Anhedonia - the inability to feel pleasure

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Anhedonia - the inability to feel pleasure

#1  Postby Keep It Real » May 13, 2014 4:52 am

Wiki Anhedonia

In psychology and psychiatry, anhedonia (/ˌænhiˈdoʊniə/ an-hee-doh-nee-ə; Greek: ἀν- an-, "without" and ἡδονή hēdonē, "pleasure") is defined as the inability to experience pleasure from activities usually found enjoyable, e.g. exercise, hobbies, music, sexual activities or social interactions. While earlier definitions of anhedonia emphasized pleasurable experience, more recent models have highlighted the need to consider different aspects of enjoyable behavior, such as motivation or desire to engage in an activity ("motivational anhedonia"), as compared to the level of enjoyment of the activity itself ("consummatory anhedonia").[1]
...
Anhedonia can be a characteristic of mental disorders including mood disorders, schizoaffective disorder, schizoid personality disorder and schizophrenia. For example, people affected with schizophrenia often describe themselves as feeling emotionally empty.[3]
...
Causes
Researchers theorize that anhedonia may result from the breakdown in the brain's reward system, involving the neurotransmitter dopamine. Studies by Paul Keedwell, MD, then of King's College, found that the brains of participants who were clinically depressed had to work harder to process rewarding experiences.[5][6] While earlier research believed dopamine to be primarily involved in the subjective experience of pleasure, the last 20 years has seen a conceptual shift, such that dopamine is now believed to underlie various aspects of reward anticipation, learning, and motivation.[7][8][9]

Anhedonia is also a relatively common side effect of antidopaminergic neuroleptics or antipsychotic drugs.


I have schizophrenia, entailing the consumption of antipsychotic (dopamine inhibiting) drugs to stop the paranoid delusions. I also have Anhedonia. It seems likely this Anhedonia is a result of taking the antipsychotics. I've never been told this by a mental health worker. It's as if it's been kept secret to stop me from refusing the dopamine blockers. No wonder suicide rate is at 5% for schizophrenics if we're all on meds which remove the pleasurable sensations normally found in life. There has to be a better way...
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Re: Anhedonia - the inability to feel pleasure

#2  Postby Keep It Real » May 13, 2014 5:05 am

http://en.wikipedia.org/wiki/Schizophrenia

Positive and negative
Schizophrenia is often described in terms of positive and negative (or deficit) symptoms.[16] Positive symptoms are those that most individuals do not normally experience but are present in people with schizophrenia. They can include delusions, disordered thoughts and speech, and tactile, auditory, visual, olfactory and gustatory hallucinations, typically regarded as manifestations of psychosis.[17] Hallucinations are also typically related to the content of the delusional theme.[18] Positive symptoms generally respond well to medication.[18]

Negative symptoms are deficits of normal emotional responses or of other thought processes, and respond less well to medication.[8] They commonly include flat expressions or little emotion, poverty of speech, inability to experience pleasure, lack of desire to form relationships, and lack of motivation. Negative symptoms appear to contribute more to poor quality of life, functional ability, and the burden on others than do positive symptoms.[19] People with greater negative symptoms often have a history of poor adjustment before the onset of illness, and response to medication is often limited.[8][20]


My bold: These three negative symptoms can all be explained by the damage that dopamine inhibiting antipsychotics do to the brain.
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Re: Anhedonia - the inability to feel pleasure

#3  Postby Scar » May 13, 2014 8:05 am

Interesting. I'm in meds against my depression and I feel exactly these symptoms when I'm off them. I can see how this is troubling you.
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Re: Anhedonia - the inability to feel pleasure

#4  Postby Keep It Real » May 13, 2014 8:18 am

Are the anti-depressants you're taking SSRI's Scar? Maybe the problem is common to dopamine and seratonin - where a low level of neurotransmission leads to anhedonia and a boost is required - perhaps the type of neurotransmitter isn't so much the problem. Nevertheless, post one does state dopamine system interference is the cause, not (so much?) seratonin.
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Re: Anhedonia - the inability to feel pleasure

