AreasLow mood and hard feelingsWhen you go numb

Five minutesAny ordinary dayEmotionally focusedLow mood and hard feelings

If a medicine has taken the edge off everything, including the good things, that is worth raising with whoever prescribed it. Taking the sharpness out of pain is one thing. Feeling nothing at all is not a way to live.

It matters practically as well as personally. Anything you are trying to change, in a relationship or in yourself, needs some feeling to work with, because a moment only teaches you something new if you are present for it. So a flattening that has gone too far quietly holds up everything else. This is a conversation about adjusting a dose or trying something different, not about stopping on your own.

Qur’an and Sunnah

Is a dead person brought back to life by Us, and given light with which to walk among people (Quran 6:122). Being able to move among people again, rather than merely being upright, is what the verse treats as life.

أَوَمَن كَانَ مَيۡتࣰ ا فَأَحۡيَيۡنَٰهُ وَجَعَلۡنَا لَهُۥ نُورࣰ ا يَمۡشِي بِهِۦ فِي ٱلنَّاسِ كَمَن مَّثَلُهُۥ فِي ٱلظُّلُمَٰتِ لَيۡسَ بِخَارِجࣲ مِّنۡهَاۚ كَذَٰلِكَ زُيِّنَ لِلۡكَٰفِرِينَ مَا كَانُواْ يَعۡمَلُونَ

Is a dead person brought back to life by Us, and given light with which to walk among people, comparable to someone trapped in deep darkness who cannot escape? In this way the evil deeds of the disbelievers are made to seem alluring to them

Qur’an 6:122read it in the library

Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.

What the research says

The flattening of pleasure is known to be stubborn. In a secondary analysis of 440 depressed patients from a randomised trial, both cognitive behavioural therapy and behavioural activation improved the loss of pleasure and interest, but it responded less completely than the other symptoms and often lingered. This part often needs to be raised specifically rather than waited out.

Alsayednasser B, Widnall E, O'Mahen H, Wright K, Warren F, Ladwa A, Khazanov GK, Byford S, Kuyken W, Watkins E, Ekers D, Reed N, Fletcher E, McMillan D, Farrand P, Richards D, Dunn BD. (2022). How well do Cognitive Behavioural Therapy and Behavioural Activation for depression repair anhedonia? A secondary analysis of the COBRA randomized controlled trial.. Behaviour research and therapy doi

Strength of evidence: one line of research. A single study, or a theoretical account.

Why it works

Nothing new gets learned in a state where nothing registers.

When not to

Never stop or reduce a psychiatric medicine on your own; raise it and plan any change with the prescriber.

This one is still a draft. It is waiting on a scholar and a clinician to read it before it is published.

Near this one

More on low mood and hard feelings

If a medicine has taken the edge off everything, including the good things, that is worth raising with whoever prescribed it. Taking the sharpness out of pain is one thing. Feeling nothing at all is not a way to live · Inshirah