The sound of a crackling fire. The feel of a warm shower. The smell of bread baking in the oven. Many people take delight in these experiences. But for people with anhedonia, these little pleasures can feel meaningless.
Experts typically describe anhedonia as the reduced ability to feel enjoyment in activities or experiences that once brought pleasure. It’s a condition associated with several mental health disorders, and it’s a primary symptom of major depressive disorder.
Clinicians are still learning how to treat anhedonia. The condition is complex, and researchers don’t even agree on a definition. Problematically, as many as 20 percent of Americans will experience depression in their lifetime and are at risk of developing anhedonia.
Anhedonia is typically defined as the loss of enjoyment in daily activities and experiences that a person previously found pleasurable. People with depression or schizophrenia are at greater risk of developing anhedonia. The condition has also been observed in people with post-traumatic stress disorder (PTSD), chronic illnesses and eating disorders.
Researchers have debated whether anhedonia should be divided into two distinct categories — physical and social. Physical anhedonia relates to a loss of enjoyment of physical sensations. This broad category involves touch, smell, sound and sight.
A person with physical anhedonia, for example, may no longer enjoy taking a warm shower. Or they might not appreciate a view they once found inspiring. They might have a diminished libido and refuse intimacy with their partner.
The second category, social, relates to a person’s enjoyment of being around others. A person with social anhedonia may no longer enjoy spending time with friends or family. They might feel indifferent if they see a friend smile or they may no longer take satisfaction in helping others.
Researchers typically use structured questionnaires to measure how people with anhedonia experience daily pleasures compared to people without the condition. These questionnaires can show scientists how much anhedonia diminishes past pleasures, but it doesn’t tell them much about what it is like to live with anhedonia.
In a 2019 study in European Child & Adolescent Psychiatry, researchers conducted interviews with 34 adolescents who were either diagnosed with depression or elevated depressive symptoms. The participants were located in the South of England and ranged in age from 13 to 18. Officials from their schools or clinics recruited them. None of the participants reported having psychotic features.
The study’s authors found several shared themes among the interviews. In addition to experiencing a loss of enjoyment, the teens also said they struggled with motivation. They lost a sense of connection to others and didn’t always know where they belonged.
One participant said that the loss of pleasure in daily activities made it feel as though she was on a “constant loop” in which every activity felt mundane. “I was just like completely bored with it. Like you get bored with a TV show, and you’re like, okay, leave it then, just move on to another one,” she said.
Other teens in the study also agreed that nothing seemed exciting, and they felt they had nothing they looked forward to. One said his upcoming birthday would be “just another day.”
Many said their emotionless state meant they felt “grey,” “empty,” “flat,” and “vacant” about life. The study’s authors noted the participants spoke with little intonation, and even their voices reflected their diminished feelings.
The teens with anhedonia also described a lack of motivation, which, for one participant, meant he didn’t want to get out of bed and was forced by his parents to leave his bedroom. Another said he mostly watched television and did other passive activities because he wasn’t motivated to do much more.
Due to their lack of motivation, participants said they weren’t interested in spending time with family or friends, and they frequently turned down invitations to socialize. One teen knew she was missing out on fun times with her friends, but she couldn’t motivate herself to join her peer group. Although her exclusion was her choice, she said it made her feel lonely.
The disconnection between people and the pleasures of daily life left many of the participants questioning the meaning of life. One teen said he didn’t see the purpose of taking his academic qualifying exams, which were needed to graduate secondary school and apply for post-secondary education. “…eventually we’re all gonna die; what use does it really have.”
Although anhedonia was first described in the early twentieth century, researchers have a limited understanding of what happens in the brain to cause anhedonia and what it’s like to live with the condition. For many years, researchers focused their attention on anhedonia as it related to schizophrenia and depression.
Currently, many clinicians find the best way to treat anhedonia is to address the underlying condition, whether that is schizophrenia, depression, PTSD, eating disorders, Parkinson’s disease or other conditions.
Depending on the underlying condition, the patient might be prescribed talk therapy, antidepressants or a combination of both treatments to treat anhedonia. In some circumstances, a clinician might recommend electroconvulsive therapy.
For people who suspect they or a loved one has anhedonia, medical advocates recommend seeing a psychiatrist, psychologist or other medical professional in order to receive a proper diagnosis. And although it may be tempting to self-diagnose based on symptoms, medical advocates say people with anhedonia need to be under the care of a medical professional.
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