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Recovering from severe chronic anhedonia

Recovering from severe chronic anhedonia

I've been having chats with @AuntGlow @Jynx and @rav3n about my experience of chronic severe anhedonia and how the traditional 'behavioural activation' has not produced the pleasure/reward stimulation (even when sustained for 20 years of doing!).

So I decided to start a thread because I've come to realise this is a bit more common with complex/chronic depression that I realised, and a discussion around it at a general level might be interesting & helpful to others too -- both intellectually and/or practically 😊.

I invite people to share their personal experiences (postive and negative; what has and has not worked for them or people they know), as well as interesting articles or research, or treatment perspectives that relate to the topic. 😊. I am very much a believer that "one size does not fit all" and hence welcome the diversity of experience and advice without judgement.

To kick it off, a link that @AuntGlow shared to me which I found resonated with me a lot when explaining the challenge with severe anhedonia (as opposed to 'traditional' anhedonia which does respond to standard behavioural activations techniques), and some ideas on what might help people to start that process of being able to recognise and experience neutral and progressively positive things again.

https://yung-sidekick.com/blog/severe-anhedonia-a-somatic-and-behavioral-protocol-for-rebuilding-the-capacity-for-reward

I found it very interesting also to read in a research article (https://www.clinicalkey.com.au/#!/content/playContent/1-s2.0-S2213158222000559) about the link between what is clinically termed 'treatment-resistant-depression' and a higher activity level in the part of the brain that processes/encodes adverse or negative stimuli and a diminished sensitivity to the reward-stimuli (this is when compared to "treatment-sensitive-depression" and 'healthy control' patients). So potentially it could be physiological, and "trying harder" may not work if our brain is literally not processing the positive/reward stimuli!

47 replies

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In response to: Recovering from severe chronic anhedonia

Re: Recovering from severe chronic anhedonia

Hey @Cuddlebear , what do you mean by "brain overdrive from one disaster, problem to another"?

Do you mean in terms of the fight/flight/freeze anxiety response?

In response to: Re: Recovering from severe chronic anhedonia

Re: Recovering from severe chronic anhedonia

@AlwaysMyself I mean that my brain is in like a loop mode and goes over all doom scenarios, worry about bills, showering, that something bad will happen, that someone I love will die, that I’ll never feel any better etc etc. It’s stuck in a loop going from one bad thing to another. I try to counteract those thoughts and it does not work. It happens the moment I wake up in the morning.

When that’s not happening I’m just disassociated and my brain is blank. It’s like because I can’t fight or flight my body shuts-down instead.

In response to: Re: Recovering from severe chronic anhedonia

Re: Recovering from severe chronic anhedonia

Ah, right, i understand now @Cuddlebear .

I sometimes find myself rehashing things in my brain in circles (usually for me it's annoyance/frustration, rather than anxiety though). It can be so hard to break that cycle of thoughts. I generally try to either talk to myself about what I *can* do within my control (including how i choose to acknowledge and validate my feelings, but decide to act not out of them), and/or then try to distract myself with something.

When I had anxiety attacks a year ago, the only 2 things that helped me (other than medication) was:

1. Taking a walk (ironic! It helped with the anxiety, but it has never helped me with my depression)

2. Watching comedy - the laughing response drives out the anxiety. It really worked for me. I would watch Would I Lie To You on ABC iView when I felt the dread building up.

Have you ever tried writing down what you are worried about (e.g. someone you love will die) and then trying to then list the *reasons* you think it might happen, and then rate how *likely* you think it would be, and if able the *reasons you don't think this would happen*.

It might not work as well for some worries (such as worries that you will never getting better).. but in that case you could perhaps imagine it was me or someone else on the forum who was saying it and write down instead what you would say to one of us?

I know thinking/saying and genuinely believing inside and emotions are different things and things dont always translate down. But for some people i have heard that the more they repeat something the more the belief starts to grow inside.

I don't know if that would help; i am a very brain-thinking-logic based person, so for me it probably works better than for people who are much more emotion-based?

