioid, some serotonin subreceptors and also D2 (as I remember).
It's common that people that use antipsychotics and some people that uses certain SSRIs or SNRIs develop anhedonia at a certain time.
I wouldn't say, ok, it's only because of dopamine, it can be some receptors related with antipsychotic action or even serotonin/dopamine imbalance.
I can say something for sure: if I take more kratom, instead of less I get more spacey, and more anhedonic. Normally "spacey" means serotonin... but... who knows what's really going on?

If you go to the subreddit of quittingkratom you'll see a lot of people complaining about anhedonia. I know it's a negative echochamber in some ways, but it's pretty common as a complaint, so probably there's something about it.

Another possibility of the cause of anhedonia it's hormone dysregulation (testosterone drop).