Anhedonia: when you don’t enjoy or absolutely nothing excites you

Do you have the feeling that nothing excites you? Do not you enjoy things like before? Do you feel that you have lost the ability to experience pleasure? So perhaps you are experiencing anhedonia.

Anhedonia is defined as an absence of pleasure or an inability to experience pleasure, satisfaction, or enjoyment. It is a very characteristic symptom in depression, but it can also appear in other disorders or in isolation, at specific times in our lives.

If you want to know what exactly it consists of, what causes it and how it is treated, stay!

Anhedonia: what is it and when does it appear? 

• The word “anhedonia” is a term that comes from the Greek, from the words ἀv- (which means “lack of”) and ἡδονή (hedoné, which means “pleasure”). Thus, it consists of an inability to experience pleasure.
• Normally, we experience this sensation with things or situations that used to give us pleasure. That is, it usually entails a loss of pleasure or enjoyment.
• In this way, we can say that anhedonia implies a lack of enjoyment, interest and/or satisfaction; It is that sensation that we experience when nothing excites us and when we feel like nothing.
• In which people does it appear? Anhedonia is a typical symptom of some mood disorders such as depression or dysthymia, but also of psychotic disorders such as schizophrenia. However, it can also appear in people without any mental pathology, as an isolated symptom (at specific moments or periods of their lives, due to X circumstances).

Anhedonia as a symptom 

1. The fundamental symptom of anhedonia is, as we said, the inability to experience enjoyment or pleasure. Many times it is a temporary symptom, which occurs within or outside the context of a mental disorder; that is, that ability to enjoy can be recovered over time, it is not something that lasts forever.
2. Actually, rather than talking about “anhedonia symptoms” we can talk about “anehdonia as a symptom”, and this implies a lack of reactivity to normally pleasant stimuli.
3. It is important to know that, although the first definitions of anhedonia placed the pleasurable experience as a central element in their definition, recent models have begun to emphasize another fundamental element in this concept: motivation or the desire to participate in certain activities.
4. That is to say, they emphasize, beyond pleasure, the motor that moves us (motivation) and the sensation prior to the pleasure or the execution of the action (desire).

Causes of Anhedonia

There are several causes that can explain the appearance of anhedonia:

Dopamine deficiency 

1. On the one hand, the possible existence of physiological causes has been postulated, through an alteration in the brain that hinders the synthesis of dopamine. Dopamine is a brain neurotransmitter that is involved in feelings of pleasure and gratification.
2. If its synthesis is impaired (and therefore we have less dopamine in the brain), symptoms such as anhedonia may appear.
3. Dopamine synthesis does not depend solely on our brain mechanisms, but on our daily habits. For example, the consumption of certain drugs or withdrawal from them, taking certain drugs (especially antidepressants and anxiolytics) or leading a sedentary life, can affect the synthesis of said substance (reducing its levels). On the other hand, playing sports, listening to music or meeting friends (and having fun with them) can increase dopamine synthesis.

Suffering from a mental disorder 

Another possible cause of anhedonia is suffering from a previous mental disorder that justifies the symptom, such as:

Depression

Beyond the physiological causes, the fact of suffering from a mood disorder, such as depression, could also explain the appearance of anhedonia. In turn, the causes of depression are related to biological, social, and emotional mechanisms.

Schizophrenia

Having schizophrenia could also be another possible cause of anhedonia. In this case, it is part of the negative symptoms of schizophrenia (Kaiser et al., 2011), together with other symptoms such as affective poverty or affective incongruity.

Anxiety and stress

Living through a particularly stressful time can also lead to a symptom such as anhedonia. Similarly, suffering from anxiety can also cause this type of symptom.

A variant of anhedonia: social anhedonia

• There is a variant of anhedonia that is social anhedonia. This is defined as a lack of interest or enjoyment in social contact and a lack of pleasure in social situations.
• According to an article by Gooding et al. (2016), published in the Journal of Psychiatry and Mental Health, social anhedonia is a common feature in a wide variety of psychiatric disorders. These include: major depression, schizophrenia and schizophrenia spectrum disorders, post-traumatic stress disorders (PTSD), autism, and eating disorders (EDs).
•  In the same way, in these disorders we can also find generalized anhedonia (to which we have referred so far), either at specific moments of the disorder or for longer periods of time.

Anhedonia treatment 

• Many times treating anhedonia involves treating the underlying disorder that justifies said symptom. For example, in the case of depression, the programming of pleasant activities is usually used, a type of technique framed within behavior therapy.
• Its objective is for the person to get out of the state of apathy in which they find themselves and return to doing things that make them enjoy (progressively). Once the person comes out of that state of apathy (which usually appears together with anhedonia), they can start working on other more emotional aspects and symptoms, such as feelings of sadness and/or emptiness, anger, guilt, etc.
• Importantly, this is considered an effective treatment for depression, with empirical evidence to back it up. Through this technique, anhedonia is combated, but also other depressive symptoms.
• In the same way, each specific disorder where anhedonia appears should be treated, with specific treatments for each case. And in the event that a disorder that justifies this symptom does not appear, it will be important to analyze the cause of it and start working on it.
• Active listening (which encourages the emotional expression of the patient) and emotional validation (which implies not judging their emotions, normalizing them), are useful techniques for the patient to begin to open up and so that they can gradually understand what causes this anhedonia and how You can start fighting it.

We can all feel anhedonia at some point. 

1. As we have seen, anhedonia can appear in isolation or in the context of a mental disorder. Feeling anhedonia can lead to different emotions in each person: there are those who experience it with discomfort and suffering and there are people who internalize this symptom from a calmer state, understanding it as something that is temporary.
2. It is important to normalize the anhedonia; normalizing does not imply detracting from it, but understanding that there are many people who feel anhedonia throughout their lives and that it is something normal, which is often linked to personal experiences (a situation of loss or mourning, sadness, etc.). Many times, we need a readjustment time to face certain situations and reorganize our reality, and this process entails symptoms such as the one described.
3. But to normalize does not imply not to treat; If we see that this state is prolonged over time, we will always recommend seeking professional help.