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Apathy, anhedonia, emotional numbness, emotional anesthesia

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theelt712

Thank you, Cymbalta.

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cymbaltawithdrawal5600

Really, theelt? Oh please sweetie,, I'd like to think I did something 'helpful' because right now, I cannot even help myself.

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theelt712

I know that I can't help myself either, but maybe the ideas there will be useful for teens suffering from anhedonia.

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cymbaltawithdrawal5600

It wasn't just the 'teen' part, per se. It was the 'constant need for stimulation' that the writer was getting at. That, in the absence of stimulation that 'the internet' and electronic devices bring, we become habituated to 'outside stimulation' and the feelings those stimulations bring. When those things no longer give a sense of relief, or NOTHING does, we give a name to the feeling we are left with and one of it's labels is 'anhedonia'.

 

Don't forget, I am a 'child of the internet' too. I just started later in life. There was probably, in my life, an adequate balance of 'nature stuff' and other: TV, books, etc. My dad was a 'nature nut'. Nowadays, I tend to run to my computer to 'fix what ails me', instead of going for a walk, immersing myself in 'petting my cat', cleaning the house. All of those take you out of your 'mind' and into your body and the world of 'sense' (sensory). The internet keeps you focused mainly in your 'mind'.

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Barbarannamated

Really, theelt? Oh please sweetie,, I'd like to think I did something 'helpful' because right now, I cannot even help myself.

I relate to this feeling.

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cymbaltawithdrawal5600

Barb, I hope you are not 'feeling' it too, because I feel really, really bad right now. No appetite, no motivation, tearful and irritable,yada yada I am DEPRESSED. That's what this feels like, it's not anhedonia. Good old garden variety depression, my life companion. I have not made any progress at all.

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SigmundFreud

Hi all. I think my new waves now consists of symptoms resembling somewhat cyclothymia. what are the things i can do or supplements i can take to help when i feel that 'blah' that the mood cure was talking about. I think I am already overstimulated and I use taurine, GABA, propranolol, and xanor when i get back to anxiety/panic symptoms. i tend to get stimulated on b-complex, fish oil, st. johns wort, and sam-e. Im waiting on my order of d-phenylalanine because in the mood cure, it turned out i might be low on endorphins after all the painful things that happened to me. any inputs will be greatly appreciated. hang in there guys lets help each other in our journey towards healing.

Edited by SigmundFreud

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JanCarol

Wow, I was sent here because on my "intro thread" I mentioned lack of pleasure in anything.  What I'm hearing here is anhedonia, lack of pleasure, and depression, lack of motivation.  Or maybe I am just conditioned, after decades of depression, to make myself do things, even when there is no apparent benefit, reward, or emotional stroke?  I gave up on sex over a decade ago because I just couldn't feel anything.

 

The best description I've heard in here (sorry it was pages ago) was "Danger?  Really? I'll just watch and see what happens, because to do something would take too much involvement, commitment"  (paraphrased)

 

But I take that back.  I do feel things.  I feel sadness, loss, disgust, annoyance, anger, all those negative emotions.  But not all of them.  It is as though they are at the bottom of the well, and the well is my body, and I can glimpse the thing that is "disturbing the waters" and maybe identify it, but I don't really touch what I suffer from.

 

And the anhedonia:  this is, to me - a trip to the hairdressers.  Gonna get a nice new 'do.  I have to do it, since I lost my thyroid, my hair gets really unmanageable (those of you who cut it off in tangles, I empathize).  So this girl1s fingers are running through my hair, shampoo, hot water, no pleasure.  I remember when this would bring tingles up and down my arms, and a sigh would escape my breath.  Now, nothing.

 

Same with massage.  I thought I would test it and went for a relaxing Bali massage (not an intense, pounding, take your breath away remedial massage).  I could not wait until the girl stopped touching me.  I actually prefer the intense pounding remedial massage, because then I feel SOMETHING, even if it is pain.

