Help when you feel it's all too much
If you consistently feel “meh” about daily life, you might have anhedonia.
Described as a lack of pleasure in previously enjoyed activities, Diego Pizzagalli, PhD, a Distinguished Professor in the Department of Psychiatry & Human Behavior at the UC Irvine School of Medicine, has expanded the definition to include a loss of motivation to seek them out.
For anhedonia sufferers, the physical or mental effort of things like reading, going to the beach or spending time with loved ones outweighs the benefits, says Pizzagalli.
“Anhedonia can be a symptom of an underlying mental health condition such as depression,” says Dr. Hayley B. Kristinsson, a neuropsychologist at UCI Health Neurology who specializes in neurological disorders.
Chronic stress causes an initial surge of dopamine, followed by a drop when the fight or flight system becomes overwhelmed. Schizophrenia and substance abuse can also cause anhedonia.
What we know about symptoms
In 2022, Pizzagalli conducted a study of young adults who had experienced maltreatment as young children. Although they were not diagnosed with depression, the reward systems in their brains were less active when they imagined a potential reward – a warning sign for anhedonia.
Other symptoms include:
- Feeling disconnected from pleasure or excitement
- Becoming more socially withdrawn
- Difficulty maintaining emotional connections with friends and family
- Reduced excitement for future events such as vacations
- When something good does happen, an individual might experience a sense of feeling flat or not having positive emotions
While there is no single cure for anhedonia, Pizzagalli and his team are currently studying brain biomarkers to help predict medications that work best for each person and one day may lead to more personalized treatments.
Treatment options
New research has given clinicians a better understanding of the causes of anhedonia and the symptoms, allowing them to provide more robust treatments to manage the condition.
If an individual receives an anhedonia diagnosis, their physician will first evaluate any underlying mental health conditions.
“Treatment may also involve some combination of psychotherapy and medications prescribed by a psychiatrist,” says Kristinsson. “Lifestyle changes can also be effective, such as stress reduction techniques, mindfulness, exercise, improved sleep and dietary changes.”
In addition to treatment, Kristinsson shares these tips to manage and cope with symptoms:
- Make a point to participate in small activities, such as taking a short walk outside or listening to music, even if it doesn’t feel enjoyable at first. Structured activity scheduling, called behavioral activation, can help to rebuild a sense of enjoyment.
- Create a daily routine with a few meaningful or enjoyable activities each day, even if you don’t feel like it at first.
- Track your mood before and after activity, as people may experience a slight lift afterwards, even if it is subtle. Social withdrawal reinforces anhedonia, so it is important to try to stay socially engaged, even if it is a passive activity such as watching a movie with a friend.
- Consider seeking professional help in the form of therapy. Talking about your experience with a therapist or friends and family can help reduce shame and isolation.
When to seek help
If anhedonia interferes with daily activities, such as school or work performance, make an appointment with a medical professional.
If the anhedonia is also accompanied by other symptoms, such as depressed mood, fatigue, hopelessness, thoughts of self-harm, or feelings of worthlessness, seek help urgently by immediately contacting a mental health professional or calling 988, the Suicide & Crisis Lifeline.
Additional signs include:
- You no longer derive any pleasure from things you typically enjoy or are becoming more socially withdrawn
- You feel emotionally disconnected or numb
- If symptoms have lasted for an extended for several weeks
These may may be warning signs of depression or another serious condition that needs immediate support.