Intro

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Rem346
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Intro

Unread post by Rem346 »

Hi, M24, I had depression that started a year ago. Everything was fine until I had sever anxiety and a breakdown like no other (May 2019). I thought it would go away but it got very bad, thought my brain was going to explode. I felt slight retardation, feeling like I wanted to die, guilt. I then went on to see a psychiatrist and take sertraline 25mg (July 2019) then bumped it up to 50mg. I then took that with rexulti for a while and got better. However, instead of getting cured I just felt numb. I then took Wellbutrin 300mg (October 2019) and it did not do much. My main symptoms were anhedonia across. I was also in school at that time and was completely alone (minimal help). I did not feel anything but stress from school made me a mess. I then took viibryd fomr December to January and again, it did not do much improvement. Psychiatrist then recommended adderall for adhd, effexor and eventually lithium (I did not take any of them). That's when I realized that the psychiatrist was just toying around with meds. In March 2020, I tried 3 ketamine infusions. They were expensive and i gave it my last shot thinking ketamine eases depression in TRD patients. I wasn't able to finish the rest due to COVID. Ketamine eased a lot of anxiety but the dreaded anhedonia remained. I should note that the feelings of horror guilt ended with viibryd. After that it was strictly anhedonia. Anyways in April 2020, I researched and found out about testosterone replacement therapy (TRT) for men. MY testosterone levels were low/low normal. I thought getting T up would fix the depression as many people have had success with testosterone therapy. I took that route for about 5-6 months. I did notice some improvement in energy and brain fog which was unbearable go away. I still felt irritable, tired, and had no emotions. I tried so many options to combat whatever I had. Any blood test i took showed everything was normal, brain and back MRI is normal. I have destroyed all my relationships. Now I have the following symptoms: No libido, No arousal or sensation whatsoever, no emotions, can't feel, can't feel love, connection, don't want to socialize, can't feel pleasure in anything, can't feel orgasms, poor memory, lack of focus, speech is poor, have to fake things, no sense of well being, genital anesthesia, genital feels limp like noodle.
This brings me here to this forum unfortunately, I feel like I have tried everything. I don't know what to do and need help...
JakeLawe
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Re: Intro

Unread post by JakeLawe »

If possible, don't despair, I know it ain't easy and this may sound bad but it is hope that drives us to despair. I know cause my numbed down dick can drive me to despair sometimes.

To me, we're all quite sad/anxious/stressed, others have a chemical approach, a dietary approach, mine's a psychosomatic approach. I took sertraline too.. one pill, basically.. I've had things reverted back and some still to go.. seems to be a slow process and, if you ask me, dependant on both: time and mental health.

Hypothesis: Somehow the mind took the opportunity and the moment of ssri ingestion to transfer the depression trauma to the dick, etc. and/or.. one's anxiety/stress/depression somehow surfaced after the ingestion of the ssri, at full force.. while the chemicals may have been responsible for this, the symptoms per se are caused by sadness, stress, anxiety etc, in my perspective.

Now, of course some of us have been/were depressed for years (15 in my case) so ssris were "promised" to fix things.. due serotonin hypothesis of depression (debunked by tianeptine, ketamine, etc) but it may have only "made us numb" and you say.. meaning, I'd say, that the mind took that conditioning about ssris to relieve itself and transfer stuff to the body.

I know it doesn't feels like depression and like something else.. but, in my perspective it is the same..

So how one goes about treating depression? that's the 64 million dollar question..

Cognitive behavioral therapy, books about placebos/psychosomatic symptoms, buspar, lithium orotate, magnesium, inositol, SJW, saffron, Rodhiola, weed, therapy, good diet, meditation, etc, etc, etc.

Where you are right now I think is important to breath.. don't fall into despair (only easy if one doesn't 'hopes'!).

If you manage to cry to sad music, for example.. I'd say is worth a shot.. training yourself to resensitize again.. when we're too mental we can't feel.. we're filled with thoughts..the mind gets in the way.. we become prideful.. and we're not grateful, we're effectively in hell.

Of course you can try more meds for depression too, but yeah, at least me, I ain't taking sertraline no more. I'd avoid any that's linked to sexual symptoms/ numbing of sensitivity.

Don't believe the thoughts! You may have to replace hope with trust/faith. And work on acceptance and work from there your way back to the ups and downs of being human.

You say you fake it. I suggest you fake listening to chopin, or some piano, fake feeling it.. until you cry..or laugh. Fake enjoying painting..until you actually do.. Fake enjoying a walk in nature, until you do..

Hey, I'm in hell like you.. i just abandoned hope.. like the sign said ;).

