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Learn more about anhedonia, and what may be behind it.

Without Joy: Could Your Anhedonia Be a Sign of a Larger Mental Health Issue?

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We all have down days where we feel bored, listless, and emotionally flat. But what if your down days are stretching into weeks, even months? If you are finding your zest for life has flatlined, you may be living with a condition called anhedonia.

You have noticed for a while that you don’t feel the way you used to. The things you used to enjoy or get excited about don’t interest you anymore. You don’t go out as much, and when you see friends or loved ones you feel tired and disconnected rather than re-energised or happy. It is hard to even put words to what you are feeling, because you’re not really feeling anything. Your emotional response button seems permanently stuck on mute, and you are not sure why.

If you are unable to experience pleasure, you may be struggling with a condition known as anhedonia. While this is often associated with depression, anhedonia can also be a symptom of other mental health issues. Understanding where your anhedonia is rooted is the first step in reclaiming your joy.

Social Anhedonia vs. Physical Anhedonia

Anhedonia generally comes on gradually rather than abruptly, so it may be difficult to identify at first. You might have trouble describing what you are feeling, perhaps calling it “flat” or “blah.” You may feel as if you are fading away or are sinking.

Anhedonia tends to manifest in two different ways—socially, which is related to how we feel about our experiences and social interactions—and physically, which links to an ability to physically gain pleasure through actions such as eating, touching, or sex. Symptoms tend to include things like:

  • Loss of response to affectionate or sexual touch
  • Disinterest in physical intimacy; lack of libido
  • Lack of response to pleasurable sensations, like the smell of a favourite dish, or the feeling of a soft blanket
  • Decreased, dulled or absent interest in things previously enjoyed
  • Social withdrawal
  • Increasing isolation from friends and loved ones

Experiencing symptoms like these indicates that you may be living with anhedonia, but the exploration of what’s going on with your health shouldn’t stop here. Anhedonia is caused by a variety of mental and physical health issues, which can include depression, PTSD, grief, and drug and alcohol withdrawal. Understanding what is underlying anhedonia is critical in providing the proper treatment and care. Speaking with a mental health professional is an important first step in gaining clarity on your condition.  

Anhedonia and Depression

Anhedonia is most often a core symptom of depression, and occurs in around 70% of people with this disorder. It is thought to stem from dysfunction in the brain’s reward system, particularly in how the brain produces or responds to dopamine, a neurotransmitter which is linked to a positive mood and pleasurable feelings. 

While anhedonia related to depression is often treated with antidepressant medication, these are not always effective in alleviating symptoms of anhedonia and in some cases may actually exacerbate feelings of emotional disconnect or flatness. This is why a holistic approach to depression treatment is often recommended, incorporating talk therapy, mood-boosting wellness practices, and modern technologies to overcome anhedonia.

Transcranial Magnetic Stimulation and Anhedonia Treatment

For treatment-resistant depression and anhedonia, a newer, non-invasive treatment called transcranial magnetic stimulation (TMS) has been shown to be effective in significantly improving symptoms. TMS uses magnetic pulses to painlessly stimulate nerve centres in the brain responsible for mood control, and activate areas of the brain that have decreased activity in cases of depression, alleviating symptoms of anhedonia.

Anhedonia and PTSD

Trauma can also play a role in the development of anhedonia, which is a common symptom in people who have post-traumatic stress disorder (PTSD). Studies have shown that not only do those with PTSD report decreased positive experiences, they also report an increase in negative responses to positive events. 

Additionally, people living with PTSD who experience symptoms of anhedonia are also at a greater likelihood of developing a substance use disorder as they attempt to cope with the discomfort of their feelings. This is particularly true for those who have been through a recent trauma, although childhood trauma is also linked to anhedonia.

Anhedonia and Grief

While some people feel intense, overwhelming emotions when they are grieving, others experience the complete opposite. There can be a lot of guilt associated with anhedonia, as people question themselves (or are questioned by others) about their lack of emotional response to the loss of a loved one. People may feel disoriented by the inability to access their emotions in a time when they know they are supposed to be feeling them, and act out by picking fights or engaging in reckless behaviour in order to try and jumpstart an emotional response.

Anhedonia and Substance Withdrawal

For those newly in recovery from addiction, the onset of post-acute withdrawal symptoms can include anhedonia. These symptoms occur as the brain slowly recalibrates after an addiction. 

Recalibration is needed because substance abuse results in artificially heightened levels of neurotransmitters like dopamine repeatedly flooding the brain, causing the brain to build up a tolerance as it strives to create balance in a highly unbalanced environment. When a person stops using, it takes time for the brain to readjust to normal levels of neurotransmitters in the brain, resulting in anhedonia while the mind resets itself. These symptoms will subside after time, but can be eased by professional treatment.

Anhedonia and Anxiety

Anxiety can also drive anhedonia, as people with anxiety begin to lose pleasure in once-enjoyable activities as they fear that partaking in them will trigger their anxiety. Here, the anhedonia acts almost as a defense mechanism, protecting the person from anxiety and stress by removing the motivation to seek out experiences or engage in interactions with others.

Rediscovering Joy at The Dawn

Rediscovering Joy at The Dawn

The Dawn Wellness Centre and Rehab Thailand offers an environment of personal growth and healing for people who want to overcome mental health and addiction issues. At The Dawn, our experienced, internationally-trained staff  will work with you to develop your treatment plan based on your goals and your needs. We specialise in treating addiction, depression, anxiety and trauma and are the only residential treatment centre in Asia to offer TMS treatment.

Our  Twin Pillars Approach to Treatment

Internationally accredited by the American Accreditation Commission International (AACI), The Dawn has designed our own effective treatment model, known as the Twin Pillars. It combines the most effective psychotherapies currently in use with a range of scientifically-proven wellness practises to achieve holistic healing. The first pillar concentrates on a psychological approach to rehabilitate a client’s mind by helping them gain self-awareness and personal insight.  The second pillar focuses on the mind, body, and soul by using a variety of ancient  wellness and holistic therapies such as mindfulness meditation, yoga, Thai massage, and art and music therapy.

Call The Dawn today to learn more about how we can help you reconnect with your inner joy.


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