u/caffeinehell

Im mot talking about anticipation or avolition.With substance blockage psychedelics and MAOIs dont work on consummatory aspects, even if they may still help anticipatory. Mood stabilizers dont bring back actual pleasure.

By consummatory I mean the actual buzz in the head, and feeling passive pleasure of existence.
I am in an agitated state daily due to the anhedonia. The only thing that kinda helps is benzos but every day they are risky. And they only help take edge off

This constellation of symptoms can happen in severe PSSD, PFS, and post viral syndromes. Where th

In many cases the nervous system is so extremely dysregulated that substances further dysregulate it. Brain retraining also isnt possible due to the anhedonia itself.

What helps the goddamn blockage? Who had it and got out of it?

Ketamine does not work for me.

What explains this issue? Where someone even one who has improved or remitted years later suddenly takes some normally benign supplement, drinks or something and then has a crash in anhedonia and other symptoms?

It happens even in the akathisia communities where recovered people can get retriggered into the nightmare in a flash.

To me this aspect does not seem like a metabolite thing. It seems like a legit neuroplastic or epigenetic memory being retriggered. Almost like a “PTSD” except its not a regular psychological PTSD its a “chemical PTSD” at the cellular level and is often extremely refractory to standard PTSD methods like EMDR.

Also the more one crashes the more sensitive they get to things too. I know of people who crash from even just smelling chemical scents, and its affected me too.

The ANS has gone completely haywire and there does not appear to be some sort of easy reset and deletion of the cellular memory. The so called “brain retraining” programs do not work because of the unique nature of the symptom presentation being anhedonic, and joy and connection is necessary for safety signaling. Something needs to be designed physiologically to restore safety in the nervous system.

Who is done it primarily for these symptoms?

Substance blockage is when even substances fail to provide reward effects. So no drugs work essentially. As of now, medicine does not have answers to such a dramatic condition. And it can happen instantly from a drug or virus itself.

What results did you have?

Its something ive noticed in these communities . Many had a deep inner world, were very intelligent, felt things deeply and maybe things that neurotypicals wouldnt notice. And an ability to learn things easily.

I wonder if the nervous system was hyperexcitable, and then the SSRI gets introduced and creates massive havoc. Maladaptive plasticity occurs and the “ability to learn” becomes a downside here as the system quickly learns this state

What was otherwise physiologically a benefit at normality with no toxic exposures becomes a problem when the neurohormonal/neuroimmune insult happens

I don’t want to live anymore. This is IMPOSSIBLE to treat.

Even strong perfumes can cause increased anhedonia ever since my covid reinfection in the Fall

This is even after tons of mast cell stabilizers. Quercetin, luteolin, cromolyn, loratidine, xolair, amlexanox. They help with low level stuff but not strong smells, and they also DONT HELP WITH REBOUNDING BACK. Thats the critical issue. Anhedonia can worsen from a reaction but then it becomes its own thing my system is unable to recover from

And on top of that, the severity of the anhedonia prevents substances from working. Like benzos don’t always get me out of a reaction. It depends how blocked they are

And sure it may be nervous system dysregulstion but those techniques are completely utterly useless for the anhedonic phenotype. There is no relief of stress whatsoever when anhedonic, because pleasure relieves stress.

I have seen doctors and the only treatment that keeps coming up at this severity is essentially ECT again to reset the nervous system paired with the mast cell meds i take

Its fucking insanity.

I crashed again from a strong perfume smell that came from a nurse who came over to do a sleep study. Anhedonia that was already severe became even more severe and caused a massive panic spiral. This symptom is constantly a threat to me. Im not able to not see it as a threat either. Pleasure and emotions define existence therefore it doesnt make sense to exist without them.

The only thing that slightly helps is benzos only a tad as i have substance blockage. They just make it easier to get out of the panic spiral part.

For me also anhedonia is causing panic, not vice versa. Anhedonia is the root of all anxiety for me. And its so utterly resistant.

If it was some OTHER more physical or other mental symptom outside of anhedonia or blank mind and I had full hedonic tone I wouldnt experience the spiraling to the extent I do with anhedonia and would be able to calm the nervous system because i could use the pleasure to distract myself. Its like oxygen and water to me.

Wtf does one do for such intense anhedonia? Antidepressants like strong MAOIs do not work and I cannot tolerate that stuff after a week when the serotonin part kicks in, initially the dopamine part of Parnate does help. And they don’t address rhe sensitivities anyways.

