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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by pseudoname on October 26, 2005, at 14:53:51
I've noticed for years that "good" events in my life, including almost any small success (in social, work, financial, educational, family, relationship, status, aesthetic, personal, intellectual, creative, housekeeping, trivial, etc areas), ends up making me feel immediately TERRIBLE! So I avoid good events, which means I end up hiding in my house doing nothing as much as possible.
Does this bizarre reaction happen to anyone else? Have you taken any med that worked on this??
I figured it was an over-sensitive reward system regulator, and I thought the opiate antagonist naltrexone might help with that, but it didn't. I just finished a 35-day trial of it at 50 mg/day. I wasn't taking any other drug with it and I have no history of opiate use.
Afterward I tried several days of late-night low-dose naltrexone (3-6 mg), which also has had no effect.
I guess endorphins respond rather slowly in the brain (is that true?), so my IMMEDIATE bad reaction to good things may not be related to any opiate stuff.
Any thoughts??
Posted by lunesta on October 26, 2005, at 19:13:33
In reply to good events feel BAD, posted by pseudoname on October 26, 2005, at 14:53:51
LOW dose naltrexone takes some months to work for some people, but it increases endorphins, enkelphins and all, immune system etc.. it can effect mood, sleep everything. You need to give LDN a fair trial but ive never heard of this being used like this. I am very well versed with LDN. You are taking 4.5mg at night after 9PM, and before 1AM, correct? It will only work at this dose and time in general.
Posted by UgottaHaveHope on October 27, 2005, at 0:06:15
In reply to good events feel BAD, posted by pseudoname on October 26, 2005, at 14:53:51
Oh I know too well how you feel. With me, I had felt bad for so long that it felt awkward or weird when good things were happening. The bad felt normal, and the good abnormal. It was, of course, a great lie.
What you have to do is the hardest thing on here, at least to me, even harder than going through the meds. YOU NEED TO WORK ON YOUR THINKING PATTERNS. You need to change the way you look at things, perceive an event. If 99 out 100 things go right, you need to think "I had a great day" rather than "why did that one thing go wrong."
It is soooo tough. It is a battle of the mind. And it takes practice. Improvement takes a while. You did not get into this situation overnight and you will not get out of it as quick.
However, trust me, there is HOPE. You can do it, if you so desire. It will be hard, but worth it. E-mail me if you need any thought exercises at sportscarvell@aol.com
Posted by pseudoname on October 27, 2005, at 10:47:48
In reply to Re: Yes, that makes sense, posted by UgottaHaveHope on October 27, 2005, at 0:06:15
"Ugotta", ;)
Thanks for the cognitive advice. I've used & believed in CBT and thought-management techniques for years. I think they can be very helpful.
But what I'm trying to describe is a different sort of experience. My bad reaction to good things comes independently of my thoughts about the situation. It's like an autonomic adrenaline surge or insulin release, but it releases foul feelings.
For example, I may sincerely think, "That went well. Good!" But horrid private responses out of nowhere flood me.
I've looked for unconscious motivations for it as well. I could literally have bought a small house for what I've spent over the years on psychoanalysis and related therapies. But I'm now convinced that it is some kind of dysregulation in some neural arena.
Thanks for the personal offer, though. Very supportive.
Posted by Declan on October 28, 2005, at 3:45:54
In reply to good events feel BAD, posted by pseudoname on October 26, 2005, at 14:53:51
(Just kidding) You're not talking about ambivalence are you?
Declan
Posted by pseudoname on October 28, 2005, at 10:59:38
In reply to Since you mention psychoanalysis » pseudoname, posted by Declan on October 28, 2005, at 3:45:54
Declan, thanks for your response.
> You're not talking about ambivalence are you?
No. More like...
When some people look into bright light, they sneeze. I look at some good development and start having very strong, foul feelings unrelated to any other ideas or attitudes I may have. It's a post-hoc thing.
In psychoanalytic ambivalence (as I understand it), two opposing inclinations or feelings about something come into conflict over some possible future action – a choice. I don't really have opposing feelings. I cognitively evaluate a situation as "good" and start having bad feelings.
Having mixed feelings is something else, too. I don't seem to have *mixed* feelings when the foulness starts. It comes out of nowhere and increases the more I see that I've succeeded or whatever.
