u/Diksup

I’ll provide the specifics at the end.
I’m 33m and I’ve had issues with chronic throat clearing since early teens. Feel like a lump of phlegm at the back of my throat that won’t move. Sometimes I’m able to cough up phlegm but most of the time it’s too deep to cough up, so I have fits of having to keep clearing my throat constantly, not just because of the annoying sensation but also because the phlegm would often drip onto my vocal cords after a while and make me choke the next time I spoke.
I’ve gone to several ENTs starting around 2008 age around 14 and none of them have helped at all. They’ve said it’s acid reflux, but I never had any improvement with antacids. They said it was an auditory tic and sent me to a speech therapist. They said it was stress and I got meds for that too. None of it worked and I’ve basically concluded that it’s either all in my head and I’m nuts, or it’s abnormality of my throat itself, like excess tissue or even polyps or pockets of skin that get stuck with mucus, 🤷‍♂️. But no one has been able to see it.
Well last year I was finally diagnosed with severe obstructive sleep apnea, and am currently using a CPAP machine. I knew I had it for a while, because friends and family have told me that I snore louder than they’ve ever heard or thought possible, and sometimes stop breathing for long periods and gasp for air. And I even remember waking up several times gasping, with the sensation that I was about to suffocate. Scary stuff. Well the sleep centers are so small and backed up that you have to wait 6-8 months just to schedule to first visit. As is common with my ADHD, I of course missed the appointment and had to wait another 6 months. But at that time I had a new job with insurance that didn’t cover any local sleep specialists, so things were put on hold for a while. Eventually I get Medicaid and was able to schedule again, I got a sleep study, results were 67 breathing events per hour which is very high. My throat collapses while sleeping and causes ridiculous snoring and periods where my throat is closed completely.
I hate the CPAP, but the specialist told me it would help and to give it a chance. But I toss and turn in my sleep, and I like to cuddle with my dog, and so none of the masks I tried were comfortable at all. I finally found a nasal mask that is acceptable, but still very inconvenient and awkward. Plus, I still snore and my breathing events are still usually above 10.
Its dawned on me that my 20 year chronic throat clearing is related to my Sleep Apnea. But I’ve had the CPAP for 8 months and my throat clearing hasn’t improved. I have another appointment with specialist in a month or 2, but at our last appointment she said that a dental device would be the next try, then possibly the inspire device. Well I’ve been doing some research about the correlation between obstructive sleep apnea and chronic throat clearing, and I kind of doubt either will work. My opinion is that my throat has an abnormality that have been making me miserable for the last 20 years, and has also caused sleep apnea as well. I’ve read that the throat closing up can cause a vacuum effect that can suck stomach acid into the throat and irritate it, which is why I wake up with a throat full of thick phlegm that I spend all day clearing.
I think surgery will be the best option to try to end all of it. I’m wondering if any ENT experts here have heard of this or have any advice as to how to convince the sleep specialist to consider this, and try to get me approved for a surgery? Anyone else here had these two symptoms severely? Thank you for any help. Thank you.
Details: I have Obstructive Sleep Apnea, HBP, and several psychological disorders (not Tourette’s or tic disorder) I had a stutter when I was around 6 or 7 but I grew out of it with speech therapy for a year or two. Meds for HBP, a stimulant ADHD med, an NDRI, an SSRI, a mood stabilizer, an antihistamine for anxiety and sleep, and Multivitamin. Cannabis and Alcohol used regularly, but throat problems started in early teens when I was on Adderall for ADHD, but years before any other meds or recreational substance use.

