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Lack of stress / apathy/ anhedonia
Hi. I am 5'6". 76 kg. Currently taking paliperidone 75 Mg monthly depot injection.
My problem is that I dont feel stressed or anxious before important events like interview, exam, public speaking or even simple ones like before boarding the bus on daily commute. I used to feel stressed or anxious before but stopped feeling it in 2016. I also stopped getting pleasure from substances for e.g. alcohol. Felt stipend for fellowship was too little for too much hassle in one of the fellowship that I joined. Also felt the prospect of going to fellowship for 6 months as unsurmountable after attending just 3 days of orientation sessions. This all happened after 2016.
What might be causing this? Can vitamin b12 or vitamin D deficiency cause this?
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The symptoms you’re facing like not feeling stress before important events, reduced pleasure, low motivation, and feeling overwhelmed are unlikely to be caused by just vitamin B12 or D deficiency.
These signs may be related to negative symptoms or depression. This needs a proper psychiatric review to understand if your current treatment is fully suitable or needs adjustment.
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Symptoms that you have mentioned are suggestive of depression. B12, vit D deficiency can cause weakness but the symptoms of inability to experience or feel pleasure, loss of interest are of Depression.
*You must consult with your doctor and discuss with him, so that medication can be added to target your symptom
Do not worry, you will be alright once proper advice followed
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The features you are facing is negative affect which is common in schizophrenia and can also occur due to medication given for treatment because of dopamine blockade which is the neurotransmitter for happiness.
Mood disturbances may occur due to vitamin deficiency but there are many other symptoms which can occur due to vitamin deficiency other than mood.
Next Steps
Consult your psychiatrist for further evaluation and change of medication or therapy may also work
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The symptoms you are experiencing â lack of stress before important events, reduced motivation, and absence of pleasure â are signs of what we call negative symptoms. These are commonly seen in conditions like schizophrenia or schizoaffective disorder and are harder to notice than hallucinations or delusions but equally important. Since you are on paliperidone, which is a long-acting antipsychotic injection that blocks dopamine activity in the brain, some of your emotional blunting and lack of drive may be related to the medicine itself. While deficiencies in vitamin B12 or vitamin D can cause fatigue, low mood, and poor concentration, they do not usually cause this level of emotional numbness unless they are severely low.
Next Steps
You should discuss these symptoms directly with your treating psychiatrist. If these symptoms began or worsened after starting paliperidone, the dose may be higher than needed for your current condition or might need rebalancing. Sometimes doctors consider adding medications like aripiprazole or switching to a milder antipsychotic to bring back some emotional responsiveness. Blood levels of vitamin B12, D3, and thyroid hormones should still be checked to rule out additional contributing factors. Therapy focused on goal-setting and structured activity scheduling can also help bring back some internal drive.
Health Tips
Try to rebuild daily structure with small but consistent habits. Wake up and sleep at the same time every day, even if you do not feel like it. A short morning walk in sunlight can help regulate your body rhythm and mood. Include high-protein foods like lentils, eggs, or paneer, and consider taking B-complex supplements after checking your blood levels. Avoid alcohol entirely as it can further blunt your motivation. Keep track of activities that used to give you joy, and talk through them with a therapist even if they feel far away right now. With the right medical adjustments and slow reconditioning, emotional awareness and interest in life can be revived over time.
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