Stop enjoying things

Anhedonia: Symptoms, Treatment, and More

Anhedonia is a word that describes a reduced interest in activities an individual used to enjoy, as well as a decreased ability to feel pleasure. It’s a core symptom of major depressive disorder, but it can also be a symptom of other mental health disorders.

Not everyone who experiences anhedonia has a diagnosed mental health issue.

While researchers are still debating whether anhedonia can truly be categorized into two main types, some literature suggests that this mental health issue can be divided into social anhedonia and physical anhedonia.

Social anhedonia is often defined as an increased disinterest in all aspects of interpersonal relationships and a lack of pleasure in social situations. Physical anhedonia is an inability to feel tactile pleasures such as eating, touching, or sex.

The symptoms of anhedonia can include:

social withdrawal
diminished pleasure derived from daily activities
a lack of relationships or withdrawal from previous relationships
less of an interest in previous hobbies
a loss of libido or a lack of interest in physical intimacy

Some examples of what it feels like to experience anhedonia:

You used to love playing in a soccer league in the evenings but now no longer have the desire to play the game or interact with anyone from your team.
Cooking used to be a favorite hobby of yours, but now you aren’t interested in it anymore and sometimes have to remind yourself to eat.
You’re no longer excited to go out with friends.
You feel indifferent or withdrawn from your partner, and have a severely lowered libido.
An activity that used to fill you with happiness, such as going to see live music, no longer provides positive feelings.

While anhedonia can be a sign of a serious mental health condition, it’s important to resist self-diagnosis. If you believe you may be dealing with anhedonia, talk with your doctor or a mental health professional as soon as you can.

Anhedonia is a core symptom of depression and schizophrenia but has also been identified in individuals dealing with chronic pain and Parkinson’s disease.

Additionally, it can be caused by substance misuse (like habitually using illegal drugs).

One important note of differentiation: Anhedonia is not the same as social anxiety, which is categorized as withdrawal from social situations due to a fear of how those situations might go. If an individual is dealing with anhedonia, they avoid social situations because there seems to be no reward or point to participating.

If you have been diagnosed with depression or schizophrenia, there is an increased risk of developing anhedonia. Other risk factors include:

living with PTSD from a traumatic event or events
a chronic illness that impacts your quality of life
an eating disorder

Your doctor will ask you questions about your symptoms and your general mood. They may also ask if you have a history of using substances such as illegal drugs.

Your doctor may perform a physical exam to determine if you have any physical problems.

Additionally, your doctor may order a blood draw to test for a vitamin deficiency (like vitamin D) or a thyroid problem, which could be contributing to symptoms of depression.

Anhedonia can be challenging to treat. In many cases, treatment starts with tools to help you manage the mental health issue that’s likely causing the symptom, such as depression.

The first step in your treatment should be seeking the help of a medical professional. A primary care professional should be your first choice to rule out a medical cause of your symptoms. If they don’t find any medical issues, they may recommend you see a psychiatrist, psychologist, or other mental health professional.

A primary care professional can refer you to a therapist, or you can ask your insurance company to help you find someone.

Medications and therapy

Your treatment may include talk therapy, along with prescription medications such as antidepressants. In some cases, other classes of medications may be recommended, your doctor will help you create a treatment plan that is right for you.

You should take the medication as prescribed and let your doctor know if you have any side effects. They may need to adjust your dosage or medication.

These medications affect people in different ways. A medication that works for you may not work for someone else with the same symptoms.

ECT therapy

Another type of treatment that may be used in some cases is electroconvulsive therapy (ECT). ECT is one of the most effective treatments for severe depression that has not been relieved by therapy or medication. Some experts feel that it should be used sooner rather than later — especially with people who have uncomplicated depression.

During this treatment, a doctor places electrodes on the head and applies an electric current while the person undergoing the procedure is under general anesthesia. This induces a small brain seizure.

TMS

Transcranial magnetic stimulation (TMS) uses a magnetic field to stimulate nerve cells. It uses a smaller electric current than ECT and does not require general anesthesia. TMS can treat major depression in people who have depression that is not responding to medication.

VNS

A third treatment option is vagus nerve stimulation (VNS). Your doctor will implant a medical device similar to a pacemaker in your chest. The wires of this device create regular electrical impulses that stimulate your brain. As with ECT and TMS, VNS can treat depression in people who have depression that hasn’t responded to other treatments.

Online therapy options

Read our review of the top online therapy options to find the right fit for you.

An inability to experience pleasure and/or a reduced interest in things that used to make you happy can impact your quality of life. You don’t have to live with these feelings, and help is available.

If you’ve noticed a waning interest in things that once brought you joy, contact a doctor or a mental health professional.

