Anhedonia – what is it, how to deal with it?

Even though the sun is shining outside, you are not happy about the walks that gave you so much joy … When you met your partner, you lived the most beautiful six months in your life and suddenly you stopped enjoying this relationship … joy, and then for no reason joy gave way to sadness. Long-term lack of pleasure and joy has to do with anhedonia . Find out what it is and how to deal with it.

Anhedonia – what is it?

The term “ anhedonia ” comes from Greek and means something like “ no joy / pleasure “. Those who suffer from it cannot experience for a long time neither joy nor pleasure from lofty things, nor small pleasures in everyday life. While short periods of joylessness and apathy may be normal and not yet disturbing, long periods may indicate anhedonia .

Anhedonia affects many people with mental disorders and can be very stressful for those affected. The modern term refers no longer only to the loss of pleasure from pleasant experiences, but also to a reduced interest in everyday life, lack of willingness to act , motivation and purpose in life.

How to recognize anhedonia?

Anhedonia has little to do with normal sadness. It not only means ceasing joy from pleasant experiences, but also a loss of interest and activity. This generally includes the inability to feel positive emotions as well. People with anhedonia can no longer get excited or happy about anything. They lose the desire to do anything and can’t bring themselves to experience something they’ve enjoyed before – cooking, hanging out with friends, playing sports, and more.

This pathological helplessness should not be confused with sadness, as people with anhedonia often do not describe themselves as sad, but rather perceive their experiences and feelings as muffled or barely present. Not having joy can include both the anticipation and the experience of the moment. Even with particularly positive or long-awaited experiences, there is no satisfaction or change of state of mind.

Anhedonia is often accompanied by other symptoms such as:

fatigue,
insomnia,
loss of appetite,
no drive.

Remember that anhedonia is not a disease but a symptom. It is one of the three main symptoms of depression, but it can also occur in depressed moods and other mental illnesses.

Anhedonia and no motivation for anything

Anhedonia is often not understood by outsiders. They don’t understand how someone who theoretically has no reason to worry might say:

I am not able to enjoy this work / relationship / everyday life.
Nothing makes me happy.
I don’t feel joy in life >.
I have no purpose in life .

This is the lack of purpose in life and the ability to enjoy life is the foundation of the anhedonia experience.

What does a person with anhedonia feel? For example, imagine that you want to go to the movies. To make a decision, you first need a joyful wait: there is curiosity about the plot of the new movie and the hope that you will like it. Then the motivation must be sufficient to accept some effort. After all, you need to arrange a visit, get ready, get out of the house and invest your money in tickets and possibly a drink and popcorn. During the movie, the best you can do is amuse yourself, get excited about the plot twist or be moved by the tragedy of the movie story. Ultimately, you weigh – mostly unconsciously – whether the experience was worth the effort and whether you want to repeat it soon. If one or more of these functions is disturbed, anhedonia appears: the fun disappears, life loses its flavor, you don’t get any joy or pleasure from visiting the cinema and other venues. This is how people with anhedonia work – they feel neither the need nor the motivation to do anything.

Known forms of anhedonia

Anhedonia is almost always accompanied by alexithymia, a type of emotional blindness (inability to perceive and describe one’s feelings), the so-called no emotion. In the narrower sense, there are four commonly observed forms of anhedonia:

Social anhedonia is the lack or diminished enjoyment of social interaction. There is neither interest nor pleasure in conversations, meetings and joint activities and other social contacts. Social anhedonia is especially noticeable as those who are affected withdraw more and more socially.
Physical anhedonia in this case, the physical feeling of pleasure is severely inhibited or non-existent. . So you cannot enjoy a pleasant massage, good food or other benefits as they do not make you feel happy.
Musical anhedonia is a form that is referred to in the context of “people who don’t feel the music”. People with musical anhedonia cannot enjoy music despite being healthy and content – they don’t even react physically to music. For these people, music is nothing touching, joyful or inviting to play. It is just a sequence of notes, sounds that do not evoke any feelings.
Sexual anhedonia is a dysfunction in which all the body’s reactions are normal, even physically orgasmic but not feeling adequate pleasure, lack of sexual satisfaction.

