What is Anhedonia: It’s Link with Depression, Symptoms, Types, Causes

Anhedonia is referred to as a symptom of mental disorder whereby a person is unable to feel satisfaction, joy, or pleasure from activities they would have often enjoyed, such as reading, singing, exercising, sports, social activities etc… For example, a person who usually found pleasure in singing and no longer finds it pleasurable is said to be affected by Anhedonia.

In life, people often experience good feelings of accomplishments and rewards from activities they are engaged in. These accomplishments and their rewards are often worth the pursuit, because of the positive feelings they bring.

Such things people often pursue to accomplish include basic biological drives like eating delicious food, exercising/working out, sex, and hygiene, cleanliness etc…

Social drives like socialization and productive activities, for which they receive rewards of recognition, accomplishments, and acceptance, also in activities of appreciation of beauty, art or nature like listening to music, art, dancing, literature and the natural environments, which often create sense of appreciation and joy. In a state of Anhedonia, the patient lacks the ability to enjoy and experience these things.

There is currently very little research done to give better explanation as to the level of enjoyment either gained or lost in the illness of Anhedonia. Most researches had only highlighted on different types of pleasant behavior such as motivational anhedonia.

Anhedonia is a major symptom of major depressive disorder or clinical depression and this feeling is often seen in mental disorders like mood disorders, schizoid personality disorder, schizophrenia, schizoaffective disorder, and borderline personality disorder (BPD). Wherever these mental disorders or depression is diagnosed and detected, anhedonia will always be present and shows itself in the level at which a diagnosed person enjoys activities that he/she would ordinarily have enjoyed. For instance, in a situation of schizoid personality disorder.

Previous researches have shown that there is a huge relationship between depression and anhedonia. In every person with major depressive disorder or clinical depression, there is always a great presence of anhedonia. When people are depressed, they lose interest in activities and hobbies they used to enjoy. A research carried out by Faith Brynie (2009) stated that the pleasure circuits may not be entirely blocked during a period of depression, and so pleasure is actually fully experienced but within a very short limited time, not enough to become interested, motivated and involved with the activity. The individual in this case is described as having a major depressive disorder or clinical depression along with anhedonia.

On the other hand, most people suffering from mental health conditions usually experience a great deal of depression (clinical depression or major depressive disorder), and as such will develop high level of anhedonia. This is why people with mental illnesses such as schizophrenia, bipolar mood disorder, personality disorder, etc., often show severe cases of anhedonia.

Nevertheless, people with some depression may not have anhedonia. Anhedonia usually is mostly inhibited by most people with clinical depression/major depressive disorder and even after being treated of depression, anhedonia may continue for a while.

There are four types of anhedonia usually found in people with the disorder of anhedonia. They are:

1. Consummatory Anhedonia: The individual derives no satisfaction from activities considered to be enjoyable. In this case the person does not have any anticipation for reward and as such does not show any form satisfaction from the activities.
2. Motivational Anhedonia: This is a situation whereby a person shows no interest in taking part in pleasurable activities. Nothing motivates him/ her to do anything even when there is a reward for accomplishing such an activity.
3. Social Anhedonia: This is a situation whereby an individual withdraws from all social gatherings and contacts, living in his/ her own world. There is no interest whatsoever to interact and make friends with people. The person always wants to be alone all of the time. The person has no close friends, has a depressed mood, cannot adjust socially, and shows a great deal of social inadequacy and anxiety, feels very insecure in social gatherings.
4. Sexual Anhedonia: Sexual anhedonia in males, this is known as ejaculatory anhedonia. It most often suffered by male than the female. Women can also suffer from it during the organism process. This means that when an individual even makes an effort to have sex with his/her partner, there is no feeling of sexual gratification or fulfillment or enjoyment from the activity. Sexual anhedonia may be caused by low level of the testosterone, multiple sclerosis, fatigue, hyper-prolactinaemia, hypoactive sexual disorder (HSDD), physical illness, intake of SSRI antidepressants, or use of anti dominergic neuroleptics.