In response to: Re: Recovering from severe chronic anhedonia

Re: Recovering from severe chronic anhedonia

I have gone through those steps you described @AlwaysMyself and have had benefits from it.

ive found writing the item down, brain storming all possible positive and negative things, weighing them up etc helps slow my mind down and helps stop the thought taking over. I also try to work out the ‘source’

eg my cats at cattery recently and my thoughts I was abandoning them, linked to my fears of being abandoned.



Years ago when my anxiety attacks were really bad, psychiatrist I was seeing advised me to do 2 things each time I felt the attack start:

1) acknowledge the feelings to myself followed by that I was ok

2) slowly extend my comfort zone.

@Cuddlebear



In response to: Recovering from severe chronic anhedonia

Re: Recovering from severe chronic anhedonia

Managed to get out for short walk this morning.

cat in carrier, on a cart and took her for walk with me.

bit of chores and that was it.

Rain and cold weather this afternoon. hrs spent with feet up, patting whichever cat was in my lap.

how was today for you both? @Cuddlebear @AlwaysMyself

In response to: Re: Recovering from severe chronic anhedonia

Re: Recovering from severe chronic anhedonia

Oh thats encouraging to hear someone else also finds it helpful too @Flutterbug9 . 😊 sometimes i don't know if my own "brain hacks" only work on me 🤣.

I find acknowledging my own feelings is really important as a first step for regulation (not just holding back the tide!). Today after my GP appointment i felt emotionally teary still (always hard talking about how MH has been) and i needed to get a few things whilst at the shops. But instead of masking and withholding the tears, i allowed myself to have tears if that was what came. I allowed myself not to smile if it wasn't natural. I decided i didnt care what others thought if they saw me walking with tears down my cheeks. For abit i still felt sad and teary, but as i got to the shop and had to focus on what i needed to get, i realised 10min later i no longer had tears or felt as sad inside. I think because i wasn't focused on "holding it in" i was able to just let it feel and slowly fade as i went about my things. (It did come back again after as i drove home, but at least for a brief while i was able to do something without feeling it).

Wondering how you are all doing today? @Cuddlebear @Captain24 @J_Oz @NightFury @MissGremlin @Flutterbug9

I still dont feel pleasure from painting, but since it is neutral i am doing it. About to start doing some now that i am back from the shops and dont have to go out again until the afternoon. Not currently in tears, so that is a good start. 😊

In response to: Re: Recovering from severe chronic anhedonia

Re: Recovering from severe chronic anhedonia

@AlwaysMyself I'm so proud of you for letting yourself just feel whatever came without trying to mask things. I'm glad you got through the shopping trip and even have some time where you didn't feel as sad and the the tears had stopped. It's ok that it came back again, those feelings and emotions will always come and go but they are always valid and it's ok to feel them.

I'm feeling a mixture of things today but I won't take over your thread sharing it all here.

Hope the painting goes well, I'm glad it's at least neutral for you.

In response to: Re: Recovering from severe chronic anhedonia

Re: Recovering from severe chronic anhedonia

The things we have both mentioned @AlwaysMyself is my understanding of schema therapy. One aspect of the different aspects I find myself fairly easily doing quite often is the brainstorming plus (where applicable) viewing things from all perspectives.

today has been a neutral day. Sorting. Semi boring yet essential, trying to thoroughly sort my garage, finding spots for items etc.

need to deal with, face and calm thoughts in my mind, today is not the day for it though. Debates within my mind with myself about new psychologist plus possible outcome of referral to a new psychiatrist.

Painting can be relaxing past time and hobby. Ability to put paint on canvas and produce art is a talent.

proud of you for letting the mask down and letting yourself show each different emotion.
I fully understand the emotions coming back once you were at home as I do exactly the same. The feelings of home is safe and can 100% be oneself.

In response to: Re: Recovering from severe chronic anhedonia

Re: Recovering from severe chronic anhedonia

@MissGremlin Do you have a thread on which you would like to chat? Maybe talk about how you are feeling, only if you want to share, no pressure. Sending hugs. 🫂

In response to: Re: Recovering from severe chronic anhedonia

Re: Recovering from severe chronic anhedonia

@Flutterbug9 I'll tag you in my thread sweet. Thankyou for the hugs ❤️.

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