Need Help [ANHEDONIA QUESTION] - Should I stay away from SSRIs and SNRIs? How about Tianeptine?

[ContemporaryCaveman]

Hello

Unfortunately, I have been dealing with Anhedonia for over a year and a half now. I am basically bored with everything - Nothing to look forward to and nothing to enjoy in the present. I just don't seem to enjoy things anymore.

Filling my day with activities feels like a chore. Some days are better than others. Everything feels harder.

Why did this happen - A few ideas:

I am 29 - and have been exercising and eating pretty healthy throughout my 20s. So this can't be the problem.

A few years ago I had half of my thyroid removed due to a nodule - My TSH is now around 3 vs 1 pre-op, but I am supplementing to get my TSH back to how it once was. This could be a lead, but I've been supplementing for a few months now and can't see a lot of success

Weed - PORN - MASTURBATION - I had, for 1-2 years, a really bad habit of watching porn and smoking weed in the evening - and masturbating. For hours on end. 3-4 hours. Every evening. I gave up this habit a year ago.

Nicotine - Nicotine affects me differently. It's easy for me to quit smoking. I started smoking just before I started experiencing this anhedonia - I could feel my anhedonia growing 'stronger' the more I smoked. Weird. I gave up smoking around 4 months - still the same issues. Also smoking always made me anxious. First time I've started - fight or flight states when smoked

I took Aceylcysteine for a year - around 1.2g per day (this could lower glutamate levels but I doubt this is the case) - gave up on it a year ago

Can't think of anything else

What meds did I try:

My first med was Fluoxetine - Shortly after I started feeling like this. Took it for around 6 months and didn't notice any benefit.

Then right after I gave up on it, in November last year, I got on Bupropion - 150mg and sometimes 300mg a day. Took this until March. Didn't notice much to be honest.

I have also been prescribed methylphenidate which helps a bit but not a lot - I'm not taking it anymore because I don't want to fuck up my dopamine receptors even more.

--------

I honestly don't know if I should pursue meds anymore or try behavioral activation; change my attitude towards anhedonia, do more CBT/therapy, and so on.

However, I've talked with my psych and I don't know - I keep hearing how SSRIs and SNRIs are bad for anhedonia because they themselves can cause emotional numbing.

Bupropion, as I said didn't help me.

My psychiatrist is open-minded and is open to suggestions but in our last session she recommended Tianeptine. This seems to be a weak agonist of MU opioid receptors which I can see it working, but I don't want to do even further damage and desensitize my opioid receptors.

I don't know honestly where to go from here. Any advice? Stories? I wonder if I should give Tianeptine a try - or try more meds, other SSRIS, etc.

Thank you

 

[cdin]

Hello

Unfortunately, I have been dealing with Anhedonia for over a year and a half now. I am basically bored with everything - Nothing to look forward to and nothing to enjoy in the present. I just don't seem to enjoy things anymore.

Filling my day with activities feels like a chore. Some days are better than others. Everything feels harder.

Why did this happen - A few ideas:

I am 29 - and have been exercising and eating pretty healthy throughout my 20s. So this can't be the problem.

A few years ago I had half of my thyroid removed due to a nodule - My TSH is now around 3 vs 1 pre-op, but I am supplementing to get my TSH back to how it once was. This could be a lead, but I've been supplementing for a few months now and can't see a lot of success

Weed - PORN - MASTURBATION - I had, for 1-2 years, a really bad habit of watching porn and smoking weed in the evening - and masturbating. For hours on end. 3-4 hours. Every evening. I gave up this habit a year ago.

Nicotine - Nicotine affects me differently. It's easy for me to quit smoking. I started smoking just before I started experiencing this anhedonia - I could feel my anhedonia growing 'stronger' the more I smoked. Weird. I gave up smoking around 4 months - still the same issues. Also smoking always made me anxious. First time I've started - fight or flight states when smoked

I took Aceylcysteine for a year - around 1.2g per day (this could lower glutamate levels but I doubt this is the case) - gave up on it a year ago

Can't think of anything else

What meds did I try:

My first med was Fluoxetine - Shortly after I started feeling like this. Took it for around 6 months and didn't notice any benefit.

Then right after I gave up on it, in November last year, I got on Bupropion - 150mg and sometimes 300mg a day. Took this until March. Didn't notice much to be honest.

I have also been prescribed methylphenidate which helps a bit but not a lot - I'm not taking it anymore because I don't want to fuck up my dopamine receptors even more.

--------

I honestly don't know if I should pursue meds anymore or try behavioral activation; change my attitude towards anhedonia, do more CBT/therapy, and so on.

However, I've talked with my psych and I don't know - I keep hearing how SSRIs and SNRIs are bad for anhedonia because they themselves can cause emotional numbing.

Bupropion, as I said didn't help me.

My psychiatrist is open-minded and is open to suggestions but in our last session she recommended Tianeptine. This seems to be a weak agonist of MU opioid receptors which I can see it working, but I don't want to do even further damage and desensitize my opioid receptors.

I don't know honestly where to go from here. Any advice? Stories? I wonder if I should give Tianeptine a try - or try more meds, other SSRIS, etc.

Thank you

Anhedonia is a real bitch. I went through five years of it with cPTSD. Have you considered that the problem may be more psychologically/soulfully based? —— in my situation what got me through was martial arts and Buddhist meditation. Then, finally got an ibogaine treatment and that resolved things fairly completely.