This is why I think it's maybe a reward system dysregulation. As the brain detects some good event, it triggers certain neurons to release DA or endorphins or whatever. I think in *my* brain, instead of detecting that release as a normal thing, my brain says, "Whoa! Too much!" and reverses the reward action until I feel WORSE than before.
Such a dysregulated response could get mistaken for ambivalence or unconscious self-destructive motivation or cognitive filtering or some other hypothesized psychological construct, and I have often tried to explain it in such terms. But the physiological theory fits my experience much better.
I don't remember ever reading anything that described what I'm trying to talk about. I was hoping that this might ring a bell for someone out there in Babbleland. Surely, I'm not the only one who experiences this.
Posted by zeugma on October 29, 2005, at 6:00:35
In reply to good events feel BAD, posted by pseudoname on October 26, 2005, at 14:53:51
People with ADHD (including myself) often report feeling worse after achieving something.
ADHD is definitely a dysregulation that involves the reward system.
Ritalin was helpful for this negative affect in response to positive events.
The negative response, in ADHD, correlates exactly with the amount of effort used to obtain the positive result. This can easily be (and in the infernal dungeons of the past, was) explained as perverse motivation or will to failure. Cognitive behavioral therapy carries on this tradition, as my extremely dysphoric reaction to it testifies.
One theory (Hermann van Praag's) hold that norepinephrine is responsible for the level of reward experienced through activities, but I have not found this to be true. norepinephrine is more about survival instincts (which I am happy to have), but dopamine definitely is responsible for pleasure experienced through activities. I don't know much about the opioid system except that Strattera has an opioid effect that made me very, very depressed after a while.
The last paragraph of your post is the giveaway. Dopamine governs immediate responses.Sorry, if I am incoherent, have a lot on my mind right now myself...
-z
Posted by pseudoname on October 29, 2005, at 11:02:53
In reply to ADHD?, posted by zeugma on October 29, 2005, at 6:00:35
zeugma, I appreciate your post very much.
I had not heard ADHD described as reward-system related, but then, I haven't paid much attention to ADHD. (Er, no pun intended.) But this is a very interesting idea.
I've never been diagnosed with ADHD and I don't have trouble concentrating or sticking to task -- EXCEPT when anticipation of success (and the foul reaction that may follow it) scares me off.
And the only thing in 18 years of drug treatment for depression that has helped me was Ritalin! But I develop tolerance to it quickly and had to keep upping the dose, and it has a crash period when it wears off every day that's awful. I haven't tried the newer, longer-lasting versions.
I've recently tried Adderall XR, which I take sparingly and have not gotten caught in tolerance with. It also doesn't give me a bad crash afterward. I only take it on horribly depressed mornings, and I haven't been paying any attention to whether it affects the post-achievement foulness. It does not seem to improve things in the same way that Ritalin did. I will start paying attention to those aspects. Maybe I should give Ritalin another go.
> The last paragraph of your post is the giveaway. Dopamine governs immediate responses.
I've tried Wellbutrin a couple times over the years, hoping to boost the dopamine side, but except for helping me sleep much better (an unusual effect, I guess), it didn't help. Maybe I should consider combining Wellbutrin and a stimulant. Anyone have experience with that?
> Strattera has an opioid effect that made me very, very depressed after a while.
I haven't tried Strattera. I wonder what the bad opioid effect was. I don't seem to find anything Googling <strattera opioid>.
> One theory (Hermann van Praag's) hold that norepinephrine is responsible for the level of reward experienced through activities
I assume all the transmitter flavors are interconnected in most responses and that as individuals we may have a dysfunction along any particular line. Tweaking one type may catalyze others, or something like that. So I don't rule out anything. But neither SSRIs, NRIs or Wellbutrin have helped me.
Incidentally, I just found that von Praag has ideas about psychiatric diagnosis that I endorse: he's against diagnositic splintering, for the patient's subjective experience, and for focusing on functional impairments. Amen.
> Sorry, if I am incoherent, have a lot on my mind right now myself...
Far from incoherent. I appreciate you taking the time to pass these thoughts on to me. You've given me a lot to look into; I am more hopeful now.
Please take care and hang in there.
