The skeptical movement is not so hot at dealing with mental illness, and not so hot at education about mental illness. Because of that, I’m going to spend some time talking about elements of mental illness that require a bit more exploration than “it’s a chemical imbalance!!!”
One of the more common symptoms of depression is what is known in psychology circles as “anhedonia”. Most people see this word and go “huh?” then continue their lives. However for those people who experience anhedonia, it’s an incredibly debilitating aspect of depression and is one that more people need to understand. Without that understanding, others can make suggestions that seem like impossibilities, or simply say things that are cruel without realizing it.
Anhedonia is a lack of pleasure in in what would typically or in the past have been enjoyable activities. It is often found in depression as well as some other mental illnesses. Unfortunately this is one of the elements of depression that often gets overlooked in the face of things like low self esteem, isolation, irritated mood, or low energy, however anhedonia can play a huge role in all the other elements of depression because it makes it nearly impossible to find activities that will alleviate feelings of depression.
Anhedonia can feel like a lot of things. For some people it’s a lack of interest or motivation in doing things. Nothing sounds appealing. For as miserable as it feels to lie around in bed all day, it feels as if getting up would be just as bad and you’d be exhausted and put out by doing it. Other times, it might be that you can motivate yourself to get up and do something, but no matter how hard you try you can’t become engaged in the activity. You’ll watch a movie but never lose yourself in the plot, you’ll try to have a conversation and constantly find your mind somewhere else, bored and frustrated and unhappy. You might try to do something you’ve always loved, like exercise, or music, and find that no matter how much you do it or how hard you try, your mood does not rise when you engage in the activity. Or even worse, you might try to do something and feel completely detached. This can lead to some intense frustration and anger, as well as potential social anxiety (how hard is it to hang out with people when you can’t join in their jokes or games?)
Anhedonia is hard to describe because it doesn’t make events bad. It’s not as if your favorite activities necessarily suddenly cause anxiety or depression. They may even be entirely neutral. The problem is that you don’t get any sense of fulfillment out of doing them. This is particularly difficult when you lose the sense of mastery or accomplishment that you may be used to getting from completing tasks. Oftentimes it’s the sense of pride or accomplishment you get from doing things that helps you to solidify your self identity. That in turn with things that you enjoy creates your personality. If you lose both of those things, you can feel unmoored, as if you don’t know who you are or what way to turn anymore because you have lost all bearings.
Many of the remedies for depression include telling someone to get out of the house, increasing socializing, finding activities that are relaxing or restful, doing things that make you feel grounded, connected, or joyful. The difficulty with anhedonia is that it makes nearly all of these things impossible. How on earth are you supposed to fight a nasty low mood if nothing makes you feel good?
An additional element of the frustration of anhedonia is that it can lead to some serious hopelessness. Oftentimes we hold on to certain things in the midst of hard times: love for family or friends, a particular activity that truly drives us, or important work. Something about anhedonia makes it feel like these things have been pulled out from under you. They’re still there, but somehow the emotional pull of them is gone. You can feel broken, as if nothing will ever bring you joy again. Without any indication that your mental state might change and allow you to feel pleasure again, it’s hard to have hope that your life will improve.
Anhedonia can also make someone suffering from depression seem cranky, unpleasant, and nagging to be around. They might complain about things, they may seem unhappy all the time, they may come across as a drama queen. Please remember that someone else’s depression is not about you, and that while it may be a pain in your ass to deal with, it is much more difficult for them to have to be experiencing this lack of pleasure all the time. Patience is a major virtue when it comes to depression.
Overall, anhedonia is one of the more difficult elements of depression because it can underpin and exacerbate almost every other element of depression. Unfortunately there’s very little education done about it and many people don’t even know what the word means. It can help to understand yourself if you’re going through it, to have more hope, and to have better tactics for fighting it if you know about anhedonia, and if you’re a support person it can lead to perhaps more patience and less guilt. If you have any more questions about the internal experience of anhedonia, please ask away (although I can’t speak for everyone, just myself), or if you have experiences to share I’d love to hear them in comments.
Cross-posted from We Got So Far to Go