What the hell does one do? Just suicide if even perfumes are crashing? Its a literal emergency 24/7 for me this symptom.

To me it does not feel possible to recover with all 3 of these nightmare symptoms at once

I cannot keep doing ECT but its the ONLY thing that worked 30% from unilateral. The problem is if I do it and then crash later constant fear. Thats what happened in December from a fried food reaction (before i started most of the stabilizers continuously but still)

**Mast cell stabilizers ARE NOT FOOLPROOF and the phenotype I have of MCAS is a suicide phenotype as the presenting symptom is anhedonia, and losing pleasure and cognition causes suicidal ideation. Its not the same as just having some bedbound days to rest and recover. Its a severe neuropsych phenotype thats actively dangerous. My physical symptoms resolve but mental crashes do not**

I don’t want to live anymore. This is IMPOSSIBLE to treat.

Even strong perfumes can cause increased anhedonia ever since my covid reinfection in the Fall

This is even after tons of mast cell stabilizers. They help with low level sruff but not strong, and they also DONT HELP WITH REBOUNDING BACK.

And on top of that, the severity of the anhedonia prevents substances from working

And sure it may be nervous system dysregulstion but those techniques are completely utterly useless for the anhedonic phenotype. There is no relief of stress whatsoever when anhedonic, because pleasure relieves stress.

I have seen doctors and the only treatment that keeps coming up at this severity is essentially ECT again to reset the nervous system paired with the mast cell meds i take

Its fucking insanity.

I crashed again from a strong perfume smell that came from a nurse who came over to do a sleep study. Anhedonia that was already severe became even more severe and caused a massive panic spiral. This symptom is constantly a threat to me. Im not able to not see it as a threat either. Pleasure and emotions define existence therefore it doesnt make sense to exist without them.

The only thing that slightly helps is benzos only a tad as i have substance blockage. They just make it easier to get out of the panic spiral part.

For me also anhedonia is causing panic, not vice versa. Anhedonia is the root of all anxiety for me. And its so utterly resistant.

If it was some OTHER more physical or other mental symptom outside of anhedonia or blank mind and I had full hedonic tone I wouldnt experience the spiraling to the extent I do with anhedonia and would be able to calm the nervous system because i could use the pleasure to distract myself. Its like oxygen and water to me.

Wtf does one do for such intense anhedonia? Antidepressants like strong MAOIs do not work and I cannot tolerate that stuff after a week when the serotonin part kicks in, initially the dopamine part of Parnate does help. And they don’t address rhe sensitivities anyways.

What the hell does one do? Just suicide if even perfumes are crashing? Its a literal emergency 24/7 for me this symptom.

To me it does not feel possible to recover with all 3 of these nightmare symptoms at once

This condition can literally hit you like 💥

Everything is fine and then suddenly you get a virus, take a supp or drug, and GG, system just shuts down and in some cases can take YEARS to come back online

Only to suddenly crash again from something small

What is with the lack of recognition? MECFS eventually got real recognition. What do we need to do to get recognition for the ANS type of anhedonia sudden onset.

Its a debilitating life ending condition that can just happen and now increasingly im getting convinced the cause is some sort of toxic exposure that damages the nervous system. Some have other dysautonomia symptoms too

Kind of like similar mechanism to Gulf War illness, which also has no known cure

Im increasingly convinced anhedonia is a horrible term to describe this sudden onset state. Its not a lack of interest. Its a problem with integration of sensory information. Comfort is lost. Some may say the system doesn’t feel safe, but the problem is nervous system work does not work because of the lack of pleasure itself since pleasure signals safety itself

So I have been doing Parnate for 6 days now. For anhedonia and emotional blunting and blank mind issues primarily

And at first it actually helped the anticipatory (but not consummatory) side. I was feeling more optimism, better well being and general mood, and also had gotten rid of my “desperation/emergency” feeling where I could sort of relax. Had more interest in music and things but did not truly feel them. Mainly was able to distract and pass time easier

Clearly felt like the dopaminergic effect. However on Day 6 when I woke up suddenly overnight I felt even more blank and more blunted than before. Its like the dopamine effect just vanished and I am feeling the serotonin blunting similar to SSRI. Im very sensitive to it seems. Its so quiet in my head its unnerving and hard to distract myself.

Feels like a big joke, after 5 days of feeling relatively better at least in terms of coping it suddenly just numbs me completely.

What causes this? I presume maybe the initial stim effect got tolerance faster than the adaptation to the serotonin part.

