Anhedonia: When you lose the ability to feel joy.
Are you just "going through the motions" in life?
"I'm just going through life because I have to. I don't really gain anything from living each day - neither excitement nor joy."
This firsthand account is what it's like to experience Anhedonia, a condition that takes away the feeling of pleasure in the things you used to love.
For example, if you are an avid reader, Anhedonia might cause you to no longer gain any enjoyment from reading. It makes you lose the ability to feel enjoyment in many of the things you used to enjoy, be it sports, hobbies, and food.
This lost of pleasure is often accompanied by a sense of hopelessness. It's hard to be optimistic when you start to wonder if you will ever be able to regain the ability to enjoy.
The world seems to have lost its multicolor vibrancy - only to be substituted by shades of grey.
What is Anhedonia?
Anhedonia is derived from Greek, where it stands for “A (without) - hedone (pleasure).”
Anhedonia might occur on it's own, or as part of other mental health conditions.
It's a common symptom with Major Depressive Disorder (MDD), with research suggesting that 37% of individuals experiencing MDD will also experience clinically significant Anhedonia.
Other than Major Depressive Disorder, it also presents itself with other conditions like Bipolar Disorder, Schizophrenia, Parkinson's, and Post-Traumatic Stress Disorder (PTSD).
Anhedonia presents itself in two categories:
1) Physical Anhedonia:
Difficulty experiencing pleasure from physical or sensory experiences - like eating, sex, playing sports, or any hobbies you used to love. You might even feel you've lost the ability to feel pleasure when your loved ones hug you.
"It just feels like a part of me is broken. I don't function like a normal human being anymore. I don't even enjoy ice-cream or sex."
2) Social Anhedonia:
Lost of pleasure from interacting with others socially. You might start to feel like you no longer enjoy time out with your friends, which makes you see no point in going to social situations. This contributes to further emotional detachment from others, including your loved ones.
"One day I went out with some friends and I just felt numb. I didn't see the point in it anymore. So I stopped going out to meet friends."
Spotting Anhedonia in a loved one.
A person with Anhedonia may struggle to show interest in various things, be it meeting friends, engaging in his or her favourite hobbies, doing chores at home, or even leaving the house.
They will display sharp changes in their thinking patterns and speech. You might hear them frequently complain that there is no point to doing anything, that nothing really matters, and that the future is pointless.
This might make them appear lazy, but understand that it's driven by their loss of motivation to pursue activities, since they don't get any joy out of it. Having to do so is simply energy draining for them.
Since they don't see the point in doing anything, they might also appear apathetic and disinterested in what you and other people around them are doing.
A core part of Anhedonia is that it makes it difficult to remember the good times. They might frequently say they can't remember what was it that they used to find pleasurable, exciting or engaging.
Seeing a loved one struggling with Anhedonia is painful, and sometimes frustrating. Here's what to do to help.
There are two types of treatment often used to treat Anhedonia. The first are medications, like selective serotonin reuptake inhibitors (SSRIs).
Research has found that Anhedonia is linked to to abnormal volume in brain structures related to seeking rewards (i.e. ventral striatum and the prefrontal cortex). According to brain scans, there is also less activity in these areas.
However, like many other Neurophysiological disorders, it's difficult to say if Anhedonia causes these changes, or if these neurobiological changes cause Anhedonia. It's a chicken and the egg situation.
Do note that the use of SSRIs do help to relieve hopelessness and other negative feelings. However, they haven't been found to be successful in treating Anhedonia or promote positive feelings or joy specifically.
On the other hand, there is Psychotherapy. The most common therapy will be Cognitive-Behavioural Therapy (CBT), the treatment of choice for Depression.
CBT works by targeting thoughts and beliefs related to Anhedonia. By challenging negative and defeatist beliefs, the person is encouraged to restructure their thoughts into something more constructive.
Through the use of behavioural strategies, they are further encouraged to engage in frequent, healthier activities, instead of unhealthy ones like drinking. Through repetition, they slowly relearn the ability to feel pleasure again.
Similarly, Acceptance and Commitment Therapy (ACT) has shown results in helping people to recover from Anhedonia. ACT teaches people to become more aware of their thoughts and beliefs, learning to accept them as they are while recognising they don't have to be controlled by them.
ACT then teaches them to refocus on their values, encouraging them to engage in behaviours that are personally meaningful, where over time they learn to find pleasure in doing these meaningful activities again.
You can read more about ACT on this blog.
Thanks for reading Kaya Toast for the Soul. If you need more information, don't hesitate to contact me via email. I can send you recommendations for therapy too.