What causes anhedonia?

Anhedonia is a symptom of a mental illness and at the same time a risk factor for further complications. Lack of joy occurs with the following diseases:

depression,
anxiety disorders,
schizophrenia,
schizoid personality disorder,
bipolar disorder,
addiction,
dementia,
post-traumatic stress disorder (PTSD),
eating disorders,
Parkinson’s disease
sometimes also brain injuries,
psychoses (so-called negative symptoms),
physical causes (iron deficiency, hypothyroidism, neurological and physical diseases).

Anhedonia can affect various functions of thinking, feeling and acting, so it is important to make a correct diagnosis. At the neurobiological level, anhedonia is associated with a disturbance of dopamine in the brain. Changes in dopamine balance can be observed in all those affected by anhedonia. There is a decreased release of dopamine, leading to decreased activity in the mesolimbic reward system. These changes can be triggered by environmental factors such as chronic stress and stressful events.

Anhedonia and depression

Along with depressed mood and a lack of libido, anhedonia is one of the major symptoms of depression. However, anhedonia can also occur in anxiety disorders, schizophrenia, addiction, and dementia. When people have anhedonia, they are more likely to develop depression. They also tend to experience a more severe disease course than those without anhedonia, and treatment takes longer.

People with depression with anhedonia are more likely to show loss of appetite and social isolation / withdrawal than those who only struggle more with depressed mood. Additionally:

regenerate more slowly,
have fewer periods of “no depression”,
have a more severe depressive phase,
have relapses more often diseases,
have an increased risk of death,
are more likely to commit suicide.

Feelings of depression , sadness and inner voids are clearer and last much longer. Depressed people with anhedonia are unable to feel any joy, they feel completely exhausted and apathetic. Thinking is slowed down, concentration weakened by meditation. Feelings of hopelessness and futility in your own life often result in suicidal thoughts. Affected people often feel restless, tense and irritable, but on the other hand they are exhausted, tired and depleted of energy.

How to deal with anhedonia?

Treatment of anhedonia in the course of depression is difficult because patients respond less to psychotropic drugs. Drug treatments that upset the dopamine balance can in turn have a negative effect on depression. In the therapeutic and pharmacological treatment of anhedonia, it may take more time to find an appropriate approach that takes into account all systemic effects and leads to lasting improvement.

Overall, treatment for anhedonia depends on its condition and personal factors. For physical causes, the emphasis is on medical therapy and is aimed at treating the appropriate underlying disease. If anhedonia is caused by a mental illness, psychotherapeutic treatment may provide relief. The psychologist most often undertakes cognitive-behavioral therapy or psychoanalysis. The first form of psychotherapeutic help is a classic method, especially eagerly used to promote positive emotions or reduce negative thoughts.

In the case of self-help, apart from going to a psychologist’s appointment, it is worth taking other forms of activity that will restore the lost joy of life and motivation. You can, among others

keep a gratitude journal in which you will write down every day what you feel grateful for during the passing day,
practice mindfulness exercises,
be tempted to yoga or meditation
practice visualizing future events.

Basically, anhedonia has a rather poor prognosis. Without the therapeutic support of a psychologist and / or medical care, the patient rarely manages to cure it on his own, or at least alleviate symptoms by his own effort. Therefore, do not wait when suddenly what gave you strength in the past was fun for you, awakened your passion or stimulated you spiritually, suddenly lost its sense. When everything becomes covered with a gray veil that separates you internally from the world, people and what is happening. When you can’t get excited anymore and nothing gets you interested. Do not wait, but consult a specialist who will help you regain the joy of everyday life . Anhedonia can affect anyone and with the help of a professional it is very easy to treat.