I am looking for help with certain symptoms I’m dealing with that are hard to describe. To my knowledge, they don't fit neatly into a psychiatric label.
The main problem is:
Poor emotional reactivity - So, if someone tells me a dramatic story or a funny anecdote or terrible news, I cannot for the life of me relay the same emotions that the person is expressing to me back to them. What I mean is, I am totally unable to respond naturally to emotional information. For example, a friend recently told me about a big accomplishment in their life and I wanted to say, “Whoa! No way! That’s awesome!” But the only thing I was capable of muttering was a monotone “wow. nice” even though it was very exciting news. It’s like the information registers in my mind, I process and understand it, but there is no emotional output. This is not anhedonia. I still feel pleasure in life; from listening to & playing music, cooking, eating, learning, watching comedies, exercising, and socializing. I’m not apathetic or depressed either. I want to socialize! But there is a disconnect between how I feel inside and how my body, voice and face express those feelings.
And,
The rare times I am able to outwardly express an emotion, it’s comes on too strong. For example, when I truly find something funny, it is very difficult to contain my glee. The muscles in my face tighten and contract in a way that it almost hurts. It feels like my emotional responsiveness is totally fractured. Most of the time it’s completely absent, but when it does manifest itself, it’s like a surge of excitatory neurotransmission, like a rush of upward movement into my head and face without a break pedal. I'm not in control of it and I have to put in immense effort to moderate the emotion to a normal level. FWIW, this is only with "positive" emotions, I don't experience this with anger or sadness.
Another odd one:
My ability to think properly deteriorates when making eye contact - When I’m engaged in a face to face conversation, it is difficult to focus on what the other person is saying. Instead, I’m fixating on where the other person is looking, what emotions they are expressing & whether my facial expressions are matching the flow of the dialogue. I guess this is a form of anxiety but intertwined with my poor emotional reactivity. I’m not sure what causes what. On the flip side, when I’m talking on the phone with someone, riding in the car or walking with someone but facing forward and not directly towards them, I can think much more clearly, my listening skills are solid, and my verbal recall is much better.
Lastly,
There is a general anxiousness that comes with all of this. I don’t know if this is true clinical anxiety or if the anxiety just stems from my awareness of these deficiencies and the ruminating I do about whether I’ll ever be normal again. Either way, the anxiety is mostly bearable. It's the other symptoms that make life difficult.
Overall, I’m just a regular person. I did struggle with severe cystic acne and depression years ago but I’ve overcome those things. I also abused cannabis in the past and used LSD, MDMA, & psilocybin. Though today, I haven’t touched a single drug (including alcohol & caffeine) for 2 years now. I eat healthy, exercise regularly and occasionally supplement with things like Magnesium, Zinc, Collagen, and Resistant Starch. I don’t have any mental health problems in my family and I had a normal & healthy upbringing. I used to be much more emotionally expressive but now I don't feel normal. It wasn’t until 3-4 years ago (I’m now 26) that this happened. I can’t say what precipitated it exactly.
Successes:
I found out that dextromethorphan (DXM) improves these symptoms by a good 30-40% after taking cough syrup when I was sick one time and felt much more responsive and much more like myself. Since dextromethorphan is an NMDA antagonist, I tried memantine hoping this would work in a similar way. It didn’t seem to work at all. I just felt loopy and tired on it.
Failures:
Choline makes all of these symptoms much worse.
NAC worked for like a day and half but then worsened everything after that.
Theories:
Glutamate Dsyfunction:
Could it be that my glutamate auto-receptors have been downregulated leading to over-active glutamate neurotransmission? Would Ketamine ultimately upregulate glutamate autoreceptors? What about sarcosine? Are there other anti-depressants like Ketamine that work through NMDA & AMPA action?
Serotonin Overactivity:
I’ve also wondered if my serotonin 5-ht1a autoreceptors have been downregulated leading to a similar situation of overactive serotonin neurotransmission. Maybe this is a result of using psychedelics in the past. I've read that they can downregulate serotonin receptors semi-permanently. Though, I’ve always had positive trips and these symptoms did not seem to correlate to those trips.
I’m afraid to try an SSRI for fear that I might become even more emotionally blunted. Are there any anti-depressants or anxiolytics that upregulate 5-ht1a receptors, slow serotonin firing, and/or modulate serotonin receptors rather than just raise serotonin levels? I’m considering trying Buspirone (Buspar), a 5-ht1a autoreceptor agonist, to see if my problem could be attributed to excess serotonin.
If you have had a similar experience or know of any medications that could treat this (or what these symptoms are even called), please help a brother out! I’m tired of feeling this way.
Thanks!
Edited by Furniture, 25 January 2020 - 03:34 AM.