Lack Of Motivation

[wcdean]

Yes I have Major Depressive Disorder, which requires medication. Less severe forms can often be treated naturally or by sheer will power alone. It is up to you and your docs, again, to decide what is right for you. Sometimes people can "snap" out of it by forcing themselves to get out of their current routine or lack there of.

 

[maddog]

I know the major depression beast all too well, was diagnosed about 18 months ago, was likely suffering from it for about, erm, 25 years before then. In fact I was diagnosed and treated for depression, with medication and psychotherapy, for a good while before any discussion of trauma and resulting PTSD diagnosis was ever made. Something to do with the fact that I chose not to disclose anything of past traumas for a long time, until my psych more or less put 2 and 2 together and presented the number 4 to me on a silver platter... no more lying Maddog.

Anyway, I digress. Loss of motivation and loss of interest in previously pleasureable activities, and indeed in the activities of everyday life, is a classic depression symptom and one of the early signs and most enduring symptoms. And yes, as others have said, when the depression is severe or long lasting, the situation becomes a catch 22. The acts of forceably motivating yourself into activity and engaging in stimulating connecting social and other activities require the very motivation and physical and psychological energy that you don't have, which then leads to self-criticism and feelings of failure, which then perpetuates the original depression... etc.

That's why sometimes we can beat the beast through sheer willpower and self-discipline, sometimes with the benefit of psychotherapy and specific cognitive and behavioural change strategies, and sometimes only through the addition of medication to chemically lift the mood state and provide us with the basic resources to make the longer term behavioural and cognitive changes.

I was a fiercely stubborn and narrowminded medication skeptic for a long, long time. Not for me, no thanks, happy pills are for sick people, and, well, ya know that's not me, right?

But reality bit, long and hard. I fell, kicking and screaming, onto the medication bandwagon and held on grimly, determined to see it out and hang in there until something had a positive effect. Tried several, under 3 different psychiatrists - lexapro, edronax, seroquel, some other sedative i can't recall, tofranil... and of course as the issue of my diagnosis became more controversial and complicated, so did the medication merry-go-round.

Sadly, this story doesn't have a happy ending yet. Currently I have found nothing that has made appreciable improvements to my mood, or to related issues of sleep disturbance, anxiety and other dissociative and PTSD symptoms. My current psychiatrist holds the view that complex trauma is considerably drug resistent, a view that is held in some circles within the mental health industry and poo-hooed by others.

Me? I don't know. I feel beaten into empty despair about it right now, at a loss to see the way forward. Schema and exposure therapy help, they feel like the only productive things I've been able to do to date, to address any of the symptoms and causes of depression, anxiety, C/PTSD and whatever the hell else is swimming around in my broken little brain.

Maybe one day I'll want to do things and be part of the world again. I've just cancelled a planned trip to the park with a friend and our dogs today, partly because my dog is a bit sick, but somehow that was just convenient... the shame is biting hard right now, I guess not as hard as the dread at the thought of going though. And it's such a glorious spring day... I hopeI find something to do with it other than sit here. I hope I can be strong enough for that today.

Maddog

 

[wcdean]

Sorry to hear that, Maddog, and you sound striking stubborn as myself. If you are, then you have the strength to pull through it; you'll find a way. You seem determined, and yet somewhat defeated. If I may make a suggestion, reschedule the trip to the park. Perhaps then it won't seem as defeating; we all have harder days than we'd like. Maybe rescheduling it will be a mental win by saying "you got me today, but I'll triumph over you tomorrow."

My .02 cents; it's free, and worth every penny.

 

[maddog]

Well, they do say that the best things in life are free Wcdean... and that advice is free, and good. Yes, I should do that... will try to do that, possibly for next weekend. Seems as though my life is an endless series of hard fought decisions, trade offs, internal bargains... all feels so horrifically exhausting most of the time, leading to times like now, when the world is too much. But yes, tomorrow might be better... it's a work day, so it will have to be.

