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 simple, 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?