Anhedonism: the inability to experience pleasure

The concept of anhedonia is widely used in psychology and psychiatry, Because it refers to a strange phenomenon that is very relevant to the person who experiences it: the inability to experience pleasure and a sense of satisfaction.

This makes it a stumbling block to the quality of life of the patients who manifest it, because anything that can be related to motivation, well-being or interest in things is canceled.

Below, we’ll take a look at what anhedonia is and how it impacts people’s quality of life.

What is anhedonia?

In general terms, anhedonia is the total absence of pleasant and satisfying sensations whatever the context in which one finds oneself.

In other words, anhedonia is the inability to fully experience the pleasure and feelings associated with it, such as joy or appreciation for the humor around us, and which has as one of its main causes an alteration of the mental processes of the person. This means that it does not manifest itself only in a specific area, such as playing sports or intimate relationships, but in all possible experiences that the person in question is going through.

It should be noted, however, that in some cases anhedonia is not entirely global and manifests itself in certain areas of life, as we will see. Musical anhedonia, for example, is said to be one such variation, although of this one in particular almost nothing is known beyond what appears in people who may not enjoy listening to music.

Anhedonia can be understood as reverse anesthesia: Instead of canceling all painful experiences, cancel those that produce pleasure or a feeling of well-being. In short, living anhedonia is living without pleasure, we do what we do.

Anhedonia is not a disorder

This may sound confusing, as anhedonia reveals a serious disorder that needs to be treated, but the truth is that it is not in itself a mental disorder. It is a symptom, not a syndrome or psychological disorder, although it is usually one of the expressions of different types of mental illness. That is to say that it is the expression of a pathology which produces this effect, but which can also generate other mental problems.

Disorders in which it is present

The disorders in which anhedonia is most common are, in particular, depressive disorders: in depression there is usually emotional flattening and a low level of anticipation and consumer pleasure, And a feeling that patients describe as an inability to appreciate things that should be positively stimulated. Something similar happens with the disorder known as dysthymia.

However, Anhedonia is also relatively common in cases of schizophreniaAs well as in people who have become so dependent on a substance (alcohol, cocaine and other drugs) that they have become accustomed to it and become unresponsive to other forms of satisfaction.

On the other hand, there is evidence that anhedonia is not expressed in the same way in people with depression as in people with schizophrenia: in the first group, this symptom usually weakens over time, whereas normally this does not usually happen in the case of patients with schizophrenia who have manifested this symptom.

What causes can result from the absence of pleasure?

The biological causes of anhedonia are not well known, but there are theories. One of the most assumed is that this symptom results from an alteration in the brain’s reward system, Located in structures related to the limbic system.

In normal situations, certain situations cause our brain to trigger a process that will cause us to try to repeat this experience. To do this, these parts of the brain generate the sensation of pleasure, in which hormones like dopamine play a key role. In Anhedonia, this reward system would be incapable of activating the mechanism of repetition of behaviors, and hence the absence of pleasure.

Some parts of the brain that have been linked to anhedonia (for abnormalities in many patients with this symptom) include the amygdala, the orbitofrontal cortex and the hypothalamus, Estrucutas that participate in setting goals and motivation, or promoting or inhibiting the desire to satisfy the need with pleasure.

Certain types of anhedonia

Here you will see some relatively common specific variations of anhedonia.

Social anhedonia

There is a phenomenon known as social anhedonia in which lack of interest and lack of pleasure appear specifically in social experiences. People with social anhedonia find no reason to interact with others unless it meets very specific material needs.

Social anhedonia is often one of the first signs of the onset of schizophrenia in some of its forms.

In addition, it has been observed from research in which brain scans have been used, in the brains of people with severe anhedonia, there are also alterations in certain parts of the cerebral cortex responsible for carrying out related cognitive processes. to the representation of “I” and others.

Sexual anhedonia

This form of anhedonia usually occurs in men who do not experience pleasure during ejaculation.. In women, there is also an analogous form of this symptom, but it is less common.

It is an alteration that not only harms the quality of life of those who suffer from first-person sexual anhedonia, but also poses a relationship problem that must be managed. This not only makes it a phenomenon to treat the patient psychologically, but often also requires intervention through couples therapy.

possible treatments

Anhedonia being a symptom, to know how to remedy it, we must first know its root, that is to say the disorder or neurological disorder that produces it.

This will detect the external factors that promote and maintain their appearance (as very stressful elements) and will also facilitate the use of the appropriate elements if they opt for a treatment in which psychotropic drugs will be used.

Bibliographical references:

  • Beck, AT and Freeman, A. (1995). Cognitive therapy for personality disorders. Barcelona: Paidós.
  • Blanchard JJ; Horan WP; Brown SA (2001). Diagnostic differences in social anedonia: longitudinal study of schizophrenia and major depressive disorder. Journal of Abnormal Psychology. 110 (3): pages 363 to 371.
  • Der-Avakian, A .; Markou, A. (2011). The neurobiology of anhedonia and other reward deficits. Trends in neuroscience. 35 (1): pages 68 to 77.
  • Jaspers, K. (1946/1993). General psychopathology. Mexico: FCE.
  • Vallejo-Riuloba, J. (1991): Clinical cases. Psychiatry. Barcelona: saved.
  • Vallejo-Riuloba, J. (2002): Introduction to psychopathology and psychiatry. Barcelona: Masson.

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