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

by Wayne Drevets, MD, established leader in neuropsychiatry, Johnson & Johnson Innovative Medicine

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 that lasts for hours, days, or even weeks at a time. This feeling, known as anhedonia, 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 better identify and manage your symptoms and empower you to discuss possible treatment options with your healthcare provider.

What is TDM?

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 last over time and negatively affect a person’s usual functioning, often presenting differently in people, which can make diagnosis a difficult path. An estimated 280 million people worldwide currently live with MDD.

What is anhedonia?

Anhedonia, one of the two cardinal symptoms of a major depressive episode, is defined as the inability to enjoy experiences or activities that you once found pleasurable, such as eating your favorite foods, listening to music you normally enjoy, or engaging in hobbies. Anhedonia can be described as numbness or emptiness, where you simply cannot feel anything. Relationships become a struggle and there is no motivation to spend time with others. Basically, 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 find it difficult to describe their experience with it. They often say things like, ‘I feel like I’m living in a black and white world when everyone else lives in color,’ or ‘Sometimes I feel like a blank slate and I don’t want to do anything,’” shares the Dr. Craig Chepke, MD, DFAPA, board-certified psychiatrist, medical director of Excel Psychiatric Associates and adjunct associate professor of psychiatry in the Sandra and Leon Levine Psychiatry Residency Program at Atrium Health.

Nearly 70% of people who take an antidepressant to treat their MDD continue to experience symptoms of depression despite medication use.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 is being done to help us better understand the biological causes. What we do know is that factors such as chronic stress, inflammation, and other conditions can lead to a reduction in our ability to form a link between goal-oriented behavior and our enjoyment of pleasurable activities. This means that when we experience anhedonia, our brain is less motivated by the things we normally enjoy doing, resulting in a general feeling of numbness or emptiness. Researchers are investigating ways to restore normal activity in 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 who suffers from anhedonia and MDD?

If left untreated, anhedonia can have a major effect on physical and mental 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 and understand how to spot the signs of anhedonia.
  • Recognize how anhedonia affects daily life; This may be different for each person, so it may be helpful to check it out yourself or ask the person if they have noticed any changes in how they feel.
  • Tell your healthcare provider about your symptoms so they can help you find a solution to help you regain interest in experiences you used to find pleasurable.

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 health professional. He would advise people who think they may be experiencing anhedonia to be direct and say, ‘I read about anhedonia and it sounds a lot like what I feel, can we talk about it?’”

By having the ability 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 screening, visit the MHA website. National Detection and Prevention Program website.

***

Wayne Drevets, MD, is a disease area leader in neuropsychiatry for neuroscience at Johnson & Johnson Innovative Medicine, where he leads a cross-functional team in developing J&J’s portfolio of novel therapies for psychotic and mood disorders, a leader in the industry. Dr. Drevets has published more than 390 articles and chapters and has been cited more than 80,000 times in the 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 therapies for mood and psychotic disorders. .

Craig Chepke, MD, is a board-certified psychiatrist in clinical practice as medical director of Excel Psychiatric Associates in Huntersville, North Carolina, and is an adjunct associate professor of psychiatry in the 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 CME family of conferences and has been recognized as a Distinguished Fellow of the American Psychiatric Association.

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

References

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

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