Anhedonia Talkback, Part One

Anhedonia is a standard symptom of depression. In previous posts I have reviewed the nature of anhedonia and a series of strategies designed to cope with and overcome it. Those posts have been extremely popular and have attracted a number of comments. In this video I respond to some of these comments with further discussion of anhedonia and its treatment.
I'm the author of books on assertiveness and private practice, in addition to the "How to be Miserable" books. To see my books at Amazon, visit: amzn.to/2VtGHjy
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#anhedonia

[@Thomas-pq4ys]

I'm there... I've dealt with depression all my life. I have watched it come, murder my self-esteem, drive, motivation.... I learned that my depression is an injury that will heal. It takes time... and this has beeeeen proven, time after time. Recently, my sister passed. It isn't her death that has me down. It was that through her executors, I discovered within minutes, that I was the family scapegoat, black sheep, whipping boy, control freak narcissistic supply.. I went into a rage like I've never felt. An old friend noticed long ago that I take my anger, and turn it into depression. My narcissistic mother would beat me bloody for getting angry... and this is how I learned this process. The rage didn't go away, slowly turned into such a deep depression, that I got anhedonia... which has sucked all drive, motivation, joy, from my wonderful life. It's like my family is punisuing me still from the grave... I'm still the whipping boy. It's been 5 months. Slowly, the anger is lifting. The depression, anheddonia, not so much. I live for music. I'm a life-long performing professional... it, and being on stage, is my ultimate experience in life. Now, I can't even practice, or play for pleasure. Like one of the folks above, I'm most comfortable, laying in bed with my kitty. What gets me out of bed is taking care of a feral family that lives on my deck. I cry over the darndest things. A moving thought about a certain song, and it's performance, by an original artist, animals, my beloved cats, departed, and soon-to-be-departed long time friends. I've been diagnosed with an ischemic stroke that affects my balance... and I'm grateful that that is all it is... I've found supplements, through professional friends that really work well to keeps vertigo away at best, controlable at worse. I've read much about stroke, and that it can affect moods, emotions... and I wonder if that is the case since my sister, who passed 3 months after the stroke... regardless, I've persued psychological results of being raised by a narcissist, and how my sister was recruited in on the plot to control me with shame... and later, my father was recruited as well. I had no family allies. I feel no grief, and know why. I was blatantly abused. But I'm here now. I used to love to have a drink, play guitar at home, get crazy creative. I discovered that multiple drinks produce no bigger, better high, or artistic results... so I just have one. I'm seeking help... but meanwhile, I've so many responsibilities. Not only for myself, but for dear old friends who are getting dementia... who helped me in my past when I needed it most... it is time for me to pay them back... I hope to find joy in this effort...

[@pault9544]

I've had anhedonia for about 10 years (started in my early 20s). Some years, it gradually started to lift sort of just on it's own and I got my emotions back in a more subtle way. However, 2021 in the thick of Covid, I had a very bad mental breakdown which brought the anhedonia back stronger than before. I could not feel anything at all. This is what I have found through research. Anhedonia is a condition of the brain. Your neurotransmitters are no longer working properly due to multiple reasons, two common big ones: very stressful situations or trauma. through my own research, I have found that one way to actually effectively treat this is brain exercises. As it is with anhedonia, we often can not feel positive emotions. What I do are brain exercises, 10-15 minutes a day of things that I "enjoyed". I use quotations because obviously with anhedonia you can't enjoy or it's very blunted. You have to train the brain to start feeling again. I'm not fully healed but I have gone from 0 flat feeling anything to being able to enjoy music, food, shows, connections with people etc. It's not linear though, some days you'll feel and some days you won't. It takes time ive been doing this over a year now but trust me it does work but you have to do it every single day and be consistent.

[@fairy601]

I’m curious what specifically you mean by brain exercises? Could you give an example? Thank you for the help 🙏

[@johnpatterson6448]

Hi Randy Namesake, I find your content and honest style helpful. The word ‘anhedonia’ has been on the periphery of my awareness for a while. This is the first time I have explored it more deeply. In itself it is helpful to have the term. I see the term ‘depression’ - often conflated with ‘sadness’ - and immediately I know that person doesn’t get it. Not my situation. Although I have taught creative visualisation to others successfully, I could never generate excited anticipation myself. Your comments on feeling v action, Randy, are very enlightening in that regard.

