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Old 04-21-2015, 09:24 AM   #1 (permalink)
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Anhedonia


There are some recent threads about people in recovery feeling blah. I read this article the other day and thought it applies here.


World without Pleasure in Addiction Recovery

A world without pleasure is a grey place indeed. Without this emotion, life become monotonous, and there doesn’t seem to be much point in doing anything. Day to day living becomes an endurance race, and there is no motivation to try to improve things. The inability to experience pleasure means that life can feel pointless, and that is not a satisfying form of existence. It is a particularly dangerous way to feel if people are trying to recover from an addiction. If there is no pleasure in recovery there is no point in staying away from alcohol and drugs.

Anhedonia Defined

Anhedonia is defined as a loss of capacity to experience pleasure. This inability to enjoy pleasurable things is associated with a number of mental health problems including depression. The word anhedonia comes from ancient Greek and means without delight. The individual who is experiencing this condition will find that their life is emotionally empty.

Types of Anhedonia

It is possible to divide anhedonia into different types:

* Motivational anhedonia means that the individual has no desire to engage in enjoyable activities.
* Consummatory anhedonia means that the individual does not get enjoyment from the actual activity that would normally be considered enjoyable.
* Sexual anhedonia refers to a situation where a man ejaculates but receives no sense of pleasure from this. Women can also have a similar problem with receiving pleasure during their orgasm.

Symptoms of Anhedonia

* The individual experiences a flat mood all the time. They may describe this by saying that they feel nothing.
* They have little motivation to do things due. This is due to a lack of variation in mood.
* There is no positive reward for doing things.
* The individual may have a loss of sex drive.
* The person no longer gets enjoyment from activities that they once found enjoyable.

Causes of Anhedonia

There are a number of possible reasons for why people develop anhedonia including:

* One possible for why people develop anhedonia is as a result of social learning. This means that the individual has learnt to associate certain experiences with lack of pleasure – this could mean that the person has learnt to indentify life away from addiction as being without pleasure.

* It is suggested that the [brain of those who are dealing with anhedonia are functioning abnormally. In particular the parts of the brain that deal with mood changes, empathy, and reward signals.

* It may also be that those who are suffering from this condition have difficulty processing happiness. This is due to problems with the brain’s internal reward system.

Anhedonia as a Symptom of Mental Illness

* It is frequently associated with addiction. It is a common symptom that people experience during withdrawals.
* It is a core symptom of depression
* Schizophrenia
* Post partum depression is where a mother is unable to get pleasure from her newborn baby.
* Bipolar disorder

Dangers of Anhedonia in Recovery

Anhedonia is a fairly common symptom for people in early recovery. It is most often associated with the withdrawal stage when the individual initially gives up alcohol or drugs, but it can persist for longer. There dangers of anhedonia in recovery include:

* If the individual is unable to experience pleasure in recovery they will not see any point in staying sober. Their sober existence may feel more miserable than their life in addiction.

* In order to be successful in recovery the individual will need to be highly motivated. Those who are dealing with anhedonia will struggle to develop any type of real motivation for anything.

* Those who are attending rehab will be expected to absorb a good deal of knowledge to help them cope in the outside world. If they are dealing with anhedonia they may struggle to absorb any information.

* Even if this person somehow manages to stay sober their life will remain unsatisfying until they overcome anhedonia.

* Pleasure is a vital component of the internal reward system – it helps people grow and learn. If the individual is unable to experience rewards they will fail to make any progress.

* Those individuals who are dealing with post acute withdrawal symptoms may have to deal with anhedonia for a year or longer. It is going to be a real struggle for them to remain sober long enough to recovery from the condition in recovery.

* If the individual relapses as a result of anhedonia they may have lost their only chance at sobriety. The fact that their time in recovery was miserable will dissuade them from making any further attempts.

* Persistent anhedonia in recovery may be a sign that the individual has a dual diagnosis. Unless they get this other mental health problem dealt with the symptom may persist.

How to Deal with Anhedonia in Recovery

If people are dealing with anhedonia in recovery there is likely to be things they can do to improve the situation including:

* Knowledge about anhedonia can be a great help to those who are dealing with this symptom. They will learn that it does not mean that they will feel this way forever, and that there are treatment options.

* Those people who develop persistent anhedonia may be suffering from depression. They may benefit from taking antidepressant medication.

* It is important that those who are struggling with anhedonia seek medical advice. Failure to deal with the problem will be putting their sobriety at risk.

* It is suggested that regular physical activity can help the individual
overcome this symptom. The worst thing that the individual can do is isolate and become inactive.

* Practices such as yoga may be of benefit to people who are dealing with this type of problem.

* Just going for walks in nature can be of value to the individual who is dealing with anhedonia.

Source - Anhedonia in Recovery - Alcohol Rehab

Last edited by Dee74; 04-21-2015 at 04:11 PM. Reason: delinked commercial link
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Old 04-21-2015, 09:38 AM   #2 (permalink)
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Thank you for this.
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Old 04-21-2015, 09:39 AM   #3 (permalink)
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Thanks Art.

