Dr. Siva Anoop Yella
Psychiatry
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I am 30 years old and I have never fallen in love, even though I have been with girls I liked very much. I think it is because I took Venlafaxine (Effexor) a few years ago. I stopped using it eight years ago. However, I feel like my emotions are very much like when I was taking them. I feel like I am starting to have emotions. It rises and then crushes and comes back down. I think the medication prevents me from having strong emotions. Is there anything I can do at all?
Please help.
Hello,
Welcome to icliniq.com.
I went through your query and understood your concern. May I know if you are still using Venlafaxine (antidepressant) or not? If you stopped eight years ago, it is unlikely that the emotional blunting is due to it. It might be due to anxiety and depression. So kindly tell me if there are any symptoms of anxiety and depression.
Patient's Query
Hi doctor,
Thank you for your reply.
No, I am never going to use this drug again or anything that influences my brain chemistry. I do feel depressed, but not always. For example, I spent a nice week with a girl in a transcontinental country a year ago. And I felt very happy with her, but as soon as I returned home, I felt nothing. I fell in love once when I was 22. It was entirely hormones based and faded after a week, I felt invincible. I have never felt like that again.
Please give me your opinion.
Hi,
Welcome back to icliniq.com.
As age progresses, there are possibilities for the hormones to become low. I would suggest you to get a hormonal profile done for serum testosterone and serum prolactin. Also, I have a few questions for you, may I know if you are having sexual desires on a normal basis, like erections and ejaculation? How is your sleep lately?
Kindly follow up.
Patient's Query
Hi doctor,
Thank you for your reply.
Fine, I will see if I can do those hormonal tests. Yes, I get erections regularly. But, sometimes, it is hard to reach orgasm, just like when I took Venlafaxine. With Venlafaxine, it was impossible to reach orgasm, which is now difficult sometimes. My sleep is always a problem, but I am trying to fix it by improving my sleep hygiene. Please give me your suggestions.
Hi,
Welcome back to icliniq.com.
Depression could be one of the main reasons for your decreased orgasm. Kindly answer few questions, do you feel low most of the time during the day? Do you have decreased interest in your daily activities? Do you have decreased appetite? Do you have negative thoughts about your future? Do you feel lonely or stressed mostly?
Patient's Query
Hi doctor,
Thank you for your reply.
To answer your questions, I do not have decreased orgasms. I have orgasms multiple times daily, and it is difficult. Yes. Lately, I have been feeling low and have difficulties even sitting idle. I find it exhausting. I am unemployed. So, my daily activities are playing video games and watching pornography. I try to do some exercise like yoga, though. No. I do not have decreased appetite. But I have frequent nausea, which is why I dislike eating. Yes, I have negative thoughts about my future. I do not see a future for myself. I have suicidal thoughts. I do not think I would commit suicide, but if I do not wake up tomorrow or if a car hits and kills me, that would be great. Yes, I feel lonely. And even though I could not feel love with the girl I spent a week's holiday with, I still miss her. I tried revisiting her five months ago, but that is when the war started with the flight restrictions.
Please help me.
Hi,
Welcome back to icliniq.com.
Then definitely you need treatment with medications for depression as it is of moderate intensity. I recommend you to consult a psychiatrist in your city so that you can get a prescription. Meanwhile, I suggest you to follow few instructions exercise daily, follow a daily routine, try to be productive, consider having daily goals, and try to achieve them. Socializing with friends and family will get you out of loneliness. Have a good diet especially, those rich in vitamin E and serotonin, to improve your depression and orgasm. If you are drinking coffee regularly, kindly avoid it. Drinking excess coffee and tea also decrease your sleep. However, I have one more question for you. Do you drink alcohol, smoke cigarettes, or any other substances?
I hope this has helped you. Take care.
Patient's Query
Hi doctor,
Thank you for your reply.
No, I will never take any medications that influence the brain. It did enough damage to me already. But, I will follow the instructions mentioned by you. Yes, I will try following a daily routine. No, I do not drink alone. I always socialize. I do not smoke. I think it is disgusting. I do not drink coffee. I drink tea occasionally, but more in the winter. Thank you for your advice on the diet. I will try that out.
Thank you for your time, doctor. I wish you a good day.
Hi,
Welcome back to icliniq.com.
If there is anything else that I can help you with, do not hesitate to consult me through icliniq.com.
All the best. Take care.
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