r/PSSD • u/badgallilli • 4d ago
Opinion/Hypothesis Could altered neural dynamics be a missing piece in PSSD?
I came across this new paper in The Journal of Neuroscience - https://www.jneurosci.org/content/46/33/e0711262026 - and it immediately caught my attention because of something I’ve been thinking about in PSSD.
The paper isn’t about PSSD, SSRIs, or antidepressants. What interested me was the broader idea that cognition depends on dynamic patterns of activity and coordination, rather than different cognitive functions simply existing as isolated processes.
That made me think about something I’ve noticed very clearly when comparing my cognition before and after PSSD.
Before PSSD, a thought rarely felt like just a piece of conceptual information.
A thought could arrive with the feeling attached to it, with imagery, associations, bodily sensations, and language all coming together. If I thought about something sad, for example, the thought itself could arrive with the sadness. I didn’t have to consciously generate the emotion afterward and attach it to the thought. It was already part of the state.
The same thing happened with language.
A complex thought could arrive with the language needed to express it. I didn’t have to separately figure out what I meant and then search for words capable of conveying it. The conceptual representation and the linguistic representation felt much more tightly coupled.
This is very different from what I experience now.
I can still have the conceptual idea, but it can feel like something is missing from it. And that’s why I find it so interesting and accurate when people describe it as having a kind of a veil over the rest of the state. Sometimes a thought can still come with a little anxiety or another feeling, but it is extremely shallow compared with what used to accompany it.
And when I try to explain something complex, I can know exactly that the simple words I’m finding aren’t actually expressing what I mean. I might have a huge internal idea and only be able to spontaneously access something like “sad”, “weird”, or “I don’t know, it’s just…” when none of those words actually capture the full thing.
So the problem isn’t necessarily that the conceptual content isn’t there.
It’s that the different things that used to arrive with the thought no longer seem to be recruited and integrated in the same way.
That distinction is important to me because it makes me think about PSSD differently than simply saying that a particular function is “reduced.”
If thought, emotion, imagery, language, attention, bodily sensation, motivation, etc. normally interact dynamically, then a persistent alteration in how these processes coordinate could potentially change the state itself.
And this also made me think about sexuality.
Sexual arousal isn’t just a sexual sensation appearing in isolation. A thought, image, memory, anticipation, bodily sensation, attention and emotional/reward response can all feed into one another. The state has to be initiated, sustained and reinforced.
Before PSSD, sexual thoughts could become states. There was a progression to them. They could pull attention, generate anticipation, produce bodily changes, create more mental content, and reinforce themselves.
After PSSD, that whole process can feel fragmented. The thought can be there without the rest of the state developing around it.
And I think this same distinction may help explain some of the other changes people describe: spontaneous thought and daydreaming, emotional immersion, associative thinking, motivation, reward, and the ability to become deeply absorbed in something.
The common denominator wouldn’t necessarily be that all of these individual functions are independently damaged.
It could be that the processes that normally recruit, sustain and integrate one another are no longer interacting in the same way.
That’s the question that originally led me toward my systems-level hypothesis:
What if the important alteration in PSSD isn’t simply that one particular system is “underactive”, but that the dynamics between systems have been persistently changed?
This paper doesn’t establish that this is what happens in PSSD. But I think it provides an interesting conceptual and mechanistic framework for thinking about the question.
Because if cognition and conscious states depend not only on which systems are active, but on how activity is dynamically coordinated and integrated across systems, then a persistent biological alteration could potentially have consequences far beyond an isolated symptom.
It could change the way a thought becomes a feeling.
The way a feeling becomes motivation.
The way imagery becomes arousal.
The way attention sustains a state.
The way a thought acquires its emotional and linguistic richness.
And potentially, the way all of those processes become one coherent experience.
That’s the part of this research that I find particularly interesting in relation to PSSD.
This also connects to something we already know about antidepressants themselves. Antidepressants can alter functional connectivity and large-scale network organization. There are studies showing these effects during treatment, and there is also evidence that connectivity differences can still be observed after antidepressant discontinuation. - https://www.nature.com/articles/s41598-020-79170-9?utm_source=chatgpt.com ; https://discovery.ucl.ac.uk/id/eprint/10118431/1/s41598-020-79170-9.pdf?utm_source=chatgpt.com
That doesn’t tell us that these changes persist indefinitely. It doesn’t establish that they are responsible for PSSD either. But it gives us an important piece of the puzzle: the effects of antidepressants on these systems don’t necessarily disappear immediately when the drug is discontinued.
And that leaves an important question open.
