My Acute Dysphoric Anhedonia!

Ian McKlatchie

New Member
(I hope this isn't too long. People often think of me as being weird. I thought, by telling my most recent psychiatric story, I might be able to make more sense of my oddness, to folks.)

My mental health history goes back around 55 years - the depression and anxiety started when I was still at school. I'm now in my late 60s. Over the decades, I managed with medication, personally invented therapies and with just...time. That meant that I knew my depression, and how to deal with it, pretty well.

Last year, that all changed, thanks to the incompetent healthcare system, here, in the UK!

In January of 2025, I was hospitalised for 3 weeks - a kidney related thing. One knee-jerk doctor's decision later and my life took a terrible turn for the worse. The doctor in charge of my case saw that I was taking amitriptyline. He saw that I was on 75mg a day.

Instead of tapering down the dose to gradually remove it, he...just...stopped...it - DEAD!

AFTER FORTY YEARS!

No medication was given to me, to compensate, or relieve! Every body part I owned was twitching, jumping and spasming. It affected my balance, my reflexes, my eyesight, my co-ordination, my speech - everything: I was in Hell! All of this was seen - nothing was done about it! Once the physical/kidney problem had been addressed, I was discharged, mid-breakdown! At least, half way through breakdown No 1.

This is how I usually tell the rest of the story...

Ian died, last year! I am merely Ian's ghost!
I haunt the house in which Ian lived when he was alive!
I'm a spectral detective, trying to figure out who Ian was, what he was like, what he did, etc..

I know Ian watched movies, because I found 800 of them, here, in the house.
I know Ian listened to music, because I found lots of it on his computers.
I know Ian read books because I found books with bookmarks in them.
I know Ian wrote a diary because I found one of them in this bedroom.
I know Ian wrote poetry because I found a few poems on this hard drive.
I know Ian ate chocolate because I found boxloads of it, here, at the house.
I know Ian was a smoker because I found a pack of cigarettes and some lighters.
I know Ian was a photographer, because I found a few expensive cameras, here.
I know Ian was a weapons collector, because the upper floor is packed with swords, knives, machetes and tomahawks.
I know Ian played chess against online computers - the links say so in this browser.
I know Ian played Gran Turismo on his PlayStation 3 - the disk was still in the machine, here.
I know Ian did weight training - the bench is still in the front room, here.

But, as Ian's ghost, I feel absolutely nothing for any of it!
Everything in that list...means nothing to me!

I don't understand why Ian did those things, or why I would want to, in the complete absence of all interest in any of them.

I no longer suffer from only something familiar, like depression. My condition is called..."Acute Dysphoric Anhedonia" - no longer just a brain chemistry thing. It's apparently a neurological condition, caused by being forced aggressively off the amitriptyline, in January of last year. My pleasure centres in the brain are chemically cut off from the rest of the brain. For that reason, I find the feeling of pleasure impossible, except in the most fleeting of situations/occasions.

That's the state in which I now am.

So, when I'm feeling the depression at full strength, I'm no longer shocked when somebody on the Mental Health Crisis Line says, "Read a book" or "Watch some TV" or "Play a game" or "Listen to some nice music". They don't understand, even in the Crisis Service, what this condition does to the patient.

MISSING: Other people (even the "experts") say, "Which hobby do you miss the most?" Yes...they don't get it, either, but understandably so, because they don't suffer from this. The person with anhedonia would LOVE to miss a hobby - WE YEARN TO MISS OUR HOBBIES, but...to miss something, you must be able to sample the former pleasure derived from having it. I can't feel pleasure at all, so I can't even miss the very hobbies that I wish I still had.

"STILL HAVE YOUR HAPPY MEMORIES": They say that to me a lot. No, I don't...I can't have my happy memories. To have a happy memory, you have to be able to "sample" the pleasure of the happiness from back then, and my brain can't do that, either. So, I don't even have the happiness of memories to turn to, for solace.

THE CRUELLEST: This is the most terrible one of them all? I know Ian was a Christian, because I found a wooden "holding" cross in his bed when I got back from the hospital - and, some crosses on the walls of his house. But, I feel nothing. Losing my Faith is the cruellest blow of all! That little wooden cross means nothing to me - it meant plenty, to Ian!

