Imagine living a life without the ability to relish the delectable surprise of a great meal, the joy of getting together with an old friend, the pleasure of a first kiss, ￼or a triumph at work. People who suffer from a condition called anhedonia find it hard to enjoy much of anything. They are not necessarily sad, but feel very little pleasure in daily existence, or none at all. Finding the motivation to socialize, take action in the world and access life’s rewards is painfully elusive for them. Anhedonia is a common symptom of depression.
The neuropsychology of anhedonia is not yet well understood, although it has been linked to abnormal volume in brain structures related to seeking rewards and, according to brain scans, less activity in these areas. Anhedonia is also associated with a poor prognosis, including heightened risk of suicidal thoughts and recurrent depression.
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.
Symptoms of Anhedonia:
- Avoiding social situations with friends.
- Avoiding romantic relationships or pulling away from current relationships.
- Feeling or thinking more negative about yourself or other people.
- Including saying negative things to yourself.
- Feeling fewer emotions like joy, sympathy, empathy, and having more blank/unemotional facial expressions.
- Uncomfortable feelings around other people, including family, friends, coworkers, or acquaintances.
- Putting on fake emotions; For example, pretending you’re happy around others.
- Decreased sex drive.
- No interest in physical or emotional intimacy.
- Reoccuring physical problems, such as being sick often, aches, pains, gastro -intestinal distress, or headaches.
- Anhedonia makes relationships, including those with friends and family members, a struggle. Research psychologists believe that ￼anhedonia may be tied to changes in brain activity. Some early research 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 to Combat Anhedonia
- Aerobic activity
Activities that raise heart rate and create adrenaline create a burst of well-being. Running, jogging and high intensity workouts that raise the heart rate. This physical activity activates your sympathetic nervous system, the body’s prompt to switch into high-gear, which creates adrenaline which amps up your entire body and counteracts anhedonia’s numbed feeling of emptiness.
- Strength training
Strength training exercises keep your heart rate up and puts tension on your muscles, which then create a protein called BDNF (Brain-Derived Neurotropic Factor), that creates endorphins and increases dopamine.
Certain foods increase dopamine production which helps relieve anhedonia. An amino acid called Tyrosine, found in food, can be synthesized into dopamine. Another amino acid called phenylalanine can be synthesized into Tyrosine. These are both found in protein-rich foods, such as turkey, dairy, lentils, and legumes
Meditation is the act of focusing on breathing or immediate surroundings as a way to calm the mind, release stress, and relax the body. Meditation decreases depression symptoms by lowering the amount of the stress hormone cortisol. Several brain scan studies have correlated high cortisol levels with symptoms of major depression. A recent study was conducted on meditation for patients with late-stage cancer who were receiving frequent radiation treatments. Results indicated that participants in yoga and chemotherapy had a much higher quality of life, as assessed by measures of depression and anxiety, compared to those who only received chemotherapy. Patients reported better mood, less fatigue, and an improvement in perceived health.
- Meaningful relationships
Having meaningful relationships that are sustained and tended to regularly increases dopamine production and decreases anhedonia.
- Physical touch
Physical touch can ￼decrease anhedonia symptoms by creating oxytocin. Physical connection with other humans like hugs, holding, or sex, produces the neurotransmitter oxytocin, which decreases cortisol levels.
Even with the best food, exercise, a host of deep friendships, and frequent meditation — the brain is not going to heal in a day or a week. Anhedonia is the result of dopamine deficits because the brain has a compromised ability to send and receive this neurotransmitter. Talk therapy can help us learn coping skills and stress reduction strategies that help deal with anhedonia.
- Adding something new
The strategy that I use in my practice is called adding something new, and not taking away things. Adding something new every week or month changes our neural pathways.￼￼ By asking people to reflect and recall things that were pleasing to their senses, therapy is essentially trying to jumpstart/reboot the connections in the brain’s reward center. Since the reward center is responsible for sending and receiving dopamine, when therapy is successful, it increases dopamine levels as well as the brain’s potential to receive more pleasure in the future.