I’ll provide the specifics at the end.
I’m 33m and I’ve had issues with chronic throat clearing since early teens. Feel like a lump of phlegm at the back of my throat that won’t move. Sometimes I’m able to cough up phlegm but most of the time it’s too deep to cough up, so I have fits of having to keep clearing my throat constantly, not just because of the annoying sensation but also because the phlegm would often drip onto my vocal cords after a while and make me choke the next time I spoke.
I’ve gone to several ENTs starting around 2008 age around 14 and none of them have helped at all. They’ve said it’s acid reflux, but I never had any improvement with antacids. They said it was an auditory tic and sent me to a speech therapist. They said it was stress and I got meds for that too. None of it worked and I’ve basically concluded that it’s either all in my head and I’m nuts, or it’s abnormality of my throat itself, like excess tissue or even polyps or pockets of skin that get stuck with mucus, 🤷‍♂️. But no one has been able to see it.
Well last year I was finally diagnosed with severe obstructive sleep apnea, and am currently using a CPAP machine. I knew I had it for a while, because friends and family have told me that I snore louder than they’ve ever heard or thought possible, and sometimes stop breathing for long periods and gasp for air. And I even remember waking up several times gasping, with the sensation that I was about to suffocate. Scary stuff. Well the sleep centers are so small and backed up that you have to wait 6-8 months just to schedule to first visit. As is common with my ADHD, I of course missed the appointment and had to wait another 6 months. But at that time I had a new job with insurance that didn’t cover any local sleep specialists, so things were put on hold for a while. Eventually I get Medicaid and was able to schedule again, I got a sleep study, results were 67 breathing events per hour which is very high. My throat collapses while sleeping and causes ridiculous snoring and periods where my throat is closed completely.
I hate the CPAP, but the specialist told me it would help and to give it a chance. But I toss and turn in my sleep, and I like to cuddle with my dog, and so none of the masks I tried were comfortable at all. I finally found a nasal mask that is acceptable, but still very inconvenient and awkward. Plus, I still snore and my breathing events are still usually above 10.
Its dawned on me that my 20 year chronic throat clearing is related to my Sleep Apnea. But I’ve had the CPAP for 8 months and my throat clearing hasn’t improved. I have another appointment with specialist in a month or 2, but at our last appointment she said that a dental device would be the next try, then possibly the inspire device. Well I’ve been doing some research about the correlation between obstructive sleep apnea and chronic throat clearing, and I kind of doubt either will work. My opinion is that my throat has an abnormality that have been making me miserable for the last 20 years, and has also caused sleep apnea as well. I’ve read that the throat closing up can cause a vacuum effect that can suck stomach acid into the throat and irritate it, which is why I wake up with a throat full of thick phlegm that I spend all day clearing.
I think surgery will be the best option to try to end all of it. I’m wondering if any ENT experts here have heard of this or have any advice as to how to convince the sleep specialist to consider this, and try to get me approved for a surgery? Anyone else here had these two symptoms severely and figured out why?
I’m not asking for a diagnosis or medical advice, only personal experience with chronic cough combined with Sleep apnea, which are both chronic illnesses. What kind of doctor did you see for these problems? Did you have results with any therapies or surgeries? Did you notice stress or diet or certain meds or other factors helped you more than others? These are chronic illnesses for me so I just want some questions for anyone in a similar situation. TY.

I’ll provide the specifics at the end.
I’m 33m and I’ve had issues with chronic throat clearing since early teens. Feel like a lump of phlegm at the back of my throat that won’t move. Sometimes I’m able to cough up phlegm but most of the time it’s too deep to cough up, so I have fits of having to keep clearing my throat constantly, not just because of the annoying sensation but also because the phlegm would often drip onto my vocal cords after a while and make me choke the next time I spoke.
I’ve gone to several ENTs starting around 2008 age around 14 and none of them have helped at all. They’ve said it’s acid reflux, but I never had any improvement with antacids. They said it was an auditory tic and sent me to a speech therapist. They said it was stress and I got meds for that too. None of it worked and I’ve basically concluded that it’s either all in my head and I’m nuts, or it’s abnormality of my throat itself, like excess tissue or even polyps or pockets of skin that get stuck with mucus, 🤷‍♂️. But no one has been able to see it.
Well last year I was finally diagnosed with severe obstructive sleep apnea, and am currently using a CPAP machine. I knew I had it for a while, because friends and family have told me that I snore louder than they’ve ever heard or thought possible, and sometimes stop breathing for long periods and gasp for air. And I even remember waking up several times gasping, with the sensation that I was about to suffocate. Scary stuff. Well the sleep centers are so small and backed up that you have to wait 6-8 months just to schedule to first visit. As is common with my ADHD, I of course missed the appointment and had to wait another 6 months. But at that time I had a new job with insurance that didn’t cover any local sleep specialists, so things were put on hold for a while. Eventually I get Medicaid and was able to schedule again, I got a sleep study, results were 67 breathing events per hour which is very high. My throat collapses while sleeping and causes ridiculous snoring and periods where my throat is closed completely.
I hate the CPAP, but the specialist told me it would help and to give it a chance. But I toss and turn in my sleep, and I like to cuddle with my dog, and so none of the masks I tried were comfortable at all. I finally found a nasal mask that is acceptable, but still very inconvenient and awkward. Plus, I still snore and my breathing events are still usually above 10.
Its dawned on me that my 20 year chronic throat clearing is related to my Sleep Apnea. But I’ve had the CPAP for 8 months and my throat clearing hasn’t improved. I have another appointment with specialist in a month or 2, but at our last appointment she said that a dental device would be the next try, then possibly the inspire device. Well I’ve been doing some research about the correlation between obstructive sleep apnea and chronic throat clearing, and I kind of doubt either will work. My opinion is that my throat has an abnormality that have been making me miserable for the last 20 years, and has also caused sleep apnea as well. I’ve read that the throat closing up can cause a vacuum effect that can suck stomach acid into the throat and irritate it, which is why I wake up with a throat full of thick phlegm that I spend all day clearing.
I think surgery will be the best option to try to end all of it. I’m wondering if any ENT experts here have heard of this or have any advice as to how to convince the sleep specialist to consider this, and try to get me approved for a surgery? Anyone else here had these two symptoms severely? Thank you for any help. Thank you.
Details: I have Obstructive Sleep Apnea, HBP, and several psychological disorders (not Tourette’s or tic disorder) I had a stutter when I was around 6 or 7 but I grew out of it with speech therapy for a year or two. Meds for HBP, a stimulant ADHD med, an NDRI, an SSRI, a mood stabilizer, an antihistamine for anxiety and sleep, and Multivitamin. Cannabis and Alcohol used regularly, but throat problems started in early teens when I was on Adderall for ADHD, but years before any other meds or recreational substance use.

