anhedonia

Understanding Anhedonia: Why You’re Losing Interest in Things You Used to Enjoy

Everyone changes interest in things over time. You might’ve loved soccer as a kid, but grew bored of it and quitted in your teens. Unlike the typical loss of interest, anhedonia makes every day uninteresting and results in many or all activities you enjoyed not eliciting excitement anymore.

What Is Anhedonia?

People with anhedonia feel like they’re just going through the motions of life. Its signs present themselves slowly but surely and may be mistaken for boredom or something much simpler.

Anhedonia can be:

  • A primary symptom of depression
  • A symptom of other mental health conditions e.g. schizophrenia, bipolar disorder, Parkinson’s disease
  • A result of substance abuse or gaming addiction.
  • A condition that appears on itself, in absence of any mental health conditions

There are two types of anhedonia:

  • Social anhedonia
  • Physical anhedonia

Social Anhedonia

Social anhedonia is the loss of interest in social situations and social contact. You might find it difficult to enjoy being with other people. You might also have little motivation to seek out social situations. As a result, you might experience emotional detachment and difficulty building intimacy.

Physical anhedonia

Physical anhedonia is the inability to enjoy physical sensations. You might find it difficult to enjoy touching, sex, eating, and so on. You might have little motivation to engage in all sensory activities including movement and exercise.

How Is Anhedonia Different From Typical Loss of Interest?

The signs and symptoms of anhedonia set it apart from the change of interest that’s expected of most people. You might have this condition if you:

  • Isolate or withdraw from social situations
  • Experience difficulty engaging with others, whereas you enjoyed social activities before
  • Struggle to listen, engage, or follow conversations
  • Exhibit inauthentic emotions that you believe are appropriate for social situations e.g. pretending you’re happy at a birthday party.
  • Find it hard to ask others for help or express emotions such as grief
  • Harbor negative thoughts towards yourself and others
  • Have low sex drive or interest in sexual activities
  • Fall sick frequently
  • Feel hopeless and/or suicidal

What Are The Causes Of Anhedonia?

Scientists are yet to understand the cause of anhedonia. However, brain imaging reveals abnormal volume and less activity in reward-seeking brain structures for people with this condition.

It’s not clear what mechanisms in the brain induce anhedonia, but experts have some theories. One theory is a reduction of dopamine — the pleasure neurotransmitter in the brain. To help you fully understand the link between dopamine and anhedonia, let’s briefly discuss how reward mechanisms work.

Reward processing involves several processes:

  1. Association between stimulus and perceived reward
  2. A cost-benefit analysis
  3. Triggering interest, desire, and motivation
  4. Consummatory behavior
  5. Pleasure

To participate in pleasurable activities, a person must have interest, desire, and/or motivation. Therefore, scientists believe that anhedonia results from defective brain reward processing. The reward cycle isn’t working as it should and finding which part of the process is defective requires more research.

Who Is At Risk Of Developing Anhedonia?

People with a family history of depression or schizophrenia are at a higher risk of developing anhedonia. Other risk factors include:

  • A recent stressful event
  • A history of abuse or neglect
  • A major or chronic illness
  • A recent traumatic event

How to Treat Anhedonia Using Therapy and Other Interventions

Anhedonia can be difficult to treat, as there isn’t a specific treatment option that’s proven effective. However, dealing with associated conditions e.g. depression or addiction can improve the symptoms of anhedonia.

Diagnosis

A correct diagnosis is essential for the treatment of anhedonia. You’ll have to work with a doctor and a therapist to find out why you’re lacking energy and interest. Some physical illnesses, like thyroid disorders, can have similar symptoms so it’s important to rule them out.

Working with a therapist can help find underlying problems that your anhedonia is a symptom of. Seeking proper treatment for the underlying problem e.g. depression can effectively eliminate anhedonia.

If you don’t have an underlying issue, talk therapy can help you reclaim joy in your life. It can help you get to the root of your lack of enthusiasm. Online therapy is particularly useful as you can get it from the comfort of your home.

Behavioral Activation (BA)

Behavioral activation is a therapy technique used to treat depression that can also help treat anhedonia. Using this method, your therapist will help you understand how your behavior influences your emotions.

Behavioral activation involves:

  • Monitoring daily activities
  • Identifying goals and values
  • Building an upward spiral of motivation and energy
  • Purposefully scheduling enjoyable and meaningful activities
  • Identifying potential barriers to enjoyment
  • Reducing avoidance

Research has proven that behavioral activation can be an effective treatment on its own. However, it might be used alongside other therapeutic interventions to fully manage anhedonia.

Mindfulness-Based Stress Reduction

Mindfulness-based stress reduction (MBSR) is an approach that combines meditation and yoga. It aims to address the unconscious thoughts, feelings, and behaviors that may trigger anhedonia.

MBSR works because it cultivates a greater awareness of the present moment. It eliminates negative thought patterns that may cause disinterest. Research also suggests that MBSR can improve one’s mood which might increase motivation to take part in social and physical interaction.

Cognitive Behavioral Therapy

Cognitive-behavioral therapy uses cognitive restructuring to treat the lack of enthusiasm. Using this technique, your therapist will help you understand the connection between thoughts and emotions.

Medication

Medications are an important part of treatment for anhedonia related to depression, schizophrenia, and substance use disorders. Psychiatrists and primary care doctors can prescribe antidepressants or antipsychotics depending on your specific symptoms.

Although you may not see an improvement at the beginning, it’s best to be patient and give the medication time to work. It’s also advisable to be honest with your doctor about how you’re feeling while on medication.

Lifestyle Changes

The symptoms of anhedonia can be improved by making lifestyle changes to go with therapy and medication. Prioritizing physical health is one change that may have a positive impact. Some ways of improving physical health and well-being include:

  • Prioritizing whole foods over processed varieties
  • Moving more daily, even when you’re not motivated to exercises, going on a walk, or taking the stairs instead of the elevator can make a difference
  • Cultivating good sleep habits
  • Making an effort to build and maintain relationships
  • Challenging negative thoughts

One of the best coping skills for someone with anhedonia is to develop accurate self-monitoring — attending to your own thoughts, feelings, and behaviors. Through self-monitoring, you can identify the signs of anhedonia and seek help promptly.

The Bottom Line

Anhedonia is an inability to feel the pleasure that is commonly seen as a symptom of different mental conditions, but there are also two distinct types –social anhedonia and physical anhedonia. It can affect your quality of life and can be tricky to treat. Many studies are currently underway to discover the causes and more effective treatments for anhedonia. If you suspect you might have anhedonia, it’s best to seek help from an experienced mental health professional who can help you determine the causes of your symptoms. Online therapy could be a good option because you can share your experiences from the comfort of your home.

Kate Skurat

Kate Skurat

Licensed Mental Health | Washington, United States

Kate has a B.S. in Psychology and M.A. in Clinical Psychology from Pepperdine University and has worked in healthcare since 2017. She primarily treated depression, anxiety, eating disorders, trauma, and grief, as well as identity, relationship and adjustment issues. Her clinical experience has focused on individual and group counseling, emergency counseling and outreach. Read more