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Anhedonia

Posted , 8 users are following.

RHGB
RHGB

This is commonly discussed in depression and mental illness forums etc, but although it affects substance abuse withdrawals, it hardly gets a mention.

Anybody who has ever given up alcohol and then found that they have no enthusiasm for life or any activies that they previously enjoyed, hold no interest anymore. In fact, lacking in enthusiasm for just about anything, will know this feeling, this is anhedonia.

I'll try to keep the copied items short, obviously I can't provide links, but I'm sure we all know how to use Google.

Much of the battle of recovery is a hidden, quiet affair.  After the shakes subside and a person is considered stable enough to have survived acute withdrawal symptoms, the recovering addict has a hard slog ahead.PAWS affects people recovering from different substance addictions.  Symptoms of PAWS can include depression, anhedonia, loss of concentration, craving, sleep disturbances, stress sensitivity, anxiety, and guilt.

Anhedonia refers to a physical loss of one’s ability to experience pleasure.  Though drug cues continue to elicit craving and the promise of that elusive pleasure, natural sources of pleasure will feel as if they’ve utterly lost their charms. We know that anhedonia occurs upon abstinence from the addictive substance.

 Anhedonia is the result of changes in the dopaminergic mesolimbic and mesocortical reward circuit, involving the ventral tegmental area, the ventral striatum, and part of the prefrontal cortex. The inactivation of dopamine in these areas is proposed to lead to anhedonia, though more research is needed to be certain

The evidence of anhedonia’s link to addiction is well documented.  One study (2009) presented pleasant pictures to a control group and to a group of heroin addicts and found that heroin users had reduced responsiveness to these natural reinforcers, “across a range of psychophysiological measures.”  They found that, furthermore, their subjective ratings of the pleasant pictures predicted future heroin use.

Other studies have also documented that anhedonia occurs and persists in recovering addicts, and several of them emphasize that anhedonia is a significant indicator of relapse.

I'm always a great believer in understanding why you have these symptoms and it is always easier to deal with them if you know what and why, rather than just feeling out of sorts, with no guide to dealing with it.

I didn't want to put any more in one post, if the thread develops then perhaps look at ways of dealing with it, but it is still not understood 100%. Anyone going to an ARC and has a sense of humour (not me, I don't do things like this), ask your counsellor about it and enjoy the blank stare.

 

1 like, 30 replies

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  • Sober_As
    Sober_As RHGB

    Posted

    Thanks for the interesting info. RHGB.

    I will add Anhedonia to the list of things I suffer from.

    I'm still waiting for a Miracle !

    Alonangel 🎇

  • Misssy2
    Misssy2 RHGB

    Posted

    I wholeheardetly agree that when we are aware of what is happening to us...it makes recovery easier....

    I heard about PAWS in 2005....when I had quit for the 8 years.  When I knew certain things would continue to happen to me for a period of time of up to a YEAR.  I was able to get thru those things without drinking.

    Example: with PAWS....a person can drop things alot, forget things that you know, have less patience (just a few symptoms).  Everytime I quit before 2005 and these things happened to me...I would become so frustrated and would convince myself that while DRINKING...I was more "perfect" and didn't have these problems and I thought I HAD to drink to get better.  

    What I learned from the Doctors was I had to go thru these things and at a point..my brain would heal...and I would get BETTER.  I did.

    This Anhedonia....I wonder if this is also an organic condition (prior to introducting any wet or dry substance into our bodies)?  Because prior to me EVER drinking..I had no enjoyment in any activity.  It wasn't until I started drinking early on (about 15)...that I started to enjoy things like nature, activity, fun stuff and thenI formed the believe that I had to DRINK to enjoy stuff...so when I stopped...I just re-inforced that believe that DRINKING was the only way I could enjoy stuff.

    Till my drinking progressed...and the only place I ended up for activity (intraveneous, heart monitoring, medication introduction) was in the d*mn hospital!

    • RHGB
      RHGB Misssy2

      Posted

      Oh yes, it isn't just substance withdrawal, it is part of derpression.

      'This is a little-studied area of depression. It was first observed by the Victorians, but has prompted little investigation since. Someone suffering from it has little or no ability to feel pleasure from normally pleasurable experiences. Basically, it sucks the joy out of most things that make life worth living - food, sex, relationships and achievements. They no longer make sense as something which would prompt an emotional response. It's emotional dyslexia, if you like. You know what the occasion is; you just can't rise to it.'

      And there is a fair bit of info regarding it and depression. But less so about susbstance withdrawal. And it is something I have seen many people say, what is the point of giving up, if I'm going to feel no enjoyment for the rest of my life. I may as well die a happy alcoholic. Which points to the comment above, about it being an indicator of relapse.

      Plus this is an alcohol forum and it is relevant to that.

    • Misssy2
      Misssy2 RHGB

      Posted

      I've even said in the past...whats the point of quitting, I'd rather die a happy alcoholic....UNTIL...I was no longer HAPPY being an alcoholic sad...Wish I could be....Wish I did not get so sick.....but thats my life story now.

      I think pretty much everything we learn or read pertains to us as alcoholics...because most of the stuff is NEW to us....and we need to learn everything we can and have every tool to combat the demon!