I’ll provide the specifics at the end.
I’m 33m and I’ve had issues with chronic throat clearing since early teens. Feel like a lump of phlegm at the back of my throat that won’t move. Sometimes I’m able to cough up phlegm but most of the time it’s too deep to cough up, so I have fits of having to keep clearing my throat constantly, not just because of the annoying sensation but also because the phlegm would often drip onto my vocal cords after a while and make me choke the next time I spoke.
I’ve gone to several ENTs starting around 2008 age around 14 and none of them have helped at all. They’ve said it’s acid reflux, but I never had any improvement with antacids. They said it was an auditory tic and sent me to a speech therapist. They said it was stress and I got meds for that too. None of it worked and I’ve basically concluded that it’s either all in my head and I’m nuts, or it’s abnormality of my throat itself, like excess tissue or even polyps or pockets of skin that get stuck with mucus, 🤷‍♂️. But no one has been able to see it.
Well last year I was finally diagnosed with severe obstructive sleep apnea, and am currently using a CPAP machine. I knew I had it for a while, because friends and family have told me that I snore louder than they’ve ever heard or thought possible, and sometimes stop breathing for long periods and gasp for air. And I even remember waking up several times gasping, with the sensation that I was about to suffocate. Scary stuff. Well the sleep centers are so small and backed up that you have to wait 6-8 months just to schedule to first visit. As is common with my ADHD, I of course missed the appointment and had to wait another 6 months. But at that time I had a new job with insurance that didn’t cover any local sleep specialists, so things were put on hold for a while. Eventually I get Medicaid and was able to schedule again, I got a sleep study, results were 67 breathing events per hour which is very high. My throat collapses while sleeping and causes ridiculous snoring and periods where my throat is closed completely.
I hate the CPAP, but the specialist told me it would help and to give it a chance. But I toss and turn in my sleep, and I like to cuddle with my dog, and so none of the masks I tried were comfortable at all. I finally found a nasal mask that is acceptable, but still very inconvenient and awkward. Plus, I still snore and my breathing events are still usually above 10.
Its dawned on me that my 20 year chronic throat clearing is related to my Sleep Apnea. But I’ve had the CPAP for 8 months and my throat clearing hasn’t improved. I have another appointment with specialist in a month or 2, but at our last appointment she said that a dental device would be the next try, then possibly the inspire device. Well I’ve been doing some research about the correlation between obstructive sleep apnea and chronic throat clearing, and I kind of doubt either will work. My opinion is that my throat has an abnormality that have been making me miserable for the last 20 years, and has also caused sleep apnea as well. I’ve read that the throat closing up can cause a vacuum effect that can suck stomach acid into the throat and irritate it, which is why I wake up with a throat full of thick phlegm that I spend all day clearing.
I think surgery will be the best option to try to end all of it. I’m wondering if any ENT experts here have heard of this or have any advice as to how to convince the sleep specialist to consider this, and try to get me approved for a surgery? Anyone else here had these two symptoms severely? Thank you for any help. Thank you.
Details: I have Obstructive Sleep Apnea, HBP, and several psychological disorders (not Tourette’s or tic disorder) I had a stutter when I was around 6 or 7 but I grew out of it with speech therapy for a year or two. Meds for HBP, a stimulant ADHD med, an NDRI, an SSRI, a mood stabilizer, an antihistamine for anxiety and sleep, and Multivitamin. Cannabis and Alcohol used regularly, but throat problems started in early teens when I was on Adderall for ADHD, but years before any other meds or recreational substance use.

