Anhedonia: Symptoms, Causes, Treatment, Cost, and Side Effects

Anhedonia is described as feeling ‘deactivated’ in the medical world. It is characterized as the inability to take pleasure in activities that ordinarily generate happiness and pleasure. People who suffer from anhedonia essentially lose the ability to enjoy themselves or their favorite activities and hence remain uninspired, unexcited, or pessimistic and depressed.

Anhedonia is broadly divided into two categories based on its symptoms;

• Social anhedonia: A person has social anhedonia when they no longer enjoy social interactions, such as interacting with friends, trying new things, or even competing with others, as much as they once did.
• Sensory anhedonia: Also known as physical anhedonia, refers to persons who no longer find physical experiences enjoyable, such as looking at a flower or even sexual stimuli (also known as sexual anhedonia).
• For someone with anhedonia, relationships, particularly those with friends and family, become difficult to maintain. It becomes challenging for them to be motivated to interact with others when the incentive of enjoyment is gone. The patient starts to exhibit social withdrawal and may start to decline invitations and avoid social gatherings or even one-on-one interactions because they no longer seek any satisfaction or enjoyment from this.

Anhedonia symptoms can include:

• Social exclusion
• Reduced enjoyment from daily activities
• A lack of connections or a breakup with past partnerships, a decrease No interest in former hobbies
• A lack of desire for sexual intimacy or a declined libido

Anhedonia can result from grief and worry. Additionally, the syndrome has been related by many experts to PTSD, Parkinson's, schizophrenia, anorexia, and other mental health issues. However, the main cause of anhedonia is still unknown.

Some studies link the condition to a decrease in dopamine levels, the brain's pleasure neurotransmitter. It is believed that a failure in any of the brain's happiness-seeking regions, such as the prefrontal cortex, which prepares and processes rewards, and the amygdala, which processes emotions, effectively shuts down the ability to feel joy and pleasure, thus causing this unhappy state of mind.

Despite its close association with depression, anhedonia itself isn’t a sign of depression or unhappiness. Additionally, it can appear in people who have diabetes, coronary artery disease, addiction issues, and other disorders that don't seem to be related to one another. Furthermore, substance or drug abuse can also be one of the major contributors to anhedonia, if illegal drugs are used habitually.

The key to preventing anhedonia is doing anything that promotes the production of additional dopamine or brain regrowth, a process called neurogenesis.

• Do meditation
• Do what excites you
• Physical exercises
• Eat healthy
• Stay social
• Pan a trip with friends
• Talk with your friends and close ones
• If you have any health condition such as depression and schizophrenia you are at high risk of developing anhedonia, hence, always talk about your doctor to help you prevent such mental condition
• Stop any addiction if you think you are starting to have or take an expert help if you find it hard to quit your addiction be it gaming, drugs, alcohol or any other thingTake experts’ help if you start to exhibit anhedonia symptoms

• Don’t cut off yourself from your loved ones
• Do not self isolate yourself
• Do not develop an addiction of anything or seek all the pleasure and happiness from it but work on your real relationships and happiness
• Do not drink or take any recreational substance such as alcohol or drugs that can be addictive
• Do not avoid your symptoms of anhedonia and take expert help

Anhedonia typically manifests as a lack of feeling or numbness in the person. The anhedonia patient also adopts a pessimistic mindset and generally, stops smiling and reacting with joy, instead shows more signs of despondency.

Symptoms
To assess your condition, the health professional may look for your symptoms and general attitude. He may also ask you about any drugs or other substances you may have used in the past.
The physician may also check for any underlying issue such as depression, diabetes, any chronic health issue or any health problem that may have an impact on your mental health.

Physical
Your doctor might perform a physical examination to assess conditions like fatigue, sleep, appetite changes, and pain that are often linked to anhedonia and may occur due to differences in hormone and neurotransmitter levels.

Lab tests
In addition, your doctor could request a blood test to check for thyroid problems or vitamin deficiencies such as vitamin-D, which may be causing your depressive symptoms and lack of enthusiasm

The patient himself/herself may not be aware that they are suffering from anhedonia. Since they can not sense the difference in their behavior, family and friends play an important role to assess their condition and get them the needed treatment.

Many times an off-mood is sensed by a family member or a close friend. Hence they are regarded as the first ones to notice the symptoms of anhedonia. If you know someone who is not acting themselves and is always unhappy, unmotivated or unenthusiastic about everything, take them to a health professional.

As the patient suffering from anhedonia doesn’t show any sign of happiness or excitement but is constantly in a gloomy and quiet state, the only way to treat such person is to engage them in such activities that stimulate their brain to release dopamine that may trigger neurogenesis, a process that makes your brain regenerate. No matter how simple this may sound but it isn't simple and easy to treat an anhedonia patient.

