Listener Maro from Argentina wrote in and noted that recently, he hasn’t been enjoying things the way he used to. It’s as if nothing really matters anymore. Like most of us, he asked Dr. Google for information and discovered a new term: anhedonia.
So what exactly is anhedonia? Well, if hedonism (the concept, not the clothing-optional resort in Jamaica) is the pursuit of pleasure and gratification, anhedonia is its opposite. The brain’s ability to feel joy, satisfaction, or enjoyment gets put on mute. There’s little to no motivation to see friends or do the things we love. It feels like there’s nothing to look forward to, plus what’s the point, anyway. All in all, anhedonia feels like the moment in The Wizard of Oz when Dorothy steps from her black-and-white world into Technicolor, except in reverse.
Anhedonia can be a part of PTSD, substance abuse, schizophrenia, and even Parkinson’s disease, but the granddaddy of anhedonia is depression. A study in The American Journal of Psychiatry found that 95% of people with major depression reported a loss of interest or pleasure—a virtual vaporization of joy from their lives.
It’s not random that the study used those two particular words: interest or pleasure. Those two concepts are actually quite different and illustrate how anhedonia packs a one-two punch. How? Well, it turns out there are two types of enjoyment: anticipatory, also known as “wanting,” and consummatory, also known as “liking.”
In anhedonia, both wanting and liking are muted. You can’t see the reward or pleasure at the end of the road, so why bother going down it in the first place?
Think of the difference between looking forward to a vacation and actually being on vacation. There’s the excitement of planning and imagining what you’ll do and how you’ll feel beforehand. But then there’s the pleasure of the moment—how you feel when you’re finally on the beach with your mojito, riding up the ski lift, or hiking down the trail in search of a blissful lack of cellphone coverage.
But in anhedonia, both wanting and liking are muted. Without “wanting,” you may not look forward to things or feel unmotivated. You can’t see the reward or pleasure at the end of the road, so why bother going down it in the first place? Without “liking,” you may take no joy in things you usually love. It’s when a superfan doesn’t care if his team wins, the social butterfly withdraws from her friends, or the avid gardener lets his roses go to seed. Things we usually love—even food or sex—become one big “meh.”
So even if you try and you try, but you can’t get no satisfaction, what should you do? Anhedonia is tough to beat, but it can be done. This week, here are two big ways to lift the fog:
Tip #1: Do what you like and value, even if you don’t feel like it.
The way out of anhedonia is, counterintuitively, through the back door. Don’t wait until you feel better to do the things you love. Instead, do what you used to love, even if you don’t feel like it.
This is hard. It’s easy to get pulled down the swirling drain of inactivity and apathy because your brain and body get understimulated. Breaking the cycle and actually doing something takes a lot of effort, especially if you’ve felt depressed for a long time.
Luckily, doing what you used to love can be accomplished on many scales. Start with a small thing that takes two minutes, like playing with your dog, making homemade hot chocolate with marshmallows and whipped cream, or blasting your favorite song. Whatever it is doesn’t have to be big. It may feel like just a drop, but drop by drop, you can fill an ocean.
Next, if you can’t stomach being around people just yet, that’s fine. Stay in and do things you love: make brownies, do some online yoga, work on your guitar riffs, or watch a comedy special (but don’t over-rely on the screen time). The point is to be intentional and deliberately do things that you enjoy and are in line with your values.
Eventually, schedule things that get you out of the house, even if you don’t see the point. Accept your friends’ invitation to get tacos, go for a hike, or, as in one of my favorite client stories, sign up for the Mr. Leather contest at the corner gay bar, and to your surprise, win.
Psychologists call this behavioral activation, and if it sounds like fake it ‘til you make it, you’re right. It may feel fake, fleeting, or hopeless at first, but the reason it works is because it sets up a positive feedback loop. The brain affects your behavior, but behavior also affects your brain. So do the things you love, even if you don’t feel the effects right away. Like the Velveteen Rabbit, it’s fake until it becomes real.
A big asterisk: Don’t use this technique to be productive, get stuff done, or motivate to do stuff you hate. The only goals in behavioral activation are meaning and happiness. So don’t use it to do your taxes or your laundry.
Now, here’s a challenge: What if you’ve been depressed for so long, you can’t remember what you like to do? Think back to childhood. What did you love then? Do it again. If you loved riding your bike, plonk a helmet on your head and go for a spin around the neighborhood (or for the grownup version, sign up for a spin class). Bonus points if you get ice cream afterwards. Did you love to draw? Take a studio art class or bring your sketchbook to your favorite coffee shop.
Do these things even if it feels like you’re just going through the motions. It won’t feel the same as when you’re healthy, but it will likely feel better than doing nothing at all. If nothing else, getting out of the house will keep you from sliding further into the depths.
The take-home? Don’t leave these actions to chance. Purposefully schedule activities you love and value, even if the forces of gravity gets really strong right around your couch when it’s time to put on your shoes. There will be a million reasons not to go, but do your best not to listen to them.
Tip #2: Savor the moment.
Another practice to push back against anhedonia is called savoring. To savor, hold a metaphorical magnifying glass up to your hot chocolate, your hike, or your guitar riffs.
Zoom in on any sense of pride, joy, or accomplishment It will likely be small or fleeting, but pay close attention and wallow around in it to make it last.
Anhedonia tells you to discount these small pleasures, write them off as a fluke, or to say, “Well, I didn’t feel better, so that was a waste of time.” Instead, notice with as many of your five senses as possible what you just did, even if you have to peer really closely to find any enjoyment. Lean in to the taste of the tacos, the beat of your favorite song, or the warm and fuzzy energy of your dog.
In addition to paying attention with your senses, zoom in on any sense of pride, joy, or accomplishment you may feel. It will likely be small or fleeting, but pay close attention and wallow around in it to make it last.
And don’t stop with savoring the moment. In addition, you can bring to mind recent pleasures. Each evening, take the time to note three things you enjoyed that day. Actually write them down, in a journal or even just in the notes section of your phone. That way, you’ll create a growing list of things—those drops that make up the ocean—that emphasize and reinforce pleasure, mastery, and joy.
To sum it all up, do what you used to love, on a daily basis (at minimum!), before you feel like it. Pay close attention to the experience with your five senses, and revel in it, even if it doesn’t seem like much. Eventually, you’ll find yourself stepping out the door and back into a world of Technicolor.
Disclaimer
All content here is for informational purposes only. This content does not replace the professional judgment of your own mental health provider. Please consult a licensed mental health professional for all individual questions and issues.