[black649]

Hello there!
I'm new to the forums on PsychCentral, but I wanted to ask if anyone here is dealing with the same, admittedly strange, symptoms of depression as I am.

First, let me give you a bit of background. I had been dealing with very severe depression for the better part of my life. I had never been institutionalized, but only just barely. I had dealt with suicidal tendencies when I was in my mid teens and, besides an overwhelming sense of sadness and hopelessness, I could not be bothered to care about or engage in any sort of hobby or personal pursuit. Needless to say, I was a live-wire of emotional instability.

However, this past year was when I had finally been able to push back against my illness. With the help of my therapist, medication, friends, family and some good choices on my part, I finally feel like I'm winning the fight against the negative torrent of emotions in my head. That being said, I'm still struggling against some of my old symptoms. While I find myself in a generally good mood these days, the next problem I find myself faced with is the symptom of "Anhedonia." For those who do not know, anhedonia is the inability to feel pleasure from any sort of activity.

This is where tings get a little muddy, for me. While I find myself in a fairly positive mood, I can't seem to get myself emotionally involved in any kind of activity at all. Whether it's school work, hobbies, exercise or even sex, I can't feel the emotional pull toward any of these things that would drive me to excel or even care about them. I can get short "Bursts" of excitement from things, but it fades rapidly and soon I am unable to care about it at all. I can recall enjoying certain things I used to do before my depression set in, but if I pursue them now, it feels like an emotional flat-line. The idea of a hobby might peak my interest, but in practice, I receive no positive emotional feedback (or any emotional feedback, for that matter) no matter how good or bad I am at it. With no internal-emotional support, I simply lose interest and abandon it.

Is it possible anhedonia can be a condition in and of itself rather than just the symptom of something else? Has anyone else here felt this kind of emotional numbness in their everyday pursuits? Is this just a remnant from my experience with depression or is it something else? Any help would be appreciated!

Hello, black649. I'm really glad to hear that you are getting help and that your mood has gotten somewhat better. That is a major improvement.

You asked:

Is it possible anhedonia can be a condition in and of itself rather than just the symptom of something else? Has anyone else here felt this kind of emotional numbness in their everyday pursuits? Is this just a remnant from my experience with depression or is it something else?

My understanding is that it's both. I also think that it doesn't necessarily get better at the same rate as other dysfunctions that may come along with depression. (I read that somewhere, too, in addition to experiencing it myself.)

It has been several years since I experienced severe anhedonia. I do remember what it felt like, because it feels so abnormal if you've had a normal pleasure response before.

At the moment, I am dealing more with severe avolition than with anhedonia. Generally, if I can convince myself to do something, it goes fairly well.

I think that it's possible that your anhedonia will improve on its own with time, as long as your other depressive symptoms stay better and don't start to get worse again.

From what I've read about anhedonia associated with depression, if the depression improves, the anhedonia usually improves as well. This apparently isn't true of anhedonia associated with schizophrenia. That can be a stable personality trait. (I read that in the article I linked to further down in this reply.)

There are medications that can cause anhedonia as a side effect, so you want to make sure that you don't have that going on.

SSRIs can cause sexual anhedonia. I already knew that. I just read, though, that some antipsychotic medications can cause general anhedonia as a side effect. So it seems possible that if you were taking one of these medications, it could prevent your preexisting anhedonia from improving.

Dopamine. I don't know how valid the science is, but it's generally believed that increasing dopamine in the brain will improve the ability to feel pleasure. This can be done through medication or nutritional supplements.

Rewards. Are there any things (doesn't have to be objects) that you still enjoy or want (or don't want?) A reward can also be not having to do something that you don't want to do.

In trying to deal with my avolition, I have started examining the idea of rewarding myself for doing things that are important to my recovery but which I have no desire to do.

Pushing my trash bin to the curb on trash pickup day seemed, a few months ago, as difficult to do and about as appealing as going for a colonoscopy. (Which I also need to do.) I am doing better with the trash now but still having problems with more complicated behaviors.

