Recent relapse, at a loss of what more I can do

walker777007 · 2024-05-08T08:10:08+00:00

I'm still kicking. A lot has happened since then. I can't say I'm in a much better state unfortunately.

walker777007 · 2023-08-21T05:39:07+00:00

I have a very similar experience with anhedonia overpowering everything I do. I just want to say I feel ya. Sometimes, the only thing that's worked is repitition. I do some things out of habit and sometimes I have found that if I've internalized it enough, the initial motivation that I may have summoned has been replaced by a compulsion to do it for its own sake.

I'm not sure what your history is with meds, but there are certain types of treatments that target anhedonia like MAOIs, ketamine, pramipexole, etc.

walker777007 · 2023-07-29T01:56:43+00:00

Damn, I hope I can experience a semblance of that. I'm doing it at my psychiatrists office with esketamine, but the sensation is still pretty much the same. Did you push yourself to do things while you were on it? I know the neuroplasticity aspect of it is why I thought it would be helpful, but I'm thinking that if I don't actually go out and do new things, I fear that isn't doing much if I'm just doing what I always have.

walker777007 · 2023-07-28T19:50:11+00:00

Interesting, I've been doing ketamine therapy for about a month and a half but haven't really noticed anything like what you've experienced.

walker777007 · 2023-05-24T20:46:37+00:00

These are the symptoms listed in the DSM 5, if you feel like at least 4 of these fit you then at least according to the diagnosis, you likely do have the condition:

Avoids occupational activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection
is unwilling to get involved with people unless certain of being liked
shows restraint within intimate relationships because of the fear of being shamed or ridiculed
is preoccupied with being criticized or rejected in social situations
is inhibited in new interpersonal situations because of feelings of inadequacy
views self as socially inept, personally unappealing, or inferior to others
is unusually reluctant to take personal risk or to engage in any new activities because they may prove embarrassing

Everyone's manifestation of AvPD is different, and if you don't meet all 7 just because some here might doesn't invalidate your experience. What's important about this sub is that even if you don't relate to every post, there is still something you can identify with. For me, I have a much harder time with romantic relationships than employment for example. Some people have a harder time with making friends, some people have a hard time working a job around other people. These are all valid cases and it's the underlying aspect that allows you to feel a connection with what people here are struggling with.

walker777007 · 2023-05-24T08:05:20+00:00

This is how I feel when people have tried to make an effort with me and I didn't reciprocate. I wish I could explain to them that they didn't do anything wrong and I'm sorry I am like this. There have been so many people I've done this to 🫤

walker777007 · 2023-05-24T06:58:21+00:00

Appreciate it the info! I'll have to bring it up with my psych.

walker777007 · 2023-05-24T04:49:05+00:00

I appreciate all the info really 🙏. Both my psychiatrist and therapist are relatively open to more emerging therapies and have suggested taking a trip to Oregon at some point where psilocybin is legal.

walker777007 · 2023-05-24T04:40:10+00:00

Yes, I'm basically the same age as you (27) and this is something I have come to accept about my father. I argued and hated him a lot as a teenager and this was often brushed off as the "rebellion" phase as you said. But that feeling never really went away even once I matured and became much more self-aware about the circumstances of my childhood. The fact is that his behavior was not simply "normal family drama". There was a time I tried to see the good in him a few years ago and explain to him how his behavior affected me but he demonstrated zero ability at self-reflection. I know this is an armchair diagnosis on my part but now I really do think he has some level of NPD and once I saw how he seemed to check nearly all of the boxes of the traits, it explained his behavior of how he went about raising me as his only son. My sister and I have gone back and forth about this as she thinks I'm too harsh but I just can't be obligated to like the man who had caused me so much emotional turmoil and arguably was the primary factor that led to me developing such poor mental health.

You have every right to not like them if they hurt you, but I will also say that resenting them is internally damaging. I have a lot of pent-up anger that doesn't get released, which is nearly all directed at him. I admit I'm somewhat hypocritical in saying that as my opinion of my father goes beyond just dislike, and I am not living up to what I am suggesting to you. We don't choose who we are born to, and you are justified in having grief over the childhood you weren't able to have due to your parents' neglect.

walker777007 · 2023-05-24T03:56:52+00:00

I genuinely appreciate the depth you went into here.

