What Is Anhedonia?

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Anhedonia describes the inability or reduced ability to feel pleasure. When a person suffers from anhedonia, they lose interest in the activities, hobbies, or experiences they used to love.

It has been associated with many mental disorders, including depression, bipolar disorder, schizophrenia, and substance use disorder. People who have physical conditions like chronic pain and Parkinson's disease may also experience anhedonia.

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Types

Some researchers divide anhedonia into two types: social and physical. Social anhedonia revolves around social situations and causes a decreased interest in social interactions as well as a reduction in pleasure from engaging in social situations.

On the other hand, physical anhedonia describes a person’s inability to feel pleasure from physical things that are normally pleasurable, such as eating, touching a loved one, or engaging in sexual interactions.

Causes

It's unclear exactly what causes anhedonia, but it's linked to several mental disorders. Anhedonia is considered one of the core features of depression. People with schizophrenia often report both physical and social anhedonia. Research has shown that depression in bipolar disorder is also associated with anhedonia, and doctors use the severity of anhedonia to determine how severe a case of bipolar disorder is.

The use of recreational drugs can potentially lead to anhedonia. Research has shown that anhedonia can also lead to drug addiction.

Risk Factors

The major risk factors associated with the development of anhedonia include a family history of mental disorders such as schizophrenia or depression.

A study found that people with schizophrenia, substance use disorder, Parkinson's disease, and chronic pain experience moderate levels of anhedonia, but those with depression have more severe anhedonia.

Other conditions that have been associated with anhedonia include Parkinson’s disease, chronic pain, and diabetes. Those with eating disorders, autism, or neurodegenerative diseases can also experience anhedonia.

Experiencing high levels of stress or traumatic events, including abuse or neglect, is also a risk factor for anhedonia.

Symptoms

The symptoms of anhedonia depend on the type. Symptoms of social anhedonia may include:

  • Very few or no relationships at all
  • Complete withdrawal from existing social relationships
  • A diminished capacity to express emotions
  • Fake emotions in social situations
  • Preference for being alone

When a person suffers from physical anhedonia, they may experience:

  • A complete loss of libido or interest in sexual interactions
  • Frequent illness or other physical health issues

A person with anhedonia may miss out on big life events. By not maintaining their social connections, people with anhedonia may have strained relationships and even a loss of social connections.

Why Are Some People More Prone to Depression Than Others?

Depression is a complex disorder, and there’s likely more than one reason why some people are more likely to develop it than others. Many factors are at play in the development of depression, such as genetic, environmental, social, and lifestyle factors.

Complications

Studies have shown that those who have anhedonia are more likely to be at risk of suicidal ideation, suicide attempts, or death by suicide, especially among those with post-traumatic stress disorder.

Research has also shown that anhedonia may also be a psychopathological risk factor for dementia-related diseases, such as Alzheimer’s disease. Older adults who have anhedonia were five times more likely to develop dementia compared with people who don't have anhedonia.

Anhedonia has also been associated with a heightened risk of adverse cardiac events among patients with heart conditions.

Diagnosis

Medical professionals will often use anhedonia as a symptom to diagnose a mental health illness. For example, anhedonia may lead your doctor to look into whether you have depression or bipolar disorder.

Anhedonia can be measured using a questionnaire. One of the most popular ones is the Snaith-Hamilton Pleasure Scale (SHAPS). It consists of 14 statements about enjoyable situations typically encountered in daily life, such as food or drinks and interests or pastimes. You will be asked to rate how strongly you agree or disagree with the statements based on your memories of the past few days.

Your doctor may also perform a physical exam and blood tests to ensure your anhedonia is not caused by a physical condition.

Treatment

Treatment for anhedonia depends on the condition or mental disorder it's associated with. For people with depression, antidepressants may be prescribed, while people with schizophrenia are often treated with antipsychotic medications. Treatment may also include psychotherapy.

Recent research has also found anhedonia may be closely tied to certain processes in the brain. Researchers found that the part of the brain that controls reward, decision-making, anticipation, and motivation is often involved in anhedonia. They theorized that people with anhedonia may also lack the ability to anticipate good things, find motivation, and judge the effort required to achieve a certain reward accurately.  

Since anhedonia may be associated with deficits in the reward system of the brain, a different approach may be necessary for its treatment. One study found that positive affect treatment, an approach that attempts to increase the way the brain perceives rewards, resulted in better outcomes than the treatments that focus solely on reducing negative feelings for people who experienced anhedonia.

Some medications may be able to help with anhedonia associated with physical conditions. Research has shown that people with Parkinson’s disease experienced a reduction in anhedonia after receiving treatment with dopamine agonist medications such as pramipexole.

You should never quit taking your prescribed antidepressant without speaking to your doctor first. If it is not helping or you’re experiencing unwanted side effects, talk to your doctor. They will determine whether your medication dose needs to be changed or if you need a new medication.

Summary

Anhedonia is when your ability to feel pleasure is reduced or absent. You lose interest in the things that normally give you pleasure, and may withdraw from social interactions. Anhedonia has been associated with different mental disorders and physical conditions. The way to treat anhedonia is by treating the condition that it's associated with.

Frequently Asked Questions

How do you cure anhedonia?

There is no one way to cure anhedonia, but it can be managed by treating the underlying condition or mental disorder. For example, if it is caused by depression, managing depression symptoms with antidepressants and psychotherapy will help alleviate anhedonia. The same goes for anhedonia that's associated with a physical condition.

How long does anhedonia last?

There is no set time that anhedonia will last, and it’s different for everyone. Typically, when the condition that is causing it to occur is managed, anhedonia will go away or become less severe over time.

How do you help someone with anhedonia?

The best thing you can do for someone with anhedonia is to offer them support while they seek out treatment. You can encourage your loved one to seek the help they need and stick by them while they get treated for the condition that has led to their anhedonia.

A Word From Verywell

Losing interest in the things you once loved can be difficult to experience. The best way to deal with anhedonia is by reaching out to a healthcare provider to figure out what is causing it and how you can get back to experiencing pleasure in your life again.

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