In a recent post, “Reclaiming Joy With Positive Affect Treatment” (PAT), I wrote about how lost pleasure isn’t just a symptom of anxiety or depression—it’s a distinct problem we now have a powerful, targeted therapy to treat.
Long before PAT had a name, I was writing about this same brain-body cycle in my book. The excerpt below from my book, Why Good Sex Matters (Houghton Mifflin Harcourt, 2020), traces how anxiety and anhedonia feed into each other. It can manifest either as a depressive flatness in which there is little or no motivation or, alternatively, as a cycle of endless seeking without satisfaction that can drive compulsive behaviors leading to addiction. Either way, anxiety-fueled anhedonia is a painful state that robs us of presence and joy in everyday life.
Anxiety-Fueled Anhedonia and Finding Pleasure Again
Indeed, when it comes to anxiety, there is definitely too much of a good thing. Persistent, unremitting anxiety will deplete your resources, both physical and emotional, until depression takes root and triggers or reinforces even more anhedonia. It’s a vicious cycle of emotional dysregulation: the inability to have pleasure drains us of enthusiasm for life; anxiety and depression rob us of the appetite and enthusiasm to pursue pleasure; and these negative emotions keep feeding off one another.
Clinically speaking, anhedonia is the inability to feel a satisfactory amount of pleasure in many, if not most, aspects of what would ordinarily be pleasurable in our lives, leaving people with a nebulous sense that something is just not right. In other words, neither our brain nor our body can experience the gratification of pleasurable sensations. Others may be able to feel some pleasurable sensation, but that feeling never registers sufficiently to provide satisfaction.
Regardless of its manifestation, anhedonia points to a dysfunctional neural system that affects both the brain and the body. Indeed, I consider this vital, inseparable connection to be better captured as one’s “brain-body” because they are so closely integrated. When we untangle the neural web, parse out the blocks or triggers that cause the dysfunctional reactions (or lack of reactions), we gain insight into how the disruption of our pleasure system affects all dimensions of our lives from the enjoyment of food to the enjoyment of physical activities, engagement in work and other intellectual or creative pursuits, and the sense of wholeness that comes from real intimacy in our relationships.
Think of anhedonia as a giant, numbing cloud pressing down from above, smothering your brain-body system so that it can’t gather enough psychic energy to respond to sensual stimuli. You stay in emotional and physical lockdown, constrained and incapable of letting go into the pleasurable release of joy, camaraderie, excitement, curiosity, and adventure.
At a neurobiological level, people suffering from anhedonia and anxiety have lost the ability to regulate. Their biochemical systems no longer respond to natural modulators such as exercise, rewarding social interactions, sex, rest, meditation, or other endorphin boosters that used to reset their biochemistry. So, when the natural remedies don’t work, more people who want to feel good, less anxious, and more motivated in their daily lives turn to antidepressants and/or anti-anxiety medicines, which cannot address the related psychological and social issues. Though helpful at alleviating symptoms, the use of antidepressants surely masks the complexity of the pleasure problem.
Obviously, some medicines are necessary and lifesaving; they can mobilize the brain and help us climb out of a state of shutdown. But just taking the medicine will not provide a complete solution to constant anxiety or anhedonia. We need to keep in mind that, like pleasure, anhedonia is not just an emotional or mental construct; there’s an underlying biological impact (a bit of a “chicken and the egg”). Essentially, people suffering from mild or extreme anhedonia have dysregulated chemical systems—including dysregulated dopamine and/or serotonin, dysfunction in opioid receptors, and high cortisol (if they are also experiencing anxiety).
Some people are particularly vulnerable to maladaptive stress responses, including those who are genetically prone to addiction. Born with highly reactive brain chemistry, they are especially sensitive to stress, and once they discover that substances dull the pain of stress, their seeking system interferes with their reward system. Unable to experience the natural “high” of positive feelings from a release of dopamine triggered by the experiences of everyday living, they come to rely on shortcuts: drugs or other addictive habits, which do not truly satisfy.
They get caught in a loop of endless seeking, which often leads to escalating compulsive behaviors. Chinese Buddhists have described this situation as “chasing the hungry ghost,” where tortured souls are stuck in a hell-like existence, driven by extreme emotion, unable to digest the nourishment (i.e., pleasurable release from pain) that they relentlessly seek.
Anhedonia Essential Reads
In this way, addictive behaviors only drive yet more anhedonia and even more compulsive behavior, reinforcing a cycle of misery. These people are in a constant seeking state—looking for an elusive, constantly higher pleasure “hit,” which is no longer under their conscious control.
One of the reasons it’s so difficult to “get out of” the anhedonia cycle is due to this complex interplay between the brain and the body. But as we’ll see, once aware, we can mobilize our top brain’s capacities to consciously regulate the emotions that live in our brain’s so-called basement, and then reteach our midlevel (mezzanine brain) new associations, behaviors, and habits. As a result, we will feel newly empowered.
Ultimately, when we get our emotional system in check, we can lean on our top brain to help us reframe situations. Change can even be as simple as telling ourselves, “Go and meet your friends for coffee; that will make you feel better.” This type of top-down command is one of the key ways to restore our pleasure system and get us on our way to healthy hedonism and elevate the importance of pleasure, sexual and otherwise.
In Conclusion
Pleasure is not a luxury, but a necessity for a well-balanced life. Healthy hedonism practices mobilize the top brain to regulate the basement and retrain the mezzanine’s habits, one small act of savoring at a time. If this resonated, you can read more in “Reclaiming Joy With Positive Affect Treatment” and click here to learn more about the three-level brain-mind.