 

That is the hug that people want from me, and I give it, but cannot wait until it is over.  That is the kiss that, "kissing 2 minutes a day will heal any relationship", I feel him responding and feeling it, and it is nothing to me.  Nothing.  Just a wet messy motion with my lips and mouth, are we done yet?  When I see kissing or sex scenes on TV, it is like being an alien watching the mating habits of another species.  "What odd things they do with their mouth, what strange ways they have to express their feelings!"

 

As for what I see here as depression:  the "give-a-yhit-a-tude" that makes you do things, get up and go.  Sometime in the 90's I decided that to do one thing a day was good.  Whether that was work, or exercise, taking a bath/shower, or dinner with friends - I didn't distinguish because I got similar reward from all.  Today it is an appointment with the dietitian, I will write more about that in my intro thread.  SOME DAYS I actually do two things, like yesterday was a trip to the chemist and going to a test at my karate school (not my test, just the littlies getting their first belt).  Both were fairly low key, but involved talking to people, thinking of things to say (especially when the kids got discouraged).

 

And doing one thing a day, is like clawing my way back out of the well.  I still am waiting for the good feelings - you see - I don't trust them.  I equate intense, good feelings with manic episodes, and wonder when the axe is going to fall.  Maybe I hold myself back from all feelings because of this.  Maybe I feel safe with "negative" feelings because that's "depression" and cannot be manic.  And it's held true, the last good feelings I had were in 1995 and a few trickles after that for a few years.  And 1995 was my "documented manic episode."

 

When I see hubby doing 10 things in a day, I am in awe of him, and I also wish he could scale back because I think it's too much and is running him down.

 

Decision making:  I made up a little OCD thing in the 1980's.  There is a random number (between 1 and 9) for each day.  Today's number is 8.   When I cannot make a decision, such as what to wear, I just count 8 from the last thing I wore, and wear it.  If I don't LIKE the decision, then I am pleased:  OMG, I have an opinion about this! and am free to make another decision.  That's why it's not really OCD, because it's just a guideline, not carved in stone.  Then I don't spend hours paralysed in front of the closet or fridge or CD collection, I just choose one and go.  (this does not work as well for major decisions, just the minor ones which can trip you up)

 

I'm just starting my first taper, but I've been on and off antidepressants for 30 years, and have no way to know what was actual depression, what was situational, and what was my brain screaming for fresh chemicals after the last antidepressant was gone.

 

I hope these items fit this topic, thank you for listening.

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RebelMaven

It is like I am just blank.  I had so many wonderful interests and hobbies.  Now I am so flat.  I'm not interested in anything.  I keep trying to get interested in something but I don't know what interests me anymore.  I feel like I have to force myself to find something but it is jut not happening.  I think about starting up my old interests but most of them I can't do and the others just don't interest me any longer.  I am so stuck.

 

Yet I am so bored I could scream.

 

How do you figure out what you are interested in when you are so flat line?

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Barbarannamated

RM,

This is probably my worst symptom at 2+ years after DCing Pristiq and Vyvanse. The apathy/ emotional anesthesia /anhedonia leads to excruciating boredom for me. Complicating matters, I lost my career (and life structure, coworker friends) several years ago and it's SO difficult to force myself out of the house to do things on my own that bring no pleasure, satisfaction or sense of accomplishment or reward.

 

I have little natural curiosity any longer. Actually, it comes and goes in tiny spurts but there's no "flow". There's another thread that discusses the loss of ability to follow through on ideas or projects, which, I think, is a bit different. Most have said this does come back, but life feels very flat in the meantime.

 

Link to thread referenced:

 

http://survivingantidepressants.org/index.php?/topic/1203-disconnect-between-interest-and-actionmotivation/

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RebelMaven

Yep.  That's me.  Very similar to you.

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pinkpeony

All you can do is calm yourself and find what pleasure you can, however dilute. Slowing down your mind to be in the moment helps a lot. Your ability to enjoy will come back, slowly.If you've got a camera, take pictures of things that strike you as interesting, lovely, or funny, and look at them later. They will remind you it's not all dull and gray, there are glimmers of pleasure here and there.

Wow. I really love this idea!! 

