Depression

An Anhedonia Aha Moment

An aha moment!  Understanding anhedonia and depression – graphic of a combined brain and lightbulb

Recently, I had a bit of an aha moment while commenting on a post by Caz at Mental Health 360º, making a connection related to anhedonia that had never crossed my mind before. She was talking about the idea that motivation follows activation.

Earlier in the course of my illness, I figured it was worth doing things that were “supposed to” help with depression. Even if it didn’t feel like they were helping, I kept on going on the off chance that they would.

I used to take dance classes as my main form of physical activity. I had no interest in doing them, but I knew that physical activity is supposed to be good for depression, and motivation was supposed to follow activation. But motivation didn’t come, and I figured the whole thing was just a load of crap.

My aha moment was that I realized motivation wasn’t the problem. I was waiting for motivation to come, but it wasn’t what was missing.

What was missing was due to anhedonia. Anhedonia, or loss of interest pleasure, can occur as a symptom of depression and other illnesses, including schizophrenia. It’s a major element of my depression, and on average, it’s had a greater impact than low mood has.

Anhedonia is one of the core symptoms of depression. If someone has anhedonia, they can still be diagnosed with a major depressive episode, even without depressed mood. At any given moment, it doesn’t feel as bad as depressed mood, but when it’s persistent, it casts a rather grey light over everything.

Behavioural activation is a cognitive behavioural therapy (CBT) intervention that’s one of the recommended ways of dealing with anhedonia. But it relies on the idea that motivation follows activation, and assumes that you’ll actually feel a little better when you do things that are supposed to be good for you.

It’s not always that simply, though, because what if doing something doesn’t make you feel good, no matter how many times you do it? That’s where I’m at. If I want or need to do something, I’ll do it. But there’s never any desire, because I just don’t care. I can force myself to do things, but it’s like pissing in the wind for all the good it does me.

Aside from the guinea pigs, nothing that I used to like does anything for me anymore. Travelling used to be my great passion, but now I just don’t care. A couple of years ago I did a trip to Italy hoping that might put a dent in the anhedonia. It didn’t.

I like blogging, but it’s more a matter of mental stimulation and social contact than any actual feeling of pleasure. I know I sometimes comment on other blogs that I enjoyed a post or something along those lines. However, it’s on a cognitive level, not emotional.

In the last year or so, I’ve given up pushing myself to keep doing things just because, in general, they’re supposed to be helpful for depression. All along, I put it down to motivation following activation just not being true. But now I( think that comes at it from not quite the right direction. Motivation can follow when activation produces a pleasurable reward. If there’s no pleasurable reward following activation, motivation is irrelevant; there’s still no positive feeling toward the activity.

This realization doesn’t actually change anything in my life, but insight is something I value with regards to my illness, and I like it when pieces, even little ones, start to fit together.

Is anhedonia something that’s been an issue in your illness?

book cover: Managing the Depression Puzzle by Ashley L. Peterson

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32 thoughts on “An Anhedonia Aha Moment”

  1. Wow, that’s a lot that you’ve figured out!! Great job!!

    I wish anything you could find pleasure in things!! I feel sad that you can’t!!

    Anhedonia has never been an issue for me!! I can almost relate to the concept of going out to do something social, like taking a dance class for example, and feeling like, “I need the exercise, but this is stressing me out and I’d rather not be here,” or with ice skating classes, “I want to be a better skater, but I’m not connecting with any of my classmates.” And so it becomes a means to an end, but I get disappointed, because I was hoping for more.

    But anyway, what you’ve realized about yourself is massive, because it means you haven’t given up on trying to get better; you’ve just realized that engaging in certain acts is futile. If that makes sense. Here’s praying for a cure!!

  2. Wow! Can I relate to this! It feels like I did a lot of the things I was “told” were good for me, and that right there, has yielded my doing things that are more cognitive based than emotionally based. I don’t know what proper emoting even looks like anymore. Hmmm. Maybe a good subject for a post!

      1. I understand. It sucks. The meds, while providing some amount of help, can also cause terrible side effects. I am not even sure it’s the side effects in all cases, but the meds themselves, causing us to be this way!

  3. Anhedonia is a big issue for me. I think it was there going back to my teens, maybe even earlier. Even in my less-depressed state, I think it can be there; certainly when very depressed it’s there. I’m not sure where I am with it at the moment. I seem to be enjoying writing my novel at least some of the time.

    I do force myself to do some things even if I don’t enjoy them, like personal hygiene and exercise. I don’t always enjoy running, exactly, but it does tend to make me feel somewhat better. I’m not sure I can describe this well.

