In psychology, anhedonia (< Greek αν- an-, without + ηδονή hēdonē, pleasure ) is an inability to experience pleasure from normally pleasurable life events such as eating, exercise, and social or sexual interaction. Psychology (from Greek grc ψῡχή psȳkhē, "breath life soul" and grc -λογία -logia) is an Academic and Greek (el ελληνική γλώσσα or simply el ελληνικά — "Hellenic" is an Indo-European language, spoken today by 15-22 million people mainly
Anhedonia is recognized as one of the key symptoms of the mood disorder depression according to both the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Statistical Classification of Diseases and Related Health Problems (ICD). A mood disorder is the term given for a group of diagnoses in the DSM IV TR classification system where a disturbance in the person's emotional mood is hypothesised Major depressive disorder, also known as major depression, unipolar depression, unipolar disorder, clinical depression, or simply depression The Diagnostic and Statistical Manual of Mental Disorders' ( DSM) is published by the American Psychiatric Association The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases Other than anhedonia, the DSM considers only depressed mood to be a key symptom. The ICD lists both depressed mood and fatigue or loss of energy as the other key symptoms. Anhedonia is also seen in schizophrenic disorders and other mental disorders. Schizophrenia ( from the Greek roots schizein (σχίζειν "to split" and phrēn Mental disorder or mental illness is a psychological or behavioral pattern that occurs in an individual and is thought to cause distress or disability that is not expected as
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Causes
Researchers theorize that anhedonia may result from the breakdown in the brain's reward system, involving dopamine pathways. The nucleus accumbens (NAcc also known as the accumbens nucleus or as the nucleus accumbens septi (Latin for nucleus leaning against the Septum Dopamine is a Hormone and Neurotransmitter occurring in a wide variety of animals including both vertebrates and invertebrates Two 2005 studies by Paul Keedwell MD of King's College found that certain sections of the brain in depressed subjects had to work harder to process happy thoughts. [1][2]
Anhedonia is often experienced by drug addicts following withdrawal; in particular, stimulants like cocaine and amphetamines cause anhedonia and depression by depleting dopamine and other important neurotransmitters. Cocaine ( benzoylmethyl ecgonine) is a Crystalline Tropane Alkaloid that is obtained from the leaves of the Coca plant Amphetamine, and related drugs such as Methamphetamine are a group of drugs that act by increasing levels of Norepinephrine, Serotonin, and Dopamine In the fields of Psychology and Psychiatry, the terms depression or depressed refer to both expected and pathologically chronic or severe Dopamine is a Hormone and Neurotransmitter occurring in a wide variety of animals including both vertebrates and invertebrates See Chemical synapse for an introduction to concepts and terminology used in this article Very long-term addicts are sometimes said to suffer a permanent physical breakdown of their pleasure pathways, leading to anhedonia on a permanent or semi-permanent basis due to the extended overworking of the neural pleasure pathways during active addiction (particularly as regards cocaine and methamphetamine). The term " addiction " is used in many contexts to describe an obsession compulsion or excessive Physical dependence or psychological dependence such as Cocaine ( benzoylmethyl ecgonine) is a Crystalline Tropane Alkaloid that is obtained from the leaves of the Coca plant In this circumstance, activities still may be pleasurable, but can never be as pleasurable to people who have experienced the comparatively extreme pleasure of the drug experience. The result is apathy towards healthy routines by the addict. Extended periods of healthy lifestyles away from active addiction have been shown to reverse these feelings.
Significance in depression
As a clinical symptom in depression, anhedonia rates highly in making a diagnosis of this disorder. The DSM describes a "lack of interest or pleasure" but these can be hard to tease apart given that people become less interested in things which do not give them pleasure. The DSM criterion of weight loss is probably related to it and many depressed people with this symptom describe a lack of enjoyment from food.
Sexual anhedonia
Sexual anhedonia is known as 'ejaculatory anhedonia'. This rare condition means that the person will ejaculate with no accompanying sense of pleasure. Ejaculation is the ejecting of Semen from the Penis, and is usually accompanied by Orgasm. This condition is most frequently found in males, but women can suffer from lack of pleasure when the body goes through the orgasm process as well. An orgasm (sexual climax is the conclusion of the plateau phase of the sexual response cycle, and may be experienced by both males and females
Sexual anhedonia may be caused by:
- Hyperprolactinaemia
- Hypoactive sexual desire disorder (HSDD), also called inhibited sexual desire
- Low levels of the hormone testosterone
- Spinal cord injury
- Use (or previous use) of SSRI antidepressants[3]
A urological examination and blood tests can determine the cause of a specific case of sexual anhedonia. Hyperprolactinaemia ( BrE) or hyperprolactinemia ( AmE) is the presence of abnormally-high levels of Prolactin in the blood Testosterone is a Steroid hormone from the Androgen group In mammals testosterone is primarily secreted in the testes of males and the Ovaries Selective serotonin reuptake inhibitors ( SSRIs) are a class of Antidepressants used in the treatment of depression, Anxiety disorders
Patients may be prescribed sustained-release bupropion to aid in treatment, because bupropion has been shown to increase sexual desire and intensity of orgasm. Bupropion ( INN, previously known as amfebutamone; sold as Wellbutrin, Zyban, and several other Trade names is an atypical Antidepressant
See also
References
- ^ "No Pleasure, No Reward -- Plenty of Depression" by John McManamy; URL accessed 2007-02-08
- ^ "Neural systems underlying affective disorders" by Simon Surguladze, et al. Dysthymia (pronounced /dɪsˈθaɪmiə/ is a Mood disorder that falls within the depression spectrum. Major depressive disorder, also known as major depression, unipolar depression, unipolar disorder, clinical depression, or simply depression Year 2007 ( MMVII) was a Common year starting on Monday of the Gregorian calendar in the 21st century. Events 421 - Constantius III becomes co- Emperor of the Western Roman Empire. , Advances in Psychiatric Treatment (2003) 9: 446-455; URL accessed 2008-02-08
- ^ "Persistent Sexual Dysfunction after Discontinuation of Selective Serotonin Reuptake Inhibitors" By Csoka et al. 2008 ( MMVIII) is the current year in accordance with the Gregorian calendar, a Leap year that started on Tuesday of the Common Events 421 - Constantius III becomes co- Emperor of the Western Roman Empire. , Journal of Sexual Medicine 5 (1) , 227–233; URL accessed 2008-02-28
External links
- No Pleasure, No Reward
- Discussion of male orgasmic dysfunction (ejaculation without orgasm) on the Sexual Health Forums of HisandHerHealth.com
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