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Needmylifeback

When they upped my buspar nov 23 (to 30mg am/15mg pm) I went dead numb. My son came to tell me in person that the drs had found two cancerous lesions on his head and neck.... He just turned 25yr old, has been married almost three years, just had his first baby ~preemie in march, and started law school this past august.

 

He fully expected me to be emotionally fragile as I have been since the dog accident 2008. But I had nothing!! I felt flat. Nothing at all. That was when I was sure this drug was not good for me!! Although I had enjoyed the break from the tears and emotional upheaval!!! But being totally flat is not healthy at all.... So I began reading all I could on buspars side effects.

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NoMeaning25

These people are 6-8-10 years off (Druid, Buxy etc) and still have anhedonia, DR/DP, apathy i cant live like this for 10 years :'( oh no this is just too much to handle

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Newbeginning

Hello everyone,

 

I'm new here :). Just started on the withdrawal wagon a few weeks ago, under dr supervision.

 

I read through all the thread about "anhedonia"/demotivation/apathy. I can identify with much of what was said. I still have to wonder though, how can we be sure it is not a symptom of depression?

 

Depression can manifest in a lot of ways and "atypical depression" often involves fatigue and apathy.

 

It's also entirely possible that atypical depression is a result of chronic antidepressant use. In my own experience, lack of motivation often emerged after starting SSRIs and seeing improvement in the most severe symptoms (lack of appetite, anxiety, crying spells, insomnia, guilt, rumination). After about 6-8 weeks on the SSRRI, these symptoms would improve and be replaced with apathy. I always assumed it was a residual symptom of depression (that is, a symptom that didn't respond to the antidepressant). However, these symptoms would typically not improve on antidepressants.

 

I also noticed these symptoms got worse over the years. With any new episode of depression treated effectively with SSRIs, the residual apathy seemed worse.

 

I eventually got to a point when the apathy was so bad that I couldn't shower or do my school work even when it was late. Deadlines and bad consequences had no effect on me, other than the dread that came after the fact when I realized I would have to face my failures in front of others, with no reasonable explanation. I dreaded facing others, knowing they would think I was lazy or irresponsible.

 

It's then that I started wondering if the SSRIs might be making the apathy worse, because this episode of worse apathy coincided with a time when I took an SSRI at a much higher dose and for a much longer time than I usually did. The nurse just refused to lower the dose or help me quit. Every time I brought up the topic she made it clear she was not supportive of the idea because I risked a relapse into worse depressive symptoms. I didn't know what I was getting in and was too busy (and not assertive enough) to insist, so I let it go. That's how I ended taking 200mg zoloft for about 1 year and 10 months. 

 

Anyway, back to the apathy, the only thing that helped me was taking Nuvigil (a stimulant) 3-4 times a week. I know it is not a long term solution, but it's the only thing that helps me function. I don't take it everyday and can often go several days without taking it and still have less apathy. I basically use it to get me going and then the things that I get done help my mood further and further reduce the apathy. So I depend on it to fight the apathy, but I do the work too.

 

I think it's important for us who are going through this to keep an open mind and don't just assume it's only withdrawal and/or assume all we can do is wait to detox or wait for the brain to naturally regain balance. I'm not denying the horrible toll that withdrawal from antidepressants can take! What I'm saying is that there are many other factors at play that affect our brain health and they should not be dismissed. It is empowering to know we're not passive in this process. The brain has an immense potential to adapt (so-called brain plasticity) and anything we learn literally changes the connections between neurons and increases brain mass. We should not underestimate the power we have in shaping our brain through changes in cognition, behaviors, experiences, learning, nutrition, exercise, meditation, relationships, spirituality and so much more.

 

I read with interest the information on fish oil and magnesium on this forum (still reading). Fish oil helped me with motivation long time ago when the apathy was not as bad as it is now. I'm starting a new trial with a higher dose to support my brain in regaining balance. Will comment on that thread another day too.

 

One thing I recommend to anyone having any symptoms of depression (including apathy) is to get checked for possible physical causes once a year: thyroid, sex hormones, anemia, B 12 level, vitamin d level. Each of these things can cause symptoms of clinical depression.