Maddog

 

[mamachick]

I feel so grateful to be part of this group and appreciate how much caring and sharing is available for the asking.

Angel-I agree that where there is shame there must be some depression. Shame is very tough to overcome, easy to understand intelectually that we don't need it but difficult to rid the heart of. My T says that it has to change on the cellular level. Since we are made up of energy, we actually have to transform somehow.

As Ivy said, I think forcing ourselves to do things that we dont really want to is where we have to start. Maddog, I know Ivy is right and it sounds like you do some of what I do-and am glad to cancel. And as wcdean said, sometimes meds are necessary to get the boost to even do that. Im glad that you have become more open to meds wcdean-keep trying. I was on celexa and it stopped working, changed to Lexapro and I went downhill real bad. I am now on pristiq and I feel pretty good on it as far as mood, but I still have a sleep disorder and other stuff. I do feel joy. I laugh a lot, find humor in things, and am very grateful for the few people in my life. My dogs bring me great joy.

wcdean, I did not know that meds work differently for people with ptsd. I seem to be very sensative to many meds like anti-biotics and have even developed severe allergy in recent years. One dr suggested that I take a medication used for parkinson disease(evidently helps with loss of motivation from head trauma) , however, it can cause psychotic symptoms and I live alone-that scares me, so I have not tried it.

I do think we have to just force ourselves to do the things that we do not really want to do. I think that for some-a 30 day program for ptsd might be a good thing. While I would not like being away from home, I think that it would have helped me to rid of the overwhelming feelings that I felt before I shut down and let it all go. It feels as if I have to re-learn a lot and structure is the key. I know it is said that it would be too costly, but I dont think it would cost more than all the trials and errors and tests as a result of symptoms when treatment is so ineffective.

 

[NutritionNerd]

I didn't mention dopamine - it may be that some of the medications you are on have an impact on circulating dopamine. It combined with epinephrine are the two that get you going. And epinephrine can be in short supply as well. Sometimes it is a chicken and egg situation which can be attacked at either end - you get going and your chemicals boost as a result or you boost your chemicals to get you going.

One reason for short supply of neurotransmitters can be diet - I found out you need about 3 times as much protein when you are under high stress. I can look for the article if anyone is interested.

 

[wcdean]

If you don't mind and it isn't too much trouble I would love to read that article. I was heavily into nutrition (still am a health nut) but have never heard this. I used to bodybuild so would eat tremendous amounts of protein; after stopping the 6 meals a day, I did notice a significant increase in stress but I never thought the two may be related.

 

[Gamereign555]

I tend to burn myself out on tasks I commit to. My therapist says I should take a break, and put those items on my list of things to do the next day, and so on. But yeah, I have the same issues, cleaning the house, doing dishes, mowing the lawn... I tend to just let stuff go.

 

[mamachick]

game-thats exactly right-I had a history of cfid/fibromyalgia and 2 cervical herniated discs. I got much better. Prior to a head injury, I completed a bachelor in 3 yr and then masters in 3 yrs while working part time. Combined hours working about 50 -60or so. All the time, being a single parent of 2 teens who were extremely active in extraa cirricular activities and at different schools, driving, orthodontist appts, 100 yr old house that I have laid floor, replaced shower, tiled, put up fence, etc., painting, cleaning, yard work, etc. I continued after accident but was no longer happy doing all this stuff and became resentful. I was angry and depressed and in pain. I was overly tired and my judgement started being impaired. The first to go was social and hobbies. After 2 yrs, I quit working. Then as my kids went off to college, I took custody of a 7 yr old relative for one year. I continued with all the physical labors. I vowed to stop because of pain. I am 52 and about 115 #. I have done this all of my life. I have taken care of others and had too much responsibility. Now its just me and the dogs. Kids in grad school. The house is for sale. I still do maintainance but am learning to let it go as well. I think it is also part of detatching from the home we have lived in for 20 yrs.