Expert: Ivan Goldberg, M.D. - 12/22/2010

Question
I am 22 years old, female and used to be an exceptionally emotional person. I
felt more emotion, and love than any person I knew. I considered myself to be
extremely passionate, but in the past two years, I have lost all ability to
feel.

One morning I just woke up and felt empty inside and have remained empty since
then.

I have tried telling doctors this, but they refuse to believe me - thinking that
I am exaggerating or making it up.

I have actually been hospitalized on 7 different occasions with bipolar manic
episodes - but have not needed to be hospitalized in the past two years since my
mood has not fluctuated at all.

I'll be in a movie theatre and look around me and see people crying and tearing
up, yet I feel nothing.

The best way to describe it is being very monochrome -  feeling the same all the
time.

I was on 300 of seroquel and thought that was the reason, but went off of it
about 4 months ago and still feel relatively numb.

I have been an asexual for a total of 2 years now, and do not feel any sort of
attraction (physical or emotional), towards people.

I am thinking of seeing a neurologist but am not sure if it is a waste of their time.

I don't believe that I deserve this, and assume that I must have damaged my
brain somehow. The lack of emotion occurred 4 days after a severe manic episode. During that time I experience strong euphoric like love and emotion, and then it was proceeded by a complete lack of all feelings and has persisted since then.

My history: from age 5 - 17 - I experienced what can only be described as an emotional nightmare - I experienced so much emotion there are no words to explain it - I did not feel a moment (this is not an exaggeration) of calm, or non depression in all those years - I was depressed, anxious and stressed every moment I was awake. Essentially the opposite of what I experience now.  I used to have bald spots, grey hair and would also pull out my hair from stress.

I have come to the conclusion that the lack of emotion is NOT from trauma or anything related, and is chemical in nature - my brain literally does not let me feel.

Thank you so much for reading this, and I am honestly desperate to find some help. I Really appreciate you taking the time to help me.

Should I go to a neuropsychiatrist?

Any insight would be great!

Answer
Hi Krista . . .

I have had more than a few patient use the word "monomood" when describing their (lack of) emotional life. In my experience there are three causes for such feelings:

1. Currently taking too high a dose of mood controlling medication. Antidepressants, lithium,
   and mood stabilizers such as valproate, and carbamazepine can all cause this feeling of
   being emotionally (and sexually) dead.  I have never seen such symptoms persist when the
   dose of the offending medication was lowered, in instances when medication was the cause.

2. Some people report "monomood" as a symptom of depression.

3. Emotional blunting is one of the criteria for the diagnosis of PTSD. You might want to
  read more about PTSD at: http://www.homepage.psy.utexas.edu/HomePage/Class/Psy394U/Bower/03%20Emot,%20Tra...

If you are currently on medications, a psychopharmacologic second opinion is where you might start. If you are not taking at medications at this time you might want to consult with a psychiatrist who is an expert when it comes to PTSD.

Best regards . . .

Ivan
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