Just to say — if it were me I’d be focusing on those things as opposed to adding more drugs to a clearly non drug responding mental condition

 

[ContemporaryCaveman]

Anhedonia is a real bitch. I went through five years of it with cPTSD. Have you considered that the problem may be more psychologically/soulfully based? —— in my situation what got me through was martial arts and Buddhist meditation. Then, finally got an ibogaine treatment and that resolved things fairly completely.


Just to say — if it were me I’d be focusing on those things as opposed to adding more drugs to a clearly non drug responding mental condition

Five years? Holy shit man. That must've been rough

I'm glad you said that - That's actually the main thing I am considering - not relying so much on meds and trying lifestyle changes - attitude, therapy like behavioral activation
At the same time I didn't want to miss that 'window of opportunity' or so - they say depression responds better when treated early, although I'm not really sure I'm depressed

 

[cdin]

it was. almost ended my life. I had to take things into my own hands, re-create my narrative about myself and work on really implementing mindfulness and taking care of myself. it's amazing what that will do.

 

[Jerry Atrick]

Hello

Unfortunately, I have been dealing with Anhedonia for over a year and a half now. I am basically bored with everything - Nothing to look forward to and nothing to enjoy in the present. I just don't seem to enjoy things anymore.

Filling my day with activities feels like a chore. Some days are better than others. Everything feels harder.

Why did this happen - A few ideas:

I am 29 - and have been exercising and eating pretty healthy throughout my 20s. So this can't be the problem.

A few years ago I had half of my thyroid removed due to a nodule - My TSH is now around 3 vs 1 pre-op, but I am supplementing to get my TSH back to how it once was. This could be a lead, but I've been supplementing for a few months now and can't see a lot of success

Weed - PORN - MASTURBATION - I had, for 1-2 years, a really bad habit of watching porn and smoking weed in the evening - and masturbating. For hours on end. 3-4 hours. Every evening. I gave up this habit a year ago.

Nicotine - Nicotine affects me differently. It's easy for me to quit smoking. I started smoking just before I started experiencing this anhedonia - I could feel my anhedonia growing 'stronger' the more I smoked. Weird. I gave up smoking around 4 months - still the same issues. Also smoking always made me anxious. First time I've started - fight or flight states when smoked

I took Aceylcysteine for a year - around 1.2g per day (this could lower glutamate levels but I doubt this is the case) - gave up on it a year ago

Can't think of anything else

What meds did I try:

My first med was Fluoxetine - Shortly after I started feeling like this. Took it for around 6 months and didn't notice any benefit.

Then right after I gave up on it, in November last year, I got on Bupropion - 150mg and sometimes 300mg a day. Took this until March. Didn't notice much to be honest.

I have also been prescribed methylphenidate which helps a bit but not a lot - I'm not taking it anymore because I don't want to fuck up my dopamine receptors even more.

--------

I honestly don't know if I should pursue meds anymore or try behavioral activation; change my attitude towards anhedonia, do more CBT/therapy, and so on.

However, I've talked with my psych and I don't know - I keep hearing how SSRIs and SNRIs are bad for anhedonia because they themselves can cause emotional numbing.

Bupropion, as I said didn't help me.

My psychiatrist is open-minded and is open to suggestions but in our last session she recommended Tianeptine. This seems to be a weak agonist of MU opioid receptors which I can see it working, but I don't want to do even further damage and desensitize my opioid receptors.

I don't know honestly where to go from here. Any advice? Stories? I wonder if I should give Tianeptine a try - or try more meds, other SSRIS, etc.

Thank you

Hey there, welcome to Bluelight. Nearly 20 years ago I had medication induced anhedonia from being injected with Risperdal, an anti-psychotic. It eventually subsided but I don't think your case is the same. A couple years ago I was fairly abruptly switched from Duloxetine to Lithium. Immediately afterward I became exhausted every day, like taking naps all the time and lacking energy. The reason I became tired all the time was because Lithium was affecting my thyroids and gave me hypothyroidism. I'm sure had it lasted longer, it probably would have led to anhedonia. The doc gave me the option of quitting Lithium or starting thyroid meds. I chose to switch from Lithium to something else and the problem went away.

My entire point is that if your anhedonia and lack of motivation is from your thyroid issues, then psychiatric meds have nothing to do with it. I agree with @cdin that martial arts and other physical activity can work wonders for one's mood; however, if we are talking about thyroid issues, exercise may not be an option until that is resolved.

I am not a doctor or medical professional but I do know what I might do in this situation. First off, do you have a mental diagnosis or is your doc prescribing all these psych meds for the anhedonia? I would keep getting blood tests to keep an eye on my thyroid levels. I would want to rule that out before starting any psych meds that are intended to "treat" this condition. In fact, after successfully treating the thyroids and ruling them out, then I would try the physical activity, diet, and mindfulness. Maybe even talk therapy. After all those options are exhausted and the anhedonia still isn't gone, then maybe as a last resort I might seek help with psych meds. And I wouldn't rush through any of those steps. It might take months of therapy or a few weeks of thyroid treatment to make all the difference. Just gotta take it one day at a time.

 

[cdin]

fully could be thyroid or another genuine physical issue,