The good news is, once you start treatment, you should be able to start feeling pleasure and happiness again. Typically, anhedonia dissipates once the underlying condition is managed.

Anhedonia: Symptoms, Causes, Treatment

Written by Barbara Brody

Most people understand what pleasure feels like. They expect certain things in life to make them happy. Maybe you enjoy riding your bike, listening to the sounds of the ocean, or holding someone's hand. But some people lose the ability to feel joy. The things that once made them content are no longer fun or enjoyable. That's anhedonia.

There are two main types of anhedonia:

Social anhedonia. You don’t want to spend time with other people.
Physical anhedonia. You don’t enjoy physical sensations. A hug leaves you feeling empty rather than nurtured. Your favorite foods taste bland. Even sex can lose its appeal.

Anhedonia makes relationships, including those with friends and family members, a struggle. With the reward of enjoyment gone, it's hard to get motivated to spend time with others. You might turn down invitations and skip events like concerts, parties, and even one-on-one get-togethers because you no longer believe there's any benefit in taking part.

Or you could have social anxiety. You feel like you don't fit in, especially when meeting new people.

Relationships also thrive on positive feedback, and without it they can wither: Imagine not being able to tell someone you love them or that you had a great time spending the day with them. But if you have anhedonia, you can't, because you don't have those feelings. Meanwhile, loss of libido can take a toll on a romantic relationship.

It's also worth noting that some scientists believe anhedonia isn't always a black-and-white issue. You might feel no joy at all, or you could find that your positive emotions are dulled. In other words, it's possible to still like eating chocolate ice cream or listening to jazz; you just don't like those things nearly as much as you used to for reasons you can't explain.

What Causes It

Anhedonia is closely linked to depression, but you don't have to be depressed or feel sad to have it. It also affects people with other mental illnesses, like schizophrenia and bipolar disorder. And it can show up in people with seemingly unrelated health concerns like Parkinson's disease, diabetes, coronary artery disease, and substance abuse issues.

Scientists think anhedonia may be tied to changes in brain activity. You might have a problem with the way your brain produces or responds to dopamine, a "feel-good" mood chemical. Some early research (on rats) suggests that the dopamine neurons in an area of the brain called the prefrontal cortex might be overactive in people with anhedonia. This somehow interferes with pathways that control how we seek out rewards and experience them.

How It's Treated

Anhedonia can be tricky to treat. There’s no clear way to do it. The first step is generally to find any unknown cause, focus on treating that issue, and hope the anhedonia gets better as a result.

That's often true, especially when it comes to depression. People who take antidepressant medications (selective serotonin reuptake inhibitors, or SSRIs) may find that anhedonia improves along with the rest of their depression symptoms, but that's not always the case. Sometimes these medications blunt emotions and make this problem worse.

Scientists are working on new treatments for people with anhedonia who don't get better with treatments like SSRIs and talk therapy. One that shows promise is ketamine, a medication best known for being a party drug that also has an antidepressant effect. More research is needed, but at least one study found that people with bipolar depression who had anhedonia got relief from this symptom within 40 minutes of a ketamine shot.

Six ways to enjoy life | PSYCHOLOGIES

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Practices how to

Slow down running

Our lifestyle makes us move faster and faster. We suffer, but we cannot stop: we need to run further in order to have time to do more and better.

“In yoga, the feeling of life is very much connected with what is happening to us here and now,” says Yulia Makarova, teacher at the Iyengar Yoga Center in Moscow. - To see the world for real, to be surprised at its depth, you need to learn to stop. Not only physically - it is also important to learn how to slow down our internal dialogue: constantly thinking about our actions, we get hung up on useless experiences.

In India I have met many poor people who know how to enjoy the simplest things: warm weather, a smile. They seem to remind us that we can notice and appreciate the very feeling of life. “Let go” of yourself, give yourself the opportunity to slow down and get rid of the superficial. It does not require much effort: put on comfortable clothes, go outside, look around, “turn off” thoughts and feelings and just enjoy the good that is happening to you now.

Open to beauty

“We are used to living in our thoughts and anxieties, which, like a veil, block us from reality,” says Varvara Sidorova, art therapist, head of the Art Therapy Center. - When drawing, we focus on what we are doing, on our movements, brush, paints. We can transfer our thoughts to a piece of paper, or we can depict what attracted our attention, entered into resonance with our “I”.

Subsequently, this becomes our resource, here we can draw strength and inspiration. For example, you saw a beautiful tree on the street, and then drew it. Every time you look at this sketch, you will return to your feelings and experiences and recharge with positive, creative energy.”

When drawing, we focus on what we are doing, on our movements, brush, paints. We can enter into resonance with our “I”

“At the same time, it does not matter at all whether you can draw: even in a small simple line there is beauty, mystery, charm,” continues Varvara Sidorova. — Blooming sakura, of course, fascinates, but a petal invisible at first sight is also beautiful… The main thing is to draw and enjoy it.

