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Neurostimulator Implant

Probably not in the way you're thinking... the latest frontier is treatment of depression that is often responsible for anhedonia.
Is the depression the cause of anhedonia or a result?

I was treated with Fluoxetine initially for depression, but it made me a zombie and I had no feelings of enjoyment over anything: my emotions were blunted to zero and I just existed. It could be argued the treatment for depression worsened the anhedonia I was experiencing up to that point.

Speaking personally, it's more likely that anxiety was raising the threshold for enjoyment to heights I could not reach; however treating the anxiety resulted in feeling unwell in other ways that did not help the anhedonia, probably because it was not actually treating the cause of the anxiety, only the symptoms and unbalancing neurochemistry in other ways.

Interesting but disturbing. I always cringe when the medical profession don't understand what they are working with and simply throw random things at the problem, hoping something will be effective without causing something worse.

I remember reading about experiments with electrostimulatory implants in the spines of women who were experiencing pain and the researchers noticed that it often triggered an orgasm in the women if applied in a certain way. This led to me wondering whether it might also work in a similar way for men, but my own situation could be caused by something completely different (ie not so much a failure of stimulation, but an overstimulation that my brain can not keep up with, similar to ADD patients).

Unfortunately the medical profession have more important things to concentrate their meager resources on than my anhedonia and they prefer to adhere to their own perceptions of my illness than listen to my actual experience.
 
Is the depression the cause of anhedonia or a result?
Anhedonia is a symptom of depression. Pleasure doesn't eliminate depression, it just masks it.


I was treated with Fluoxetine initially for depression, but it made me a zombie and I had no feelings of enjoyment over anything: my emotions were blunted to zero and I just existed. It could be argued the treatment for depression worsened the anhedonia I was experiencing up to that point.
SSRIs and similar drugs can induce a feeling of detachment. That detachment might be an improvement for those who are suffering from situational depression from traumatic events. Unfortunately, that detachment can also result in sexual dysfunction in some people.

I once heard someone taking an SSRI for debilitating depression say, "It makes me feel like my dick is somewhere else but I feel so much better overall that I just don't care about my dick's problems.". That pretty much sums up the side effects of SSRIs- it removes the pain but it also removes the pleasure, and for many who are profoundly depressed, getting rid of low lows might be worth forgoing high highs- at least for the short term.

Interesting but disturbing. I always cringe when the medical profession don't understand what they are working with and simply throw random things at the problem, hoping something will be effective without causing something worse.
There is research supporting neurostimulation for depression and it does seem to be effective for recalcitrant depression in people who don't respond to traditional methods.
 
Anhedonia is a symptom of depression. Pleasure doesn't eliminate depression, it just masks it.
In my personal experience, I am no longer depressed as I once was, yet I still experience anhedonia.

I would suggest that the current understanding is flawed, or at least omits the possibility that for some, a chronic lack of pleasure in life from whatever cause can result in depression (ie depression is a symptom of something else and not a cause in itself).

My personal feeling is that depression is an imbalance in brain chemistry as a result of various causes, including situational unhappiness, but that we don't understand the chemistry enough to adequately treat it and instead of adjusting a number of neurotransmitters to achieve balance, we take the most simple route of targeting only one. Whilst this approach can be better than nothing, it is still doesn't fix the original issue and can lead to collateral damage.

I once heard someone taking an SSRI for debilitating depression say, "It makes me feel like my dick is somewhere else but I feel so much better overall that I just don't care about my dick's problems.". That pretty much sums up the side effects of SSRIs- it removes the pain but it also removes the pleasure, and for many who are profoundly depressed, getting rid of low lows might be worth forgoing high highs- at least for the short term.
For many people, the lesser of two evils is a big improvement: until the improvement then starts to be impinged by loss of other pleasures as a result of treatment.

I have heard about people treated with SSRI's who then become depressed because they have lost their ability to feel sexual pleasure: whilst no longer depressed via other causes, their lives can not return to normal because they have lost something else that was important to them as a result of treatment.

The diversity of situations means that we shouldn't simply give Sophie's Choice to everyone.

There is research supporting neurostimulation for depression and it does seem to be effective for recalcitrant depression in people who don't respond to traditional methods.
But at what cost?

My own experience is that depression was focused on as the causal element and inappropriate treatment used to no effect other than dissuading me from further treatment, because the depression was actually a result of something else. With extensive psychotherapy, I had a glimpse of the real cause, but not until the therapists actually listened to my experience instead of applying pet theories of their own to keywords. So much of my life wasted because prevailing theory trumped my own experience.

I will applaud the time when health sciences begin to take an individual approach to treatment and actually listen to what the patient has to say about their own experience as they are the only ones who can really "know". Diversity is real and important.

Having said that, I don't discount that prevailing treatment can work for many to relieve suffering, but it shouldn't simply be applied to everyone regardless as a broad brush approach.
 
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