I’ll provide the specifics at the end.
I’m 33m and I’ve had issues with chronic throat clearing since early teens. Feel like a lump of phlegm at the back of my throat that won’t move. Sometimes I’m able to cough up phlegm but most of the time it’s too deep to cough up, so I have fits of having to keep clearing my throat constantly, not just because of the annoying sensation but also because the phlegm would often drip onto my vocal cords after a while and make me choke the next time I spoke.
I’ve gone to several ENTs starting around 2008 age around 14 and none of them have helped at all. They’ve said it’s acid reflux, but I never had any improvement with antacids. They said it was an auditory tic and sent me to a speech therapist. They said it was stress and I got meds for that too. None of it worked and I’ve basically concluded that it’s either all in my head and I’m nuts, or it’s abnormality of my throat itself, like excess tissue or even polyps or pockets of skin that get stuck with mucus, 🤷‍♂️. But no one has been able to see it.
Well last year I was finally diagnosed with severe obstructive sleep apnea, and am currently using a CPAP machine. I knew I had it for a while, because friends and family have told me that I snore louder than they’ve ever heard or thought possible, and sometimes stop breathing for long periods and gasp for air. And I even remember waking up several times gasping, with the sensation that I was about to suffocate. Scary stuff. Well the sleep centers are so small and backed up that you have to wait 6-8 months just to schedule to first visit. As is common with my ADHD, I of course missed the appointment and had to wait another 6 months. But at that time I had a new job with insurance that didn’t cover any local sleep specialists, so things were put on hold for a while. Eventually I get Medicaid and was able to schedule again, I got a sleep study, results were 67 breathing events per hour which is very high. My throat collapses while sleeping and causes ridiculous snoring and periods where my throat is closed completely.
I hate the CPAP, but the specialist told me it would help and to give it a chance. But I toss and turn in my sleep, and I like to cuddle with my dog, and so none of the masks I tried were comfortable at all. I finally found a nasal mask that is acceptable, but still very inconvenient and awkward. Plus, I still snore and my breathing events are still usually above 10.
Its dawned on me that my 20 year chronic throat clearing is related to my Sleep Apnea. But I’ve had the CPAP for 8 months and my throat clearing hasn’t improved. I have another appointment with specialist in a month or 2, but at our last appointment she said that a dental device would be the next try, then possibly the inspire device. Well I’ve been doing some research about the correlation between obstructive sleep apnea and chronic throat clearing, and I kind of doubt either will work. My opinion is that my throat has an abnormality that have been making me miserable for the last 20 years, and has also caused sleep apnea as well. I’ve read that the throat closing up can cause a vacuum effect that can suck stomach acid into the throat and irritate it, which is why I wake up with a throat full of thick phlegm that I spend all day clearing.
I think surgery will be the best option to try to end all of it. I’m wondering if any ENT experts here have heard of this or have any advice as to how to convince the sleep specialist to consider this, and try to get me approved for a surgery? Anyone else here had these two symptoms severely? Thank you for any help. Thank you.
Details: I have Obstructive Sleep Apnea, HBP, and several psychological disorders (not Tourette’s or tic disorder) I had a stutter when I was around 6 or 7 but I grew out of it with speech therapy for a year or two. Meds for HBP, a stimulant ADHD med, an NDRI, an SSRI, a mood stabilizer, an antihistamine for anxiety and sleep, and Multivitamin. Cannabis and Alcohol used regularly, but throat problems started in early teens when I was on Adderall for ADHD, but years before any other meds or recreational substance use.