[@angelafitzwater616]

I have several crush fractures causing kyphosis and pain on walking with a walker. I am grieving the death of my husband 2 years ago. Having sold our house and moved to a different state, to live with my son and his family, I became depressed. Anhedonia set in and my immobility is making it difficult to go places and do things which might help. I am not currently driving a car.

[@historianz3711]

22 years Anhedonia, 23 years Paxil. First taken to treat depression developed from complicated grief. Now reduced dose of Paxil being 10mg/daily. No improvement from Anhedonia yet. I would do anything for even 1 hour of non total-numbness

[@cyndijohnson5473]

Drop the Paxil

[@ShaunLuttin]

You addressed the importance of doing something, and talked about how doing certain things has a better outcome than doing other things does. In that part, you briefly mentioned meeting "the requirements of the situation." I needed to hear that, because recently I have focused on doing something that "contributes to my values." As a result, I have forgotten to address the requirements of the situation. I have been spending most of my time contributing to _others_ and very little taking care of myself. For instance, it contributes to my values to volunteer at the local community center, but the situation requires that I earn a living to pay for groceries, the mortgage, and retirement savings. If I spend all my time volunteering, and none earning a living, then eventually I won't have enough money for rent or groceries and will never have enough to retire! I notice so many messages about doing something meaningful, something that matters, and I tend to forget that fundamentally I value self-preservation! It seems so obvious on reflection, that when we choose to do something, we ought to prioritize the must-have requirements first - like eating and earning a living! Only then take care of the nice-to-haves like contributing to something larger than ourselves. Doing _anything_ beats sitting on the couch; then, doing self-preservation beats most other things; after that, consider contributing to others in a way that aligns with our values. Does this seem reasonable?

[@iamthefiremanjj]

For this condition to I would check any food sensitivities and work with those and get your vitamin d levels check as well as hormones . It helped me out a lot . It sounds crazy but keto fasting helped me sometimes as well

[@ShaunLuttin]

I listened to this while doing Pilates on a reformer at home. It felt pointless and lame, but I reminded myself that doing it helps and that, over time, things can get better.

[@boltneck1705]

Bingo! I wish I could get a hold of someone to talk to about this. We all have different reasons that lead to this mindset, but this is the first time an actual name has been put to something I could never put into words. Trying to explain these feelings to someone often leads further misunderstanding and coming off as we somehow act this way on purpose.

[@RandyPaterson]

Amongst the general public anhedonia is not well-known. However, well-trained mental health clinicians will generally know what you are talking about when you use the term.

[@boltneck1705]

@@RandyPaterson Thank you much!

[@SoSkepticalFox]

16:35 this sounds like my feelings, I used to love to draw and now i hate it. I never want to draw ever again but i do want a hobby. However with anhedonia i cant figure out if i enjoy it to know if i keep doing it will it bring me joy. My thought process during drawing and why i hate it now is "this is difficult, i dont like how it looks, no one cares if i draw this or not either so why am i putting myself through it" It just puts me into further depression when i try to draw because its just frustrating

[@RandyPaterson]

The "try it and see how it feels" idea seems to make sense, but during anhedonia it isn't the greatest guide. Initially, nothing may feel right. A better question is "what is there to lose?" Most of us spend hours doing things that are a complete waste of time: Facebook, Twitter, KZbin, gaming, old episodes of Game of Thrones. Time spent drawing without an ultimate payoff won't be such a disaster. One hint in your post is that it sounds like you're having difficulty turning off the evaluative part of your brain. "This isn't Rembrandt; it's not even Stan Lee, so why bother - I'm a talentless lump." That'll take the joy out of almost anything. The mission for many is to do whatever it takes to anaesthetize the evaluative brain. "I don't care if it's crap; it's about drawing, not producing a masterpiece." One way of doing this is to approach it with a counter-goal: The intention of making it lousy. "Let's see how badly I can draw." Frustration isn't often welcome, but it is useful information. Frustration is the emotion we feel when we are prevented from reaching a goal. Feeling it tells us that we had a goal in mind (often unstated; often outside conscious awareness). We can use frustration as a cue to identify what that goal might have been and what might have been "good enough" - usually something unrealistic and out of reach. When working with anhedonia, part of the task is to let go of the goal. "I'm just doing this; I'm not trying to do it WELL or produce anything." I'm just walking, I'm not walking brilliantly or "SO THAT ___." We need to get rid of the "so that." Google the Buddhist saying "Abandon any hope of fruition" for more on this subject.