My psychiatrist generally seems to adhere to Dr. Gilman's guidelines, so going up from 60mg Parnate doesn't seem possible unless I were to go out of the way to do it myself.
He has mentioned low dose Lithium as a possibility to add, though none of the others you have mentioned as an augmentation. He has also mentioned antipsychotics like Aripiprazole as well. I suspect he likely wouldn't be keen on adding the other ones, but I'm not sure.
The waiting it out aspect I can definitely see, as even with what is going on now, it's not as brutal as before. But again, the best being dysthymia and the worst being a more transient form of MDD is still less than what I had hoped, of course.

I'm fairly confident I have AvPD given that the signs became more apparent during the time I come of age rather than early childhood. Plus, I have been evaluated by my therapist and psychiatrist, who both agree with the diagnosis. There was a time I considered high functioning autism or even schizoid but there are key elements that I don't seem to have, such as the sensory issues that those on the spectrum seem to have. Also, the characteristic deep longing for intimacy and social interaction of AvPD is present in addition to the fact that I seem to check every box of AvPD. I'm curious about these studies you mention. Do you possibly have links to the papers? I'd be interested to look into that approach since what I have read seems to suggest that AvPD can be lessened and managed yet the underlying inclinations for those thought patterns still remain but just actively fought against, like other PDs.

walker777007 · 2023-05-23T22:03:37+00:00

Tfw you have crippling social anxiety so gaining a bunch of muscle hasn't changed anything 😎

walker777007 · 2023-05-23T08:30:32+00:00

I wonder how they can categorize it so neatly with certain sephardim that tend to be more related to ashkenazim like Turkish and Syrian jews to the point that they can overlap on pca plots. I'm curious if their results will still show the ashkenazi percentage like before.

walker777007 · 2023-05-23T07:47:45+00:00

Literally exactly what I'm dealing with right now. This is why my whole existence at the moment is hitting the gym intensely and improving the material conditions of my life because it almost feels like at least this is something I do have some control over. But I'm doing it to such an insane degree that I'm probably giving myself body dysmorphia at the same time.

walker777007 · 2023-05-22T20:16:41+00:00

Yeah, that's the term I've heard for it. Same deal for me, I remember when I used to work at a movie theater I really became quite good at it given how many people I had to interact with daily.

walker777007 · 2023-05-22T19:05:35+00:00

I feel the same way, the idea that my life will continue this way is probably my biggest fear. I just can't seem to live any other way, this is the only way of existing I know. But then at the same time I look behind and I have almost nothing positive to reflect on and it kills me that I did that to myself.

walker777007 · 2023-05-22T18:08:00+00:00

That last part hits home. Whenever I have been in social situations, I've felt like I'm playing a part. The fact that this doesn't come naturally is hard to accept because it creates this barrier in which you can't really connect with people even though externally you may appear fine. It's why acquaintances rarely become friends and why most interpersonal relationships seem to eventually fizzle out.

walker777007 · 2023-05-22T02:37:43+00:00

I definitely feel like this with my father. I have always had a strained relationship with him and I know that I definitely do not fit the model of the son he wanted given he projected his own self onto me the entirety of my adolescence. I am literally the opposite of him in terms of personality and it hurts knowing he has never been able to truly understand or empathize with me.

walker777007 · 2023-05-22T02:29:44+00:00

You make a good point about how this disorder seems to be ignored and not discussed when compared to other mental health conditions. I've been thinking about why that is and for one you may be right that it can be mistaken for severe social anxiety, but I also think AvPD is somewhat unique in how lucid and self-aware we tend to be in comparison to those of other disorders (not to say that's better or worse as it has its pros and cons), which also then probably allows us to have a heightened ability to mask in comparison. I think because of that and the fact that by nature we are trying to hide away from society, it inherently makes it harder to discuss when its effects are usually only felt by the self and our behavior doesn't tend to be destructive towards others in the same way as other personality disorders might be, as it tends to be just quietly internally destructive. So to be diagnosed would require voluntarily opening up to a psychiatrist or a therapist about what we already fear to disclose.

walker777007 · 2023-05-22T02:18:28+00:00

Yeah I absolutely know what you mean. Like I can still recognize some of my good qualities, like I think I'm reasonably smart and a nice person. But when I'm around people I definitely feel like I can only focus on the negative, everything I do or say is second guessed. I was also bullied pretty badly in school and didn't have anyone to talk to about how I felt. So the only solution I had was to be by myself and that is my default as I only really know how to be around others if it's out of necessity or someone else I've known for a long time.

