Anhedonia is b Loqueo of the capacity of reward before stimuli usually reinforcing and the p Loss of interest or pleasure in all or almost all activities.
Both definitions refer to the same: the loss of the capacity to experience pleasure. This term f Which was coined by Ribot in 1897.
Thus, a person suffering from anhedonia has reduced his ability to enjoy the things of his environment.
It is very common to confuse this problem with A depression , Since the person is shown without wanting to do things, when he does them without appetite, And he never seems to have any kind of motivation nor is he happy or happy.
However, although anhedonia is usually a symptom in depressions, (a person with depression may lose Experiencing pleasure), the fact of suffering anhedonia by itself does not imply suffering a depression.
Characteristics of anhedonia
It is important to define that anhedonia is characterized by the inability to experience pleasure, nothing more.
Similarly, it is important to differentiate anhedonia from lack of motivation ( apathy ).
Apathy is characterized by a lack of will or interest in daily and leisure activities. The loss of interest in these activities the brand A total lack of motivation.
A person suffering from anhedonia may also show little interest in leisure activities (apparently pleasurable) but the motive that causes them to lose The interest in them is knowing that you will not experience any pleasure in performing them.
Having no pleasure in anything, it is understandable that the person with anhedonia chooses to remain inactive instead of performing activities.
If we think about it well... Would you go to the movies if you were there when you did not experience any kind of pleasure? Would you stay with friends if you could not enjoy?
These may be the thoughts of a person with anhedonia, so it is very likely that he is also apathetic and without any motivation, but his Main problem will remain the inability to experience pleasure.
Put another way: loss of motivation is usually a consequence of anhedonia.
To further delimit the term anhedonia, we must ask ourselves another question:
A person who does not experience pleasure in various activities but has some that enjoy themselves gets rid of suffering anhedonia? The answer is no, since there are different types of anhedonia.
On the one hand we would have the Total anhedonia (Which we have explained so far), which, apart from being the most severe type of anhedonia, is characterized by Lose the ability to experience pleasure in absolutely all areas of life, and in all activities.
However, there are what we might call" Partial anhedonias ", That is, inability to experience pleasure in some activities or in some Aspects.
Among them, we find social anhedonia, when the person does not enjoy contact with others and is totally incapable of experiencing pleasure When it relates to people.
In these cases, the person chooses to avoid social contacts and becomes socially isolated.
There are also sexual anhedonias, where pleasure is lost because of the affectionate activities, anhedonias in the appetite, in which the interest for Food, or anhedonia in leisure activities and situations that were previously pleasurable for the person.
Thus, in the anhedonia there are degrees. There are people who can suffer a total inability to enjoy anything, and there are people who suffer a Decrease of enjoyment by some activities.
However, whenever there is an alteration in the capacity to experience pleasure in a person, this is a case (greater or lesser Gravity) of anhedonia.
Symptoms of anhedonia
Anhedonia is not considered a disease in itself, but a symptom that can appear in different mental illnesses.
However, there are a number of features that can be associated with anhedonia and there are a number of symptoms that may appear alongside it.
With the aim of delimiting the concept of anhedonia a little better, I will now comment on some of those that are, in my opinion, more relevant.
Inability to experience pleasure: As we have said, this would be the definition of anhedonia, so it is the main symptom that appears when we will refer to this problematic Psychological.
Loss of interest: Not being able to experience pleasure with activities, people with anhedonia lose interest in them.
Inactivity: The inability to experience pleasure in activities produces a decrease in the activity of the person.
Decrease in expressiveness: People with anhedonia often have difficulty expressing positive emotions such as enthusiasm or happiness.
Changes in appetite: There may be changes in appetite and ingestion due to the inability to experience pleasure when they eat.
Isolation: People with anhedonia often separate from their social circle because they do not enjoy their personal relationships or social activities.
Sexual problems: Loss of interest and inability to enjoy sexual activities may be accompanied by other problems such as dysfunction erectile .
Absence of energy: People with anhedonia may be less able to do things and get tired more easily.
Lack of attention: People with this problem may be less active, less attentive and having problems paying attention and to concentrate .
Generalized malaise: Anhedonia can produce a global feeling of discomfort.
Diagnosis of anhedonia
According to researchers, it seems that anhedonia is caused by an alteration in the reward system of the brain.
The reward system would be like"a network of neurons"within Our brain , Which fulfills the function of producing feelings of pleasure.
For example: when we do an activity that we like, we eat when we are hungry or drink when we are thirsty, the reward system of Our brain is activated, and we immediately experience the sensation of pleasure.