[@loribilodeau714]

I've dealt with major depression my whole life due to continuous trauma. When I was younger, through my 20's I had a desire to fo things, but I couldn't make decisions. I never could figure out what I wanted, and it progressively got worse. I only went through short periods of "making myself" do things and get out the door! I had and still do have more energy and a more positive outlook if I get out the door. Unfortunately, that is the "BIGGEST STRUGGLE, EVER! Forcing yourself to go Anywhere! I came out of a 22 year marriage, and raising a son who went off to college at same time. I Let "EVERYONE" down. My husband wanted sex.Because of things he did, I couldn't love him, or have the desire to please him in ANY way, anymore. Trauma induced obviously w me. I found pleasure in my son though! Because He needed me! I LOVED AND ENJOYED going to his Track/Xc. Etc. I loved animals. But as the marriage was coming to a close, I realize I'm sad because I don't want to damage anyone else's life. They can't fix us! I've been on every med probably around. I know I'm intelligent, and when I worked, I excelled. But, I can't keep it up. No one wants someone in there lives that has no motivation to do anything. Or a man, to show love. I give up. I'm trying to accept what I have and that they don't know enough yet. And that is the truth! So, I'm 60, and I accept that I did the best I could. According to some, I've messed up their lives. To others, I am a burden. I don't feel for people anymore to be of help to them. For me, this anaconda is pretty consistent. So be it. I'm tired

[@Dietconsulting]

I had severe anhedonia for close to 3 months as I was recovering from a major depression. Your original video was REALLY helpful. Things I did to keep connected 1) didnt withdraw from my bowls team, kept going even though I felt "meh". I went to see if i could suck a bit less than the previous week and because two of the team were going through horrible family issues and our time playing was respite for them. 2) im a very competent crocheter and i just chose a very simple pattern and made it in time for a baby arriving in my circle. My motivation was the mother's delight. 3) i mechanised a lot of simple tasks in my business. Initially I wasn't even certain i wanted to try and be a practitioner with anhedonia. I then decided that i needed structutes to be as good as i could be if this persisted. I realised i could still do one part of practice with anhedonia - the detective work on "whats not working" at a physiology/nutrition level. If the anhefonia had persisted I would have struggled to get the niche working but im sure I could have found a place. Im glad i recovered and i also learned a lot.

[@RandyPaterson]

These are all strong components of recovery. To reflect: 1. Declining to obey anhedonia's impulse to isolate, and permitting feelings of "meh" to be there. I n effect accepting the emotional state (which we cannot control well) and choosing to act anyway (which we can). 2. Ramping down expectations by continuing with activity but at a less demanding level, relinquishing the demand on self to be perfect or performing to our highest level. 3. Simplifying life so that ongoing chores impose slightly less of a burden.

[@gojo-zn7du]

Thank you for sharing what worked for you. thank you for also giving the time period it took to work for you. This is a good starting place. Now that I have a blueprint, I'll try to modify it to my needs and circumstances and like Dr. Paterson has kindly reiterated, I'll keep his points fresh in my mind. Thank you so much!!

[@Dietconsulting]

@@gojo-zn7du hey good luck and the effort is worth it. I had a bit of a dip in July again but managed to get through it without having to alter meds, just more light lamp time. Currently working on setting up a more sustainable workload for 2024. Probably my biggest long term learning is the need to pace myself better. I hope you have good people to support you. We are 2 weeks off starting bowls again after the winter break and it's something I'm looking forward to playing again

[@earthworldadventurer]

Your comment at around 27 about for some people this is a cue to shift away from what-do-i-predict-will-give-me-pleasure TO what-would-be-an-expression-of-my-values…THANK YOU! YES! That makes sense! That feels like something instead of nothing!

