u/Unique_Avocado1208

29F. Looking for advice.

Venlafaxine consistently works for me. It gets rid of my depression, severe social anxiety and binge eating. I tapered off it once, but within 7 months all those symptoms gradually returned, so I had to restart medication.

Since then I've tried venlafaxine IR 37.5 mg → desvenlafaxine ER 50 mg → now venlafaxine ER 75 mg.

The pattern has been identical every time. My mood becomes stable, anxiety is controlled, and I'm no longer depressed. But I still have almost no motivation, very low energy, excessive sleepiness and severe anhedonia. I barely function at work. I often end up working from bed and only push myself to meet deadlines or attend meetings. Outside of work, I'm almost always in bed because nothing feels rewarding or worth doing.

The downside is that venlafaxine/desvenlafaxine also seem to worsen my physical symptoms, especially TMJ, body aches, chronic tongue pain/burning, acid reflux, and poor sleep quality.

I've also failed sertraline, fluoxetine, escitalopram (gave severe mood fluctuations), and couldn't tolerate bupropion.

At this point, would you:

Increase venlafaxine to 112.5 mg (or eventually 150 mg)?

Switch to vortioxetine?

Consider TMS or esketamine?

My biggest goal is to improve motivation, energy, and the ability to enjoy life while keeping my depression under control and not making my physical symptoms worse.

I would really appreciate any recommendations in this situation. Thanks so much!

I feel like I don’t have a personality.

I don’t really enjoy things. Even when I try to relax, there’s this constant sadness in the background—like I’m not good enough compared to others.

Socially, I feel off. I want to connect, but I just don’t have words. I’m not funny, not quick, and I rarely have anything “smart” to say. I just sit there feeling like something should come out, but nothing does.

Even around friends or family, I feel disconnected—like I’m there but not really part of it. I get tired quickly and can’t keep up.

Meanwhile, everyone else seems effortless—funny, present, actually enjoying life. I feel like I’m falling short in every way.

I guess my real question is:

How do I come to terms with not being funny or sharp, while also figuring out how to genuinely enjoy things again? Right now everything just feels boring or disconnected.

I feel like I don’t have a personality.

I don’t really enjoy things. Even when I try to relax, there’s this constant sadness in the background, like I’m not good enough compared to others.

Socially, I feel off. I want to connect, but I just don’t have words. I’m not funny, not quick, and I rarely have anything “smart” to say. I just sit there feeling like something should come out, but nothing does.

Even around friends or family, I feel disconnected..like I’m there but not really part of it. I get tired quickly and can’t keep up.

Meanwhile, everyone else seems effortless funny, present, actually enjoying life. I feel like I’m falling short in every way.

I guess my real question is:

How do I come to terms with not being funny or sharp, while also figuring out how to genuinely enjoy things? Because everything just feels boring or disconnected.