No more pleasure as a result of panic disorder

[MattMVS7]

I question whether my depression will get better and I am going to explain why.  When I started to have this panic disorder, I realized that there could be the possibility of me experiencing many panic attacks all throughout the day each day (though this is something that could be false and could only just be a few panic attacks per day instead).  However, it could also be something true--we don't know.  But this is a risk that my mind was not willing to take and decided to shut down all emotions in order to prevent the fear from happening, leaving me in a state where I feel no pleasure at all.  I feel that not even this state I'm in will even get better because my mind is also not willing to take the risk of having it get better because of the possibility (whether true or false) that if it does get better, that will no longer hold off the fear and cause the panic to return because if my emotions return (in this case, pleasure), then my panic will also return since panic is also an emotion.

[Teeman3]

You WILL GET BETTER if you DON'T GIVE UP!!!

NEVER EVER, EVER, GIVE UP.

IF YOU ARE STILL BREATHING THERE IS HOPE...REMEMBER THAT!

[Paxiled]

Look, this can go on forever, as you're very good at arguing.  I'd go so far as to say you find it, ahem, pleasurable to keep an argument going.  Anhedonia seems to be a totem for you, but it's generally a common part of being severely depressed, which you say you are.  You're trying to separate the two because by doing so it gives you something to argue about, but the label isn't relevant in whether you get better or not, it's just useful in choosing your treatment by a medical professional and your reimbursement from an insurance company.  So really, you're depressed and anxious and apparently, since you never answer nursegirl's question, not in treatment.  You say if you're not comfortable in confronting panic then neither therapy nor medication will work, but nobody's comfortable facing panic -- that's why we panic.  Developing that comfort is the whole purpose of therapy, it's something you either learn or not and that determines whether the therapy takes or not.  It doesn't come first, because if it did you'd be better and wouldn't need therapy.  As for medication, it forces the brain to work in an artificial manner that, when it works, makes you feel better whether you want to or not.  There are obviously problems with making the brain work in an artificial manner, but that's what drugs do, so again, it doesn't matter if you're comfortable when you take them or not, they're going to do what they're going to do as that's how they're designed.  Now, we can go on with this ping-pong forever, and try to rationalize the mess we're all in, but then you're still in the mess, rationalized.  My guess is what you really want is not to be in the mess.  Get into therapy.  The first thing you need is someone to tell you, hey, you can argue all you want and you're really good at it but in the end all you've done is argued.  But, you know, if that's what turns you on...

[nursegirl6572]

The best advice I could give you is to start working with a therapist, and make a concerted effort to STOP trying to analyze everything.  It's definitely not helping matters any!  Print out your threads here, and let a therapist read them.

Have you ever tried medications?  I can't recall.  That may be a reasonable option for you as well.  You need to find a way to quiet your mind a bit.  Like I've said countless times, it's your worst enemy.

You're trying to make sense out of things that don't always make sense.  The brain is a complex organ, and mental illnesses are very much a mystery in a lot of ways.  You're trying to apply reason and sense to things that don't make sense, things that are not black and white...and you've been doing this for a while.  It's just causing more frustration and torment for you.  That's why I asked about OCD....your thought processes seem very obsessive...you're getting "stuck" on the round and round thinking.

That's my advice to you....get some help, and try to keep your mind on something, ANYTHING else.

[MattMVS7]

I already am doing everything I can in addressing this issue, but I am also here talking about it at the same time because that is what these forums are all about and I wish to know very important things here.

I believe what I'm having now is not depression, but anhedonia because that is something that happens when your mind decides to shut down your emotions because, in my case, the fear was too much.  But it is something that does not cause you to feel hopeless or sad as in depression.  In my case, it leaves me with no fear of these thoughts and no ability to experience pleasure.

Now tell me if I am true or false on this which is that the only way I see getting better is that if I were to be comfortable with having these panic attacks because depression and anhedonia, in this case, ease up when you are comfortable with something and no longer view it as a problem.  So in other words, is the only way for me to get better is for me to feel comfortable facing my panic attacks?  I have the strong will and determination to face my panic in order to get out of this anhedonia.  But as long as you are not comfortable facing these panic attacks which is how I feel, you can have all the will and determination in the world and it won't do anything.  You can even address this issue through medication and everything else, but that won't do anything either as long as I am not comfortable having these panic attacks.