Individuals with anhedonia generally have a very flat mood. Their mood can be described as neither high nor low, so that they show no feeling for anyone or to anything. This is the major symptom of anhedonia. It is most times very difficult to understand such people and probably work with them. You will see some of the following signs and symptoms in anyone with anhedonia:

• If the individual does not express any interest in normal daily activities, they usually enjoy. The things they used to enjoy, they no longer enjoy them, and they find no interest in doing them. When they even try to take part in such activities, they find no joy or gratification in them. This could be a Symptom of Anhedonia.
• If the individual does not have the capability to experience or show pleasure, joy and happiness in those activities, they would usually have experienced great pleasure, joy, and happiness.
• If the person has no motivation to do anything. Most people are motivated by rewards, recognition, and fulfillment they would derive from engaging in a particular activity, but people with anhedonia are not motivated by any of these rewards. They have no desire to achieve the best in whatever they are doing. They feel it is worth nothing to them.
• The person losses weight unexplainably, because the person always thinks a lot and feels really bad about themselves.
• The person suffering from Anhedonia would have symptoms of feeling restless and sluggish and can hardly complete any task.
• One of the symptoms of Anhedonia is that the person often feels depressed, sad and sometimes thinks of suicide.

Most researchers have pointed out that the breakdown of the neurotransmitter dopamine of the brain serves to send rewarding signals to other nerve cells, could be the cause of Anhedonia. Most of the causes for Anhedonia, which were pointed out by recent researches, include:

• Social Learning. This is a situation whereby the individual with anhedonia has learnt to identify and get used to feeling no pleasure from certain experiences.
• Anti-dopaminergic neuroleptics or anti-psychotic drugs and withdrawal also cause Anhedonia from stimulants like phenethylamines or amphetamines. Evidences have shown that antibiotics also cause Anhedonia.
• Diagnostic and Statistical Manual of Mental Disorder (DSM) criterion of weight loss can also cause Anhedonia. This is because many people with this disorder usually experience lack of satisfaction from food and they also suffer from depression.
• A study highlighted that the reduction in the activity of the amygdala and stratium may prevent the prefrontal cortex from processing rewarding experiences leading to Anhedonia because of the breakdown of the brain’s reward system.
• It has also been pointed out that Anhedonia is caused by severe depression disorders such as borderline personality disorder, schizoaffective disorder, schizoid personality disorders, mood disorders, and schizophrenia.
• Child abuse while they were children can also lead to anhedonia.
• Anhedonia is also caused by drug abuse/overdose.
• Clinical depression or major depressive disorder also exhibit great amount of anhedonia.
• People who take excess alcohol also face the danger of anhedonia.
• People who have different sexual partners may also experience sexual anhedonia.
• Many Psychiatrists have highlighted that anhedonia is also caused by prolonged stress, which is as a result of a minor neurological malfunctions.
• Several diseases have also been linked to cause anhedonia such as gastrointestinal diseases, diabetes, stroke, high cholesterol etc…

The causes listed above have various degrees and extent to which a person can be affected by anhedonia. Nevertheless, the major risk factors that have been identified to frequently lead to anhedonia are:

• Excessive use of antipsychotic drugs and the use of withdrawal stimulants like Phenethelamines or amphetamines.
• Clinical depression, borderline personality disorder, personality disorder, mood disorders, schizoaffective disorder, and schizophrenia produce very severe cases of anhedonia.
• Addiction to drugs and alcohol.

Anhedonia complicates the overall wellbeing of the individual, socially, family life, work, health and various personal interests. People with anhedonia will experience the following:

• Anhedonia causes the individual to lack the motivation to do anything.
• The person suffering from Anhedonia will no longer derive enjoyment from the activities they previously enjoyed.
• Anhedonia causes the person to become distant and show no emotion with anyone. They become distant to their children, wife/husband.
• They feel no emotion or attraction to beautiful creations such as flowers, animals, sunset, decorations and other beautiful scenery.
• They most times show fake emotions to avoid questions.
• Anhedonia makes people forget things and past events due to the lack of interest they have.
• It makes them no longer enjoy listening to music and enjoy their favorite songs.
• Special occasions like wedding, birthday celebrations, and other celebrations. They will often have to forget the birthday of their children and loved ones.
• The dreams that they always had of becoming something great or achieving a particular thing in life becomes an illusion.
• They lose interest in intimate contacts with their spouse.
• They will lose total interest in their favorite hobbies like, playing games, trailing, skiing, chatting, reading, travelling, etc.
• They will lose interest in spiritual activities.
• Anhedonia can affect the growth and development of their children, as they may suffer in social activities.
• Anhedonia can lead to serious health problems like acute mental problems.

Also Read:

• Anhedonia: Diagnosis, Treatment, Recovery Period