Here are five effective home remedies to help anhedonia patients to feel and express their feelings of happiness and excitement;

Aerobics and strength training
Physical exercises are very effective in elevating mood. Exercises like strength and cardiovascular activities (such as running or jogging) also produce adrenaline, which can be used as part of a long-term treatment plan for anhedonia patients.
During workout your heart rate increases as you exercise, and your muscles become more tense. Your brain starts to produce BDNF (Brain Derived Neurotrophic Factor), a protein that nourishes your brain, after around 30 minutes of stress or an elevated heart rate, in following ways;
Similar to how other proteins heal muscle damage after exercise, BDNF activates the development of new brain cells, new pleasure receptors, and new pathways to repair damage and process pleasureIt develops more connections so that the brain can transmit and receive impulses more effectively, hence enabling the patient to feel betterBDNF facilitates the production of Dopamine

Nutrition
Eating a healthy and balanced diet is very important for boosting your overall health. Certain nutrients can either enhance the amount of dopamine you produce or they can be metabolized into dopamine. Therefore, modifying your diet in a planned approach is a simple strategy to reduce the symptoms of anhedonia.

Meditation
Focusing on your breathing or surroundings when practicing meditation might help you de-stress and quiet your thoughts. Meditation also reduces the signs and symptoms of depression by reducing cortisol levels, which is a stress hormone.
High cortisol levels can adversely affect the brain's ability to utilize dopamine and serotonin (the chemical in most antidepressants) due to which mood and emotion can be negatively affected. However, studies have indicated that practicing meditation lowers cortisol levels, which can lessen the feelings of anhedonia.

Meaningful interactions with people
Being surrounded by people may not mean anything to you and you may not find a meaningful connection with them too. However, we humans as social beings need to bond with people to emotionally heal and feel loved.
It has been found that dopamine is produced when people have close relationships. When dopamine is compromised, and since someone with anhedonia has a severe lack of dopamine, socializing is another approach to find relief, it has the ability to enhance the outcome. This just means that you need to chat to people and not feel lonely, not that you need a best friend or a partner. If you've become isolated, it could take some practice.

Talk therapy
We talk the way we feel. Hence, anhedonia can also be addressed with talk therapy by encouraging the patients to talk. It is advisable to keep the anhedonia patients engaged in talks so that they can learn to express their feelings and can both learn to express and respond to happiness and other joyful emotions.

Anhedonia does not have to last forever, but it can be upsetting to lose a sense of delight in something that formerly made you happy. For some people it may feel like a transient state that may end within a few hours or days but others may experience them for weeks. However, over time, anhedonia symptoms become less frequent and less prolonged and patients, when they receive treatment, may regain their interest in doing things and engaging in life, just like before.

However, people should take expert help as anhedonia can be a serious condition if not diagnosed properly. It is always recommended to get the aid of a qualified mental health expert to treat the symptoms as they may get worse over time.

Foods are known to uplift anyone's mood. They are natural antidepressants. However, diets high in fat and carbohydrates might not be the greatest choice.

Here are some meals that can aid in reducing the anhedonia symptoms that are frequently linked to depression;

• Cold water fish
• Eggs
• Legumes
• Low-fat dairy
• Meat
• Nuts and seeds
• Soy
• Turkey
• Velvet beans
• Whole grains

Some of the foods that may interfere or aggravate the symptoms of anhedonia

• Refined foods
• Processed food
• Processed oils
• Caffeine
• Alcohol

Anhedonia itself cannot be treated directly. The therapy strategy focuses on the diagnosis and treatment of the underlying illness that is the main cause of the anhedonia, such as depression or drug withdrawal known as Post-Acute Withdrawal Syndrome (PAWS).

The first step in your treatment should be to consult a medical professional. Your treatment may include both talk therapy and prescription medications like antidepressants. Your doctor will collaborate with you to come up with a personalized treatment plan, and in some cases, different drug classes may be prescribed.

Medications and therapy

Course of medicine can be different for different people. Even if a medicine works for you, it might not work for someone else who experiences the same symptoms.

ECT treatment
A different type of treatment that could be used in some situations is electroconvulsive therapy (ECT). ECT is one of the finest treatments for severe depression patients that has not responded to therapy or medication. According to some experts, it should be used as soon as possible, especially for people who suffer from mild depression.

A medical professional places electrodes on the patient's skull while they are unconscious and then applies an electric current to the affected area, inducing a short brain seizure as a result.

Transcranial magnetic stimulation (TMS)
TMS is a medical device that stimulates nerve cells by using a magnetic field. It does not need general anesthesia and uses a lesser electric current than ECT. Major depression is treated with TMS for those with unresponsive depression to medicine.

Vagus nerve stimulation (VNS)
It is a different type of therapy that involves implanting a pacemaker or other medical device on the patient's chest. Regular electrical impulses from the device's connections stimulate your brain. VNS can be used to treat depression in patients who have not responded to standard therapy, much like ECT and TMS.

You should tell your doctor straight away if you have any side effects and follow the prescription as recommended. There may be a need to adjust your medication or dose in case you have any side-effects from the medication.

