Apathy and anhedonia are often symptoms of other mental health problems, such as depression. Apathy is thought to be an issue of motivation. Anhedonia is the inability to experience pleasure. The two are often experienced together. Learn more about them here.
The word ‘apathy’ comes from Greek and means “without emotion, feeling, suffering”. Interestingly, originally it meant “freedom from suffering”. It is now defined as the absence of emotion, and can feel like generalised unaffectedness or indifference and a lack of motivation. It is often a symptom of other neurological, or mental health conditions like Parkinson’s or Alzheimer’s disease, or depression, or burnout. People who are affected by it will often experience a reduction in cognition, emotion, and activities.
‘Anhedonia’ also comes from Greek and means “without pleasure”. Epicurus and other ancient philosophers were interested in the nature of pleasure and its absence. Thus, anhedonia is the inability to feel pleasure and enjoyment and often accompanies apathy as a symptom of it. Because apathy and anhedonia are thought to be symptoms of other ailments, there are no specialised treatments for them in their own right. Normally the underpinning issue will be the focus of treatment.
Due to the lack of motivation and inability to derive pleasure from things, people can find routine day to day activities too effortful, making them feel more challenging than normal.
Things that may have been of interest before no longer are. This usually results in a reduction of activities due to the lack of motivation and pleasure experienced, making people feel indifferent to things.
The energy required to feel motivated is just not there. People don’t feel the general sense of motivation or purpose they normally might. This means normal tasks and goals are not accomplished, or if they are, it is with great difficulty.
Apathy makes people feel numb to a range of emotions, both positive and negative. Anhedonia relates to pleasure which means those afflicted cannot enjoy what they normally would as they do not experience pleasure, they feel indifferent instead.
Often apathy and anhedonia will bring about lethargy, this is a state that impacts the mind, body, or both. So you feel tired, drowsy, fatigued, sluggish, or slow.
Because normal activities feel challenging and therefore require more effort, and because there is an inability to feel pleasure at the thought of doing them, those impacted will often start to do less.
Sometimes the cause of apathy and anhedonia are related to things we can easily identify. For example, we may be unhappy at work, or realise that we no longer feel happy in a relationship.
And at other times they can be a symptom of a larger issue, like an underlying neurological and physical health condition like Parkinson’s disease (PD), Alzheimer’s, fronto-temporal dementia, or stroke.
Apathy and anhedonia can also accompany mental health conditions such as anxiety, depression, bipolar disorder, schizophrenia, and post traumatic stress disorder (PTSD).
They may also occur as a side effect of medication or due to illicit substance misuse.
Because it is the underlying cause that we treat, when it comes to the symptoms of apathy and anhedonia, we will provide a thorough initial assessment in order to gain some understanding of the underpinning cause.
This should identify ways in which we can reduce apathy and anhedonia. For example, your therapist may identify lifestyle changes and self-care as ways to reduce your symptoms.
Or, based on what you disclose, they may suggest a visit to your GP to rule out any concerns about an underlying neurological or physical problem.
Alternatively, if the apathy and anhedonia relate to life events that have impacted your mental health, they will suggest some useful ways of working through issues.
Or, if for example the situation relates to a life circumstance like work or a relationship, they can work with you to improve these, by offering coaching, or relationship counselling, if these are of interest to you.
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