Or am I false on this and that since the mind is a very complex organ, then that makes this situation more complex in that my mind can somehow recover the ability to experience pleasure while still suppressing my fear?  Has anyone here had anhedonia as a response to trauma or panic and have gotten better with it despite the fact that you were never comfortable facing your trauma or fear?

[nursegirl6572]

Needs repeating:


"Believe me, I know what being stuck is like, and I don't recommend you stay there.  Make a move, any move, because you can argue yourself into anything that continues avoidance, but avoidance makes the problem worse as assuredly as failing at a particular mode of therapy does.  I'm old now and drugs did me in, but I continue to stress that you're young and resilient and don't want to grow old with this.  Make a move."

[Paxiled]

Nobody can guarantee you something that will work.  You're right, therapy is not only not a guarantee, it isn't usually effective in chronic cases.  Neither is any particular medication.  But because there are so many different meds and so many different therapists and forms of therapy, if you keep trying, you might just find something that does help you help yourself.  CBT, by the way, is very hard to do -- I agree.  First, you have to blindly accept the cognitive distortion theory which never explains how you got the first anxiety attack, but if you can do that many people have been helped by it.  Second, it doesn't work very well with depressed people unless you also go after the depression, which most CBT therapists don't do.   Third, attitude is the most important part -- you have to be willing to fail and fail and fail until you succeed, and that means facing your anxiety head-on.  If you can do that, it can work, and if you continue to avoid, it can't work.  I didn't do well with it, but I still recommend it to everyone including you because, without taking what you call a risk but I see as just a possibility of failure, you're just stuck.  Believe me, I know what being stuck is like, and I don't recommend you stay there.  Make a move, any move, because you can argue yourself into anything that continues avoidance, but avoidance makes the problem worse as assuredly as failing at a particular mode of therapy does.  I'm old now and drugs did me in, but I continue to stress that you're young and resilient and don't want to grow old with this.  Make a move.

[MattMVS7]

I have come up with the solution that would completely bring back my ability to experience pleasure again.  When I had these panic attacks in the very beginning, even though I did become depressed, this depression was simply a response at the time and was not a defense mechanism that shut down the fear and my ability to experience pleasure as a result in order to prevent the panic from happening.  At the time, I thought to myself that maybe in 1 month this would all get better and that maybe I won't have panic all throughout the day each day.  However, the moment that I began to have an extreme fear in which I experienced as many as 3 panic attacks in 1 minute and the panic didn't seem to stop, I made the realization that this is likely that this is something that is not going to stop and would almost continue all day everyday.  That is when this depression became the defense mechanism and shut down the fear and shut down my ability to experience pleasure in order to not take that great risk.  There is also another realization that I made that is also contributing to this depression in taking on the form of this defense mechanism which is that there are people who are treatment resistant in terms of panic disorder and hardly or do not get better despite medication, CBT, meditation, exposure therapy, and everything else.  Therefore, this is also something that poses yet another great risk which is that my panic could continue and hardly or never get better and that I will live an entire life of panic or at least many years of panic.  Since my mind is also not willing to take that great risk as well, this is also another reason why this depression remains there holding off my fear and pleasure all the time as a defense mechanism.

In CBT, this is something that addresses something known as 'cognitive distortions.'  I already realize that me thinking that there is the possibility that I will have many or even almost constant panic all day everyday and also that it might hardly or never get better would be me catastrophizing which would mean that my thinking here is not true because we don't even know if this is a possibility or not.  However, there is something that is true which I feel therapy and such cannot address which is that there is the RISK of that happening if my depression were to somehow go away right now or ease up which would no longer hold off the fear.  Again, I know from personal experience that when there were moments in which this depression went down a bit, that did cause the panic to return.  But now there are never such moments and the depression remains there all the time 24/7 holding off my fear and pleasure.

Let's pretend right now that I would be completely comfortable with this risk stated above, that would cause my depression to go away completely right now.  However, this is completely impossible for me to feel comfortable at all with this risk and I do not think it would be possible for any human being to feel comfortable with such a risk either.  This is why my depression remains there and is not getting better in order to avoid this risk.