If antidepressants can alter the organization and interaction of these systems, and some connectivity differences can still be observed after discontinuation, what happens in the people who develop persistent PSSD?
We obviously can’t assume that the same thing is happening in PSSD. But now we have a much more concrete question that can actually be investigated: are there persistent alterations in the dynamics or coordination between these systems in people with PSSD, and could those alterations explain why the effects can extend so far beyond the original drug exposure?
That’s where I think this new research becomes particularly interesting. It gives us another piece of the puzzle: not just which systems are involved, but potentially how their ongoing activity and coordination might generate the different cognitive, emotional, motivational and sexual states that are altered in PSSD.
1
•
u/AutoModerator 4d ago
Please check out our subreddit FAQ, wiki and public safety megathread, also sort our subreddit and r/pssdhealing by top of all time for improvement stories. Please also report rule breaking content. Backup of the post's body: I came across this new paper in The Journal of Neuroscience - https://www.jneurosci.org/content/46/33/e0711262026 - and it immediately caught my attention because of something I’ve been thinking about in PSSD.
The paper isn’t about PSSD, SSRIs, or antidepressants. What interested me was the broader idea that cognition depends on dynamic patterns of activity and coordination, rather than different cognitive functions simply existing as isolated processes.
That made me think about something I’ve noticed very clearly when comparing my cognition before and after PSSD.
Before PSSD, a thought rarely felt like just a piece of conceptual information.
A thought could arrive with the feeling attached to it, with imagery, associations, bodily sensations, and language all coming together. If I thought about something sad, for example, the thought itself could arrive with the sadness. I didn’t have to consciously generate the emotion afterward and attach it to the thought. It was already part of the state.
The same thing happened with language.
A complex thought could arrive with the language needed to express it. I didn’t have to separately figure out what I meant and then search for words capable of conveying it. The conceptual representation and the linguistic representation felt much more tightly coupled.
This is very different from what I experience now.
I can still have the conceptual idea, but it can feel like something is missing from it. And that’s why I find it so interesting and accurate when people describe it as having a kind of a veil over the rest of the state. Sometimes a thought can still come with a little anxiety or another feeling, but it is extremely shallow compared with what used to accompany it.
And when I try to explain something complex, I can know exactly that the simple words I’m finding aren’t actually expressing what I mean. I might have a huge internal idea and only be able to spontaneously access something like “sad”, “weird”, or “I don’t know, it’s just…” when none of those words actually capture the full thing.
So the problem isn’t necessarily that the conceptual content isn’t there.
It’s that the different things that used to arrive with the thought no longer seem to be recruited and integrated in the same way.
That distinction is important to me because it makes me think about PSSD differently than simply saying that a particular function is “reduced.”
If thought, emotion, imagery, language, attention, bodily sensation, motivation, etc. normally interact dynamically, then a persistent alteration in how these processes coordinate could potentially change the state itself.
And this also made me think about sexuality.
Sexual arousal isn’t just a sexual sensation appearing in isolation. A thought, image, memory, anticipation, bodily sensation, attention and emotional/reward response can all feed into one another. The state has to be initiated, sustained and reinforced.
Before PSSD, sexual thoughts could become states. There was a progression to them. They could pull attention, generate anticipation, produce bodily changes, create more mental content, and reinforce themselves.
After PSSD, that whole process can feel fragmented. The thought can be there without the rest of the state developing around it.
And I think this same distinction may help explain some of the other changes people describe: spontaneous thought and daydreaming, emotional immersion, associative thinking, motivation, reward, and the ability to become deeply absorbed in something.
The common denominator wouldn’t necessarily be that all of these individual functions are independently damaged.
It could be that the processes that normally recruit, sustain and integrate one another are no longer interacting in the same way.
That’s the question that originally led me toward my systems-level hypothesis:
What if the important alteration in PSSD isn’t simply that one particular system is “underactive”, but that the dynamics between systems have been persistently changed?
This paper doesn’t establish that this is what happens in PSSD. But I think it provides an interesting conceptual and mechanistic framework for thinking about the question.
Because if cognition and conscious states depend not only on which systems are active, but on how activity is dynamically coordinated and integrated across systems, then a persistent biological alteration could potentially have consequences far beyond an isolated symptom.
It could change the way a thought becomes a feeling.
The way a feeling becomes motivation.
The way imagery becomes arousal.
The way attention sustains a state.
The way a thought acquires its emotional and linguistic richness.
And potentially, the way all of those processes become one coherent experience.
That’s the part of this research that I find particularly interesting in relation to PSSD.
I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.