Nobody in the professions has a clue whether or not I'll ever beat this thing - they've started me on "Behavioural Activation" therapy...gentle exposure (without expectation) to things connected with those hobbies Ian engaged with when he was alive.

It is my sincerest hope that I have not depressed anybody with this account of what happened to me!
 
Amy trip. I’ll stop here cause I don’t know how to spell it. Anyway it’s one of the oldest drugs isn’t it?
I haven’t used it in decades.

Who was Ian? Maybe you might not want to go back? Ian wasn’t happy right? Need to shed your own skin?

Please continue to speak here. You’re fascinating.
 
A cousin has the same diagnosis, and had sent me this.

Anhedonia and Depressive Disorders - PMC

His treatment for it would vary from yours, so I will not note it here.
Have you sought another medication since being taken off your previous medication?
Because of my kidney condition, I cannot increase my current anti-depressant, I cannot add any other anti-depressant and I cannot switch to any other anti-depressant. I'm stuck on Mirtazepine, 30mg, nightly. If anything is going to be used, it will have to be of the psychotherapeutic type - meds leverage is off the table, for me.
 
Amy trip. I’ll stop here cause I don’t know how to spell it. Anyway it’s one of the oldest drugs isn’t it?
I haven’t used it in decades.

Who was Ian? Maybe you might not want to go back? Ian wasn’t happy right? Need to shed your own skin?

Please continue to speak here. You’re fascinating.
The Ian who lived here had something to go to and be interested in. As Ian's ghost, I have none of those things. Everything in that list is available to me, but is useless: I feel nothing when I think of them or try to involve myself with them. This is the most frightening feeling I've ever known in the history of my time as a mental health patient. And, at 69 years of age, I'm expecting no miracles to happen along any time, soon.
 
I had to look it up. What I read is depressing all on its own. Please keep us updated on how the therapy is working. Whether they decide to put you back on medications. The one scientific hospital article I read suggested the therapy you're getting but they also mentioned that different antidepressants can have a positive outcome.

edit: I just read what you said about your kidney issues. Now you're really limited on what avenues you have.
 
Because of my kidney condition, I cannot increase my current anti-depressant, I cannot add any other anti-depressant and I cannot switch to any other anti-depressant. I'm stuck on Mirtazepine, 30mg, nightly. If anything is going to be used, it will have to be of the psychotherapeutic type - meds leverage is off the table, for me.
Ah, so you had to be taken off the previous med because of your kidney condition. That WILL limit other prescription options going forward.

"Last year, that all changed, thanks to the incompetent healthcare system, here, in the UK!"
No, the system was not incompetent. The kidney issue contraindicated that particular medicine. From your description, you were in a situation where a medication must not be used under any circumstances because it could be life-threatening or cause severe, irreversible damage.
 
@robin416 Thanks, for that. It was not my wish to cause anybody distress. On too many forums, people haven't a clue how to interact with me until they know what made me what I am, currently. I will update this thread on the progress made, if any, during therapy.

@That Lady in PA The amitriptyline was stopped because of the urinary retention side effect that it has. It was a knee-jerk response "by-the-book", without forethought of the damage done to the patient by the severity of the withdrawal shock.

It was hoped that the Mirtazepine I was given, later in the year, in a psyche hospital, would be sufficient to weaken the anhedonia, but...that has not proven to be the case, in the longer term, at all.
 
@That Lady in PA The amitriptyline was stopped because of the urinary retention side effect that it has. It was a knee-jerk response "by-the-book", without forethought of the damage done to the patient by the severity of the withdrawal shock.
True that a step down would have been preferable.
Perhaps your situation was seen as life or death, which is why they abruptly pulled it. I don't know, nor should I know.
Hope things improve for you going forward. They ARE options available. My cousin is much improved.
 
Welcome to the forum, Ian. Please don't apologize for the length of your post—sharing your story took immense courage, and I am so glad you found your way here.

What happened to you in that hospital was an absolute tragedy. To be taken off a medication like amitriptyline cold turkey after forty years is a profound medical failure, and the neurological shock you experienced is entirely real. It makes perfect sense that you feel the way you do; your brain went through an immense chemical trauma. You are not "weird"—you are surviving a very severe, forced medical injury.