I am somewhat of a proponent of the "fake it until you make it" school of thought. I think that if we do things routinely, it can often change the response in our brains eventually.

Here's a link to a fairly technical article about the neurobiological aspects of anhedonia. I don't know if you'll want to read it. It discusses how lack of brain function in expected areas can be seen through imaging in people who suffer from anhedonia.

It also discusses the individual psychological and cognitive steps involved in performing an action and how lack of chemical reward by the brain interferes with this process.

I don't know what level of medical care you have access to. If you have very good health insurance, you might look into seeing a psychopharmacologist.

If your current meds provider is a smart one, if you haven't already discussed your concerns about anhedonia with him/her, an addition to or change in your medication might help you.

I have one more suggestion, which is totally my own. I have no basis other than personal experience for recommending it. If you can afford to get regular massages, I would highly recommend that. In my experience, depression is very much a bodily illness as well as one of the brain. I have found in the past that regular massage can help to improve recovery from depressive symptoms.

Thanks for your question. I hope that you'll post again at Psych Central to let us know how things are going with you.

P.S. There is a new forum on this site called "Habits". I don't know if you've read any of the many books and articles out at the moment about how forming habits affects our brains.

[black649]

Thank you so much for the reply! It really helped give a little more perspective into my current state of mind. I really appreciate it!

Personally, I never recovered from anhedonia. I was institutionalize during my first "breakdown" in 1999 and anhedonia was one of my minor diagnoses. It actually started in 1997, though, when I first began to notice a severe change in my libido. I had been hypersexual most of my life but I began to notice that I became less and less interested in sex. Then taste followed – I was a good cook but I lost all interest in food. I used to be (and this was before Starbucks became ubiquitous) a coffee snob and I loved to have three or four great cups of coffee a day. I don't drink it any longer, and not for 15 or 16 years. I don't enjoy, well, anything any longer. It is a complete inability to experience pleasure.

jo_thorne seems to have pointed out some food for thought but I can only speak from my experience. Even when my depression was under control, via ECT, the anhedonia stayed. I have tried, over these 16 or 17 years to resurrect something that I could feel pleasure again, going so far as to try to find pleasure from some 'new' pursuit as well as taking up the old.

When I finally got out of a nursing home after eight long years, I felt that I could find pleasure in outfitting my new apartment. I spent thousands of dollars on kitchen gear that is still in the box in storage. A recent example: since I have been spending most of my time in bed, in February I bought a new ultra-high def TV that I had hung in my bedroom, buying a new (I already had one) Blu-ray player with it. The cable guy hooked it up and it hasn't been on since he made sure it was working. The BR player is still in the box. I really used to love to watch movies and TV shows – I pay $200 per month for cable that I don't watch, a telephone and Internet service that I do use. But pleasure? No.

So now I just purchase gadgets. I bought a new iPad in February. I bought an iPhone last week. I thought that these things would bring some pleasure. I bought a Garmin GPS mapping system that works with the iPhone and I listened to the directions as I went to my biweekly doctor's appointment. I really didn't get any pleasure from that. I really didn't need the latest and greatest iPhone to lead me to my doctors office – I'm not driving.

I'm overstating the obvious here. Except for engaging with other people, something that frightens me, I've tried everything that I can think of and has been suggested to find a modicum of pleasure in anything and I've been unable to do it.

I was one of those people who had so many friends that I had to keep a social calendar to make sure that I wasn't excluding anyone (that sounds like a bad joke now) and I can't tell you if my social phobias are more anhedonia or depression oriented. The depression is back for its second bout with me and the anhedonia never went away.

So, for me, the disorder is a disorder within itself. I really can't even say that it's exacerbated by severe depression – only that it came slightly before the depression and stayed with me when the depression abated.

Good luck,

[nowhere46]

I think anhedonia can be both a symptom of depression and a condition on its own. Ive had depression for decades and during that time had limited experiences of anhedonia. But for the last 4 years, anhedonia has basically taken away my life. As mentioned above, I too have read about dopamine in terms of its effect on the pleasure center of the brain but I haven't found any specific treatments regarding anhedonia. Best regards.