If you or people around you suspect you have anhedonia, you should consider going to a physician to get your symptoms evaluated. Though urgent care is not needed as it will not develop into something serious in a short time, you have enough time to get yourself diagnosed or undergo various therapies like talk therapy or touch therapy to help elevate your anhedonia symptoms.

To rule out a medical explanation for your symptoms, you should consult a primary care physician first. If no medical problems are discovered, they can suggest that you consult a psychiatrist, psychologist, or other mental health specialist.

Ketamine, a substance best recognized for being a party drug with antidepressant properties, is one that works best for anhedonia patients. As per a study, patients with bipolar depression saw significant improvement in their mood within 40 minutes of receiving a ketamine injection for their anhedonia state.

There is not any specialized therapy to treat anhedonia itself. However, altering lifestyle practices and addressing the underlying reasons may be beneficial for the anhedonia patients. Cognitive behavioral therapy (CBT), a type of talk therapy, is frequently used by mental health practitioners to treat anhedonia. CBT enables people to become aware of and change their negative thinking as well as react to difficult circumstances more successfully.

Anhedonia can be treated with a variety of lifestyle modifications, dietary changes, medicines such as antidepressants and various therapies. There is no surgical treatment necessary for anhedonia patients.

There is no surgical procedure to treat anhedonia which is a mental health issue and can be treated or managed with non-surgical procedures.

Anhedonia is a curable and manageable mental condition due to which a person loses his/her ability to feel and express happiness and joy.

For anhedonia patients recovery can vary depending on the underlying cause of their problem such as if it is because of depression, drug withdrawal, or low levels of vitamin D.

With the assistance of a qualified mental health practitioner and by treating any underlying causes, anhedonia may disappear. Anhedonia symptoms are frequently transient and may appear and disappear on occasion. The best course of action for overcoming anhedonia should be discussed with a qualified specialist.

If the cause of anhedonia is depression, the condition is likely to go away with depression. However, in case of drug-withdrawal anhedonia, it may recur with the relapse in the addiction.

Anhedonia patients may recover faster by adopting following things in their daily life;

• They should always eat a healthy and balanced diet to help elevate their mood.
• Taking proper rest is the key to let the brain rewire and undergo neurogenesis to strengthen its neural pathways, hence reconstructing emotional and happiness circuits.
• Do what you love to do. Paint, dance, listen to music, engage in activities that used to make you feel good and happy.
• Engaging in physical activities is another way to lift up your mood. Physical exercises such as aerobics, cardio, strength and sports can elevate the level of happiness hormones that may directly help the anhedonia patient to feel the sense of happiness and reward.
• Go out on a stroll and observe your surroundings. Strolling and sightseeing are also known to elevate our mood.
• Meditation is the best way to heal emotionally. Meditation can help you relax and calm down. It is one of the best therapies for anhedonia patients.
• By joining talk groups the patient gets to explore a plethora of emotions by listening and talking that may further strengthen his/her emotional circuit.

Most medicines used in anhedonia treatment are primarily focused to balance the level of those hormones in your body that can make you happy. Antidepressants like serotonin reuptake inhibitors (SSRIs) and serotonin-noradrenaline reuptake inhibitors (SNRIs), are used to treat anxiety and depression by increasing serotonin ‘feel-good hormone’ production, can have following side-effects;

• Diarrhea or constipation
• Difficulties achieving orgasm during sex or masturbation
• Difficulties obtaining or maintaining an erection (erectile dysfunction)
• Dizziness
• Feeling agitated, shaky or anxious
• Feeling and being sick
• Headaches
• Indigestion and stomach aches
• Loss of appetite
• Loss of libido (reduced sex drive)
• Insomnia (Not sleeping well), or feeling very sleepy

Although some adverse effects may occasionally linger, they should subside within a few weeks.

Side effects of another antidepressant Tricyclic antidepressants (TCAs) may include;

• Constipation
• Diabetes
• Dizziness
• Drowsiness
• Dry mouth
• Excessive sweating (especially at night)
• Heart rhythm problems (arrhythmia), such as noticeable palpitations or a fast heartbeat (tachycardia)
• Problems passing urine
• Slight blurring of vision
• Weight gain

As your body gets adapted to the medication, the adverse effects ought to subside within a couple of weeks.

Anhedonia patients often show inability to feel pleasure, mostly from the things they used to appreciate. This lack of interest or inability to have enjoyment or energy for the experiences of life, can be due to any underlying health condition mostly linked to depression and drugs/alcohol withdrawal. As the former one also has somewhat similar symptoms, drugs and alcohol withdrawal can show signs of anhedonia as the patient is now dependent on drugs and alcohol to seek happiness and joy, hence fails to get it from other things.

Diagnosis and treatment for anhedonia is important to give the patient quality life. Therapies like talking, hugging, social interactions, physical exercises, and staying close to nature can help the patient to feel the happiness and joy again in life.