Is there anything that can be done about this? Its extremely uncomfortable, the fully numb feeling makes me very restless.

Its all too common in stories where basically someone is very high functioning all their life and then suddenly they take some substance or get a virus or even in rare cases from an intense stressor or out of nowhere develop debilitating anhedonia that seems to respond to nothing. The system just snaps. . Its like a nervous system shur down type thing but the reality is the meme “oh ignore it, do nervous system regulation exercises, etc” does not work

This is clearly a different entity than whatever is being called as depressive anhedonia.

Often times there are other autonomic symptoms too like gastroparesis, exercise intolerance, POTS, and more. Some people develop sensitivities where one small thing causes the system to crash further

Its a very severe state and psychiatry is completely missing it. Even the “anhedonia” literature does not describe this kind of severity of consummatory anhedonia with substance blockage, blank mind, sensitivities. They still list CBT and behavior activation or the new meme “positive affect therapy” which are all just insulting for what is otherwise basically a medical emergency.

What is it going to take for real recognition of this severe state?

Its one of the most gaslit things in the field right now.

So many people are told to just “get a hobby”, “do therapy” by providers. And so on.

Its like doctors don’t truly understand the condition of consummatory anhedonia. The most severe cases are in constant agony, can’t even feel basic comfort in the bedsheets or taking a hot shower

And somehow the field thinks therapy, behavior activation and hobbies fixes this? Most medicatiojs also do not target it and there is often a substance blockage. The ANS doesn’t function well.

What is it going to take for this condition to be more widely recognized and properly treated?

Its NOT loss of interest motivation type of depressive anhedonia. And gets confused with that. Its also not related to any belief patterns or anything. Its purely a neurobiological state. Right now the way it is, it seems like only ECT treats such a severe state. There are no medications for consummatory anhedonia, only anticipatory.

Horrific symptom, what to even do about it? Prevents social interaction completely. No ideas to engage, no complex thoughts and verbal fluency and vocabulary. Sensory input doesnt trigger daydreaming

What helped with it if you had it?

Like brain fog/blank mind and anhedonia?

Mine get a lot worse and do not rebound from flares

Post hoc meaning after a ton of reactions have already occurred.

Lets say you get on mast cell stabilizers and everything to try to prevent future reactions

But each reaction you already had caused a massive crash.

What do you do about the crash? And especially what if the crash was neuropsychiatric neurocognitive symptoms like severe anhedonia which has no treatments and causes SI?

I have an MCAS diagnosis and I will be getting on Xolair soon for insanely high 2000+ IgE.

The thing is at this point im so severe in anhedonia that treating this is not going to resolve it.

My anhedonia became progressively more severe from abrupt crashes over a few years. I now realize that a lot of these probably were mast cell reactions.

My brain feels like it does not have the plasticity resilience to recover from merely stabilizing the mast cells now. Because I have severe consummatory anhedonia and that involves blockage to substances too (not getting their reward effects).

I had done ECT in Fall 2025 and got to 30% better only to crash a few weeks later from a reaction to fried food. Physical symptoms like itching went away but mental persisted. Mentally anhedonia crashing also causes an anxiety spiral because the symptom is a nightmare, and I cannot calm down without access to pleasure. I *need* pleasure to be calm and comfortable. It’s the most anxiolytic thing in existence.

Im not sure what to do in this situation. Its a major problem when anhedonia is a presenting symptom, because this symptom can crash due to MCAS but not necessarily get resolved post hoc from stabilizers unlike other physical symptoms like itching

The only thing I can come up with after talking to doctors is to first get on Xolair, support the body with nutrients and then do ECT or psychedelics in parallel for the severe anhedonia aspect

I dont mean loss of interest type anhedonia. I dont have an issue with interest nor motivation. I mean the type where the actual signal doesnt land in the head. No buzz from sensory inputs. Not able to feel atmosphere and even passive pleasure gone, which creates constant restlessness

Its not the type thats like “oh just do what you used to enjoy”, exercise get sun bs. That is useless. Its the “actively can’t exist due to lacking the sensory input stimulation” kind. Not about specific activities, its about just existing in peace kind. I also have exercise intolerance anyways from POTS. I get sunlight already and try walks.

Especially when substances are blocked what can be done? So far it seems like the field only conventionally has ECT.

