Anhedonia Makes It Hard for People to Feel Joy—Here’s What That Means, According to Experts
Plus, how to best treat it, depending on what's causing it.
In life, there are good days, bad days, and meh days—those are the ones that are typical, where nothing terribly exciting or awful happens. But for people with a condition called anhedonia, most of their days are just meh; they've lost the ability to feel joy, and the things that used to bring them contentedness or even excitement don't elicit those same feelings anymore.
Anhedonia—which can be a common symptom of depression or other mental health disorders—can make it hard to maintain relationships with friends and family, and lead to difficulties in performing tasks at work. But, for those with the condition, it's not something they have to live with forever. Here, mental health professional explain what you need to know about anhedonia, including symptoms, causes, and treatment options.
What is anhedonia?
Anhedonia simply means "without pleasure," according to the American Psychological Association. "People who have anhedonia basically have lost the ability to experience pleasure or things they enjoy," Susan Albers-Bowling, PsyD, a psychiatrist at Cleveland Clinic, tells Health. "You feel 'blah' about things that would traditionally make you happy or excited, [and] you don't care about much and your reaction to things is flat or nonexistent."
According to the 2014 psychology handbook, Anhedonia, which provides experts with information on the condition, anhedonia can be physical or psychological, and is sometimes categorized by the different stimuli that elicit the response, or lack thereof: social and sensory.
Social anhedonia, for instance, refers to when someone doesn't get the pleasure out of social situations—like talking to friends, having new experiences, or even competing with others—like they used to. Sensory anhedonia, on the other hand—which is often referred to as physical anhedonia—is more liked to those who have lost pleasure from physical sensations, like the smell of fresh baked cookies or even sexual stimuli (also known as sexual anhedonia).
What does anhedonia look like?
Do you remember Eeyore from Winnie the Pooh? That's what anhedonia can look like, says Dr. Albers-Bowling. "Eeyore was a character who displayed a lot of [these] characteristics: He was pessimistic, gloomy, and didn't enjoy much."
However, anhedonia can present in a variety of ways, and depends on which type of anhedonia the person is suffering from. Generally speaking, people who experience anhedonia will feel a sense of numbness or lack of feeling. They'll also have an overall negative outlook, will stop smiling or reacting to things that would normally cause joy, and will exhibit more feelings of hopelessness, says Dr. Albers-Bowling.
Those who experience anhedonia, however, likely don't notice the change overnight, Jessica Stern, PhD, a psychologist at NYU Langone, tells Health. "What oftentimes happens is that people will slowly start to disengage from or step away from things that used to bring them enjoyment or pleasure [after they] find they're feeling a disconnection," Stern explains. These activities might include going for a run or reading a book or even talking to a friend on the phone—any safe and healthy activities that you used to find enjoyable but don't anymore, Stern says.
What causes anhedonia?
Anhedonia is most often a symptom of depression, Stern says. But that isn't the only cause. "People can experience anhedonia outside depression, [but] it's not a diagnosis on its own," Stern explains.
She adds that grief and anxiety can cause anhedonia, and the condition has been linked to anorexia, schizophrenia, substance abuse disorders, Parkinson's, PTSD, and other mental health conditions, according to Dr. Albers-Bowling.
It's not clear what mechanisms in the brain induce anhedonia, but experts do have some ideas. "Some theories point to a reduction in dopamine, the pleasure neurotransmitter in the brain," Dr. Albers-Bowling says. She adds that much of the brain is involved in allowing a person to experience enjoyment, and the thinking is that, when these fail, that's when anhedonia can set in. "There are several parts of the brain believed to also be involved in the ability to experience joy and pleasure like the amygdala, which processes emotions, the prefrontal cortex, which plans and processes rewards. These brain systems basically shut down."
Friends and family members often play a crucial role in the diagnostic process, according to Dr. Albers-Bowling. "Family members and friends often pick up on these symptoms and express concern," she says. Stern adds that, even if nobody has mentioned to you that you seem a little off, it can't hurt to seek out treatment from a mental health professional if you notice nothing is bringing you joy anymore.
How is anhedonia treated?
Before you can be certain you're suffering from anhedonia, a doctor will have to make sure you aren't suffering from other illnesses that might present the same way. "First, a doctor will typically rule out any kind of medical condition or vitamin deficiency that might be causing low energy and lack of motivation," Dr. Albers-Bowling says.
And oftentimes the treatment plan will revolve around whatever condition is causing the anhedonia, like depression, specifically. "There is no direct treatment for anhedonia itself. In part, it is recognizing that anhedonia is often linked to other mental health conditions and treating the primary issue," Dr. Albers-Bowling says. "By treating the depression or mental health issue as a whole, the anhedonia tends to disappear or dissipate." This could mean going to therapy or taking an antidepressant, depending on what the cause of the anhedonia is, she explains.
Stern adds that if you do seek help for anhedonia, a mental health professional might advise you in a practice called behavioral activation. "We describe anhedonia in the healthcare profession as feeling deactivated," she explains. Behavioral activation revolves around slowly taking steps to "reactivate" areas of your life you once found fun or joyful, and it's not necessarily a quick process. "Sometimes you might need to recondition yourself to find joy," Stern says. If a patient used to love going on runs, for example, they might be advised to take a small walk to get back into the habit, with the hope of finding enjoyment or pleasure during the process. The key here is to take it slow, rather than jumping back into your pre-anhedonia routine, which might be overwhelming. "Pacing is definitely very helpful," Stern says.
Fortunately, experts do know that working with a mental health professional can alleviate anhedonia, so you can get back to enjoying what you used to love to do. Dr. Albers-Bowling explains: "The good news is that anhedonia doesn't have to be permanent. When treated, people are like a wilted flower coming back to life, interested in doing things and engaging in life again."
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