Love and compassion.
Rem346
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Joined: Sun Oct 11, 2020 7:55 am
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Re: Intro

Unread post by Rem346 »

I just want to get out of this situation. I have exhausted so many resources on my mental health only coming to the conclusion I may have pssd (which sounds like I do). Several urologists have suggested I see a psychiatrist, one that specializes in sex therapy. It’s hard to get a hold of them and Idk if they would help. For now I started seeing a regular psychiatrist again, explained him my symptoms, and he wants to start pramipexole and go up to 4mg. Any thoughts on pramipexole? I know there is one who posted on this forum, but only 1... My main concern is that I can’t feel medications, like they work but not to their full extent. All senesation, even for genitals have been lost. Is low dose reinstating also an option. I can try like 2mg sertraline with buspirone. I want out of this ASAP!!
healing
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Re: Intro

Unread post by healing »

Hey there, welcome to the forum.

I know things may seem bleak now, but try to keep a level head to the best of your abilities. Try not to make any rash decisions. It's only uphill from here, right? Anyways, it's great that you've seen improvements in brain fog+energy on TRT. Unfortunately, hormones seem to be only part of the story in these post-drug conditions. If I were you, I'd continue with the TRT that you're benefiting from. I believe it's best to treat any condition as top-down as possible. In my opinion, these top-down strategies include hormones (which you're already doing), sleep-wake cycles, diet, and exercise. What does your diet consist of? I also have chronic fatigue, and I've found that eating low-carb helps (like keto). Do you exercise regularly? Do you follow strict sleep hygiene?
Lexapro 2016. Sexual, emotional, and cognitive symptoms.
Rem346
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Re: Intro

Unread post by Rem346 »

Well I started trt to think I was gonna get better, but what I didn’t know was that TRT can’t fix ejaculatory anhedonia and genital anesthesia, penile shrinkage... I stopped TRT because I don’t want it to mess up with fertility. I am looking for ways to reverse pssd and trt isn’t really a solution (Solution is Neuro psychopharmocological). My diet is still the same, hasn’t changed in years even before ssri it was not bad. I tried keto for a while it hasn’t done much and hard to keep (evoo makes me nauseous). I exercise as much as I can. Sleep is very good, but I get too tired very easily through the day and require naps when I come home so I am low on energy. TBH I am better than I was earlier in the year, severe brain fog is ok, irritability down, and general improvements. But I still have the massive problem of being unable to FEEL, I don’t feel a part of this world, no motivation, no sex drive. I used to be happy, horny, try to be social, funny, be able to LEARN. I can’t learn right now or it’s very very blunted (I don’t feel social and funny at the moment, just blank, spaced out). I want sensation, circadian rhythm and feeling alive again lol.

Is this permanent?
arahant
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Re: Intro

Unread post by arahant »

Rem346 wrote: Sun Oct 18, 2020 5:16 pm Well I started trt to think I was gonna get better, but what I didn’t know was that TRT can’t fix ejaculatory anhedonia and genital anesthesia, penile shrinkage... I stopped TRT because I don’t want it to mess up with fertility. I am looking for ways to reverse pssd and trt isn’t really a solution (Solution is Neuro psychopharmocological). My diet is still the same, hasn’t changed in years even before ssri it was not bad. I tried keto for a while it hasn’t done much and hard to keep (evoo makes me nauseous). I exercise as much as I can. Sleep is very good, but I get too tired very easily through the day and require naps when I come home so I am low on energy. TBH I am better than I was earlier in the year, severe brain fog is ok, irritability down, and general improvements. But I still have the massive problem of being unable to FEEL, I don’t feel a part of this world, no motivation, no sex drive. I used to be happy, horny, try to be social, funny, be able to LEARN. I can’t learn right now or it’s very very blunted (I don’t feel social and funny at the moment, just blank, spaced out). I want sensation, circadian rhythm and feeling alive again lol.

Is this permanent?
You soon noticed that TRT, as its name says: It's a testosterone replacement. But it is a treatment for deficient testosterone (off the chart) so that messing up fertility is highly unlikely. These might be the population that benefits from it.
It barely works for "testo in range but lower" which does not make much sense...

It's not a treatment for psychiatric problems. As you said, your case started with a nervous breakdown and suicidal thoughts before taking any medicine, followed by a sequence of small trials of just a few weeks on suggested treatments.
Usually, psychiatric treatment does not work like a fever pill. The closest one recently approved is Ketamine/Esketamine for people at risk of death due to severe breakdowns.
Sadly, you could not finish a comprehensive Ketamine treatment (FUCK COVID-19 :x ). I have not had it, but I have witnessed people who got way better on it, and it looks like you saw some results in just a few sessions.

You said your doc suggested pramipexole; it looks like he is updated.

