Anhedonia: Effects And Causes Of The Inability To Feel Pleasure
The concept of anhedonia is widely used in both psychology and psychiatry.because it refers to a strange phenomenon that is very relevant to the person who experiences it: the inability to feel pleasure and a sense of satisfaction.
That makes this become a blow to the quality of life of the patients who express it, because everything that can be linked to motivation, the feeling of well-being or interest in things is nullified.
Below we will see what anhedonia consists of and how it has an impact on people’s quality of life.
Generally speaking, anhedonia is the total absence of pleasant and satisfying sensations regardless of the context in which one is. Said psychological phenomenon must be intense enough to be considered psychopathological, that is, it negatively affects the quality of life of the individual.
In other words, anhedonia is the inability to fully experience pleasure and feelings associated with it, such as joy or appreciation of humor in what surrounds us, and which has as one of its main causes an alteration in the mental processes of the person. This means that it does not manifest itself only in a specific area, such as playing sports or intimate relationships, but in all the possible experiences that the person in question lives.
It must be taken into account that in certain cases anhedonia is not entirely global, and it manifests itself in certain areas of life, as we will see. Musical anhedonia, for example, would be one of these variants, although hardly anything is known about this specific one beyond the fact that it appears in people who cannot enjoy listening to music.
Anhedonia can be understood as if it were a reverse anesthesia: instead of all painful experiences being cancelled, those that produce pleasure or a feeling of well-being are cancelled. In short, experiencing anhedonia means living without pleasure, whatever we do.
Anhedonia is not a disorder
This may seem confusing, since anhedonia reveals a serious disorder that should be treated, but the truth is that is not in itself a mental disorder. It is a symptom, not a syndrome or psychological disorder, although it is usually one of the forms of expression of different types of mental illness. That is, it is the expression of a pathology that produces this effect, but that can also generate other mental problems.
Effects of anhedonia
As we have seen so far, anhedonia can have different consequences, depending on the lifestyle and context in which the person who develops this disorder finds themselves. However, most of these effects of anhedonia have to do with passivity and the tendency to experience everyday life in a too sedentary way.
Thus, it is common for people who experience this to present:
Disorders in which anhedonia appears
The disorders in which anhedonia appears most frequently are, especially, depressive disorders: In depression, there is usually emotional flattening and a low level of anticipatory and consummatory pleasure.and a feeling that patients describe as an inability to enjoy things that should stimulate them in a positive way. Something similar occurs with the disorder known as dysthymia.
On the other hand, it should be noted that anhedonia is more associated with major depression than with the depressive episodes that occur in bipolar disorder. While in the first type of psychopathology the symptoms are more associated with the relative lack of psychological activity, people who have developed bipolar disorder usually experience a form of depression more linked to irritability than to passivity (although this tendency does not have why occur in each and every case).
However, Anhedonia is also relatively common in cases of schizophreniaas well as in people who have become so addicted to a substance (alcohol, cocaine, and other drugs) that they have become habituated to it and have become insensitive to other forms of satisfaction.
On the other hand, there is evidence that anhedonia is not expressed in the same way in people with depression as in people with schizophrenia: in the first group, this symptom usually weakens over time, while as a general rule this does not happen in the case of patients with schizophrenia who have manifested this symptom.
What causes can produce the absence of pleasure?
The biological causes of anhedonia are not well known, but there are theories about it. One of the most accepted is that This symptom arises from an alteration in the brain’s reward system.located in structures related to the limbic system.
In normal situations, certain situations trigger a process in our brain that will make us try to repeat that experience. To do this, these parts of the brain generate the sensation of pleasure, in which hormones such as dopamine play a fundamental role. In anhedonia, this reward system would be unable to activate the mechanism to repeat behaviors, and the absence of pleasure would result.
Among the parts of the brain that have been related to anhedonia (due to abnormalities in many patients who present this symptom) we find the amygdala, orbitofrontal cortex and hypothalamusstructures that intervene in goal setting and motivation, either promoting or inhibiting the desire to satisfy the need for pleasure.
Some types of anhedonia
Here you will see some specific, relatively common variants of anhedonia.
social anhedonia
There is a phenomenon known as social anhedonia in which lack of interest and absence of pleasure appear specifically in social experiences. People with social anhedonia do not find any reason to interact with others unless this responds to very specific material needs.
Social anhedonia, in addition, is often one of the first signs of the appearance of schizophrenia in some of its forms.
Furthermore, from what has been observed from research in which brain scans have been used, in the brains of people with strong anhedonia there are also alterations in parts of the cerebral cortex responsible for carrying out cognitive processes related to representation. of “I” and of others.
sexual anhedonia
This form of anhedonia generally occurs in men who, when they ejaculate, do not feel pleasure.. In women there is also an analogous form of this symptom, but it is less common.
It is an alteration that not only harms the quality of life of those who experience sexual anhedonia firsthand, but also represents a relationship problem that must be managed. This makes it not only a phenomenon to be treated psychologically in the patient, but it is also often necessary to intervene through couples therapy.
Possible treatments
Since anhedonia is a symptom, to know how to address it, you must first know its root, that is, the disorder or neurological disorder that produces it and the contextual elements that facilitate its maintenance; We must not forget that many harmful psychological alterations remain for months or years because the person forces them through his actions, without realizing it.
This will make it possible to detect external factors that favor and maintain its appearance (such as highly stressful elements) and will also make it easier, if a treatment is chosen in which psychotropic drugs will be used, to use the appropriate ones.