This reward system of our brain works with the neurotransmitter Dopamine (A chemical that modulates the activity of our brain), So that research on the appearance of anhedonia focuses on possible alterations of these substances.
However, today no mechanism has been found to detect this phenomenon clearly in the brains of people suffering from anhedonia, So the diagnosis of this problem remains purely clinical.
In order to diagnose anhedonia, a mental health professional must evaluate the patient's actual ability to experience pleasure by examining The patient's personal relationships, daily activity, thoughts and behavior.
Anhedonia-related disorders
The inability to experience pleasure is a symptom that is often present in a series of mental disorders.
Not all cases of anhedonia are related to one of these diseases, however, the inability to experience pleasure charges special Importance in these contexts.
Let's see what they are:
Depression
The depression Is the psychopathology in which the anhedonia most frequently appears, in fact, in these cases the anhedonia constitutes an important symptom of the Depressive symptomatology.
Depression is characterized by the presence of a State of mind Decayed and diminished doing things, so the ability to enjoy in those Situations is often complex.
Bipolar disorder
He Bipolar disorder Is characterized by depressive episodes followed by manic episodes, which would be the opposite of depression: Mood rises above normal and activity is much greater.
People with bipolar disorder may suffer anhedonia in their depressive episodes, presenting similarly to unipolar depression.
Schizophrenia
The schizophrenia Is a psychotic disorder in which symptoms such as delusions, hallucinations, disorganized behavior or increase Of speech rate (positive symptoms).
However, along with these symptoms also appear opposite symptoms as the impoverishment of the language, the apathy, the loss of energy, and Evidently anhedonia (negative symptoms).
Addiction to Substances
The addiction Certain substances can also cause anhedonia.
Of all the substances, the cocaine Is the one that usually causes a greater number of cases, due to the direct alteration that it makes on the dopamine and on The reward system of our brain.
Causes of anhedonia
As mentioned earlier, the origin of anhedonia seems to be in the functioning of dopamine, especially in its participation in Of the reward system of the brain.
It seems quite clear that losing the ability to experience pleasure has to be related to those areas of the brain that are responsible for"generating" that sensation.
As we have just seen, there are certain mental illnesses that can cause this dysfunction in the brain and produce anhedonia.
However, not all cases of anhedonia have to be directly related to one of these psychopathologies.
So, regardless of these diseases, what are the causes and what are the mechanisms that our brains have to do to suffer Anhedonia
As is often the case between mental diseases , Because of its complexity, a universal explanation for this has not yet been discovered today. Question, however, there are certain aspects that seem to be important.
1. The fact of feel guilty Of being happy when other people are not and suffering from stressful situations such as hunger or pain, can be a Factor involved in the onset of anhedonia.
2. Having suffered repression to express emotions as a child can predispose to suffering anhedonia. For example, having received an educational style that Prevent express Positive emotions Like joy or humor, emphasizing in a serious and inexpressive way of behaving.
3. Try Usually feelings of guilt , Sexual anxiety, having a personality governed by the need for success or recognition can help To distort thoughts and feelings about pleasure.
4. Having suffered traumatic events during childhood can impoverish the ability to experience pleasure.
These four aspects do not create the anhedonia much by itself, but they are factors that can make that we construct a personality with Difficulties or distortions with respect to pleasure and enjoyment, a fact that could lead to (or not) anhedonia.
It can be cured?
Yes, the anhedonia can be cured, or at least improved.
When the origin is one of the mental disorders we have discussed (depression, schizophrenia, bipolar disorder and substance addiction), anhedonia Usually improved through the treatment of the underlying disease.
Also, anhedonia can be treated with pharmacology, antidepressants often help to remit this problem.
Normally, however, overcoming anhedonia involves more than just pharmacological treatment.
Learning to recognize and experience your own negative emotions is usually beneficial. You can spend a little time every day to imagine situations that you They do experience certain emotions. When you feel negative emotions, you will value the positive ones more.
Also, it is vitally important that you force yourself to do activities. If you stay all day in bed you will never get past anhedonia. Stay with friends, go for a walk, exercise... Even if you do not enjoy it now, there will come a day that you will.
To be able to do these actions you can easily benefit from the psychotherapy .
References
- Barlow D. and Nathan, P. (2010) The Oxford Handbook of Clinical Psychology. Oxford University Press.
- Caballo, V. (2011) Manual of psychopathology and psychological disorders. Madrid: Ed. Piramide.
- Michael J. Aminoff... [et al.] (2008). Neuropsychology and behavioral neurology [Recurs electrònic] / edited by ISBN 9780444518972 Publicació Amsterdam: Academic Press.
- TAYLOR, S. (2007). Health Psychology . Madrid: McGraw-Hill.