Posted by alohashirt on October 31, 2005, at 20:55:18
In reply to ADHD?, posted by zeugma on October 29, 2005, at 6:00:35
Very interesting to hear your Strattera experience. I stopped Strattera a month ago because I couldn't afford it and I have felt much better since stopping it. I don't know why. didn't expect it but I won't question teh miracle. Much more cheerful, happy and productive. I don't know why.
> People with ADHD (including myself) often report feeling worse after achieving something.
>
> ADHD is definitely a dysregulation that involves the reward system.
>
> Ritalin was helpful for this negative affect in response to positive events.
>
> The negative response, in ADHD, correlates exactly with the amount of effort used to obtain the positive result. This can easily be (and in the infernal dungeons of the past, was) explained as perverse motivation or will to failure. Cognitive behavioral therapy carries on this tradition, as my extremely dysphoric reaction to it testifies.
>
> One theory (Hermann van Praag's) hold that norepinephrine is responsible for the level of reward experienced through activities, but I have not found this to be true. norepinephrine is more about survival instincts (which I am happy to have), but dopamine definitely is responsible for pleasure experienced through activities. I don't know much about the opioid system except that Strattera has an opioid effect that made me very, very depressed after a while.
>
>
> The last paragraph of your post is the giveaway. Dopamine governs immediate responses.
>
> Sorry, if I am incoherent, have a lot on my mind right now myself...
>
> -z
>
Posted by zeugma on October 31, 2005, at 22:48:34
In reply to very interesting » zeugma, posted by pseudoname on October 29, 2005, at 11:02:53
hi pseudoname, this is the Strattera opioid reference:
Bioorg Med Chem Lett. 2004 Aug 2;14(15):4083-5. Related Articles, Links
Synthesis and biological evaluation of the major metabolite of atomoxetine: elucidation of a partial kappa-opioid agonist effect.Creighton CJ, Ramabadran K, Ciccone PE, Liu J, Orsini MJ, Reitz AB.
Drug Discovery, Johnson and Johnson Pharmaceutical, Research and Development, Spring House, PA 19477-0776, USA. ccreight@prdus.jnj.com
The major human metabolite of atomoxetine (4-hydroxyatomoxetine) was tested against a panel of receptors and enzymes, and was found to interact with the mu, delta, and kappa-opioid receptors based upon studies involving both binding and functional assays. 4-hydroxyatomoxetine was determined to be a partial agonist of the kappa-opioid receptor.>>
-z
Posted by pseudoname on November 1, 2005, at 10:57:12
In reply to Re: very interesting » pseudoname, posted by zeugma on October 31, 2005, at 22:48:34
zeugma, thanks for the link. I hadn't tried Strattera and I'm not quite as interested in it having read that summary.
For those browsing just this post: Strattera (atomoxetine) was shown to activate kappa opioid receptors on neurons. Kappa receptors are associated with reducing reward processes in the brain. Obviously, Strattera may still do particular individuals a lot of good.
Posted by Paulbwell on November 3, 2005, at 1:17:43
In reply to Strattera and kappa receptors » zeugma, posted by pseudoname on November 1, 2005, at 10:57:12
> zeugma, thanks for the link. I hadn't tried Strattera and I'm not quite as interested in it having read that summary.
>
> For those browsing just this post: Strattera (atomoxetine) was shown to activate kappa opioid receptors on neurons. Kappa receptors are associated with reducing reward processes in the brain. Obviously, Strattera may still do particular individuals a lot of good.
This compound is the oldest and one of the MOST effective in adults.If this alone is not working, at doses suggested, PDR, 60mgs and i know pwople who have taken 40mgs 3x daily=120ms Dex, EVEN 1 individual who has a rapid matobilism-apparently, who was taking 60mgs 4x daily=240mgs!!
Then Desoxyn, Methylphetylamphetamine, Desoxyn, 5mg tabs, is the final resort for this disorder.
If this proves ineffective, i would question the diagnosis?=as Desoxyn is as potent as it gets.
Cheers
Posted by pseudoname on November 3, 2005, at 8:37:31
In reply to Dextroamphetamine, or? » pseudoname, posted by Paulbwell on November 3, 2005, at 1:17:43
> If this proves ineffective, i would question the diagnosis
Paul, I'm not quite sure what you mean. A diagnosis of ADHD? or depression?
This is the end of the thread.
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