This is why I ask if there is any possible way for anyone here to address this issue and if there is any way possible to help me think differently in such a way that would be likely for me to recover from this depression or if there is any therapy and such whatsoever that would address this issue.

[nursegirl6572]

Remind me again, what kind of professional help have you sought for the anxiety and depression?  Have you been given an official diagnosis?  Are you under the care of a mental health professional currently?

Here's what I recommend...print out several of your threads here, where you're expressing not only how you feel, but your thought processes.  I think your own writings would greatly help a professional narrow down the issues you need to work on (and no mistake about it, you DO need to do some work, preferably with a professional).  A good starting place would be an assessment with a psychologist.  

I CANNOT stress to you how important it is to get busy DOING something to help yourself.  All you're doing now (and have been doing) is spinning your wheels, over and over.  Nothing is going to change if nothing changes.  Does that make sense?

[Paxiled]

Contrary to your other posts, this one actually makes sense, at least to me.  I sometimes feel that I got anxiety disorder because I used to get migraines, and I believe I held myself in a state of fear because, without knowing this was actually true, I had associated migraines with a calming after a period of stress.  I now know that's actually when many people do get migraines.  Now, I don't know if this is true or not, especially since my sister got agoraphobia and never had a migraine, but you're on to something here you should discuss intensely with a good therapist -- after all, one of the few things Freud said that has held up is that suppression leads to mental illness.  I think a lot of people are afraid to stop being afraid because of a fear of the unknown.  I think you should follow up on this thought, but the notion of you having anhedonia is probably wrong as you would have probably had that all along.  

[MattMVS7]

Thank you very much for sharing your personal experience in proving that people with such things do get better.

Now I feel as though my depression is completely gone and I feel "alive," calm, relaxed, and back to normal and no longer fell dead and hopeless inside.  Because of this, I feel as though I should be able to experience feelings of pleasure now, but this is not the case at all.  Would my inability to experience pleasure here be something known as "anhedonia?"  Or is it still depression?  I feel very depressed now knowing that I can no longer feel pleasure anymore.  It is a scientific fact that there is no known treatment for anhedonia.  So I am hoping that this is not anhedonia and is instead a very low-level depression.  Or are those two things the exact same thing?  Does anhedonia get better on its own despite there being no treatment for it, or is it something that is likely to forever remain there and never get better?

[nursegirl6572]

Oh dear Matt.  Your mind is SO your worst enemy.

While I obviously cannot diagnose you, I can tell you my hunch, because it sounds a lot like what I went through when I had my first VERY SEVERE panic attack (I have had anxiety all of my life, even as a young child).  I would be willing to be that you have Panic Disorder (or OCD), with secondary depression.  This is a very common course for these disorders to follow and they ARE indeed treatable, but you have to try.  That means diving into any and every kind of help you think may be a good fit.  Therapy, medications, meditation, etc etc.  

I'm going to tell you that without a shadow of a doubt, the only thing that's going to keep you from improving and getting your life back is YOU.  You continue to delve into these very complex depressing "what if" statements/scenarios.  Heck, I'm SURE you DO feel depressed....if living in your brain is like this all of the time, your own thought processes are horribly depressing.  Even to READ your posts gives one (me at least) a negative, down feeling.

You're going to need to bust your hind end working with a therapist to change your obsessive way of thinking.  THAT is going to be your freedom.  Until you start working on that, I'd really be surprised if you notice much progress.

We're always here for you....I hope you genuinely start trying, and start reporting what active and proactive steps you have taken to help yourself.

[MattMVS7]

Here is a revised and a more well explained version of my situation:

I am experiencing something far worse than depression.  It's not a feeling of hopelessness (depression), it is a complete inability to experience any enjoyment or pleasure and there is not a single brief moment (even a few seconds) where I am able to experience at least some level of pleasure.  This is not a matter of "I may have some loss of pleasure, but at least I am still able to experience a little bit of pleasure to make the best of my life."  This is something catastrohpically serious.   I am completely unable to experience pleasure 24/7 (as in, this ability has been completely wiped out permanently). I never experience even a brief moment of pleasure even once.  At least during even my worst moments of depression I was at least able to have moments of some pleasure.  But this form of "depression" I'm having now does not allow this at all.

