I have anhedonia and want to teach my brain how to enjoy things again

March 25, 2024 9:10 AM

I realized a few days ago that I've been dealing with anhedonia for the last decade and it's only gotten worse. Today when I woke up, I decided that I'm finally done feeling this way and I'm ready to help my body and mind regain their capacity for pleasure. I'm so tired of feeling like a husk of my former self. Open to tips, but also hoping to assemble a list of small, everyday actions that I can do to help me reestablish my identity and passions.

(Note: I'm undergoing both CBT and EMDR therapy and have been stable on the same medications for depression and ADHD for a little over a decade.)

I recently realized that I have been suffering from anhedonia after surviving an intense ten-year period of disruptive life changes and challenges. There has also been a lot of joy during that time, too, but trauma and grief have decimated my sense of self. I no longer take pleasure in the things that I used to love, and I miss the person who I used to be.

There were a few different triggers behind the anhedonia, but perhaps the biggest took place last summer, when I finished tapering off of prescription anti-anxiety medication (previous AskMe for reference) after taking them daily for ten years.

The anhedonia began when I first started taking anti-anxiety meds (benzos, to be more specific) but became much worse when I went off them. I know that's because my body became dependent on the anti-anxiety meds to create feel-good chemicals. EMDR and microdosing psilocybin have helped me reduce some of my post-benzo anxiety, but I've been so focused on treating the anxiety symptoms that I completely overlooked the depression/anhedonia.

For example, I've always been passionate about collecting vinyl records and ethnomusicology, but after last summer, I went from having less interest in music to no interest in listening to music at all(!). If and when I do listen to music now, the only genre I can really handle is ambient. I still have a deep love and appreciation for the other genres of music I once enjoyed, but it now feels like more of a "theoretical" love than something I actively desire to experience.

I know that regular exercise (including yoga to reactivate my parasympathetic nervous system) is the answer and I've spent a decade lamenting my former athletic self - I'm a broken record in that regard. But even after I pump myself up and get excited to do a yoga session or some bodyweight exercises, I lose interest and resume a "what's the point?" attitude. It's easier to do nothing and be in my head. I have enough energy to be a supportive partner to my spouse, do a good job at work, and take care of chores, but everything else feels pointless.

Anyway, now that I understand that this is anhedonia and it's common among people who quit anti-anxiety meds, I'm ready to do something about it. I woke up this morning thinking "Fuck this, I don't have to feel this way anymore," but I need some help creating a list of small, daily, specific tasks I can do to help my brain and body learn how to enjoy things again.

So far, I'm thinking small things to help me establish a baseline. They have to be small enough that it's almost impossible to say no to them in the beginning. I may only do a few of these at first and add more as I grow stronger, but here are some examples of what I'm thinking:
- Not look at or use my phone for the first hour of the day (I've been doing this one for the last week now and it's been helping).
- Do one plank every day. Hold it for as long as I can, and keep track of how long I can hold it each time to see my progress.
- Do five minutes of restorative yoga each morning. Cat/cow, child's pose, etc., to loosen my spine and get me comfortable with my body again.
- Write one haiku every day (I did a "one haiku a day" project when I was in college almost two decades ago, and I really enjoyed it).
- Do one "spa" thing for myself each day. I already have a strong skincare routine, but I've quit caring about other aspects of my appearance and I need help in that arena.
- Pick one small project I can work on while watching TV and relaxing. I've gotten back into calligraphy and drawing, so maybe those; knitting/crochet could be good to keep my hands occupied.
- Take a daily walk down the street, even if it's just to the corner and back.

I'm also setting a timer to take melatonin later because I know I do better when I wake up early in the morning, and I'd like to do a lot of these things when I first wake up so I can set a good tone for the rest of the day. I need to reset my body clock.

Open to any other ideas, suggestions, and feedback that others might have for how to "teach" my brain to enjoy things again.

posted by nightrecordings to Human Relations (20 answers total)

When you go outside, stop and look at something natural. Appreciate the beauty of it. Look at how it built itself. Look closely. Look from a distance. Think how it is enfolded in a network of life. Think on how you are also in this network, and how beautiful it is to be alive and experiencing in this moment.

Mindfulness, being present in the moment, is a gateway to joy. If you are distracted, it is hard to find joy in the mundane, but once you actively look for the beauty around you, you can see it everywhere.
posted by seanmpuckett at 9:15 AM on March 25 [10 favorites]

Take a daily walk down the street, even if it's just to the corner and back.

There's your winner. Move your body in some way. It makes all the difference. I wish I remembered to do this more often, because when I keep with it I'm a happier person.