 

At least in my own case, It's hard to tell if the apathy is due to withdrawal. It could be depression, a consequence of chronic antidepressant use, or even something else. I would be very interested in hearing how you found out the apathy was due to withdrawal.

 

Best wishes to all of you. I'm learning from everything you share and hope I can be of help too.

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daisy33

Im glad to hear Im not the only one who cannot make decisions. I am made fun of for it...but to honest, I cant make a decision because I dont really care. I find that I often just dont care about things that everyone else enjoys. What is odd--is that I am sad that I dont care...? WTF? I feel like its a sick joke. Not only do I not really enjoy anything, but I also have to feel sorry for myself for not enjoying it! AHH.

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daisy33

Has anyone had significant relief from accupuncture? How long did you have to go?

 

Can anyone recommend something else to cure severe anhedonia? (besides counseling...already doing that).

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Jemima

I'm sorry to say that there is nothing we know of to get past anhedonia, and it's often the very last symptom to go away.  I've been off of Lexapro for over two and a half years and am not yet back to normal in that respect. I get glimmerings of my old creative urges from time to time and I know that it will all come back eventually, but being patient isn't easy!

 

BTW, I merged your topic about acupuncture and anhedonia with the main discussion on anhedonia so that all comments and questions will be in one place.

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Newbeginning

Fish oil helped me with lack of motivation the first time I took it. It took about 2 months before I noticed the effect. I was taking a lower dose of zoloft and the oil.

 

Now I took it again years later when I was on withdrawal and it did not make a difference.

 

I suppose if the problem is due to ssri use, which it often is, it could get better as you reduce the dose. Several case reports in the research literature suggest that. If the problem is due to withdrawal, it seems from what people share here that it typically takes longer.

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lundeliz

I haven't read this whole topic, but I'm getting a little worried about my lack

 

of motivation. I can just lie on the bed all day long, and feel no motivation

 

to get up and do something. This is not the real me. I had lots of hobbies and

 

interests before withdrawal. When I do get up, my fatigue is so bad I don't stay

 

up long. It seems like activity stirs up my anxiety. I guess it's too much

 

stimulation for my nervous system. I'm almost 7 months off of Cymbalta. Should

 

I be worried about not doing more, or should I just assume that my nervous system

 

just isn't ready? Will my motivation just come back with time? Is it okay to just

 

lay low and let things heal or should I be doing something differently to get well?

 

I'm thinking about this because some of my family is now thinking I'm just depressed

 

and need to be getting out and doing things. It has me wondering if I'm just depressed,

 

although I wasn't depressed before Cymbalta. Just wondering what others here think.

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Newbeginning

Hi Lundeliz,

 

I have not read your intro post yet, but based on your post here and your signature, the lack of motivation could very well be due to withdrawal. Or it could be something else.

 

When exactly did it start? Was it accompanied with other symptoms like changes in your appetite or sleep? Inappropriate guilt or crying spells?

 

Have you gotten a medical check recently? You need to check your hormones, b level, anemia, because all that can affect mood.

 

Once you discard a medical reason, you can assess if it is depression, a normal reaction to what you have been through, or withdrawal.

 

All the best,

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SouthernFreeze

It doesn't sound as bad as some of the previous story's but think i a'm starting to see this anhedonia and apathy as a symptom that comes with the waves now..... Well i have always been a person who has no enthusiasm when it comes to anything at all really, even when i a'm actually enthusiastic about it. I get hassled about it at work and that's why people basically walk all over me.

 

But i a'm starting to notice periods (like recently) where i just can't be ****. I just can't be bothered doing anything at all, but i have a physical job and i have to work which gets me in the **** because i'm lazy and put no effort in. As bad as it is i think the actual having a job and having to do something helps more than sitting at home doing nothing. This also comes with a "floating anxiety" and very high irritability. 

Edited by Petu
graphic language

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Newbeginning

In your case the apathy might be the result of long term ssri use rather than withdrawal Southernfreeze. If you have the energy but not the motivation, you can try some form of behavioral therapy to increase motivation. You basically commit to certain healthy behaviors and practice them repeatedly to increase motivation.