Each of us can create a lot with our own hands. At trainings, we make cups: we mold them from clay, burn them in the oven… It turns out a warm, lively, real cup. And drinking from it is a pleasure: every time we get that warmth, that energy and joy that we put into it at the moment of creation. ”

Seeing funny things

“We, adults, are often very serious and ponderous,” says Irina Baranova, laughter therapist, author and host of the Laughter to Create Your Life training. - We rarely allow ourselves to go beyond the generally accepted and do cute, funny pranks: tie a bow, make a surprise, compose a poem. Relax, stop controlling yourself and everything around, behave like children - many of us do not even realize how nice it is to be sometimes frivolous ...

We analyze almost all of our actions from the standpoint of society. We do not see the little things, we do not notice the funny. We should learn to notice the details in order to free ourselves from the pressure of self-importance, to become lighter. And finally see your own life, linger in it. A good joke tickles the mind, turns the world upside down and brings hidden truths to light. If we feel good and comfortable internally, it will be easier for us to catch the funny even in serious matters.

Touch another

Our acquaintance with the world begins with the touch of hands, and tactile sensations forever remain for us a reliable source of information about another person. Greeting, saying goodbye or congratulating each other, we hug.

“Hugging is a non-sexual way of showing affection,” says psychotherapist Virginia Satir. “If people paid more attention to their needs for tactile contact, they might be less aggressive.”

In everyday bustle, we easily forget about the power of gentle touches. And it only takes a few minutes to feel another person, hug, touch his arm or shoulder with your fingertips. Slowly, delving into your feelings ...

Behind the small joys of touch lies the great joy of being in the world.

“To be here and now, we need tactile experiences,” says Aida Ailamazyan, psychologist, head of the Geptakhor musical movement and improvisation studio. “Alas, today we are experiencing an extreme shortage of physicality, movement… The body has turned out to be almost excluded from the life of a modern person.

We sit in front of a computer all day long, only our eyes work from our sense organs. .. In order to regain the sense of our own physicality, we only need to slightly change our habits, overcome fear or the prevailing stereotype of behavior.

Of course, without violating someone else's personal space, other people's boundaries are inviolable. It's just a matter of being more flexible, of acting in such a way that the observance of limits, propriety and distance does not turn into a cell closed on all sides. Otherwise, we risk losing access to our natural bodily and emotional needs, turning from living beings into a set of roles and functions.

Savor the taste

“Not just to swallow a hastily heated dinner, but to taste the dish using all the senses: tasting, observing the color, smelling the aroma, being inspired by the sound (the appetizing crunch of a radish, the sound of hissing meat in a pan). Drinks deserve no less attention.

“Pour some good wine into a glass and let it “breathe,” suggests Alexander Pavlov, head sommelier at the Elardzhi restaurant, seminar leader and author of a course on wine. - Then inhale its aroma, drink a little, without swallowing, and - freeze. From sensations, colorful images are born: a vine, a cherry seed, or maybe vanilla or honey. Good wine is revealed every moment, giving us more and more new semitones. It is important to try it slowly, listening - and then in a few minutes a completely different palette will open up: from meadow mushrooms to black currants.

The variety of fragrances is unimaginable, it all depends on whether we give ourselves time to experience them. In each glass there is a whole era, history, destiny... But it is impossible to feel it without paying attention, respect, patience to the drink. To get real pleasure, you need to immerse yourself in the process with all your heart, mind, soul. To catch the thread of taste and wind it like a ball... And this principle works in everything: in life, as in wine, each shade of taste diverges into other shades - and this process is endless and beautiful.”

Listen to yourself

“We are social beings, and our pleasures are not born by themselves: almost at all times they were largely constructed by society and the environment,” says Elena Petrovskaya, philosopher, anthropologist, editor-in-chief of the Blue Sofa magazine ". “Today, this control is becoming total: advertising, the media, the lifestyle of famous people impose ready-made models of pleasure on us. Get behind the wheel of a new car, for example, or climb into a hammock with a candy bar.

But what if we don't like the taste of the bar? Or are we not ready to work for a new car for several years and at the same time get into debt by getting a loan? So, you need to find the courage to resist the pressure.

In a sense, the search for pleasure is the search for oneself. Each of us has our own attachments, passions, interests. It is to them that we need to turn if we want to get our own, “private” pleasure.

For example, many people enjoy gardening, and not because they cannot live without their cucumbers or herbs. They just like physical effort, the spirit of the earth, communication with plants.

Ultimately, the question of pleasure is a question of choosing the right strategy in the relationship between the individual and society. Our business is not to go against society, but to be ourselves: to accept what is necessary, to reject what is alien and to develop what is peculiar to me.”