    • Misssy2
      Misssy2

      Posted

      Good luck Monday RHGB.....In case I get wrapped up in the day and weekend...I just recalled that you are going now...so before I forget...good luck. 

      Look to the past and all your procedures..you have gotten thru and you will get thru this as well.....Hopefully they give you some sort of relaxant to ease the panic.

    • RHGB
      RHGB Misssy2

      Posted

      Thanks, but this Monday is just to visit, view the scope and have a discussion with them about whether I will panic or not. It is my last chance to pull out. I have a liver scan on Saturday 18th at lunchtime (no food or liquids in the morning) Birthday is 19th then back on the 21st for endoscopy if I don't bottle it next week. What a wonderful weekend it's lining up to be (not).
  • Misssy2
    Misssy2 RHGB

    Posted

    Additionally, I would NEVER bring this word up to my Dr.  Because my Dr. but maybe a psychiatrist...but either way....I think the BLANK stare is they get p*ssed off when you know anything about medical or try to diagnose yourself.

    I learned that lesson.....I have a new Doctor and I let her rule the appointment and come up with my diagnosis.  I will take Newspaper articles or magazine articles and brush them past her...They like to be looked UP to...and felt to be the ones that have the answers.  

    Its hard for me to NOT let them know that I KNOW what my diagnosis is...but if I describe the symptoms clearly enough..and act like I NEED her input...I get treated MUCH better.....and the trust bond is much easier to develop.

     

  • nicole36330
    nicole36330 RHGB

    Posted

    That's why we need these new drugs to reset our brains to pre alcohol addiction

    Not that it seems to be working for me but I'm persevering

  • ADEfree
    ADEfree RHGB

    Posted

    Yes. As I understand it, the Nucleus Accumbens is part of the Ventral Striatum and that's where pleasureable events are remembered. The Dorsal Striatum stores the instructions to compel one to repeat the steps that lead to pleasure. It doesn't actually feel any pleasure itself, it has no feelings at all. Nor does it know good from bad. Nor does it respond to logic or reason.  

    One of the problems with taking Naltrexone every day to maintain abstinence is that endorphins are suppressed almost continuously and desireable behaviours can't be learned/reinforced. The timing of the response to craving and the denial of reward is important too, but eventually that drinking behavior needs to be replaced with some other pleasureable behavior. The short term upregulation of the receptors caused by taking the Naltrexone can be exploited in this sense, as they will be more sensitive to endorphin release and reward for the healthier activity will be reinforced more easily than usual. 

    The same anhedonic state can lead to drug abuse as well, as can be seen where an underlying mental illness (like depression or anxiety) results in comorbid substance abuse. 

    "Anyone going to an ARC and has a sense of humour (not me, I don't do things like this), ask your counsellor about it and enjoy the blank stare."

    Well, if you simply blame the addict, then you really don't have to know about any of that. Let the 90% who can't toe the line die and make a good example for the 10% that can. 

    • ursulauc62
      ursulauc62 ADEfree

      Posted

      Hmmnn - this is one of the things I was diagnosed with by a psychiatrist about a year ago. I hadnt heard the term before, and had to look it up.

      I did have this feeling for quite a while when attempting not to drink. I didnt think there was any point in going out and socialising because I couldnt drink, so became pretty reclusive and lost touch with alot of friends. 

      Alot of these were people who knew me for years as somone who enjoyed a drink like everyone with us, but never would have classed me as someone with a problem. I could control my intake of units and always knew when to stop.  So there was some puzzlement when I no longer seemed able to do this, or to even have alcohol in the house.

      It sometimes seems almost as hard for friends to come to terms with the 'new you' as yourself. 

      I have learned to find pleasure in other things. One of the first really big kicks I got which for me surpassed alcohol was when I discovered snorkelling - on a coral reef. Amazing experience - I couldnt get enough of it.   Unfortunately I dont live anywhere where I can do that as a regular thing - would be nice! But I holiday in places where I can do it if possible.

      Gradually it is possible to find enjoyment elsewhere and in very simple experiences, like having a good laugh, reading a good book, or simply cuddling my lovely - amazingly soft, wonderful cat - like now!  Whenever I sit down at the computer he comes over and moans at me and walks all over the keyboard until I let him onto my lap. 

      However I still have very little of a social life, which is something me and my husband keep saying we will have to 'sort out' - but seem to keep putting off.

    • RHGB
      RHGB ursulauc62

      Posted

      Too tired tonight, but will come back tomorrow, to such a nice post.
    • tess33005
      tess33005 ursulauc62

      Posted

      Cats! All mine walk over the keyboard and frequently step on buttons which confuse the laptop so I end up on a completely different website, or staring with bewilderment at a screen that is asking me things I don't understand.

      But to go back to the topic - I did experience this, big time, and it took a lot of effort to get back into doing things for pleasure. I surprised myself once I'd joined a new choir (I had been in a very good one for years) and found myself totally committed to it, and looking forward to rehearsals.

      The night I sang in my first concert for five years is something I still cannot think about without bursting into tears. I don't remember getting home after it. I think I floated. I still remember that buzz and sense of joy.

      Having done that, I was soon up to all kinds of things which were of interest to me.

      Looking back, I realise that depression was very much holding me back, but I pushed through (eventually) and it was worth it.

      Thank you, RHGB, for cutting and pasting that. It was very interesting.

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