What You Need to Know About Anhedonia

Mental health is never the easiest thing to understand. When it comes to specific disorders, depression may be one of the most difficult to deal with and to also understand. When people are going through depression and its variants, it might seem like the solution is to shake one out of his or her state to help get them moving. However, this is not a cure for depression. If anything, it can only make things worse, making the depressed individual feel even more isolated and alone. 

The key to helping people with depression is providing understanding and empathy. In fact, one of the keys to dealing with a person who has depression is establishing boundaries in a non-confrontational way. You want to be available and provide support, but you are not their safety blanket.

Anhedonia is one of the more pronounced types of depression. The key with helping those with anhedonia is understanding the nature of the disorder and doing what you can to get them through one of the most debilitating mental disorders. 

<H2>What is Anhedonia?</H2>

Anhedonia is one symptom of major depressive disorder. Diagnosed through various self-report measures usually, this type of major depression is most easily understood as a loss of pleasure. 

The classic anhedonic symptoms are notably a depressed mood combined with an inability to feel pleasure. The causes could be biological factors, such as a lack of dopamine from the nucleus accumbens (located in the ventral striatum), which affects how the brain processes a reward. Additionally, dopamine-related problems could occur with the ventral tegmental area. 

Another issue could be problems in the ventral pallidum. This results in lesser gamma-aminobutyric acid (GABA), which controls excitement. However, not all issues that cause anhedonia are necessarily based on neurotransmitter issues.

For example, the prefrontal cortex is responsible for the brain’s cognitive processes. If you struggle with decision making, then an initial scan of the orbitofontal cortex, medial prefrontal cortex, and the anterior cingulate cortex can help ensure there aren’t any injuries in these areas. Of course, if there is trauma to these areas, then this could negatively impact your emotions and decision making abilities. Still, cognitive-behavioral therapists like to rule out biology before exploring CBT issues. 

<H3>Anhedonia Definition</H3>

In order to understand anhedonia and depression, you should have a basic understanding of the clinical nature of these terms. Anhedonia and depression are mood disorders, and they differ from a personality disorder. Personality disorders affect how you interact with the world. Mood disorders are more internal, such as anxiety.

Although some symptoms of depression anhedonia may be biological, this isn’t always the case. These symptoms differ from psychiatric disorders, such as schizophrenia. When comparing depression and schizophrenia, a patient can have various causes and treatments. Depressed patients who battle with anhedonia experience a significant decline in pleasure derived from activities that normally provide a great deal of pleasure. 

<H3>Pleasure Definition</H3>

As mentioned above, the area of the brain that deals with pleasure is the mid-brain. The mid-brain deals with biological neurotransmitters like dopamine. The more dopamine courses through your system, the more pleasure you feel. A simple blood test can confirm if a lack of dopamine is affecting your ability to experience pleasure. 

The Snaith-Hamilton Pleasure Scale is a form of measurement that measures hedonic capacity, which measures the level of experiencing pleasure. In the clinical sense, hedonic simply refers to pleasure. 

The higher your hedonic capacity, the better you are at experiencing pleasure. However, it is important to note how pleasure differs from excitement. One can be excited while not experiencing pleasure.

<H3>Excitement Definition</H3>

Similar to dopamine, GABA is the body’s neurotransmitter responsible for making people feel excitement. In fact, the act of sexual intercourse is one of the easiest ways to determine if there is a low level of excitement.

Hypoactive Sexual Desire Disorder (HSDD) is notable in sexual anhedonia because a person does not display interest or lacks the ability to physically perform. This is usually due to an imbalance of inhibitors and excitement neurotransmitters. This lack of excitement is something most therapists would pick up on right away. 

While one may experience a loss of interest with a consistent partner, a lack of interest or excitement for a partner or sexual intimacy in general is a bigger problem. In fact, this is one of the hallmarks of depressive symptoms in patients suffering from anhedonia.

<H3>Inability Definition</H3>

Inability is simply not being able to do something. For example, akinetic mutism is the lack of ability to perform a specific function. So, if a person has a hypothalamic stroke, he or she may not be able to produce neurotransmitters, which could potentially lead to anhedonia. 