Text: Julia Varshavskaya, Elena Shevchenko, Yuri Zubtsov Photo credit: Getty Images

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Six ways to enjoy life

SLOW DOWN

Our lifestyle makes us move faster. We suffer, but we cannot stop: we need to run further in order to have time to do more and better.

“In yoga, the feeling of life is very much connected with what is happening to us here and now,” says Yulia Makarova, teacher at the Moscow Iyengar Yoga Center. - To see the world for real, to be surprised at its depth, you need to learn to stop. Not only physically - it is also important to learn how to slow down our internal dialogue: constantly thinking about our actions, we get hung up on useless experiences.

OPEN TO BEAUTY

“We are accustomed to living in our thoughts and anxieties, which, like a veil, block us from reality,” says Varvara Sidorova, art therapist, head of the Art Therapy Center. – When drawing, we focus on what we are doing, on our movements, brush, paints. We can transfer our thoughts to a piece of paper, or we can depict what attracted our attention, entered into resonance with our “I”.

When drawing, we focus on what we are doing, on our movements, brush, paints. We can resonate with our "I"
“At the same time, it doesn’t matter at all whether you can draw: even in a small simple line there is beauty, mystery, charm,” continues Varvara Sidorova. – Cherry blossoms, of course, are fascinating, but a petal that is invisible at first sight is also beautiful… The main thing is to draw and enjoy it.

SEE FUNNY

“We, adults, are often very serious and ponderous,” says Irina Baranova, laughter therapist, author and host of the Laughter to Create Your Life training. - Infrequently we allow ourselves to go beyond the generally accepted and do cute, funny pranks: tie a bow, make a surprise, compose a poem. Relax, stop controlling yourself and everything around, behave like children - many of us do not even realize how nice it is to be sometimes frivolous ...

TOUCH OTHER

“Hugging is a non-sexual way of showing affection,” says psychotherapist Virginia Satir. “If people paid more attention to their needs for tactile contact, they might be less aggressive.”

“Behind the small joys of touch lies the great joy of being in the world: to be here and now, we need tactile experiences,” says Aida Ailamazyan, psychologist, head of the Geptakhor musical movement and improvisation studio. – Alas, today we are experiencing an extreme shortage of physicality, movement… The body has turned out to be almost excluded from the life of a modern person.

We sit in front of the computer all day long, only our eyes work from our sense organs... In order to regain the sense of our own physicality, we only need to slightly change our habits, overcome fear or the prevailing stereotype of behavior.

Of course, without violating someone else's personal space - the boundaries of other people are inviolable. It's just a matter of being more flexible, of acting in such a way that the observance of limits, propriety and distance does not turn into a cell closed on all sides. Otherwise, we risk losing access to our natural bodily and emotional needs, turning from living beings into a set of roles and functions.

SAVE THE TASTE

“It’s not just to swallow a hastily heated dinner, but to taste the dish using all the senses: tasting, observing the color, feeling the aroma, being inspired by the sound (the appetizing crunch of a radish, the sound of hissing meat in a pan). Drinks deserve no less attention.

“Pour some good wine into a glass and let it “breathe,” suggests Alexander Pavlov, head sommelier at the Elardzhi restaurant, seminar leader and author of a course on wine. - Then inhale its aroma, drink a little bit without swallowing, and - freeze. From sensations, colorful images are born: a vine, a cherry seed, or maybe vanilla or honey. Good wine is revealed every moment, giving us more and more new semitones. It is important to try it slowly, listening - and then in a few minutes a completely different palette will open up: from meadow mushrooms to black currants.

The variety of fragrances is unimaginable, it all depends on whether we give ourselves time to experience them. In each glass there is a whole era, history, destiny... But it is impossible to feel it without paying attention, respect, patience to the drink. To get real pleasure, you need to immerse yourself in the process with all your heart, mind, soul. To catch the thread of taste and wind it like a ball. .. And this principle works in everything: in life, as in wine, each shade of taste diverges into other shades - and this process is endless and beautiful.”

LISTEN TO YOURSELF

“We are social creatures, and our pleasures are not born by themselves: almost at all times they were largely constructed by society and the environment,” says Elena Petrovskaya, philosopher, anthropologist, editor-in-chief magazine "Blue sofa". – Today, this control is becoming total: advertising, the media, the lifestyle of famous people impose ready-made models of pleasure on us. Get behind the wheel of a new car, for example, or climb into a hammock with a candy bar. But what if we don't like the taste of the bar? Or are we not ready to work for a new car for several years and at the same time get into debt by getting a loan? So, you need to find the courage to resist the pressure.

Six ways to enjoy life
In a sense, the search for pleasure is the search for oneself.

Learn more