Sunday, October 1

Anhedonia: what do I do if I can’t find any way to experience pleasure

At various times or specific situations in life it happens that it costs a lot -or it is not directly possible- experience pleasure. It is what happens in sad or traumatic circumstances, such as the death of a loved one.

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However, this loss of the ability to enjoy can also occur without apparent cause. It produces a kind of emotional anesthesia, which prevents enjoying things that in general generate pleasure or that previously generated it and now – for that person – not.

It is in these cases when we talk about anhedonia, a term coined in the late 19th century that literally means “without pleasure”. From the Greek word “hedoné”, which means pleasure, “hedonism” is also derived, the attitude towards life whose main objective and foundation is the pursuit of pleasure.

Those who suffer from anhedonia are unable to enjoy In the face of generally pleasant stimuli, from those that generate food or sex to sharing time and activities with friends or loved ones.

A symptom, not a disorder

But there is an important fact to keep in mind: anhedonia is not a disorder, but a symptom. That is, the manifestation of a greater problem that is causing it, often depression. Until the 70% of people with depression experience anhedonia, according to a ‘Handbook‘on the issue published in 2014.

The physiological reason -according to the currently most widely accepted hypothesis- has to do with the dopamine. This neurotransmitter plays a central role in the brain’s reward system. By reducing their levels or ceasing to act as appropriate, the pleasure before certain stimuli decreases or disappears.

In the worst cases, anhedonia covers all areas of life: the person is unable to experience any kind of pleasure. Other times, instead, it’s about partial anhedonia: they occur only before certain stimuli and not before others.

There are, above all, two large groups of partial anhedonia. On the one hand, related to social. The person cannot enjoy the contact with his friends, his relatives and the rest of the people around him. The result is often discouragement from social activity that ends in isolation.

The other anhedonia are the physical ones. They consist of the difficulty or impossibility of enjoying the body-related pleasures, both in relation to sexuality, food, physical activity, etc.

Anhedonia and some of its curious forms

A particular type of the latter group is the so-called ejaculatory anhedonia, also known as insensitive ejaculationWell, it consists precisely of that: the man expels the semen but this action is not accompanied by pleasure, and therefore there is no orgasm.

Another strange way is the musical anhedonia. Scientists from Barcelona, ​​together with colleagues from Canada, have investigated this question and found “direct evidence“That there are people who are unable to enjoy music (even people who compose and execute), due to certain brain processes. In these people, such processes are different than most people, for whom music does bring pleasure.

On the other hand, anhedonia -both if they cover all types of pleasure as if they are partial- present degrees. That is, the ability to enjoy can be completely nullified, but also be reduced to a greater or lesser extent.

The most common form of detect and measure anhedonia consists of the use of calls Chapman scales, designed in the 1970s to assess, separately, the possibility of a social and a physical anhedonia. In recent years, Spanish adaptations of such scales to facilitate their use.

Keep in mind that cultural factors they exert an important influence in this regard. Dancing, for example, is seen as a fun activity and a manifestation of joy. However, some people don’t like to do it. And that these people do not find pleasure in dancing is not a sign that they suffer from anhedonia. It’s just a matter of personal taste.

Depression and other causes of anhedonia

As already mentioned, anhedonia is not a disorder but a symptom. Therefore, to treat it, it is important to identify what the underlying problem that is causing it and try to solve it.

The inability to enjoy pleasant stimuli appears, to a greater or lesser degree, in seven out of ten people with depression. And according to the National Institute of Statistics (INE), depression affects 5.4% of the Spanish population: 2.1 million people, of which 230,000 are considered serious. Among women, the incidence of is double that among men.

These latest figures from the INE are based on data for the period July 2019-July 2020. They show a decrease in cases of depression compared to the previous report, published in 2014.

But they also show the incidence of the pandemic: several mental health indicators worsened in the period March-July 2020 in relation to the months included in the analysis prior to the arrival of COVID-19 (July 2019-February 2020).

Among those indicators that the pandemic worsened are the “feeling of being down or depressed” and the “little interest or joy in doing things “. Factors, of course, very close to anhedonia.

Besides depression, other possible causes of anhedonia include schizophrenia or other psychiatric problems, emotional or anxiety disorders and the intake of certain medications. People addicted to alcohol or drugs may also lose the ability to enjoy stimuli not related to those substances.

Therefore, before the suspicion of losing the ability to enjoy of pleasant stimuli, which could be a symptom of a depressive picture or some other problem, experts recommend going in search of Professional Help.

The risk of not doing so is entering a vicious circle: since you do not feel pleasure in contact with others or towards the things that should generate it, a feeling of emptiness occurs that encourages inactivity, isolation and abandonment. Conditions that, in turn, increase the risk of falling into a depression, which will deepen the anhedonia even more.

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