#5  Postby Scar » May 13, 2014 9:06 am

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Re: Anhedonia - the inability to feel pleasure

#6  Postby Keep It Real » May 13, 2014 9:29 am

A selective seratonin re-uptake inhibitor then. I'm so glad it seems to be working for you : )

http://en.wikipedia.org/wiki/Seratonin

There is investigation into whether SSRIs benefits to mood are somehow related to dopamine receptor sensitivity indirectly influenced by antidepressant mechanisms. In one study, patients with depression taking an SSRI were given low dose D2 receptor antagonist administration, and reported negative effect on mood.[91]


Clinical studies have not yet determined a common mechanism of action for antidepressant drugs, which have primary sites of action on a variety of different neurotransmitter systems. However, a large body of evidence from animal studies demonstrates that sensitisation of D2-like dopamine receptors in the mesolimbic dopamine system may represent a ‘final common pathway’ in antidepressant action...
These data are consistent with the hypothesis that sensitisation of D2-like receptors may be central to the clinical action of SSRIs.


So it seems like if you've got dopamine antagonists active then SSRI's would be innefective, unfortunately. I was on some antidepressants a while back (while taking the dopamine blocker/antagoniser flupentixol (depixol)) but found they did nothing for me. I guess this explains why. Pointless they were prescribed to me really. Looks like my psychiatrist was poking around in the dark.
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Re: Anhedonia - the inability to feel pleasure

#7  Postby Ironclad » May 13, 2014 10:27 am

You could tell the doctor, you might be on to something not considered.
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Re: Anhedonia - the inability to feel pleasure

#8  Postby Keep It Real » May 13, 2014 10:50 am

I spoke to my CPN (Community Psychiatric Nurse) half an hour ago, but didn't mention the inefficacy of SSRI's. I will at some point. At the moment I think I'll get some MCT (metacognitive skills training, privately financed) and refuse many more depixol injection.
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Re: Anhedonia - the inability to feel pleasure

#9  Postby Keep It Real » May 13, 2014 9:24 pm

CBT/MCT booked for tomorrow morning 11am. I'm going to get me my dopamine highways back - see beauty and light once again! Even if that does mean going on the run (I'm currently subject to a community treatment order) any reasonable inconvenience is worth foregoing in order to get my zest for life back - with the CBT/MCT there should be little chance of another psychotic breakdown IMO. Fuck me it seems risky though still, gotta do it. Lying in bed saying "death death death die die die" all day is unbearable.
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Re: Anhedonia - the inability to feel pleasure

#10  Postby Keep It Real » May 21, 2014 7:07 am

The CBT therapist I saw seemed really incompetent. I need to be referred to an accredited specialist in MCT I think. I'm due an injection at 10:30 today. If I refuse I'll probably be sectioned again and have it forcibly administered. I'm going to refuse the injection anyway - I just can't stand to have that shit in my brain, now that I know it's fucking me up. Wonder what will happen...
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Re: Anhedonia - the inability to feel pleasure

#11  Postby Nicko » May 21, 2014 7:23 am

Keep It Real wrote:The CBT therapist I saw seemed really incompetent. I need to be referred to an accredited specialist in MCT I think. I'm due an injection at 10:30 today. If I refuse I'll probably be sectioned again and have it forcibly administered. I'm going to refuse the injection anyway - I just can't stand to have that shit in my brain, now that I know it's fucking me up. Wonder what will happen...


The professionals responsible for your treatment cannot take into account symptoms that you have not disclosed. Better that you work with them to find a balance of medication that deals with the schizophrenia without making you want to top yourself than to get sectioned and have what you're on now forcibly administered without any input from you.

It's a shitty situation you're in; the lesser of two evils may be the best you can expect at the moment.
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