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 experiencing it: the inability to feel pleasure and sense of satisfaction.
This makes it a sledgehammer for the quality of life of the patients who manifest it, because everything that can be linked to motivation, a sense of well-being or interest in things is cancelled out.
Next we will see what anhedonia is and how it impacts on people’s quality of life.
What is anhedonia?
In general terms, anhedonia is the total absence of pleasant and satisfactory sensations regardless of the context in which one is .
In other words, anhedonia is the inability to fully experience pleasure and feelings associated with it, such as joy or appreciation of humor in one’s surroundings, which has as one of its main causes an alteration in the person’s mental processes. This means that it does not only manifest itself in a specific area, such as the practice of sport or intimate relationships, but in all possible experiences that the person in question lives.
It should be noted, however, that in certain cases anhedonia is not entirely global, and it manifests itself in certain areas of life, as we shall see. Musical anhedonia, for example, would be one of these variants, although of this one in particular we hardly know anything beyond that it appears in people who cannot enjoy listening to music.
Anhedonia can be understood as if it were a reverse anaesthesia : instead of all the painful experiences being annulled, those that produce pleasure or a feeling of well-being are annulled. 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 often one of the forms of expression of different types of mental illness. In other words, it is the expression of a pathology that produces that effect, but can also generate other mental problems.
Disorders in which it is present
The disorders in which anhedonia appears most frequently are especially depressive disorders: in depression there is usually an emotional flattening and a low level of anticipatory and consumptive 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.
However , anhedonia is also relatively common in cases of schizophrenia , as well as in people who have become so addicted to a substance (alcohol, cocaine, and other drugs) that they have become accustomed to it and insensitive to other forms of satisfaction.
On the other hand, there is evidence that anhedonia does not express itself in the same way in people with depression as it does in people with schizophrenia: in the former group, this symptom usually weakens over time, whereas this is not usually the case for patients with schizophrenia who have manifested this symptom.
What causes 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 is born 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 so, these parts of the brain generate the sensation of pleasure, in which hormones such as dopamine play a fundamental role. In the anhedonia, this system of rewards would be unable to activate the mechanism to repeat behaviors, and from that would derive the absence of pleasure.
Among the parts of the brain that have been related to anhedonia (because of anomalies in many patients who present this symptom) we find the amygdala, the orbitofrontal cortex and the hypothalamus , structures that intervene in the fixation of objectives and in motivation, either promoting or inhibiting the desire to satisfy the need for pleasure.
Some types of anhedonia
Here are some specific variants of anhedonia that are relatively common.
The social anhedonia
There is a phenomenon known as social anhedonia in which the lack of interest and the 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 concrete material needs.
Social anhedonia, moreover, is often one of the first signs of the appearance of schizophrenia in any of its forms.
In addition, from what has been observed from research using brain scans, 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 the representation of the “I” and others.
This form of anhedonia generally occurs in men who, when ejaculating, do not feel pleasure . In women there is also a similar form of this symptom, but it is less frequent.
This is a disorder that not only damages the quality of life of those who experience sexual anhedonia first hand, but also poses a problem for the couple that must be managed. This makes it not only a phenomenon to be treated psychologically in the patient, but often also necessary to intervene through couples therapy.
As anhedonia is a symptom, in order to know how to deal with it, we must first know its root, that is, the neurological disorder or disorder that produces it.
This will allow the detection of external factors that favour and maintain their appearance (such as strong stressors) and will also make it easier to use the appropriate ones in the case of choosing a treatment in which psychotropic drugs will be used.
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