[@pawlogates]

It gets you nowhere though. It just sounds good

[@PeaceboneGotFound]

Wow, you answered my question (at 8:45)! I did make the decision based on what I thought future-me would be proud of and based on my values, and it turned out well!

[@jameshenman3394]

I loved your talk! I just reconnected with LinkedIn after a long break and have been checking out my old groups and came across your video. I’ve been a Therapeutic Life Coach in private practice as a Psychologist for 40 years. I recently republished a book I wrote 20 years ago “Who’s Really Driving Your Bus Today “ available on Amazon. Your style of presenting makes Psych-Educational very therapeutic, normalizing that feelings of depression and anxiety can be normal in the challenging stresses of life. Giving some important tools like Second-Order Feelings and others make an impact on the listener’s perception. I look forward to seeing more. Yes, I did subscribe😉

[@missymurphy9996]

Yeah, it’s a hard thing to explain because nobody understands. So I try to fake it and hope for the best

[@pickelbarrelofficial1256]

On the comment about some positives to the condition, I'd say I agree with the commenter you responded to. Anhedonia is for the most part very difficult to live with however I have noticed that before I had it my mood fluctuated far more. I don't fall into crippling depressive episodes to the same extent I used to and I'm also less anxious than I used to be. I would of course much rather have my feelings back but I've found it helpful to recognise, at least in my own case and perhaps that of the commenter, that a relative silver lining is that I simply worry less and my mood is more of a stable "meh" than constantly rebounding between giddy excitement and crushingly low mood. Of course, a lot has changed in my life as well and as they say, correlation does not equal causation, but the recognition of some sort of positive has made coping a tiny bit easier.

[@knowledgeos]

great ... I love your teaching and u r best

[@brianpulley8652]

Ive struggled for the past 5 or so years with this...i force myself to get the kids to school and go to work but when i get home i hit my bed and thats it im done...on the weekends i pretty much stay in bed all weekend and I used to be very active in the gym and done a lot of stock car racing and now it's been 4 years since I raced and even then i had to force myself to go and got no enjoyment out of it and I'm just letting my home and yard go and its so frustrating wanting to get better and just can't seem to make anything work and my kids deserve the old and much better version on me.... I've tried meds and everything OTC for energy and all kinds of supplements with little to no effects and i feel like im just waiting to die...😥.

[@klanderkal]

Wow,... are situations are similar. I no longer do anything I've totally enjoyed b4.!! This suffering is unbearable and difficult to explain to others. I now lost everything..! .... and my mental and physical health are declining,... this kind of depression has worsened with anxiety! Horrible... and insomnia!! ... I 🙏for us...

[@matthewdavis3014]

I struggle with Avoidant PD. Lately I’ve been using a trick where I think of people the way I think of my cat: “just” animals with developed traits, it makes them less threatening by making them more like an observational ‘thing’ whose judgements are just a relative perspective. Do you have any other tips to help take some of the enormous anxiety out of interpersonal interaction? Mantras, if you will, little ideas to keep in mind when I engage

[@RandyPaterson]

To some readers your idea of, in effect, dehumanizing others may sound like a bad idea, but for the purpose of reducing anxiety to a manageable level it may indeed be helpful - essentially as a tool for gaining some objectivity and detachment in these situations. Two ideas that help many are “What other people think of me is none of my business,” and “We would be less concerned with what others think of us if we knew how seldom they do.” When it comes to avoidant behavior, a few are Nike’s “Just do it” (rather than dithering), “Don’t go for the best” (when deciding what to do is a secret strategy for avoiding doing anything), and “The only wrong decision is the couch.”

