Guest blog: The Enduring Numbness of Depression Has a Name: What You Need to Know About Anhedonia

This post was sponsored and developed by Johnson & Johnson Innovative Medicine

People living with major depressive disorder (MDD) may describe feelings of numbness, emptiness, or a complete loss of motivation, interest, or pleasure lasting for hours, days, or even weeks at a time. Known as anhedonia, this feeling is a core symptom of depression that many people may be unfamiliar with, even those who have experienced it firsthand. If you or someone close to you has been diagnosed with MDD, learning about anhedonia can help you to better identify and manage its symptoms and empower you to discuss potential treatment options with your healthcare provider.

What is MDD?

MDD, or clinical depression (commonly called ‘depression’), is a mood disorder that causes persistent feelings of sadness along with loss of interest and pleasure. Depression is diagnosed by the presence of multiple symptoms that endure over time and negatively affect a person’s usual functioning, often presenting itself differently in people, which can make diagnosis a difficult journey. It is estimated that 280 million people worldwide currently live with MDD.

What is anhedonia?

One of two cardinal symptoms of a major depressive episode, anhedonia is defined as the inability to enjoy experiences or activities that were once pleasurable to you, such as eating your favorite foods, listening to music you usually like, or participating in hobbies. Anhedonia can be described as numbness or emptiness – where you just can’t feel anything. Relationships become a struggle, and there is no motivation to spend time with others. Essentially, anhedonia is the persistent inability to feel pleasure or joy.

“In my clinical experience, people with depression have never heard the word ‘anhedonia’ and often have a hard time describing their experience with it. They will often say things like, ‘I feel like I’m living in a world of black and white, when everyone else lives in color,’ or, ‘Sometimes I just feel like a blank slate, and I don’t want to do anything at all,’” shares Dr. Craig Chepke, M.D., DFAPA, board-certified psychiatrist, Medical Director at Excel Psychiatric Associates, and Adjunct Associate Professor of Psychiatry at the Sandra and Leon Levine Psychiatry Residency Program at Atrium Health.

Nearly 70% of people taking an antidepressant to treat their MDD continue to experience depression symptoms despite the use of medication.1 These are known as residual symptoms, and anhedonia is one of the most commonly reported residual symptoms when taking an antidepressant.1

What causes anhedonia?

While it is not known what causes anhedonia, research to help us better understand the biological causes is ongoing. What we do know is that factors such as chronic stress, inflammation, and other conditions can lead to the reduction of our ability to form a link between goal-oriented behavior and our enjoyment of pleasurable activities. This means that, when experiencing anhedonia, our brains are less motivated by the things we usually enjoy doing, resulting in the general feeling of numbness or emptiness. Researchers are investigating ways to restore normal activity in the brain circuits involved in reward processing and learning in people living with depression, potentially reducing or eliminating anhedonia.

What can be done to help someone experiencing anhedonia with their MDD?

Left untreated, anhedonia can have a major effect on both mental and physical health. This includes developing more severe depression, social isolation, anxiety, suicidal thoughts, and malnutrition. If you or someone close to you may be experiencing anhedonia, it is important to:

Learn about and understand how to spot the signs of anhedonia.
Recognize how anhedonia impacts daily life – this can look different for everyone, so it may be helpful to check in with yourself or ask the person if they’ve noticed any changes in how they’re feeling.
Tell your healthcare provider about your symptoms so they can assist you in finding a solution that helps you regain your interest in experiences you used to find enjoyable.

Dr. Chepke advises his patients that, “Knowledge is power, and simply having access to the word ‘anhedonia’ can be the key to talking about it with a healthcare professional. I’d recommend people who think they may be experiencing anhedonia to be direct and say, ‘I read about anhedonia, and it sounded a lot like what I feel – can we talk about it?’”

By being empowered to identify the symptoms they are feeling, patients can work with their healthcare providers to navigate their MDD diagnosis and treatment options to help reduce anhedonia and improve overall depression outcomes.

For more information, and to take a mental health screen, visit MHA’s National Screening and Prevention Program website.

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Wayne Drevets, M.D., is the Disease Area Leader in Neuropsychiatry for Neuroscience at Johnson & Johnson Innovative Medicine, where he leads a cross-functional team in the development of J&J’s industry-leading portfolio of novel therapeutics for mood and psychotic disorders. Dr. Drevets has published more than 390 articles and chapters and has been cited more than 80,000 times in scientific literature. His research focuses on characterizing the neurocircuitry of mood disorders, elucidating the mechanisms underlying antidepressant and mood-stabilizing therapies, and the discovery and development of novel therapeutics for mood and psychotic disorders.

Craig Chepke, M.D. is a board-certified psychiatrist in clinical practice as the medical director of Excel Psychiatric Associates in Huntersville, N.C., and is an Adjunct Associate Professor of Psychiatry for Sandra and Leon Levine Psychiatry Residency Program at Atrium Health. His clinical and academic interests include difficult-to-treat mood disorders, ADHD, sleep medicine, and pharmacology. Dr. Chepke is the Scientific Director of the Psych Congress family of CME conferences and has been recognized as a Distinguished Fellow of the American Psychiatric Association.

The views and opinions expressed in this blog solely belong to the author, and external content does not necessarily reflect the views of Mental Health America.

References

1 Israel JA. The impact of residual symptoms in major depression. Pharmaceuticals (Basel). 2010;3(8):2426-2440.