Posted by Onestone on March 30, 2009, at 15:58:02
In reply to Re: Why is anhedonia regarded as a part of depress, posted by Zana on March 30, 2009, at 12:22:24
Hi, Z,
Thanks for the reply!
> It seems to me that you are asking a chicken and egg question here. Which came first the anhedonia or the depression and that you are struggling to diagnose yourself.
More, I was putting around the idea for discussion, that anhedonia could be a condition distinct from depression, that it should be studied in its own right, and regarding it merely as a facet of depression or a type of depression has inhibited the development of effective treatment.
> If by anhedonia you mean that you do not take pleasure in anything, it sounds to me like you are depressed.
I am most assuredly depressed, though the severity of my depression goes up and down from year to year dependent on other things. It's pretty bad at the moment. ;-(
> Anhedonia is actually not part of the diagnostic criteria for a major depressive episode - "markedly diminished interest or pleasure in all, or almost all activites of most days, nearly every day" is how the DSM IV puts it. Is that what you are experiencing?
Almost. "markedly diminished" doesn't really apply, since there hasn't been a higher level to diminish from, except for a couple of days in the last 30 years or so, and one of those came from an opioid pain killer after I'd injured myself. "Episode" sort of implies something of a timescale of weeks or months rather than decades.
> It sounds like Wellbutrin is not the right drug for you or that you need something in addition.
Why do you say this? The idea of prescribing it, my idea really, was to test whether a dopmaine deficiency was the cause. So far, the drug has been of some limited help, and the side effects seem tolerable, so far.
> You do not mention having anxiety so I would agree that ADs at the more stimulating end of the spectrum might be helpful. Have you tried any other meds?
Over the years, several SSRIs, one MAOI, possibly a tricyclic, all of which had side effects worse than any benefits. More recently Edronax, which was frighteningly bad, and Venlafaxine, which was just horrible. Only St. John's wort was really any use at all, but not by much.
Were you thinking of any drug in particular? My problem seems to be a genetic one which has been in the family for generations. It may afflict men worse than women, and is a lifelong curse rather than something which occurs in episodes.
> Zana
--
Onestone.
poster:Onestone
thread:887696
URL: http://www.dr-bob.org/babble/20090330/msgs/887774.html