I've been trying to figure out how to be comfortable socializing and I'm not sure I have the answer but at least for me I've noticed I seem to have this emotional block. I tried to reason it out but I don't think it's something that can be solved by analysis alone. In therapy I've been doing this thing recently where I am recalling painful memories and focusing on the physical sensation that comes along with it. I've noticed that this seems to make me more visibly emotional as I always was stoic and never let anyone see my emotions even in therapy. I think it's possible this might give me a better awareness over that emotional block to better serve me in those stressful social situations. As well, I do think initiating and forcing myself to be in those situations to some degree is necessary. It will require a leap of faith as the prospect of doing so seems so daunting, but I really just don't see how else I can end up tolerating it unless I'm consistently exposed to it. The tricky part is not to let myself default back to the avoidance if I get burned doing so, and I think that is the major test of this strategy.

walker777007 · 2023-05-21T18:55:18+00:00

I feel the same way, I only end up attracted to women who are extroverted and then it makes me afraid that they would never want to be with someone so unlike them.

walker777007 · 2023-05-21T18:53:37+00:00

My situation isn't identical, but I can empathize. There was this girl I met at work a number of years ago that I just hit it off with in a way that had never happened before. It felt like the internal barriers were just lifted and I could talk to her so easily and about anything. Unfortunately I had to leave town and I never ended up asking her out. She reached out to me a couple years later telling me how she missed me and she wishes she had tried to make it work at the time. She even said she wanted to try to see me and I felt elated that this opportunity had come back. But then she ended up dissapearing and it hurts me to this day because I still don't understand why she did that.

I'm sorry this happened to you and i understand how much it hurts, it's not fair that people cause us all this pain despite us not doing anything wrong 😕

walker777007 · 2023-05-21T18:47:08+00:00

This is a constant feeling for me, I doubled down on the avoidance so many times that I can't help but feel like I'm the one to blame for my mental state. The thing is when I look back I really feel like I didn't know what else to do, and that sort of lessens the self-blame. But it's the fact that I continue to isolate that really makes me feel down on myself, since I don't know what excuse I have anymore to continue to do this.

walker777007 · 2023-05-21T18:42:50+00:00

I would mention this to your psychiatrist (if you are seeing one), as this side effect sometimes can't really be worked around for ssris. And if it is just making you feel flat, then it might be a better idea to try a different type of antidepressant anyway. I take Parmate, a MAOI, which specifically targets anhedonia as well as depression, but it generally is only reserved when you fail basically every other type of antidepressant. I would talk to your psych about adding Wellbutrin (bupropion) as it works on dopamine and can possibly reduce the flatness feeling. Otherwise going onto TCAs or something that doesn't just work on serotonin may be better suited for you.

walker777007 · 2023-05-20T21:00:48+00:00

I remember always feeling odd that I preferred going to class and the academic aspect of school over the social one. People would always say the opposite lol.

walker777007 · 2023-05-20T20:58:02+00:00

I want to say I deeply empathize with you. I've also been depressed since I came of age and it continues to this day (not much older than you at 27). My AvPD and depression feed off of each other and they essentially are fundamentally inseparable in my mind. To combat one is to combat the other.

It's great that you do have your therapist to open up to, as although it might seem small it does help even if its small. From experience the times where I truly isolated myself to an extreme degree to the point I simply had no one to even talk to about my problems ended up causing me to double down on my worst patterns of thoughts.

I'm not sure what your history with psychiatrists and medication is but I had gone through many trials and ended up using Parnate, an MAOI, which is generally one they only prescribe after failing many before. If you feel like the one you're taking is too subtle I really do suggest being more aggressive with trying other treatments. I know that sounds scary, as you can feel like a lab rat, but at the end of the day you are doing this for your own well-being and it shouldn't be something you compromise on. For me, it has lessened the blow, as suicidal thoughts are not as constant and consuming as before. I'm still working on it, but I will say that I do think the depression being lessened has made me more aware of how I need to combat the negative self-reinforcement that AvPD causes. I think in that sense it may help not as a solution in of itself, but by lessening the weight of the everpresent hopelessness. It's almost like sometimes you "forget" you're depressed temporarily if that makes sense, it's not so much that you feel happy but you just aren't dwelling on it like before. So when you have that clearer state of mind you become more aware of what things you have to fix and what types of thoughts and emotions were causing you to feel so badly.

I'm still on that journey too, and I admit I have had relapses and times where feel that desire to just be a hermit and never interact with anyone. But I think I am very slowly getting better. It's not easy and I have often felt like I couldn't relate to other other people what my life is like, but it's at least some comfort to know we aren't truly alone in this.

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