 

Since you also have emotional problems like anxiety/irritability, it might also be that you're stressed or burned out by the job. Has something increased your stress level recently?

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Muddles

I think anheodinia in depression is so different to drug induced/withdrawel.

 

It's one of my worst symptoms and has got to the point of not being able to cry. I've lost every single human emotion possible....like a robot. I have to check my heart sometimes - check I'm still alive.

 

This makes it so hard to interact with people and avoid going out which I know its something we shouldn't do.

 

Let us know if acupuncture helps you. I hate the apathy part too.

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Newbeginning

I think there is a difference between emotional numbness, anhedonia and apathy, at least based on my own experience and what I've read. They may tend to occurr together and overlap, but they're different.

 

I know this was mentioned before in this thread. Emotional numbness is what you just described: the inability to feel strong positive or negative emotions or to react with emotion to situations that normally trigger an emotional response.

 

Anhedonia is a decreased ability to feel pleasure from doing/experiencing things that were previously pleasurable.

 

Apathy is lack of motivation and/or drive. In more extreme cases, one could say it's a lack of will.

 

One way in which I have learned to distinguish when these symptoms are due to depression vs chronic use of SSRIs/withdrawal, is that in depression cognitive or behavioral changes can lead to some improvement, but ssri-induced symptoms seem a lot more biologically-based.

 

For instance, when you have depression you don't enjoy things the same, but sometimes if you make yourself do something positive, you find that you enjoyed it more than you thought you would. Doing it also increases motivation because you get a sense of reward from doing it. By contrast, ssri-related apathy does not lead to a sense of reward, so doing positive things does not have the same positive effect on our capacity to experience pleasure or our motivation.

 

Similarly, I was able to push myself to do things even when I was severely depressed because of the anxiety of anticipating negative consequences. In SSRI-related apathy there is no anticipation of harm (there is cognitively but not emotionally), so negative consequences don't have the same motivating effect.

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SouthernFreeze

wow that last post was really interesting, i'm not sure i can pin point which one i'm going through as of yet...it's kind of a mix

I think it might be emotional numbness and depression, i'm not sure. Last week i was feeling too much emotion and sleep was more the problem...wtf

Sometimes i think reading this forum and constantly trying to pinpoint what symptoms are what can make it worse, some times maybe it's better just to go with the flow and try not worry about it so much.

 

Anyway to answer your last questions NewBegining, everything's been pretty cruisy at work apart from last friday...but it wasn't even a bad day, it's just like all my effort to keep a mindful out look to protect my self from any bad thinking just went out the window, ending in me being super stressed and strung out over nothing. (i'm dreading how i will react day when something bad or stressful does actually happen)

 

I will have to look at "behavioral therapy", i don't think i have ever heard of it

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Newbeginning

Hi Southernfreeze,

 

Anxiety is a very sneaky emotion. Sometimes avoiding sources of anxiety actually increases it, and it's better to expose ourselves very gradually to the source of our fear. Other times it's better to get distracted or stop the negative thoughts because they tend to amplify the emotion and get us stuck in cycles of unhealthy rumination.

 

If you have never tried cognitive or behavioral therapy, this is a good online resource for cognitive exercises: Both moodgym and ecouch might help: https://moodgym.anu.edu.au/welcome

 

This has some behavioral strategies you can try. One of my favourites (and it has worked for me to reduce anxiety) is "worry time", but there are others you can try: https://www.onlinetherapyuser.ca/downloads/wellbeing/Worry.pdf

 

http://www.cci.health.wa.gov.au/resources/infopax.cfm?Info_ID=46

 

This website has a lot of good cognitive behavioral strategies. A lot of the content is free: http://www.anxieties.com/1/free#.U6qOAijLL2Q

 

I have had reduced anxiety from regularly practicing deep breathing. Check the 3 steps they describe here to learn more about how to use breathing or other systematic relaxation exercises to reduce anxiety. It works very well for a lot of people: http://www.anxieties.com/114/gad#.U6qM2ijLL2Q

 

This is also a good resource: http://www.psychologytoday.com/blog/in-practice/201212/cognitive-behavioral-skills-youll-need-beat-anxiety

 

Finally, this is a good self help book for cognitive therapy for anxiety and depression: http://www.amazon.com/Feeling-Good-The-Mood-Therapy/dp/0380810336/ref=pd_bxgy_b_img_y

 

If you have never tried cognitive behavioral therapy, it can make a big difference on your anxiety level. Choose a couple of the resources above and give them a try. You might need to try a few things before youy find something that works, and make sure you give it a few weeks before giving up. Some things need regular practice to give results.