Another example of inability that leads perhaps to more cognitive types of anhedonia is Parkinson’s Disease. Parkinson’s patients have an inability to control tremors. As one of the non-motor symptoms of anhedonia, PD patients present an interesting question to researchers: Is anhedonia caused by Parkinson’s disease? Or is it a normal reaction for people with the disorder?

All in all, in regards to inability in relation to anhedonia, the definition is simply that a person lacks the ability to do or abstain from something. 

<H2>Anhedonia Symptoms</H2>

The symptoms of the depressive disorder can be easy to spot, but may be misdiagnosed. Since this is a type of major depressive disorder, it is important for clinicians to be thorough when diagnosing a patient or pinpointing a root cause. The biology is simple, and can be completed with scans to ensure the brain is functioning properly. Blood tests will also confirm neurotransmitter levels. 

However, there are a few symptoms that seem universal, and a good clinician will pick up on them. These symptoms include:

  • Social Anxiety: People with social anhedonia have an acute loss of interest in social activities. While there may be a feeling these issues could be due to an individual being an introvert or extrovert, the consistent lack of socialization or extreme social anxiety should be a red flag. This is especially true if an extrovert suddenly has no desire to participate in social activities.

  • Aimlessness: Anhedonia patients typically suffer from a lack of goal-directed behavior. The lack of excitement and motivation is typical for people wrestling with this particular disorder. In fact, it’s often difficult to get people with anhedonia to perform the basic activities of a daily life due to the firm grasp of aimlessness.

  • Suicidal Ideation: Anhedonia patients are so depressed that like most major depressive disorder patients, they ruminate on their suicide, preferred method, and how people will react to their death. If there is someone in your life speaking like this, please get them help immediately as people displaying suicidal ideation are a massive risk to themselves.

There are several more symptoms, but if you notice extreme lethargy and disinterest in activities that were once of great passion, anhedonia could be the reason.

<H2>Causes of Anhedonia</H2>

There can be several different causes of anhedonia, but two of the more interesting studies include the research into the relationship between Parkinson’s disease and anhedonia. Studies also involve the treatment of people suffering from addictions to drugs and alcohol. 

In short, there can be several causes as depression itself can take root from various places. If there is trauma to the areas of the brain dispensing neurotransmitters, such as a hypothamalic stroke or a stroke affecting the prefrontal cortex, then the possibility of determining a cause increases. That said, depression can come from a variety of source. Therefore, it’s important not to just look for certain biological red flags.

<H3>Naltrexone</H3>

Naltrexone is another possible cause of Anhedonia. This particular drug is used to treat people suffering from addictions. It basically recalibrates the brain’s neurotransmitters, so the brain has an easier time with chemical dependency. One of the side effects is extreme depression and anhedonia. Patients in recovery programs who take naltrexone should spend time with their mental health professionals in the event these side effects begin to take shape.

<H3>Anhedonia Treatment</H3>

Treatment will vary depending on the cause of Anhedonia. For biological issues such as neurotransmitter problems, this is where psychotropic drugs are used. Anhedonia patients also typically respond well to cognitive-behavioral therapy. This form of therapy helps people re-learn behaviors, and also recalibrates their brains so they can experience pleasure in relationships and activities. However, it is important to rule out biological indicators before going the route of CBT.

<H2>Wrapping Up Anhedonia</H2>

Anhedonia is a very serious depressive disorder. If you suspect that a friend or loved one is suffering from this particular issue, it’s important to get him or her help right away. Capable professionals in the mental health industry will test and work with these patients on therapies to help them get their lives back on track.

Not experiencing joy from things that once brought joy is a harsh cycle. Therefore, helping someone out of it is a wonderful feeling.

<H2>Sources:</H2>

https://www.healthline.com/health/depression/anhedonia

https://www.medicalnewstoday.com/articles/320737.php

https://www.psychologytoday.com/us/blog/brain-sense/200912/depression-and-anhedonia

author avatar
Angel Rivera
I am a Bilingual (Spanish) Psychiatrist with a mixture of strong clinical skills including Emergency Psychiatry, Consultation Liaison, Forensic Psychiatry, Telepsychiatry and Geriatric Psychiatry training in treatment of the elderly. I have training in EMR records thus very comfortable in working with computers. I served the difficult to treat patients in challenging environments in outpatient and inpatient settings
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