Pramipexole looks promising, and it's currently in a clinical trial (recruiting) for treating anhedonia:
Pramipexole to Target "Anhedonic Depression" (PILOT-PRAXOL)
https://clinicaltrials.gov/ct2/show/NCT04121091
If you have an official diagnosis of ADHD, stimulants are quite useful for cognitive issues like:

I have taken Buproprion, an amphetamine substituted (It can even give false positive in doping tests). Both alone and combined with Ritalin (methylphenidate).
Even pramipexole was studied for the same purpose: https://www.minervamedica.it/en/journal ... 8N03A0144

Buspirone was the drug that restored my sensations and fixed anhedonic orgasms that persisted for many years after tapering 150 mg/day of Sertraline (Zoloft).

It was also found effective in cases with marked guilt and anhedonia:
Clinical effects of the 5-HT1A partial agonists in depression: a composite analysis of buspirone in the treatment of depression
https://pubmed.ncbi.nlm.nih.gov/2198303/
The buspirone dose most frequently associated with clinically significant improvement, was 40 mg/day.
I have taken the dose above, and it has annoying side effects, like dizziness/drowsiness lasting a few minutes after taking every pill.
It's a matter of choice. I would rather be dizzy for a few minutes than being numb sexually on SSRIs.

After posting links for even a clinical trial with pramipexole, I think it's clear that you were getting some help with some suggested prescriptions.
I know it's difficult, especially in a scenario that started with lots of anxiety and loss of hope...

But you need to give time and a fair trial to things that may help you.

Best of luck.,

Arahant.
healing
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Re: Intro

Unread post by healing »

Rem346 wrote: Sun Oct 18, 2020 5:16 pm Well I started trt to think I was gonna get better, but what I didn’t know was that TRT can’t fix ejaculatory anhedonia and genital anesthesia, penile shrinkage... I stopped TRT because I don’t want it to mess up with fertility. I am looking for ways to reverse pssd and trt isn’t really a solution (Solution is Neuro psychopharmocological). My diet is still the same, hasn’t changed in years even before ssri it was not bad. I tried keto for a while it hasn’t done much and hard to keep (evoo makes me nauseous). I exercise as much as I can. Sleep is very good, but I get too tired very easily through the day and require naps when I come home so I am low on energy. TBH I am better than I was earlier in the year, severe brain fog is ok, irritability down, and general improvements. But I still have the massive problem of being unable to FEEL, I don’t feel a part of this world, no motivation, no sex drive. I used to be happy, horny, try to be social, funny, be able to LEARN. I can’t learn right now or it’s very very blunted (I don’t feel social and funny at the moment, just blank, spaced out). I want sensation, circadian rhythm and feeling alive again lol.

Is this permanent?
To my knowledge, high doses of TRT can help if you have androgen receptor issues. Apparently there's both 'androgenic' and 'estrogenic' libidos, each serving different purposes. Androgen-mediated libido is more physical, whereas estrogen-mediated libido is more emotional in nature. Of course, these are only theories derived from personal anecdotes, but it may be something to think about. To my knowledge, androgen receptors (as well as estrogen receptors) centrally autoregulate, meaning that the more androgens you have, the more receptors your body will create. So, maybe you weren't on high enough doses of TRT for increased receptors, or maybe you weren't on it for long enough? (you weren't "dialed in"). Estrogen is a bit more tricky, since we males make less of it (via aromatization), but they would also autoregulate (in theory) in the presence of greater e2 levels.
Lexapro 2016. Sexual, emotional, and cognitive symptoms.
Thomas
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Joined: Thu Jul 09, 2020 6:32 am
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Re: Intro

Unread post by Thomas »

Rem346 wrote: Sun Oct 18, 2020 4:32 pm I just want to get out of this situation.
[...]
I want out of this ASAP!!
May I suggest you to start with this treatment plan? viewtopic.php?f=20&t=2681
You will see there are no known quick fix. And trying to find one could lead to despair... which could prevent from improvement...
Forget about "ASAP" and think long term and slow improvements. After I fixed my "despair / urge to cure", I went from "no emotion" to "anhedonia" then to "slight anhedonia" slowly in 3 months, working hard for my improvement.
Escitalopram, 10mg/day, Jan-May 2019. Fluoxetine, May-Sept 2019. Mirtazapine, November 2019-January 2020. Escitalopram, Feb-May 2020.
Symptoms: low libido | sexual numbness | insomnia
Rem346
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Re: Intro

Unread post by Rem346 »

Can’t post, says I’m blacklisted
Rem346
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Joined: Sun Oct 11, 2020 7:55 am
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Re: Intro

Unread post by Rem346 »

Nvm. Pramipexole gives my side effects after increasing dose. Nothing special so far. How many success stories have there been with pramipexole? I only know 1 who claimed it and even then I don’t know his protocol. Gotta try buspirone although most people say it’s useless. I haven’t seen much benefit from ketamine. Anything I take seems to affect me somehow but NOTHING has ever attacked and removed the anhedonia.
Would low dose reinstate combined with buspar do anything?
How about Miratazapine, there are publications that mirtazapine 15mg combined with ssri can restore sexual function.
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