[@Anotherhumanexisting]

The hikkinomori thing is exactly me right now. Except I did not “fail to launch”. I was living independently for almost 2 years following mental health treatment from age 18-22. I had a job but cannot maintain full time hours due to chronic illnesses. Even if I were healthy, there are no jobs for me in my area that pay a living wage. I was depressed and struggling long before I moved back in with my parents… Another KZbinr Dr. K says that underlying the mental health crisis for my generation, there is a deeper economic crisis. We do not achieve security/safety as a reward for hard work… it feels hopeless.

[@davidfulton179]

RE: "Positives". - It is difficult for me to say for sure, but it seems like I am more productive as an artist/writer, in my work-work, stuff around the house, generally getting things done whilst in this persistent anhedonic state. It's like a restlessness of sorts? I do not know if this is an "in spite of..." or a "because of..." anhedonia. I know that being deep in a kind of anhedonic "pit" I feel much, much worse when I am not productive. Although not a "pleasure" per se, I do feel better having some production in memory to recall at the end of the a day. "Satisfaction" from accomplishment is not pleasure in itself but it has a long half-life and it is genuinely something that makes life better for me. It's in REFLECTION rather than ANTICIPATION is probably how I'd qualify it. Can this be experienced without anhedonia? Unclear since we don't run double-blinds on ourselves, except to say that I have been on antidepressants and off antidepressants. It SEEMS that "off" antidepressants I am more anhedonic but also more productive. But I cannot say for sure whether this is real cause-and-effect or maybe just me responding to anhedonia and that the "will power" that I apply to myself to keep myself busy and productive could be applied just as well to my less-depressive state experienced whilst on the meds. As in, maybe I am happier but less motivated on some level. I tend to resist this conclusion because I despise that old saw that creative people want to be angsty because otherwise they lose their creativity. I am old enough to know, and have experienced sufficient, varied brainstates to know, that that is BS. I am not altogether sure that the increase in productivity, even IF it results from a lack of a medicated state of lowered-depressive symptoms is ultimately worth it. My current plan is to see how things develop vis a vis my depression over the next month and then determine whether I want to revisit pharmacology or not.

[@iamthefiremanjj]

Anheodnia sucks because you can even use stuff like adderall or caffeine but you don’t even feel any positive effects from it . Recreational drugs just make you dissociated or give you the adverse effects only like anxiety . You don’t enjoy any highs ; mdma , etc …. I remember I could drink 400mg of caffeine in one go and my heart rate wouldn’t even go up … I wouldn’t get that nice high to perk me up and mind you I almost rarely drink caffeine …. It’s wild it’s like the nervous system is just dysfunctional

[@fairy601]

Do you know of anything that actually has worked for you? Cause none of the stuff in this video is helping

[@iamthefiremanjj]

@@fairy601 yah cfs recovery program

[@friedmule5403]

I like your video, I am looking because I have not found anyone describing my "symptoms" I do not only not enjoy music, I simply hate it!! Imagine if everybody was listening to car alarms and baby crying, and you had to listening to that at, i.e. a restaurant, playing that over their speakers. I assume you'll get stressed, would be forced to leave and hate the experience. :-) Do my symptoms have a name?

[@RandyPaterson]

No one can diagnose without a good in-person assessment. There is a problem called misophonia that may match your experience - or this may be a misinterpretation of what you have said.

[@friedmule5403]

@@RandyPaterson Thank you so much! No to get a real diagnose do I have to ge to a person who can speak with me. My goal was also only to get a hint of what I maybe should try to investigate. :-)

[@krystilkaroshka4044]

Whoever said anhedonia is the worst ever has never experienced avolition....*cringes profusely*

[@Adrem37733]

Antidepressants and antipsycotics cause this

[@IMN14_]

So sad

[@johnpatterson6448]

Hi Randy Namesake, I find your content and honest style helpful. The word ‘anhedonia’ has been on the periphery of my awareness for a while. This is the first time I have explored it more deeply. In itself it is helpful to have the term. I see the term ‘depression’ - often conflated with ‘sadness’ - and immediately I know that person doesn’t get it. Not my situation. Although I have taught creative visualisation to others successfully, I could never generate excited anticipation myself. Your comments on feeling v action, Randy, are very enlightening in that regard.