It’s normal to have stressful times in your life when you don’t feel like doing anything, and most people go back to being themselves once everything has been resolved. If you find yourself avoiding things you love, like getting together with your closest friends or engaging in a favorite sport, for a long time, you might be living with either apathy or anhedonia. These are two similar, but distinct conditions.
The good news is that you can overcome them.
Highlights
- Anhedonia and apathy often have overlapping symptoms, but they are distinct conditions.
- Anhedonia refers to a reduced ability to feel pleasure, while apathy refers more to a loss of motivation.
- Treatment for either condition depends on what is causing it in the first place.
- A combination of medication and therapies may help improve symptoms. It’s important to reach out to a mental health provider to find the right course of action.
What Is Anhedonia?
Anhedonia is officially described as “markedly diminished interest or pleasure in all, or almost all, activities.” It is one of the core symptoms of depression but you can also have anhedonia if you have PTSD, anxiety, eating disorder, schizophrenia, autism spectrum disorder, substance abuse disorder, or some neurodegenerative disorders.
If you have anhedonia, you don’t feel much or any joy engaging in fun activities like you usually would; you feel great difficulty in planning anything, and you feel no excitement or enthusiasm for upcoming pleasurable things. You may also feel less or no pleasure when you engage in recreation or social events and may stop attending those events altogether. Even eating good food or engaging in sexual activity may bring you less or no pleasure.
There are two types of anhedonia that
- Social anhedonia: Getting little or no pleasure from social or interpersonal situations.
- Physical anhedonia: Getting little or no pleasure from physical sensations such as the taste of food, the smell of flowers, or physical touch.
Typically, to get rid of anhedonia, you’ll need professional help, especially if it appears to be a symptom of a mental health condition.
What Is Apathy?
Apathy is similar to anhedonia because it is also seen in people living with depression and other brain conditions such as schizophrenia, traumatic brain injury, dementia, and neurodegenerative disorders like Alzheimer’s and Parkinson’s diseases.
If you have severe apathy, you may have difficulty with executive functioning, meaning you have issues with organizing or planning anything. You may feel indifferent to life and have trouble initiating anything.
There are
- Emotional apathy: Characterized by a lack of negative and positive emotions.
- Behavioral apathy: Characterized by a lack of self-motivation.
- General apathy: Characterized by low motivation, poor emotional responses, and low social engagement.
Just like it works for anhedonia, to deal with apathy, you may need professional help in severe cases.
How Anhedonia and Apathy Are Similar
Both anhedonia and apathy may present as a lack of motivation and desire to do fun things. You may also feel like you don’t care about the world around you. Also, these feelings are typically (but not always) signs of depression or other brain or mental health conditions.
Apathy vs Anhedonia: Key Differences
Some of the aspects of apathy and anhedonia overlap, but there are distinct differences. Apathy refers more to the motivation to do things, and anhedonia refers more to the loss of pleasure.
Another big difference between the two is that apathy is often — but not always — connected to neurodegenerative disorders such as Parkinson’s Disease and Alzheimer’s disease. Anhedonia, on the other hand, is the main symptom of depression and can often be related to substance use disorder or mental conditions like schizophrenia or bipolar disorder. See below for apathy vs anhedonia distinctions.
- Lack of motivation to do anything
- Blunted feelings
- Feeling indifferent to life
- Not seeing the importance of social relationships anymore
- No desire to make goals of any kind
- Executive functioning issues, such as no desire to plan or organize anything
- Less interest in taking care of your health
- Difficulty in making simple decisions, such as what to order on a menu
- Less interest in events that normally would matter
- Less empathy for others
- Tendency to stay home more often (especially with severe apathy)
- A core symptom of depression
- Feeling a lack of pleasure for anything (either a lack of anticipation or a lack of enjoyment during the activity)
- Having no desire to socialize even though you know it’s important
- Loss of excitement even in usual activities such as eating, socializing, or sex
- Not looking forward to anything with excitement
- Feeling fewer emotions
Causes and Risk Factors
Anhedonia
Possible risk factors for anhedonia include increasing age, depression, schizophrenia, Parkinson’s disease, autism spectrum disorder, substance abuse disorder, and a variety of neurodegenerative disorders. There seems to be a strong genetic component, so you are at higher risk if you have a family history of anhedonia. New research is looking into a possible connection between anhedonia and inflammation in the brain, and issues with dopamine in the striatal and prefrontal areas of the brain.
Apathy
Risk factors for apathy include having depression, schizophrenia, traumatic brain injury, Alzheimer’s disease, Parkinson’s disease, or dementia. Research is looking into the root cause of apathy and has found several areas of the brain that have disruptions in function, such as the medial frontal cortex, the posterior cingulate cortex, and others. There is no one definite cause of apathy, and it may not be exactly the same from person to person. There does not seem to be a genetic component to apathy.
Symptoms
The symptoms of the two conditions may overlap, but there are some differences that can help you understand which one you are experiencing and feeling. Common symptoms include:
Anhedonia:
- Feeling no excitement in things you feel through your five senses: taste, touch, smell, sight, or sound.
- Experiencing fewer emotions and some depression symptoms.
- Feeling no desire to do things even if you know they’re important (socializing, exercise, keeping up with relationships, etc.)
- Feeling low or no excitement for pleasurable things: food, sex, recreation.
