This is my first time posting and I'm not sure what to expect. I guess I should tell you a bit about me before I pose some questions that I would really appreciate feedback on.
I'm 48 (male) and battle treatment-resistant depression, generalised anxiety disorder and an alcohol use problem; all since I was in my early teens. It's been a very tough road navigating treatments (anti-depressants, anxiolytics, stimulants, anti-psychotics, mood stabilisers, ECT, TMS, CBT, interpersonal therapy, medications to address my alcohol use, etc.) and the devastating effects my condition has had on relationships. My anxiety is well-controlled with a non-benzodiazepine medication at the moment, but I expect to develop tolerance to it as has been my experience in the past. I eventually found a SNRI anti-depressant 11 years ago that prevents me from living in a crippling abyss of depression, but I'm left with persistent anhedonia that I now recognise has been the long-standing reason for my inability to define a direction for my life.
With some unfortunate exceptions, I'm grateful for my privileged access to excellent medical professionals in Australia and in the US. I'm looking forward to consulting a psychiatrist who specialises in the treatment of mood disorders, anhedonia in particular, and would really like to hear about others' experience with anhedonia.
Anhedonia is the (relative) inability to experience pleasure. Although not always present, is it the worst possible symptom of treatment-resistant depression? I think that it is.
How can anhedonia be successfully treated? I was prescribed a selective dopamine receptor agonist, a good idea and supported for the treatment of anhedonia by a small number of clinical studies, but the risk of unpredictable "sleep-attacks" makes driving too dangerous and so I won't take it.
How do you cope with anhedonia? In the long-term, it's paralysing for me and makes me periodically suicidal.
Life without pleasure is very difficult to sustain. Is there any hope?