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What Is Anhedonia? Causes, Symptoms & Treatment

Anhedonia is a term that classifies a person’s inability or reduced ability to feel pleasure. In the DSM-5, this is one of the key symptoms of major depressive disorder, but it can also be caused by several other psychological disorders as well as substance use disorders. Some of the more common disorders associated with anhedonia include:

  • Schizophrenia
  • Substance Abuse
  • Psychosis
  • Parkinson’s Disease
  • Eating Disorders (particularly binge eating)
  • Various Risky Behaviors
  • Bipolar Disorder
  • Diabetes

Though anhedonia is categorized as the overall inability to feel pleasure, in some cases it can be broken even further into social anhedonia or physical anhedonia. The first indicates that a person is unable to enjoy or find pleasure in social situations or in other people. They often experience difficulty in following conversations due to a general lack of interest in other people or situations around them. Physical anhedonia refers to a person’s inability to feel pleasure from physical sensations. This does not specifically have to be sexual and can be related to all physical sensations.

Causes of Anhedonia

There are many working theories related to the causes of anhedonia. The most common cause is associated with dopamine, or the lack thereof, within the brain. In people who are depressed or are experiencing other conditions related to anhedonia, there may be a lack of activity in the medial prefrontal cortex where dopamine is produced. Dopamine is released when the brain experiences some sort of reward, but if there is a disruption in this neurotransmitter or just a general lack of activity, people with anhedonia may struggle with dysfunctional reward processing.


Symptoms of Anhedonia

Technically, anhedonia is a symptom, but it can also lead to other complications, such as:

  • Feelings of hopelessness
  • Unable to smile or laugh organically
  • Withdrawing from friends, family, or activities that they once enjoyed
  • Feelings of dread, anxiety, or paranoia
  • Constant illnesses
  • Lack of interest in social settings
  • Refusing to seek help
  • Negative self-talk and self-perception
  • Significantly reduced emotional capacity
  • Decreased sex drive or discomfort with physical intimacy
  • Suicidal ideation

Suffering from anhedonia can also lead to a long list of problems, especially a general decrease in that person’s quality of life. Anhedonia can cause complications with the relationships in someone’s life, leading to even more isolation and discontentment. Anhedonia can also lead to social anxiety, decreased motivation, and loneliness.

Anhedonia can also complicate treatment outcomes if a person is seeking help for a condition like depression or diabetes. When it is a symptom of another disorder, anhedonia can lead to less likelihood of the person seeking help, poorer treatment outcomes, and risk for longer-term complications.

Treating Anhedonia

There is no one way to treat anhedonia, especially if it is linked to another condition. In that case, it is helpful to address the underlying condition to see if anhedonia was simply a symptom. In some cases, people who suffer from anhedonia may be prescribed an antidepressant (SSRI), but because all people are different and react to medications differently, the use of antidepressants may actually make anhedonia worse.

Recent studies have indicated that ketamine infusion therapy may be one of the more effective treatment options for anhedonia. Seeking help from a medical professional is the first step, and if they do decide to prescribe ketamine, it is critical to understand that the infusion therapy is not the same as recreational ketamine use and clients should stick to the specific instructions given to them.

Other treatment options that are undergoing more research are Positive Affect Treatment and Virtual Reality Reward Training.

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