Legs sticking out of water

The Anhedonia Monologue

Post by @kickeybean
View on Threads

 

Strictly speaking, “anhedonia” is defined as a lack of pleasure, but there are complications beyond simply being unable to enjoy something. Imagine receiving no dopamine from checking social media, going for a walk, talking with a friend, or petting your cat. If you receive no positive signals, it will simply stop occurring to you to do any of those things.

A stack of gifts wrapped in black and white wrapping paper.
Life is a gift, but the return policy sucks.

At its most extreme, anhedonia goes from a lack of enjoyment of things you love to simply not feeling any chemical reward at all, and slows you to a near form of paralysis–because there is no positive stimuli, and the idea of “neutral” stimuli becomes almost equally unpleasant. 


What does still exist are negative drives. You can react to pain, discomfort, anxiety, frustration, but there’s not much else in the world for you. Having a lack of pleasure means your baseline for neutral experiences plummets. When all you have left is pain, discomfort and fear, you stop reacting to anything at all.

I don't know what all the fuss is about frogs in boiling water is. I've been here all day and the temperature is F-OH GOD I'M FEELING IT NOW. 

Cue the inability to move.

My deepest states of depression-related anhedonia render me unable to move or talk. I’m lucky if I can even register that another person is in the room. Depersonalization sets in, because surely I’m not the person who is rendered completely useless by apparently nothing? If you don’t recognize joy, you slowly lose sight of yourself, because there are so few definitions of yourself that make sense anymore. Your brain will tell you you’re a worthless, unpleasant automaton, but because you’re not actually a worthless, unpleasant automaton, you won’t feel real at all.

I got lost in thought and ended up...Up? 

I’ve spent months like this. I’ve lost jobs because of this. It isn’t something I can simply will myself out of because there is no will, no incentive that exists in me. What further complicates my experience of anhedonia is that it’s a very common side effect of antidepressants and antipsychotics, meaning the people who experience it while unmedicated may continue to feel that way even on a medication that’s supposed to make them better.

Medicated anhedonia is similar in my experience to depressive anhedonia, but your baseline of neutral doesn’t go down quite so badly– you can still accept doing things simply for the sake of doing them, even if it all feels unreal and nonsensical. The most complex anhedonia I find from meds has been related to antipsychotics, where I have no internal motivation to do anything, ever, but if I’m told to do something externally, I can probably make it happen– cue the feeling of zombie-ism and the intense inner hell that is not feeling in control of your own fate.

A woman in dia de los muertos make up enjoying a candle lit dinner. There is a bouquet of red flowers on the table.
Excuse you me, but eating brains definitely qualifies as self-care.

Do I believe in a cure for anhedonia? Yes and no. While you’re in it? I’m really not sure there’s anything you can do. Everything is so dependent on how deep into the feeling you’re already set and what resources you have available, and what life point you’re at when it hits you. Here is the short list of things that have worked for me:

One green, one yellow, one pink and one blue gummy bear looking at a marijuana leaf. A nugget of dried leaves is beside the fresh leafNothing says "I know what I'm doing with my life" like attempting to eat 1/16th of a gummy bear. 

  • Intentional THC use. Let’s start with what may be the more controversial one. I take a low dose of cannabis in the evenings before going to bed. When it kicks in, at the lower limit of success, my baseline neutral will rise and at the upper limit of success, I may feel silly or entertained by my thoughts. If I get to that upper limit, I make an intentional note to identify that I feel happy, that this is what happiness feels like, and that because I’m feeling it in this moment, I know it’s possible to recreate, even if it’s just through substance use.

    •  

    A colony of bees between two planks of wood

    If life turns your brain into a swarm of bees, take control of the colony and create your own honey farm. Something like that.

  • Overintellectualizing Desire. Overintellectualizing is a common side effect of anhedonia, at least for me. Sometimes this falls into rumination, the intense over thinking of the worst-case scenarios. Generally speaking, therapists I’ve talked to consider this to be a bad thing, but if it’s the only tool at your disposal, I’d argue it’s your prerogative to make it a good thing, which led me to overintellectualizing what it meant to “desire” something. Desire is a strong wish- in the case of anhedonia, it might be the wish that you don’t feel like shit anymore. 
  • “Want” is a slightly more abstract concept that falls within desire, but also often has a hidden “because” - I want food because I am hungry or because it tastes good. A wish, a desire, has no “because” at the end of it- it’s simply something that you wish to have happen. Thinking in terms of wishes and desire helped me, because there was no attachment to a want I couldn’t feel.
    •
        • In practice, that looked like making very short lists, usually one or two items. At the beginning of the year, it was “I desire to read and write as often as possible, ideally, every day.” There was no goal, no amount of pages to hit or word counts, just the desire to do it as often as I could. If I missed a day, that didn’t mean I failed, it just meant I missed a day. It was easier than trying to keep a streak going by framing it as something that I desired to do continuously. Start small, one desire at a time, knowing that there will be no chemical reward for doing it– because at first, there won’t be. I’ve found that the satisfaction seems to be a form of the frog in boiling water.

    A frog sitting on a half submerged leafFrogs everywhere are turning their back on the boiling water metaphor.

        • I know you’ll see variations of this list that include things like separating an action into small steps, and I didn’t find this helpful, necessarily, or conversely thinking big picture and knowing that doing certain things will enrich your life whether you feel it or not, which is similar to what I’m talking about but diverges as an intellectual practice. What I’m talking about is abstracting the idea of desiring something entirely; sometimes you have to start with “I desire to desire something, anything” and make it more concrete from there. Abstraction doesn’t necessarily create a big picture, it’s more fractal, but that kind of labyrinthine thinking is easier for me to manage than trying to convince myself that life is in itself worth living.
    • How do I make this fun for me? This is one that takes a bit of effort to put into practice, but it’s been a life changer in how I’ve dealt with pretty much any situation, from anhedonia to job interviews. It’s not actually about succeeding in having fun, it’s about experimenting to see if you can make yourself laugh. What do you need to do, or not do, in order to enjoy the activity you’re currently doing? 
      A woman sitting in the road pouring cereal into her mouth      Look, happiness looks different for everyone and for me it looks like getting dressed up to block traffic and pelt myself in the face with breakfast cereal.
    • My most tangible example of this would be a first date I went on with a man who decided preemptively that I was out of his league and there was no way he was getting a second date, so he decided to make the first one a fun experience, because if you're in it, you're in it, right? We ended up having a lot of fun, and dated for three years, simply because one evening, he decided to not take the outcome of failure all that seriously.

    A high angle view of a silhouetted couple walking along a lakeI like long walks on the beach and appearing like I'm doing normal things with my arms while I walk.

    Three bullet points. Granted they’re lengthy in explanation, but that’s it so far, end of list. I’ve learned with time and lots, and lots of varying attempts to make myself feel better that there is no permanent answer; taking an edible won’t always take the edge off. Overintellectualizing can circle back into rumination. You can go for a run and understand conceptually that it was good for you without emotionally feeling that it did anything at all. Hell, even my medication doesn’t consistently keep the bad days from happening (it does shorten the length they last, though, which is a benefit I will absolutely take).

      Hey you! You made it to the end of a long-format blog! I don't do ads (obviously, because this website is a store) but if you'd like to support what I do, you can "tip" using this digital download. Alternatively, this article is "Sponsored" by my "I Think We're Screwed" Linen prints, which are 10 bucks plus whatever the shipping and tax fairies request. Click the image for a direct link :)
    Back to blog