This is the result of me having a severe panic disorder in which I was experiencing many panic attacks every day.  Knowing that I am in this constant state of panic and that I cannot escape from it has caused me depression. Fortunately, this depression has actually held off (replaced) the fear on the very 1st day I was in this constant state of panic. Unfortunately, this depression is chronic and is always there holding off the fear and unless I have this depression, that will cause the panic to return.  The depression started out as feelings of strong hopelessness which actually allowed many moments of pleasure (something unstable with highs and lows).  But now, this depression has stabilized into something far worse in which I no longer feel hopeless, but also feel no pleasure whatsoever.  However, I am starting to feel very hopeless now knowing that I no longer experience pleasure.  But this feeling of hopelessness does not cause me to destabalize once again and have moments of highs and lows in which I am able to experience some pleasure again.  I am stuck this time feeling no pleasure.

I notice that when I first had this chronic depression, when there were few moments in which this depression goes down, that causes the fear to return. Then, of course, immediately once the fear returns, that causes the chronic depression to take back over and replace the fear.  This time, there are no such moments or even any moments of pleasure and now this depression is something completely chronic.

Although I do not totally believe that my depression will never get better to the point where I will be able to enjoy things again, I do view it as a strong possibility that it will never get better and I question whether my depression will get better and I am going to explain why. When I started to have this panic disorder, I realized that there could be the possibility of me experiencing many panic attacks all throughout the day each day (though this is something that could be false and could only just be a few panic attacks per day instead). However, it could also be something true--we don't know. But this is a risk that my mind was not willing to take and decided to shut down all emotions in order to prevent the fear from happening, leaving me in a state where I feel no pleasure at all. I feel that not even this state I'm in will even get better because my mind is also not willing to take the risk of having it get better because of the possibility (whether true or false) that if it does get better, that will no longer hold off the fear and cause the panic to return because if my emotions return (in this case, pleasure), then my panic will also return since panic is also an emotion.

Also, I am already aware that there are many people with chronic and severe depression and have gotten better, but I can't help but keep thinking that my situation is somehow different that will leave me with this depression which will last my entire life and never get better. The reason I think this is not only because all of my reasons stated so far, but also because depression in this case is a response when your mind recognizes something as being a problem or something as a possible problem. Depression eases up when your mind no longer recognizes that thing as being a problem or a possible problem. But no matter how much coping skills I acquire and such, the possibility of having many panic attacks everyday is, in fact, something that my mind views as a possible problem and I do not see how that will ever not be perceived as a possible problem. Having many panic attacks each day would be something horrific and I do not see how it would ever be possible for you to be perfectly fine with that and not view that as a problem. Therefore, this is why I feel that this depression will forever remain there because of the fact that I will forever view that as a possible problem and to forever keep the fear shutdown.

I feel that it does not matter how much the fear goes down, my mind has decided to completely shut down all emotion anyway. So even if the fear were to get better, the fact of the matter is that my emotions will still remain shut down as they are now. This is because my mind has decided that since the fear is the problem, to completely shut it down and to do that would also require a complete shutdown of my pleasure as well. So, again, it does not matter how much the fear is addressed or how much the fear is eased up (even to a point where the fear is very close to nothing). My mind will still preserve the message that the possibility of having many panic attacks each day could be a possibility.  Because of this, my fear will still remain fully shutdown and obviously my pleasure too as a result. So even though my fear is the source of my depression, what really needs to be addressed is not the fear, but the depression. But based on my reasonings here, I do not see how it is going to get any better now. If you somehow think so anyway, then please provide a scientific explanation as to how.

Finally, I have another very important question here which is that for many people with chronic depression like me, their depression does get better but only to a certain point and they then have to learn to live with that remainder. But what if I have reached that point already?  There would be no way I could live a life of no pleasure like this and I would have to resort to having electric convulsive therapy which is a shock to the brain, or having a lobotomy which is a brain procedure that takes away who you are as a person, but is something very likely to bring back my pleasure to a degree that is livable or even completely for that matter.

[Byrdmama]

You did not mention if you have tried medication for Panic Attacks and Anxiety. It can be so helpful, and until you try it, you will never know how life can be. You do not have to live in fear, there is help.