Apathy:
- Feeling no motivation
- Experiencing the usual emotions but more blunted
- Feeling indifferent, having an apathetic mood
- Not wanting to make any goals or plan anything
- Feeling less empathy for other people
- Staying home more often
- Not caring about social relationships anymore
If you find the above explanations relatable and are wondering how to get rid of anhedonia or apathy, it’s important to reach out to a mental health professional before these symptoms start affecting your quality of life.
Treatment Options
There are several anhedonia and apathy treatments available. You will work with your mental healthcare professional to find the solution that works best for you.
The most important part of finding a treatment is to know what is causing your apathy or anhedonia in the first place. This can help your doctor choose the best therapy approach or medication.
Medication
For anhedonia, the first-line treatments are usually traditional antidepressant medications. Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) have not been very successful but studies show that pramipexole, vortioxetine, ketamine, and bupropion (particularly combined with dextromethorphan) can be beneficial — as well as some other medications.
Unfortunately, for apathy, many reports show that selective serotonin reuptake inhibitors can worsen apathy if it is connected to depression. So, other types of antidepressants or other medications can be recommended. When apathy is associated with neurodegenerative diseases, multiple medication options are available, depending on the disease.
Transcranial Magnetic Stimulation
Repeated transcranial magnetic stimulation has been shown in a few small studies to help improve symptoms of apathy, but whether it helps anhedonia is unknown. Using TMS in addition to antidepressant medication improves symptoms the most.
Cognitive-behavioral Therapy
Cognitive-behavioral therapy (CBT) has been
Self-care and Lifestyle Strategies
It’s important to talk to a mental healthcare provider to learn what you can do at home to help improve your symptoms. While everyone is different, here are a few most common self-care and lifestyle ideas to help you deal with apathy and anhedonia.
Engage in Physical Activity
Exercise is good for everyone but may be especially beneficial if you are living with anhedonia or apathy. Research shows that
Also, it is believed that dopamine and serotonin are both released during exercise, which can improve the state of your mental health. In addition,
Focus on Pleasurable Activities
For apathy and anhedonia treatment at home, try to think of ways you can increase pleasure in your life. Some ideas may include but are not limited to:
- Think back to a hobby you used to enjoy and give it another try.
- Try a new sport or activity that you have thought about trying before.
- Find a funny TV show or movie you used to laugh at and watch it again.
Find Ways to Work on Motivation
If you find it difficult to motivate yourself to do things you need or want to do, try to find a workaround to get it done. This can include:
- For regular physical activity, find a family member or a friend to do it together, so you’ll know someone will be counting on you.
- Ask a trusted loved one to check in on you daily, making sure you have taken care of what you needed to do.
- Sit down with a trusted friend or family member and write out goals, then ask them to keep an eye on your progress.
Conclusion
Apathy and anhedonia can significantly limit your ability to enjoy your days, make goals, and progress in your life. Both can be debilitating, so it’s important to reach out to a mental healthcare provider and be open to options that will help you improve your well-being. Many people have overcome anhedonia and apathy and have gone on to live fulfilling lives, so you can too! Book an appointment at MEDvidi today to have a detailed mental health assessment and receive personalized recommendations and treatment.
FAQs About Apathy and Anhedonia
What is apathy most commonly a symptom of?
Usually, apathy is connected to a neurological condition, such as Alzheimer’s disease or Parkinson’s disease. Sometimes, it can be a symptom related to other conditions, like schizophrenia or depression. Less commonly, it can be related to traumatic brain injuries. Apathy can also be a response to difficult life circumstances.
What is the difference between apathy and depression?
Apathy and depression are similar and share many characteristics, but apathy is a problem with motivation while depression is extreme sadness that interferes with your life. Understanding the difference between the two can be difficult because when you experience depression, apathetic feelings can be associated with it.
What is an example of apathy?
One example of apathy can be getting a new job that you wanted, but not feeling excited about it. Other examples include: feeling indifferent about things that used to excite you, not engaging in hobbies you used to enjoy, not spending time with friends and family, or disengaging from a sport you usually enjoy.
Does apathy go away?
Yes, apathy can be treated. Sometimes, difficult life circumstances or transitions can bring on apathy, and once life improves, you may feel better. When apathy is associated with other conditions, such as depression or neurodegenerative diseases, treatment is essential.
Do people with anhedonia cry?
If you have anhedonia, you may not cry as easily as you normally would. Anhedonia can change your emotions and make you feel more disconnected from them. Since crying is a way to express emotions, when you have anhedonia, you may not cry as you normally would.
Can you still love with anhedonia?
Yes, even with anhedonia, you can still recognize love and the importance of close relationships, but you struggle to feel the emotions associated with them. Anhedonia can be improved with time and the right treatment. If you continue to put the effort into your relationships, once your anhedonia improves, you should again feel the emotions associated with love.
How long does anhedonia last?
Anhedonia is closely associated with depression, which can last for a long time, depending on treatment. Often, anhedonia can be associated with a difficult life event, in which case the feeling can last for weeks or months, until you have worked through the emotions and difficulty. Since people experience anhedonia differently, how long it lasts can vary.
Is anhedonia my fault?
Anhedonia is never your fault. Research into the causes is still ongoing, but changes in the brain are responsible for anhedonia. With treatment, you can overcome anhedonia. Reach out to a healthcare provider to begin your journey toward mental health improvement.