Sounds like a name for an evil female character...
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Old 04-21-2015, 09:44 AM   #4 (permalink)
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* If the individual is unable to experience pleasure in recovery they will not see any point in staying sober. Their sober existence may feel more miserable than their life in addiction.
Bingo. Been there and I fear going back there again.
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Old 04-21-2015, 09:50 AM   #5 (permalink)
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Excellent post, thanks Art!
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Old 04-21-2015, 11:04 AM   #6 (permalink)
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Sounds like a name for an evil female character...

Ha! I thought the same thing!!
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Old 04-21-2015, 11:44 AM   #7 (permalink)
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Great post Art!!
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Old 04-21-2015, 11:55 AM   #8 (permalink)
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* Knowledge about anhedonia can be a great help to those who are dealing with this symptom. They will learn that it does not mean that they will feel this way forever
I would stress this point HARD.

Stopping alcohol intake following a protracted period of persistent use can cause temporary anhedonia. Habitually spiking one's dopamine levels with booze causes the brain to respond by increasing the hedonic setpoint - the dopamine threshold for feeling pleasure.

Anyone experience the phenomenon of needing more and more alcohol to get the desired effect? That's your brain raising your hedonic setpoint. (Turns out its bad for survival if you sit around buzzed all day and forget to hunt or gather. Your brain is fighting back.)

So you keep drinking more and more. Before you know it the normal things don't bring much pleasure. The only thing that does the trick is booze - more and more booze - pushing your hedonic setpoint higher and higher...

Then one fine day you realize your life is turning to crap and you stop drinking. But your hedonic setpoint is still elevated - and whammo, you've got anhedonia. You don't feel pleasure. The world is blah. Everything is blah. You could be at Disneyland and wonder why everyone is having fun except you.

Give it time. It takes months, but your hedonic setpoint will come back down from its artificially raised state and simple things will once again bring you pleasure. The anhedonia lasts a while, but it is TEMPORARY. If it takes more than 6 months, see a doctor. You might have more going on.
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Old 04-21-2015, 12:28 PM   #9 (permalink)
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Thanks Non - that is true. We (myself included) have to find a way to navigate thru those weeks without relapsing. Critical!
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Old 04-21-2015, 12:34 PM   #10 (permalink)
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This is a great topic! Anhedonia is what led me back to drinking. I had never felt so consistently low and flat. I wish I had read more about it before starting back up.... I didn't even have a name for it when it was happening.
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Old 04-21-2015, 12:34 PM   #11 (permalink)
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Thanks Artfriend.
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Old 04-21-2015, 12:35 PM   #12 (permalink)
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I think this is another point worth mentioning:

Quote:
* If the individual relapses as a result of anhedonia they may have lost their only chance at sobriety. The fact that their time in recovery was miserable will dissuade them from making any further attempts.
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Old 04-21-2015, 12:59 PM   #13 (permalink)
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That sounds alot like what I've been going thru. Pain pills are my thing but I've often felt no happiness or pleasure in anything when I didn't have them. Almost like depression but a little different. And anti depressants never helped. It's good to know that it doesn't last forever.
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Old 04-21-2015, 01:49 PM   #14 (permalink)
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Thank you ArtFriend and thank you NON!! Great points.
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Old 04-21-2015, 02:25 PM   #15 (permalink)
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Wow! Thanks Artfriend... that sounds like what I've been dealing with.
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Old 04-21-2015, 02:29 PM   #16 (permalink)
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Thanks Art. And the Friend part comes so natural. Are you working on you for me or sumpin? Seriously, Thanks! I've seen that word-that-I-can't-even-pronounce come up here often but am so ADD I've never researched it fully. My daughter asks if I'm frozen from time to time and only recently I've said yes. Cow's thread touched on this subject (intro-ed me to the word actually) months ago. I threw it into the same pile as PAWS (something new and discardable). I'm actually a poster boy for both! Thanks for being.... today.
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Old 04-21-2015, 04:59 PM   #17 (permalink)
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I am glad some people found this useful. My work here is done...at least for today.
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Old 04-21-2015, 05:01 PM   #18 (permalink)
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Mine was temporary and then things really started to get better in an all around way!!
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Old 04-22-2015, 07:12 AM   #19 (permalink)
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Thanks ArtFriend Super post, I am currently in the midst if PAWS and feel this way at times, thanks also to Nonsensical I think also that my brain has reached a high hedonic setpoint through binge drinking, determined this time at 42 days after relapse on 80 days, just not a happy camper these days and try keep bright side out, not easy. But knowledge is power and thanks again for informative posts.
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Old 04-22-2015, 08:18 AM   #20 (permalink)
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Great post.

I had many of those symptoms when I was drinking heavily, off and on, for years. Then I was trying to seek pleasure and intensity in all the wrong ways, which never truly worked of course and made everything much worse... Getting sober resolved it pretty fast for me in general, but I experienced isolated spells during ~my first sober year. This dynamic clearly varies between people.

I think what can be helpful to snap out of this state is to force it in the beginning no matter how we feel. Do those things such as physical activity, going to places we like, socialize with people we like even when we don't feel up to it. Simply going through the motions initially can help a lot in starting to change our motivational state, I think it's a more effective strategy than waiting for it to return before we start doing the things we need to do, used to enjoy, or think we would enjoy. This action-based strategy has perfect neurobiological basis, since the activities themselves can change out brain chemistry, while it's less likely to happen if we just sit and wait for it. Of course starting is always hard, but it's worth it. Of course if it's persistent, it's best to seek professional help.
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