I’ll provide the specifics at the end.
I’m 33m and I’ve had issues with chronic throat clearing since early teens. Feel like a lump of phlegm at the back of my throat that won’t move. Sometimes I’m able to cough up phlegm but most of the time it’s too deep to cough up, so I have fits of having to keep clearing my throat constantly, not just because of the annoying sensation but also because the phlegm would often drip onto my vocal cords after a while and make me choke the next time I spoke.
I’ve gone to several ENTs starting around 2008 age around 14 and none of them have helped at all. They’ve said it’s acid reflux, but I never had any improvement with antacids. They said it was an auditory tic and sent me to a speech therapist. They said it was stress and I got meds for that too. None of it worked and I’ve basically concluded that it’s either all in my head and I’m nuts, or it’s abnormality of my throat itself, like excess tissue or even polyps or pockets of skin that get stuck with mucus, 🤷‍♂️. But no one has been able to see it.
Well last year I was finally diagnosed with severe obstructive sleep apnea, and am currently using a CPAP machine. I knew I had it for a while, because friends and family have told me that I snore louder than they’ve ever heard or thought possible, and sometimes stop breathing for long periods and gasp for air. And I even remember waking up several times gasping, with the sensation that I was about to suffocate. Scary stuff. Well the sleep centers are so small and backed up that you have to wait 6-8 months just to schedule to first visit. As is common with my ADHD, I of course missed the appointment and had to wait another 6 months. But at that time I had a new job with insurance that didn’t cover any local sleep specialists, so things were put on hold for a while. Eventually I get Medicaid and was able to schedule again, I got a sleep study, results were 67 breathing events per hour which is very high. My throat collapses while sleeping and causes ridiculous snoring and periods where my throat is closed completely.
I hate the CPAP, but the specialist told me it would help and to give it a chance. But I toss and turn in my sleep, and I like to cuddle with my dog, and so none of the masks I tried were comfortable at all. I finally found a nasal mask that is acceptable, but still very inconvenient and awkward. Plus, I still snore and my breathing events are still usually above 10.
Its dawned on me that my 20 year chronic throat clearing is related to my Sleep Apnea. But I’ve had the CPAP for 8 months and my throat clearing hasn’t improved. I have another appointment with specialist in a month or 2, but at our last appointment she said that a dental device would be the next try, then possibly the inspire device. Well I’ve been doing some research about the correlation between obstructive sleep apnea and chronic throat clearing, and I kind of doubt either will work. My opinion is that my throat has an abnormality that have been making me miserable for the last 20 years, and has also caused sleep apnea as well. I’ve read that the throat closing up can cause a vacuum effect that can suck stomach acid into the throat and irritate it, which is why I wake up with a throat full of thick phlegm that I spend all day clearing.
I think surgery will be the best option to try to end all of it. I’m wondering if any ENT experts here have heard of this or have any advice as to how to convince the sleep specialist to consider this, and try to get me approved for a surgery? Anyone else here had these two symptoms severely? Thank you for any help. Thank you.
Details: I have Obstructive Sleep Apnea, HBP, and several psychological disorders (not Tourette’s or tic disorder) I had a stutter when I was around 6 or 7 but I grew out of it with speech therapy for a year or two. Meds for HBP, a stimulant ADHD med, an NDRI, an SSRI, a mood stabilizer, an antihistamine for anxiety and sleep, and Multivitamin. Cannabis and Alcohol used regularly.

I have a 2010 CR-V 4wd, and I started noticing a transmission shutter about 2 weeks after I bought it. It also threw a check engine for a O2 sensor. I brought it to my mechanic, the check engine light turned into replacing the Cat, not cheap, and his opinion on the transmission shutter was to add shutter-stop from time to time but it’s a bad torque converter and I should just drive it until it dies, because repairing it would cost more than a used transmission swap. I also called a transmission specialist who said the same thing. I asked them if changing the transmission fluid could help, and they said doubtful. One even said it could make it worse.
My point of this post is, I had a friend change the transmission fluid in his driveway, and I haven’t noticed ANY shuttering since. That was 3 months ago! Don’t listen to mechanics when it comes to transmissions. Sometimes all it needs is a fluid change. Transmissions seem to be very misunderstood in mechanics these days and many won’t even work on them.
If anyone else here has a transmission shutter in their third gen CR-V, try just getting a fluid change and it might solve the problem. My friend did it in his driveway in about 30 mins. Don’t trust the mechanic 🤷‍♂️

