- Hey everybody, happy Monday.
Now today we're gonna talk about anhedonia.
Weird word, I know, but what is it and why does it happen?
But before we jump into that, are you new to my channel?
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But let's get into this video.
Anhedonia is the inability to experience pleasure
during activities that you used to enjoy.
Meaning that if you used to love snowboarding,
guilty, but now it just seems like too much work
and even when you get up onto the hill
and you just wish you could just go back down
and go to bed, and so that's what anhedonia is.
We just don't feel pleasure for things
that we used to feel pleasure about.
And just so we can understand anhedonia a little bit more,
I always think of it as a big loss in our life.
I mean, it can feel like we can't enjoy anything anymore.
Food could lose its taste.
Or just seem, alel, not what it used to be.
Or it could rob us of our social life.
Or even the ability to enjoy sex.
And anhedonia can be part of many mental illnesses,
even though we mainly hear it talked about
with regard to major depressive disorder.
But it can be part of schizophrenia,
eating disorders, anxiety disorders, BPD, et cetera.
And so just know that it's not just depression.
Anhedonia, that lack of enjoyment or pleasure,
can be a symptom of a lot of things.
And I think that's why it's really important
that we don't just self diagnose.
We also see a mental health professional
or other health professional
so that we are properly diagnosed and treated.
Because if we have schizophrenia,
that's very different from having an eating disorder,
and the treatments are gonna be very different.
And so just make sure that even as I'm talking about this
and describing to you what anhedonia is,
we're not jumping to the conclusion
that it only happens with depression, okay.
And an interesting side effect of anhedonia
that I've been noticing more and more with my patients,
maybe it's because I, I don't know if you guys know,
I specialize in self injury as well as eating disorder work,
and so I'm noticing that this lack of enjoyment,
or honestly it can be like a total numb-out
where we just don't feel anything,
it can lead us to engaging in some dangerous behaviors
in order to quote, unquote, feel something.
Even recently I was just watching
a "Law and Order: SVU" show,
you guys know I watch that a lot,
but the main character, or actually
the person who was on trial,
engaged in extreme wrestling and it was a way
for them to feel something.
They talked about it in the courtroom
and it was really interesting to me
because I've had patients that find self injury this way.
Or even signing up for bungee jumping
or other adrenaline-inducing activities.
And so just pay attention that if you aren't finding joy
or you feel like you're numbed-out,
you're not feeling anything, be cautious
about saying you're an adrenaline junkie
and taking on new activities
that could be really dangerous for you.
It's more important that we figure out
what's causing this for us and we get it treated, okay.
And also I just want to say that anhedonia
can harm our relationships,
because if nothing seems enjoyable,
we can be hard to be around.
We could totally be a negative Nancy.
Or not up for as much as we used to be.
Because it can seem, or it can feel like a lot of work
and maybe we don't enjoy that work anymore, right.
I don't want to go out.
That just, I don't wanna shower and get dressed up
and be around people.
It can feel really like too much.
And if none of that is fun, what's it worth?
What's the use of doing it?
We just aren't gonna want to.
Okay, now let's get into the second part of this question.
Why anhedonia happens.
Now, like everything in psychology,
we don't know for sure,
because our brain is complex and everybody's different
and we aren't able to study a brain
while it's doing what it does each and every day.
But we do know that dopamine,
which we don't know what dopamine is.
It's a neurotransmitter or a chemical in our brain,
it's what makes us feel good, and so it's responsible
for attention, movement regulation, and emotional responses,
and so we know that lower levels of dopamine
in specific parts of our brain
is connected to anhedonia.
And they've also connected lower levels of serotonin
and gaba, which are just other neurotransmitters
or other chemicals in our brain.
They've connected those to anhedonia as well.
And we also know that feelings of joy,
excitement, and reward come from
specific parts of our brain.
Kinda cool.
These parts are called the mesolimbic dopamine pathway,
and the mesocortical pathway.
And you can dig into what those really are,
really the name like mesolimbic and mesocortical
kinda tell you where they lie in the brain.
And it involves various parts of our brain, right.
