Q. What causes someone to feel lonely and not socialize?

Hi doctor,

I am a 23-year-old guy and Ihave had this problem for as long as I remember. I have a constant inner feeling of emptiness in my head. Like I am not able to think clearly at all. When I close my eyes, it is completely black. No thoughts, no images, no imaginations, nothing at all. I am in my body, but my brain is dead. I have no inner monologue or stream of thought, one of the most common things humans experience. Human beings can reflect upon different things and think deeply. But for me, it just does not work. There is just blank all the time. If I try to think about something, it is just like I cannot make any words appear. The room where thoughts normally occur is filled with heavy, black fog.

How does it affect a human being to have a thought function that barely exists?

Is it normal to have a thought function run on 10 %?

When people speak together, we take turns saying what comes into our minds. One person says A, which makes the other think about B, and the other thinks about C. A play of associations. A long and stimulating talk makes people connot. Some people bond so well that they can talk together for hours.

But what if you did not have this constant stream of thoughts and did not think anything when the opponent said something to you?

Then you have serious problems participating in a normal conversation which is the fundament of building relationships with others. This condition makes you unable to connect with any person in the world. And all this makes you feel extremely lonely and isolated even though you have the same social need as a normal person. Even when you are together with other people, you still feel this loneliness because you simply can not connect.

All this affects me a lot emotionally. It is unbearable not being able to connect to anyone at all. It is so frustrating and makes me feel so lonely. It is hard to see all your potential, which cannot come to life as your brain does not work. It is frustrating to be inside a human body when you feel that the real you can only manifest 10 % of yourself. The rest is hidden in this fog of emptiness. I am only a shadow of myself. This is the worst torture I can imagine. I am so frustrated that it burns inside me. It feels like I drag around a hollow body with no one home.

I have tried different medications. SSRI (Paroxetine, Sertraline, Citalopram), Amphetamine, Methylphenidate, Pregabalin, Nortriptyline, Quetiapine, and Benzos. I also tried cannabis, LSD, and Ketamine. The only thing that had an effect was Paroxetine (very small effect, however) and cannabis (it worked once and made my thoughts flow for like 30 minutes, but if I smoke today, I feel even weirder in my head).

All this makes me so afraid, so stressed out, so frustrated, and so depressed. The worst thing about it is that this condition is not normal. No doctors or psychologists have been able to give me a proper explanation. Nobody seems to understand it (or care at all). It feels like the frontal part of my brain is sleeping, like it just needs a huge electrical shock to start working again. I do not know what to do anymore.

Thank you.