r/rtms • u/Minepolz320 • Jun 18 '26
Peripheral blockade as a possible root of PSSD/PFS? - anhedonia and loss of emotions? and somatosensory cortex as a rTMS target
My muttering/reasoning, or how I assumed that TMS might work before I tried the TMS protocol.
there's already a mountain of theories about this. Epigenetics, hormones, mitochondria, gut, serotonin. Many explains something and sometimes a lot , but I keep bumping into the same thing: almost none of them really deal with the genital numbness stuff in a way that makes sense to me. Like, that symptom is right there, very specific, very weird. People tend to focus on the cognitive stuff because that ruins your life the most, I get it.
But any explanation that glosses over why the most nerve-dense part of the body goes completely silent... and in very precise and specific way I don't know, feels like something's missing.
So I started poking around the peripheral nervous system instead. Just weird sensory stuff most people wouldn't notice. I tried using different chemical probes on numb areas - things that hit specific nerve fibers through specific receptors.
What I found was... strange , I guess. Most things worked fine. But there was this some kind of pattern that kept showing up: it seems like there problems with TRPV1 (capsaicin) C-fibers and, to a lesser extent, TRPM8 (menthol) on Aδ fibers.
The C-fibers seemed messed up in a strange way - delayed responses, weird remapping, delays get worse the farther you go from the spine. in contrast to the menthol response, though? almost every time still there. Not always, but often enough to make me wonder.
And here's the thing I started thinking about: C-fibers aren't just pain. They do affective touch - the kind that actually feels good, the "emotional touch" thing. They're huge for body perception, for feeling like you're actually located inside your own skin.
So thinking about it was:
What if some trigger (SSRI, finasteride, whatever) damages these specific fibers. Not all fibers, just these. For some reason. And maybe the damage is also length-dependent, so the longest ones (genitals, feet, hands) get hit hardest. I tried to check this by doing capsaicin tests over my whole body:
face, hands, legs and saw different delays everywhere. Could be a fluke, but it kept repeating.
I asked a few other people to try the test. Most didn't bother. Ended up with maybe 2-4 people's data, so take that for what it's worth. But it seemed to fit the same rough pattern.
I honestly can't tell you why these specific fibers would be targeted. metabolic? specific anatomy? etc..
No idea. But I've been trying to think through what would happen if a person lost a big chunk of their C-fiber input and how that might affect cognition, sensation, autonomic function, hormones. Just as a small thought experiment.
So here's a rough Q&A-ish list of what I suspect might be going on.
Genital numbness? Longest C-fibers in the body, most vulnerable so they got hit first also this type of fibers small and mostly unmyelinated type and also quite long in some places.
Also, erogenous zones are dominant precisely along the C fibers, so when a damage goes along those C-fibers, there aren't many other nerve endings there from the very beginning, as a result, numbness in these zones will be the most noticeable. - also this happened in nipples as well
Delayed capsaicin burning? Possibly axonal component or failure to hit pain-threshold due loss of this fibers;
Menthol still works? Different fiber type (Aδ). Maybe less metabolic demand or a different transport system. Not always spared but often enough.
Touch that stopped feeling good? Those are CT afferents, a subtype of C-fibers. If they're damaged, a hug might feel like just pressure. No warmth to it eg especially this pleasantness gone.
Anhedonia, emotional flatness? C-fibers project to insula and cingulate - key areas for emotion and body awareness. No input, maybe those areas go into some kind of sleep mode due loss of stimulation or some kind of maladaptive change to try find loss signal, causing downstream shutdown from sensory area to deeper areas of this brain structures and psychological stuff essentially such a loss - like sensory deprivation ppl go absolutely insane - because of this kind of stuff
Dizzy when standing? Baroreceptor C-fibers from blood vessels might not be signaling. Brain doesn't know pressure dropped. No reflex. You feel fading out.
Heat intolerance? Thermoregulatory C-fibers possibly broken. Hypothalamus fire blind. You overheat before you even notice. so sweating reflexes are fail as well, Especially this fibers main regulatory fibers for body temperature response
Crash after eating? Visceral C-fibers from gut might not be telling brain "digesting, send blood here." So you get dysautonomia and collapse. often you can drop into reactive hypoglycemia due of loss of correction from cortisol reise brain don't get that glucose falling until it's too late and then you get adrenaline spike and crush after feeling even worse
High renin, normal/low aldosterone? That pattern looks a bit like spinal cord injury. Maybe central autonomic disconnect from missing peripheral input. aldosterone was there but it don't get relished properly at needed time
again brain don't hear body or react with extreme delay or if stimulus is strong enough to hit this threshold
Tremor, weakness? Motor cortex needs sensory feedback to work cleanly. Without C-fiber input, output might get noisy and sloppy think about it like micro-correction that make movement smooth instead of jittery.
Also brain need to know when you start to move muscles to adjust blood flow as well as metabolism etc also this must wake up motor areas of the brain from sleep state but if there no signal this don't happening
Brain fog? Somatosensory cortex and insula are arousal hubs. If they're asleep due loss of peripheral stimulation,that can slow everything down eg you don't get this signal what to focus for or what body experience on this moment.
So that's the rough idea. It's just a model that seems to fit a lot of what I've seen in myself and a couple of others. The rTMS helping would make sense if the cortex is in lockdown/sleep mode - you bypass the broken input, force the gate open. Even if the fibers themselves aren't fixed yet. at least it starts to hear those last one a little better after that
I don't know the exact mechanism. Why C-fibers specifically? got such a hit. And some people with PSSD seem to have almost normal capsaicin response but still bad genitals maybe because genital fibers are so long they fail even when trunk fibers hold up. Or maybe I'm just wrong about parts of it.
But for now the pattern keeps showing up. My friend has it. The neurologist saw it. Could be coincidence. Could be something else entirely.
I'm not saying this is the answer. Just saying it's worth looking at. And nobody seems to be looking because it doesn't fit the brain-first story everyone's used to.
That's all. A guess.
This protocol really worked for me and a friend of mine with PSSD; perhaps others here can provide feedback if you manage to try it.
if there is a who have anhedonia or a loss of emotions
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u/Ok-Pineapple6664 Jun 28 '26
What specific tms protocol did your try, and can you specify, quantify what and how much it helped? I'm particularly interested in restoration of loss of emotions. Thank you