These are both pathways, so they're going through our brain.
But it involves areas like the prefrontal cortex, right,
right behind our forehead.
Our amygdala, talked about that a lot.
And many, many more, so
if there are any abnormalities in these parts of our brain,
even if we've had like a head injury
or if we were in sports and we'd been knocked out,
we could have a concussion, that could
maybe cause this as well.
And so if anything's happening in those areas,
it could lead to us not enjoying things anymore.
Or at least, those are one part
of what is a very complex problem.
So that's what we know about why anhedonia happens.
But let's talk a little bit about treatment.
And unfortunately, not all SSRIs or SNRIs,
otherwise known as antidepressants, treat anhedonia.
Obviously everyone is different,
but because anhedonia is one of the leading causes
of suicidal thoughts, we need
to get much better at treating it.
And newer research does show that ketamine infusions
can help treat it.
And if you don't know what ketamine infusions are,
you have to go, the thing that is kinda sucky about this,
and hopefully they'll get better
at allowing us to take ketamine,
but for now, you have to go to the doctor
and you get hooked up to an IV with the ketamine,
and you have to sit there, for like 30 minutes.
And then after the infusion's done,
they want you to sit for a while as well.
And you have to have someone drive you home.
It can be very difficult to manage
when we have very busy lives or we work a lotta jobs
and a lot of insurances do cover it,
which is great, but it's just very time consuming.
But it's great that at least we know
that it does help those of us who suffer with anhedonia.
There's also TMS treatment,
which if you don't know what that is,
it's transcranial magnetic stimulation.
And this again is also very time consuming.
Most of my patients who've tried TMS
go like five times a week, three to five times a week,
and you have to sit there for at least 1/2 an hour,
sometimes more, with it's like a helmet that you put on
and it has these magnets that are specifically placed
to kind of jump start different parts of your brain.
So if we think the depression or the anhedonia symptoms
are over here, we might trigger that.
And it might stimulate it, because it's trying
to get your brain going.
It's like hey, you're not doing this thing
you're supposed to do and it might, potentially,
since we talked about gaba and dopamine,
it might make that start up again.
Maybe it will trigger it
and maybe we'll start to feel better.
And I've heard from a lot of you and a lotta my patients
that it's been really beneficial.
So that's something that can help.
Also, some research, and I know people
are gonna get frustrated with this,
but a lot of research shows that ECT,
or electroconvulsive therapy,
has helped those with anhedonia.
But I believe that it's a pretty barbaric treatment option.
It's something that we can do and it's there.
It is an option if you need it.
No shame if you've tried it.
You have to do what's best for you.
But that's just another one of the treatment options
that they know, through research,
that's improved the symptoms of anhedonia.
And I also had a patient in the hospital years ago
who struggled with this, and the only thing that helped her
was Vagus nerve stimulation.
And I haven't really talked about this much,
but this is something that has to be placed,
it was like here on her and it's in your upper chest
and it's placed by a doctor.
It's kinda like an outpatient surgery, really.
And what it does, it's like a,
almost like a pacemaker or something
and it stimulates the Vagus nerve.
And the reason that this helps
with severe symptoms of depression
or anhedonia or other mental illnesses
is that the Vagus nerve is what connects
our brain stem to our body.
So by stimulating it, we could be stimulating
parts of our brain, kinda like the TMS stimulates, right.
And possibly it could stimulate the ones
that are involved in the reward system in our brain.
So I hope that that gives you some hope
and lets you know that if you've been
struggling with anhedonia for years,
that there are treatment options out there.
And there are things that we can do
to make it feel better for you,
because it can and will get better.
But I would love it if you would leave
in the comments down below,
have you suffered from this and what has helped you,
because those were only what, four options
that I offered and I know there are more out there.
And obviously talk therapy can sometimes help,
but for many people, when I was reading the research,
they reported that it didn't benefit them that much.
It like brought it from let's say here to here.
And we wanna get it all the way over here.
And so I'd love it if you'd leave some tips and tricks
and tools and things that work for you
in those comments down below,
and I will see you next time, bye.
(gentle upbeat music)