It just occured to me that substance use might have fucked up my brain and sexual functioning further. I've not noticed any changes, but they might have impeded recovery.
I don't know what to look for but I would appreciate it if someone with some knowledge could try and find out whether any of this might effect PSSD.
-Heavy smoking most of the time since my first SSRI including while on Risperidone, Risperidone + Sertraline, Risperidone + Vortioxetine
-Heavy daily alcohol use both on and off SSRIs
-Heavy cocaine use for a 2 month period while on Risperidone + Sertraline and Risperidone + Vortioxetine
-Light ketamine use while on Risperidone and Vortioxetine
-Moderate cannabis use without any concurrent medication
-Moderate benzodiazepine use while on Risperidone + Vortioxetine
And looking forward, would it make any difference to quit smoking cigarettes? I smoke enough at the moment that it probably always has an effect on bloodflow etc, but in the past I've smoked a lot less and it's not seemed to make any difference. I've quit for a month or so as well since PSSD and it made no noticeable difference. I'm more concerned with the effect of nicotine on the dopamine system which I don't understand. Should I abstain from drinking? Drink a lot? Drink a small amount?
Advice on any of this would be appreciated.