And the thing with psychedelics at least for me is that they don’t bring back the consummatory aspect. I have done Aya and after it while I did get an afterglow where my general well being and anticipatory and anxiety about the condition itself were improved significantly like 70%, blank mind and consummatory tone only improved by +10%. And it only lasted a week.

The actual “brain jizz” and blank mind is the issue. And I know its not just dopamine. Its like something is fundamentally cut off ever since my rifax crash 1.5 years ago. I didn’t have this feeling of the wire being cut before. Its like even if something tries to come, it doesnt land. I did improve my gut health and did 5 FMT last year and confirmed on testing my gut improved but the issue still persisted.

The consummatory aspect is significantly gating everything. Its like im not getting that release and comfort.

Blank mind as well, no creativity descriptive cognition is completely shot. Ideas and access to self are gone

I also have mast cell stuff going on and I can have a sudden crash from 15% tone to 0% even if I say eat the wrong thing or get exposed to too much heat or something. And the problem is mast cell stabilizers don’t work “after the fact”, and reactions are unpredictable. It feels like essentially central sensitization but to anhedonia for me. Once they happen it’s like GG because. The anhedonic phenotype of MCAS is truly a nightmare. I have very high IgE like 2000+ and am considering getting on Xolair for this soon. I also have gastroparesis.

I mention ANS because I do notice small ANS fluctuations impact this. Like even eating affects the tone and lowers it, and I already can’t eat much due to the food fullness issue. And climbing stairs multiple times in a row triggered adrenaline and that was also increasing blunting, now I do compression stuff and electrolytes for this. The issue is though if my system gets triggered it doesnt bounce back. Its a nightmare. And those hits added over time

I also believe that cell danger response is a big part of the problem, but there are no fixes for this available as Suramin is not available.

Last year the biggest thing that helped was IV methylprednisone 1 gram 3 day pulse, and I got kind of manic without emotions a few days later, and then lithium and IV NAD smoothed that out and brought atmosphere. But it didnt last and I couldnt replicate.

It seems like my system is stuck in some deep attractor state.

This is like basic things such as comfort in bedsheets, merely sitting down, etc. Lacking comfort leads to a feeling of constant restlessness and it feels like an emergency 24/7 where a solution asap is needed. Like you can’t even chill due to the anhedonia severity

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Im running into major problems with a chronic condition, I need to see clinics that are out of network for medi-cal/medicaid. But the big issue is while I can pay out of pocket, they will not accept money from me.

Its ridiculous. And also no in network provider offers the service.

What can I do? Being on medicaid is actually messing me up. And I am unable to work. I would rather just buy a plan, I have support financially. But the problem is I don’t qualify for covered CA and also I don’t have any way to trigger a special enrollment period.

I also cannot wait for the open enrollment, thats at the end of the year. I need this sorted out like asap.

Stupid medicaid policies are ruining me. It’s dumb that places can’t accept money from medicaid patients even if you are willing to pay out of pocket. This aspect is complicating things for me.

My symptoms are unbearable anhedonia, cognitive problems like blank mind. Substance blockage. I have crash easily from small things like fried food too and allergies.

I wonder if I need to get on Xolair and see if it removes a load

For some reason my body produces neurocog symptoms and not as many physical ones. Though I do have exercise intolerance shortness of breath issues but they affect me more mentally.

My Total IgE is like 2200+. And last year it was like 3500 IU/mL.

Im talking about the kind of anhedonia where literally you can physically not feel the buzz in the head. It often happens from post viral or post drug illness.

Ive done a bunch of stuff and nothing seems to really work except ECT a bit. And even that is just slight like 30% though it does bring back response to like stims. And the major problem I have is that its not reliable, it can oscillate. A session can make me better but the next worse. Is this normal?

And I just had ECT in the fall but I crashed after a mast cell reaction to something. Its been 5 months and despite trying so much I cannot get out of this crash (due to the blockage) and probably need literally emergency ECT again. But I am concerned about the unreliability and the oscillations from it.

Most things are blocked, the buzz from stimulants or benzos is not there and its not tolerance. And things can improve anticipatory but not the actual consummatory pleasure. Its like the parasympathetic system or vagal nerve just won’t activate properly.

Its a constant state of discomfort and its completely neglected by medicine. This kind of anhedonia isn’t just about not enjoying activities, its where even the passive comfort and pleasure of merely existing and sitting down is gone. Because there is no release in the head and thus it’s a constant state of restlessness. Everyone takes the passive pleasure of existence for granted.

Its ridiculous that medicine is not paying attention to all the sufferers of this and coming up with better solutions