I’m 32m and I finally got a sleep study in December and was diagnosed with severe obstructive sleep apnea. My results showed 67 events per hour and my oxygen dipped down to 70% oxygen. I was put on a CPAP machine and I absolutely hate it. But when I told me sleep doctor that she said my insurance may not cover another treatment until I’ve used my CPAP for a FULL YEAR!
Is this typical? If I have such severe apnea and I’m telling the doctor that the CPAP is making me even more tired, and she’s saying basically deal with until the insurance will approve the next option. Then if that doesn’t work you wait a year to be approved for the next least expensive option. I think I need actual surgery to remove excess tissue, but it seems like at this rate it could take 3-5 years before I’ll be able to be approved.
Like, this is a serious issue in my life and I need results. CPAP is crap and I need to figure this out. What options do I have to fix this issue in a reasonable amount of time? Right now I’m applying for disability because I can’t work full time anymore. I don’t know what to tell them except that my sleep apnea could take several years to get properly treated for. Not a great answer.

So I’ve been in adhd meds since I was 9 years old and I’ve been doing worse and worse over the years, now I’m almost 33. I’m on meds for adhd, depression, anxiety, and mood. I’m at the point where I’ve also developed a severe alcohol addiction that is starting to cause fatty liver symptoms. I’ve tried many meds and dosage changes and therapists and I’m still as miserable as ever.
I frequently feel very anhedonic, like I’ll literally sit for long periods of time just trying to figure out something I want to do, and sometimes can’t come up with anything. I spend most of my days off in bed because I really don’t want to do anything or talk to anyone.
SO my point is that the only thing I can think of doing is taking 1-2 years off from working a regular job so I can taper off all of my meds, and focus solely on therapy and staying sober and I’m hoping that it could have a tremendous change on how my brain regulates itself. All of the meds I’m currently on are involved in either increasing dopamine, or directing it to go to the proper places, but after 25 years of tolerance to meds, they don’t even seem to be very effective at all anymore.
Has anyone here done a dopamine detox or reset like this? I tried tapering off of Adderall around 2016-2017, but I had to start taking increasing amounts of Wellbutrin for “extreme irritability and frustration”. Then in 2018 I had a life attempt and I was taken off Adderall completely for about 7 months for liability concerns, and I had a horrible time keeping jobs because I was so tired and unmotivated and irritable. Then I got a new doctor and she put me in Focalin, which has made it easier to get work done but has lost most of its effects in the last 7 years even though I’m on the max dose my doctor will prescribe.
So as far as increasing meds I don’t think it’s an option, it’s up to me to figure out how to become not miserable. So once I get approved for disability I’m going to quit working and taper off of my meds, and keeping my stress level at the absolute minimum I possibly can, and also completely stop drinking. And I think once I can get my job and financial stress out of the way, that will be easier. What do others think of this?
Do any of you know anyone who has ever had to do this after years of medication?

So one of the worst if not the worst symptom of my life issues is anhedonia. It makes everyday miserable and results in spending most of my time in bed. I have few friends and have withdrawn from all of them and all family. I felt like sharing to see if anyone else can relate to me over the background of my issues:

I was started in adhd stimulant meds (amphetamines) when I was 8 and I’m still on similar stim meds today at 32. I started displaying depression symptoms around 13. Today I’m on meds for adhd, depression, anxiety, mood, blood pressure, and sleep. I also have horrible alcoholism that I’ve developed over time to keep the edge off the depression since even meds and counseling over many years haven’t solved the issue. I feel as though the years of psychological medications, mixed with my severe underlying psychological issues have resulted in a severe dopamine dysfunction, where even with medication, my dopamine system seems to be burnt out.

I’m trying to get disability so I can take a year or two off from work to find myself and get my meds and therapy worked out, and get my alcohol under control, and also my severe sleep apnea, amongst other issues; without the financial stress of losing my apartment and car.

Anyone else feel as hopeless and helpless as I do? Good luck to everyone here! Anhedonia can be so miserable that it’s honestly dangerous and makes me think a lot about ending it.