Please know that you are not alone here. Many members of this forum are going through incredibly difficult times with their health, chronic conditions, and deep personal losses. It is a safe, supportive place where you can talk openly about what is bothering you without anyone telling you to just "go watch TV" or "read a book." We get it.

When you don't have the energy or the desire to talk about the heavy stuff, this forum also has plenty of lighter places—games, discussions, and hobbies—where you can simply watch, read, and divert your attention from the illness without any pressure to perform.

I was deeply struck by your description of being "Ian's ghost." It is a profound piece of writing. But you know, ghosts have their own unique qualities and powers that the living don't always understand. A ghost isn't bound by the same expectations. A ghost can observe the world from a distance, slip through walls, and hear other people's thoughts and stories without having to carry the weight of being fully connected to the world.

I have found myself living as a ghost a few times in my own life after severe setbacks. During those times, I had to stop trying to be the person I used to be, and instead figure out what kind of quiet, observant powers I had as a spirit just drifting through. Maybe for now, being a "spectral detective" is exactly what you need to be—exploring what this quiet, detached version of you can do without forcing yourself to feel the things old Ian felt.

You haven't depressed anyone here. You have shared a profound truth. Take your time, look around the forum, and participate only when and if you feel like it. We are very glad to have you with us.
 
Thank you for sharing your story Ian. You have my deepest sympathy, not being able to feel pleasure must be one of the worst ways to live.

Your story is very timely. Right now there's a push in the United States to take patients off drugs that other people may deem unimportant. I hope your doctor will soon find something that will give your anhedonia relief while not harming your kidneys.

You say you are currently unable to feel your Christian faith, but (I believe) that even though you are not able to sense it at this time, Christ is holding you with the warmest love, until you can feel it again.

P. S. I even believe, that while I was typing, Christ was using Paco Dennis to transmit that to you. (My humble opinion, of course.)
 
Sounds like you still have most of your marbles to be able to post such a in depth description of your condition.
I understand what you are saying about losing the ability to feel or care about things but then you still have feelings about losing your faith.
At least you say you feel the saddest about that.
I hope things change for the better for you and you can get back amongst us living.
Maybe you will start caring about something like the content of the forum.
I just realized something a little while ago while joking around and that is that I am starting to enjoy just being silly and I don’t care who likes that or doesn’t.
I have had a very structured life and I feel like I am starting to feel free.
Sorry! I got off the path there!
 
I'm sorry, Ian. When we don't care about things, could it maybe help us to really, really calm ourselves down, relax, via meditation as therapy? Also to scan current events to seek something that will interest you? Also to get to know Ian more intimately?
And go on like that until something maybe engages your interest. It seems possible.
But I don't know anything. I'm a layperson sincerely wishing you well.
 
Aside from the basic mechanism, doctors don't yet understand how brain neurons work. Research isn't there yet. For example, they know certain medications block brain neurons from recognizing, picking up, and relaying pain signals, but they don't fully understand why, and they don't yet know how, why, and for how long signal-blocking effects other brain functions, and whether or not the effects are permanent.

I predict science will figure out way, way more about this within the next 5 years. And until then, doctors are gonna keep screwing up people's brains with medications. Unintentionally, of course. And when that discovery is made, we can probably only hope that big health agencies will force big pharmaceutical companies to stop producing those medications.
 
I also thank you Ian, for sharing your medical challenges with the forum. Do you have a close friend or family member in your orbit? Do you know of a church, where you have been a member? Are you in touch with any "one-person support groups"?

Another question is how would you feel if one day you answer the "door" and there your old self stands, and the two of you become one again? Would that be a desirable outcome for you?:unsure:
 
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@Meanderer

My last friend left the scene around 5-6 weeks ago.
I have no family member of any use to me.
I live alone.
I've never been a member of a church...my agoraphobia has made that highly unlikely after many years.
I must confess that I don't know what a one-person support group is, but it sounds good.

Your last question: If I could make myself the Ian that I was just 2-3 years ago?...yes, I'd like that. I would feel, then, that I stand some kind of chance against this nightmare. I look around at the other sections, here, and I crave joining in...but, I'm new and I don't want to seem too forward. New member nerves, I suppose. The feeling of isolation is horrific. I have absolutely nobody in the real world, to whom I can turn. Believe me when I say...it scares me!
 
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