HomeAnswersAndrologydepressionHow can I handle emotional numbing, lack of motivation, and very low energy?

How can I handle emotional numbing, lack of motivation, and very low energy?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Ashok Kumar

Medically reviewed by

Dr. K. Shobana

Published At April 13, 2018
Reviewed AtMay 23, 2023

Patient's Query

Hello doctor,

I am 28 years old male with a weight of 147.71 pounds and a height of 5'9". I have been diagnosed with depression along with anxiety. I have been prescribed Clonazepam (0.5 mg initially and later 0.25 mg) with Escitalopram (till last weak 20 mg). My anxiety is under control to a good extent but my depression seems to persist. I have been switched to Prozac (20 mg) with 0.25 mg Clonazepam. I am mainly describing here the main symptoms which are disturbing me and persistent for almost two years. I have emotional numbing and dissociation with everything. It seems I am just passing time and not living it. I am living my life totally in hell. I do not have any heart and mind connections. I do not have any motivation. I have very low energy. I feel sleepy all the time even after eight to ten hours of sleep. I do not have much confidence. I want to fix all these issues at the earliest as these are affecting me badly along with my work life. Please advise.

Answered by Dr. Ashok Kumar

Hi,

Welcome to icliniq.com.

I read your query and understand your concerns. From the available description, it appears to me that you have a partial response to medication leading to incomplete treatment. Considering this fact, we have two options to manage the current condition. Either increase the dose of Fluoxetine to 40 mg, wait for three weeks before taking the next step, or to add Bupropion 300 mg per day with Fluoxetine 20 mg.

As there is no motivation, emotional numbing, and loss of interest in all things with decreased energy, I feel the second option is more suitable for you. The dose is often started at 150 mg per day to be taken in the morning and increased to 300 mg after four to seven days of initial treatment. This is a prescription-only medication, and you may require a prescription to buy it from the pharmacy.

Patient's Query

Hi doctor,

Thank you for the reply.

I am positive and my emotional numbness is due to me. My father passed away when I was ten years old. And this made me act differently, and I suppressed emotion throughout life, especially my anger. Still, I was fine when I graduated college. Something happened that caused me embarrassment, and I did exactly the opposite of my value which I regret till today. I suppressed my emotion to a greater extent. And today, I do not know who I am.

Please help.

Answered by Dr. Ashok Kumar

Hi,

Welcome back to icliniq.com.

I am glad to know that you have good insight into your condition which is likely to help you during the course of treatment. However, there are negative emotions attached to the insight that need to be dealt with effectively. Although this needs a lot of work I like to help you by changing your strategy of life so you can deal with them. First of all, we need to understand that we cannot change the past. Whatever happened, it is already over and cannot be rectified.

Considering this fact, you need to learn from the past, but, at the same time, you need to think that this is beyond your control and that I am not going to think about them again in the future. Secondly, engage yourself in one or another activity. Never leave enough time to creep these absurd thoughts into your mind. This is again very important as wasting time in these thoughts is unlikely to help you, but engaging in one or another positive activity will definitely help you. Thirdly connect with family and friends. I do not think staying alone and keeping these thoughts to yourself will help you. I hope this helps you. Feel free to write back to me if you have more questions. Thanks and regards.

Patient's Query

Hi doctor,

Thank you for the reply.

What other health issue should be checked that causes depression and anxiety-like symptoms but are not due to depression and anxiety? I need to know every possible issue and checkup. Thanks.

Answered by Dr. Ashok Kumar

Hi,

Welcome back to icliniq.com.

Thanks for the follow-up. Although there is a long list of disorders that can present with all forms of anxiety and depression but following are the conditions that is often present with these disorders. In fact, there is no anxiety or depression after the correction of these disorders. They are Thyroid disorders - hyperthyroidism as well as hypothyroidism, Pheochromocytoma, Vitamin B12 deficiency, Vitamin D deficiency, Developing depression, various medications such as steroids, anti-tubercular medications, b blockers, among others and various neurological disorders. In regard to checking the first three, brain imaging (to rule out neurological disorders) is recommended. The other issues need to be checked, provided there are some other symptoms that can not be explained on the basis of anxiety and depression. I hope this answers you. Thanks again.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Ashok Kumar
Dr. Ashok Kumar

Geriatrics

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