 

Hope some of this helps,

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SouthernFreeze

yeah i have been through that cognitive stuff thoroughly over years from seeing psychologist. I think i have practised just about every exercise mentioned at some point in my life. I have a folder packed with exercises, but for some reason (even though they really helped me open my eyes) i never got any major progress out of them.

 

Maybe i didn't give things enough practice though.....well i did really, but maybe i need to try again. Maybe ill try some of those exercises again, maybe it will be more efficient when i'm not so drugged up on effexor

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Newbeginning

 

 

 

The cognitive exercises do require practice to work, and they certainly don't work for everyone. Have you tried breathing or relaxation training?

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SouthernFreeze

yeah i have tried some breathing ones, not sure about relaxation ones. I find breathing meditation more useful.

 

i did practice different cognitive exercises, but it has been awhile.  

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Newbeginning

If a therapist is accessible to you at all, it's worth giving it a second try. I would make sure it's a therapist with a lot of experience in cognitive behavioral therapy. Doing it with a therapist ensures you practice regularly, give it enough time, receive support through it, do it the right way and have more choices of strategies to try.

 

Also, some people respond more to behavioral strategies than cognitive ones and that may be the case with you.

 

After taking medicine for so long, you might have to re-train your brain to cope with negative emotions and also to re-experience positive emotions.

 

Depression itself numbs emotions. Medicine numbs them even more. It might seem like we're feeling a lot because we're anxious or sad or angry, but at the same time we may lack the capacity for joy and for being truly engaged in life.

 

Have you ever heard of Mindfulness based cognitive therapy? It might be something that works for you.

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SouthernFreeze

I'm not sure why i didn't receive your reply in e mail.........anyway

 

Yeah i assure you the psychologists i have seen have been good at cognitive therapy, and i would see them twice a week for about 3-4 months. I would pass and would ask for a different one if they didn't work out for me.

 

I think your right as in saying i should see someone and try the therapy again. I have felt like i have needed to but have just lost a lot of trust in people and kind of wouldn't even know where to start when telling my story..and of cause just even having the "get go" to get it organized. All so the whole "been there done that didn't work" feeling, but it is a totally different situation this time round.

 

I totally get what your saying about retraining your emotions. One thing i a'm noticing is that even though i feel 20 times more anxious and so forth, i feel like it's REAL and if i over come it, it will actually be over come! not just numbed. Which is why i a'm making a conscious effort to notice when i a;m starting to fall into that spiral of depression after the anxiety situations that trigger it...as hard as it is.

 

I have actually been recommended someone to see, i have no idea what they specialize in though. I think your right in that i give it a try again..the "Mindfulness based cognitive therapy" sound reaaally interesting, but the town i live in is pretty small so i would have to be lucky to find someone who specializes in that i think.

 

I just ordered a book about being assertive, this is something i really need to address also that coincides with the anxiety......just thought i would throw that in there

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schizor

someone please help. I cant feel anything, I cant relate to my family. its like I am a different person since i started zyprexa I cant remember who I am.There is no point in living like this.

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SouthernFreeze

Oh man i can relate, the last three days it has hit me again. I have family coming down tomorrow and i'm dreading it. How can you talk and be sociable when you don;t even know who you are? I just want to lie in bed.

 

I suppose in your case you better look up how and why you should get off zyprexa on this forum. Also read the previous posts if Anhedonia or apathy are what your worried about.

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Newbeginning

Why are you taking zyprexa schizor? Do you absolutely need it? Do you get any benefit from it?

 

Have you talked to your dr about this?

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