    It’s particularly problematic for me with my religious life, because Jews are supposed to enjoy doing mitzvot (performing commandments) and studying Torah. It’s hard if I can’t get that enjoyment no matter how hard I try.

    1. It would be interesting, although of course impossible, to know how many frum people doing experience joy because of mental health or other issues. I would guess it’s something people wouldn’t talk about even if that was their experience.

  4. I definitely have this. I learned about behavior activation through work training. I thought i can do that easy… nope… the desire to care … for lack of better word… isn’t there. I want my passion back but it’s no where to be found.

  5. For me anhedonia is difficult to battle because even if I know I like to do those things, I don’t feel any joy out of it.
    Now, when my doctor told me to be more active, I really try to be mindful in the moment and to enjoy the activity that I’m doing and not to let further worry come in. (like will this help me or does this matter). The only thing that I focus on is if I like to do it and when that ‘like’ is there for a second, I’ll do it. The second question that I ask myself is, is ‘Am I doing too much?’ If the answer is yes, I try to ease into the thing I’m doing without further stressing myself. I try to capture that ‘good enough’ moment. I hope it will lead me somewhere.

  6. So much. I reached a point where almost everything was irrelevant to me. I didn’t care about anything at all. Everything I did was because I had to do it, or someone expected me to. Anything else I dropped (including showering – only when I had to – disgusting!). I found pleasure in wine and sex (Yeah, I showered cause I had to), but literally every other part of my life did nothing for me. Scary place to be. That has eased over the last few weeks so I think alcohol played a big part in my case. Never, ever want to go back there. Life itself started to seem pointless, and that was when I knew things had to change.

  7. Wow, that is a MAJOR breakthrough!! And a great explanation of why the “fake it till you make it” approach does NOT necessarily work for depression!

    During a seasonal depression in January, my husband tried to help me by getting me to go on walks with him – walking usually does help with my depression, but last winter it did NOTHING for me. This post helps me make sense of that, and is an “aha” for me as well.

  8. Yes, this may be contributing to the shriveling of our life.

    Some aspects of travel we still like, in theory, and the illnesses seem to rob the experience of joy. Or overshadow potential joy.

    We are staying engaged in life for our children and, to a lesser extent, Spouse. And for the off-chance we feel joy again. We can still be coached to give a fuck, so we can sometimes care for our family.

  9. Yep, I relate so hard. Ketamine seems to improve mine temporarily, but at it’s worst, I find myself whittling down my daily activities because everything feels like way too much work for way too little reward. It makes me sad to imagine the drive I used to feel for my hobbies. Sometimes, it’s like I can aaaalmost see it, but I can’t get close enough to feel it again.

  10. For me, I am not sure if I have anhedonia.
    But let me share with you…
    I am very motivated to do my PhD. I always find time to work on it.
    If there is a period of time when I don’t get to work on it even for a little bit, I will feel very stressed and my heart feels heavy and suffocated. No matter how, I still put in my best for my part time teaching job. I don’t enjoy the teaching process at all but I enjoy the social contact from my kids. Luckily they are always active and responsive.

    I get tired after two or three hours working on my PhD. Then I will rest but feel guilty then start firing on all my cylinder again. I feel guilty to rest or do other activities. It’s either my teaching job or PhD.

    Recently I uninstalled many social media apps to stop messages coming in. I am slower in responding to messages too. I feel that too much information disturbs me. I just want to be away from all distractions in order to focus. Too demotivated to communicate. Yet, I am not confident in research. but feel glad that I have my supervisor to depend on for research wisdom and mental support. Though I put in my best now, I am not sure if I want to do academic publications in the future. Maybe I just love reading and writing.
    When I write, I don’t particularly feel much joy but I can focus in writing. It tidies up my mind closet to continue living.

    1. Tidying up your mind closet – that’s such a great way of putting it.

      I feel the same way about too much information coming in. I prefer to have notifications turned off so I can access things when I choose to look at them rather than when they get in my face.

  11. I think the “motivation follows action” implicit idea has actually been more harmful than anything. Whenever I try to do something “joyful” or that “should be” comforting in a bad period, I just end up panicking that, because it’s a part of the grey void *then*, it will be a grey void *forever.* Then, it adds the yawning maw of “what if this, but FOREVER” onto things. It is actually more reassuring to me to compartmentalize that there are things I can’t do *now*, so I’ll put them on the shelf for some nebulous “someday” wherein I will want to do them again. Rather than “taint” their past good associations retroactively with bad ones in the present. I think there is some relief in just going, “yup, things suck now. But, hey, thing x I used to like might at least still be there later if I don’t force it now.”

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