Understanding Anhedonia and Rediscovering Pleasure

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Watching a young person lose pleasure in the things they used to enjoy can feel heartbreaking. They may no longer enjoy spending time with friends, lose interest in their hobbies, and be unaffected by their passions.

Adehonia – the loss or reduced ability to experience pleasure – can affect young people for a variety of reasons. It may be precipitated by loss or grief, times of stress, or other distressing situations. Most of the time, anhedonia is a symptom of a mental health disorder like depression, bipolar, or post-traumatic stress disorder and may be accompanied by other feelings like hopelessness or low self-esteem.

The good news is that young people can recover from anhedonia and enjoy the things they love again. Treatment approaches like cognitive behavioural therapy (CBT) or medication can help teenagers and adolescents overcome anhedonia and other symptoms of depression.

Trauma-focused therapies – such as trauma-focused CBT and EMDR – may support young people to process past trauma that is clouding their experience of life.

This blog offers some information on what anhedonia is, why it happens, and the treatment available for young people.

What Is Anhedonia and Why Does It Happen?

Anhedonia is the decreased ability to find pleasure in things that were once enjoyed, from reading books to enjoying nature to sharing things with others.

Young people with anhedonia also often lack the motivation to do the things they used to love or even to try new things. They may feel like there’s no point trying when they can’t enjoy anything.

Scientists aren’t sure exactly what causes anhedonia. Neurological studies of the brain suggest that it results from – or is a part of – a complex interaction of changes in different regions of the brain. 

Some of these changes relate to what’s known as the reward pathway. The reward pathway is a network in the brain involved with motivation. It helps to reinforce certain activities, making it more likely that we’ll repeat them again. Neurotransmitters (brain chemicals) such as dopamine and natural opioids play an important role in our reward system, as well as in our experience of emotions.

Brain imaging and other research suggest that the reward pathways of young people with anhedonia may not work as well as in other young people. This may lead to decreased motivation to engage in activities – even ones that were previously enjoyed. Changes in reward system functioning are likely to be connected to unbalanced levels of dopamine and other neurotransmitters which may affect a young person’s ability to experience positive emotions like pleasure.

Scientists have also pointed to the role of our bodies’ stress responses in anhedonia and other symptoms of depression. Prolonged or chronic stress may lead to changes in our immune systems, which may lead to brain inflammation. Research has found that brain inflammation among people with depression affects their reward circuits and may lead to decreased motivation and anhedonia.

What Are Some Signs of Anhedonia?

If you’re worried that a young person may be experiencing anhedonia, there are some signs you can look out for. These include:

  • withdrawing socially or social isolation
  • finding daily activities less pleasurable than before
  • withdrawal from relationships
  • loss of interest in previous hobbies or passions
  • decreased interest in sex or physical intimacy

Some experts think that two main types of anhedonia: social anhedonia and physical anhedonia. Young people with physical anhedonia may stop enjoying tactile sensations, like being touched, hugging, or having sex. Those with social anhedonia, on the other hand, may experience decreased enjoyment in social interactions and interpersonal relations, like speaking with friends or sharing common interests. 

Other literature, however, suggests that these categories are not really meaningful or useful, and it’s better to think of anhedonia as a whole.

If you think that a young person may be struggling with anhedonia, it’s important to speak with a mental health professional for expert help and support. They can offer an accurate diagnosis of the young person’s experience and identify any wider mental health conditions that may require treatment.

How Can Young People Overcome Anhedonia?

While anhedonia can cloud every part of a young person’s life, there is help and support available. Anhedonia, and the mental health disorders that may surround it, is treatable and with effective support teenagers and adolescents can rediscover the joy in life.

Some of the treatment approaches that may treat anhedonia include:

  • Talk therapy, including cognitive behavioural therapy and behavioural activation therapy
  • Medication
  • Creative arts therapy
  • Yoga, meditation, and other mind-body approaches

Depression and anhedonia are serious mental health concerns and recovery isn’t always easy. Some young people may require a combination of treatment approaches and long-term support to make a full recovery. It’s important that young people receive the care and encouragement they deserve throughout the recovery process.

Talk Therapy

Talk therapies like cognitive behavioural therapy (CBT) can help young people to identify negative thoughts and behavioural patterns and turn them into more positive ones. CBT also involves learning skills and strategies to manage and cope with situations and difficult emotions.

Behavioural activation is a specific skill of CBT that can also be offered as a stand-alone therapy. Behavioural activation therapy helps young people to understand how their behaviours influence their emotions. It can help them to learn what things can trigger changes in mood, what things make them feel better, and what things make them feel worse.

Specifically, behavioural activation emphasises the cycle of depression, whereby a decreased interest in activities causes people to do fewer things. This often makes their depression worse, decreases their interests further, and along with it their activities.

Behavioural activation therapy teaches young people to start doing activities even when they don’t want to or think they won’t enjoy it. It’s based on the idea that young people can still benefit from the positive effects an activity may have on their well-being before they’re motivated to do it. As their depression improves, young people will start finding these activities enjoyable again, leading to an upward cycle of recovery.

Medication

Anti-depressant medication like SSRIs (selective serotonin reuptake inhibitors) can help to treat anhedonia. Anti-depressant medication is usually offered alongside a long-term treatment like CBT or other types of therapy.

Creative Arts Therapy and Mind-Body Approaches

Alternative treatment approaches like creative arts therapy or mind-body therapies may also help to treat anhedonia in depression, schizophrenia, and other mental health disorders. Research has found that motivational interviewing using group art therapy helps to improve motivation and pleasure in people with schizophrenia. Arts therapy may also effectively treat depression, trauma-related disorders, and bipolar disorder.

Mind-body approaches such as yoga therapy may also help young people to start feeling pleasure again. Yoga may help to reduce stress and improve well-being by affecting the nervous system and the balance of hormones in the brain.

The Wave Clinic – Specialist Recovery for Teenagers, Adolescents, and Young People

The Wave Clinic offers transformative recovery programs for young people, supporting them to build life advantage. Our trauma-focused programs draw on expertise from all around the world, combining their exceptional experience to make a difference in the lives of young people. We emphasis fairness, inclusivity, and acceptance in everything we do, ensuring that no young person goes without the care that they deserve.

The Wave is the only program in the world to combine clinical and medical care with education, community projects, and a gap year experience. We support young people to rediscover themselves and plan for the future, laying down the foundations for a strong and resilient recovery that lasts. We offer vocational qualifactions alongside secondary and tertiary qualifications, helping young people develop the skills they need to follow their dreams.

If you’d like to find out more about our programs, reach out to us today. We’re here to help.

Fiona - The Wave Clinic

Fiona Yassin is the founder and clinical director at The Wave Clinic. She is a U.K. and International registered Psychotherapist and Accredited Clinical Supervisor (U.K. and UNCG).

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