“I feel like I’m just going through the motions,” a depressed client told me during our therapy session.
The client continued describing how she, slowly but surely, noticed that she rarely feels excitement, has interest, or even pleasure in doing things that she typically liked doing.
This realization hit her like a ton of bricks. She felt a deep sense of helplessness and hopelessness as she questioned if she’ll ever have those feelings of pleasure again.
What this client was experiencing is called anhedonia; an often overlooked yet important symptom that can manifest in different mental health conditions.
Interestingly, this may also appear on itself, in absence of any mental health conditions.
What is Anhedonia?
‘Anhedonia’ is reportedly derived from the Greek “a- (without) hedone (pleasure, delight).”
Anhedonia is a difficulty experiencing interest, joy, or pleasure in activities that you used to enjoy. It is important to note that this symptom may vary in different levels of intensity and that this is not an absolute loss of the capacity to experience joy. In other words, some people may feel incapable of experiencing pleasure at all, while others may feel diminished, dulled, or have a lower sense of pleasure/joy.
It could also be an important symptom in mental health conditions such as Major Depressive Disorder, Bipolar Disorder, Schizophrenia, Substance Use Disorder, PTSD, among other neuropsychological disorders.
Two Main Types of Anhedonia:
- Physical Anhedonia– Difficulty or inability to experience pleasure from sensory or physical experiences like eating, touching, sex, or movement (e.g., physical activities, hobbies). For example, a person may not feel pleasure from being hugged or eating a meal they used to enjoy.
- Social anhedonia– Difficulty or inability to experience pleasure from interacting with others or of being in social settings. For example, a person may find it difficult to enjoy being with others and have little motivation to engage in or seek out social situations. This can also contribute to experiencing emotional detachment and difficulty in building intimacy and/or emotionally connecting with others.
Signs and Symptoms of Anhedonia:
- Tendency to isolate and/or social withdrawal
- Difficulty engaging with others or adapting in social situations
- Decreased interest or difficulty listening, engaging, or following conversations
- Tendency to exhibit inauthentic emotions or feign emotions believed to be appropriate for situations (e.g., pretending you’re happy at a graduation or engagement party)
- Trouble seeking help or support from others
- Having negative thoughts or feelings toward yourself and others
- Diminished emotional abilities (e.g., exhibit less verbal/non-verbal expressions, difficulty managing emotions or expressing yourself, etc.)
- Loss of sex drive (libido) or interest in physical/sexual activity
- Frequently being sick (persistent physical problems)
- Feelings of hopelessness and/or suicidal thoughts
Research divides the experience of pleasure into two phases:
Anticipation is related to imagining, expecting, or predicting pleasure/reward from future activity. On the other hand, consumption is related to experiencing pleasure/reward in the moment, while engaging in the activity.
Further research proposes that anhedonia is associated with deficits in the reward system in the brain, more specifically “the anticipation, consumption, and learning of reward.”
According to different studies, reward processing involves several steps including the association between stimulus and perceived reward, and a cost-benefit analysis, which subsequently impacts interest, desire, and motivation. If there is enough motivation, there may be a sense of expected reward and could be followed by behavior (consummatory); which could lead to a sense of pleasure.
Important areas in the brain that have been associated with the reward system include the frontal-striatal circuit, composed of the striatum, orbital prefrontal cortex (OFC), and the anterior cingulate cortex (ACC). Furthermore, evidence suggests that neurons in the OFC are linked to sensory experience and can represent more abstract dimensions of reward such as probability (which could contribute to seeking reward).
Anhedonia could represent a key symptom in different mental health conditions, or it could present independently. Experiencing anhedonia could significantly impact a person’s perception about their quality of life as it relates to interest and/or pleasure. Furthermore, some research suggests that it could be associated with thoughts of suicide, and it could present in different mental health conditions such as Major Depressive Disorder, Bipolar Disorder, PTSD, Substance Use Disorder, Schizophrenia, etc.
If you believe you might be struggling with anhedonia, I hope that this article has been helpful.
If you believe you might benefit from extra support and guidance, you may consider trying therapy for depression.
Therapy Approaches and Interventions for Anhedonia:
- Behavioral Activation (BA)
- Mindfulness-Based Stress Reduction
- Cognitive Behavioral Therapy
- Stress-reducing therapies
Dr. Gabriela Sadurní Rodríguez is a licensed psychologist at The Psychology Group Fort Lauderdale and is an expert in trauma-related issues, depression, anxiety, life transitions/adjustments, and difficulties in interpersonal relationships. Call 954-488-2933 or email today to discuss how her services can help you.
Servicios disponibles en español.
Copyright © 2021 The Psychology Group Fort Lauderdale, LLC
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Download this tool to combat anhedonia. Think of it as your medicine. Follow the instructions and notice the joy return to the activities you like.