But also, watch out for fixating on the list. Allow yourself to skip or miss an item without obsessing about it or worse just ditching the whole endeavor. You're not a machine, it's ok to do or not do things. The list is a guide not a prison.
posted by Abehammerb Lincoln at 9:25 AM on March 25 [8 favorites]

I've taken a few forest bathing classes (through my local community college, though I've seen ones offered through the arboretum and at a state park) and find it incredibly helpful for noticing small wonders. You may have something near you!

Also speaking of small wonder, this book Wonder Seeker was so delightful that I promptly ordered a copy for a friend.
posted by spamandkimchi at 9:25 AM on March 25 [3 favorites]

How often do you try new things? Try more new things.

A new thing can be as simple/cheap as walking down a different street or trying a new-to-you vegetable from the produce section. Take an intro class for a hobby you have no skills for. Get last minute cheap tickets to a live music performance you know nothing about. Go to a restaurant alone and eat something you've never had before. Volunteer. Go to your animal shelter and walk some homeless dogs. Read a book written by someone who doesn't look like you. Etc.

I try to do at least one new-to-me thing every week and it's the single action I have ever taken for my personal well being. I am deeply susceptible to inertia.
posted by phunniemee at 9:29 AM on March 25 [10 favorites]

I find getting from flatness to such lofty emotions as joy/delight/gratitude/etc. a tall order sometimes--and for me, aiming that high right out of the gate can backfire--but one detour that can be useful is curiosity. Even when what's true is that I'm just not feeling great, I can find one thing my surroundings to come up with at least one question about, and there's something about that practice that feels like a connection, however tenuous, to vitality. Curiosity is like a little spark that proves that something I like about my brain is still working, and it's a small show of belief that the world is bigger and more interesting than what's right in front of or inside of you at this particular moment in time.
posted by wormtales at 9:30 AM on March 25 [11 favorites]

When you go for a walk, don't have a set route. When you reach a corner, try to feel which direction you would like to turn. Then go that way and observe how it feels.

There is no way to do this "wrong" and it is a low stakes way to turn inward and identify feelings of desire and curiosity.
posted by mcduff at 10:18 AM on March 25 [4 favorites]

Adding an overall note to the ideas others have for you: Some people are suggesting trying something new. In my own case, sometimes that advice would make me hesitate because I'd always wonder "okay, but what if I try it and I hate it?"

If you're having similar thoughts - what changed that fear for me was giving myself permission to laugh at it. (Later, when I was home, for courtesy's sake!) It can indeed be disappointing to want to try something and be excited about it and have plans for it, but then it falls short of what you thought it was going to be; like, you sign up for the special fancy-sounding "singles' mixer" as a New Year's Eve party event and you're expecting a genteel evening of swanky cocktails and erudite people who all look gorgeous and there you are in the middle of them all, but when you get there the music is way too loud and the MC has all these super-dippy "icebreaker" games that were like the ones you had in college freshman orientation, and you just can't deal with it.

But what I'm suggesting is - instead of going home to sulk about it, go to the weird dive bar on your block and unload on the bartender about how RIDICULOUS the whole thing was, and before long you may find yourself laughing about it, especially if the bartender drags people over and says "hey, tell them about that lame party you were just at" and then they start telling you other stories about other lame New Year's Eve parties and you all bond over "they REALLY were asking you to look at people's SOCKS for that thing?" and you'll end up having a decent time after all.

It's okay to have the thing you planned on disappoint you, but sometimes turning that disappointment on its ear and poking fun at it can be its own joy.
posted by EmpressCallipygos at 11:07 AM on March 25 [4 favorites]

Somewhat counterintuitively, I find what works best is when I don't focus on the outcome. Set aside the goal of "wanting to enjoy things". Instead, commit to doing an activity. For example, 10 mins of yoga a day. Don't focus on whether you are or aren't enjoying it. That's not the goal. The goal is to do it, no matter what.

Ideally, a focus on mindfulness would help with this. Basically, try to be present in the moment when you're doing these activities, rather than focusing on if you enjoy them or not.

You can't control if you enjoy somehting or not. What you can do is commit to doing the activity and trying to be present and mindful while you're doing it.

Of course, start small. Build up from there.
posted by litera scripta manet at 11:10 AM on March 25 [3 favorites]

Also, for me, a lot of the anhedonia is related to dissociative symptoms (due to a bucketload of childhood trauma). Depersonalization/derealization. But also just that sort of pervasive numbness.

Naltrexone has really helped with that. it's like, it flicked the switch in my brain and the fog from the dissociation cleared and I remembered what it was like to enjoy things again.

There's some research I read that basically traumatic dissociation is related to the body pumping out lots of endogenous opioids. (When fight/flight - which run on adrenaline, cortisol, etc - aren't options, the body switches to fawn/freeze, hence the endogenous opioids.) Naltrexone is an opioid blocker.

The only downside is chronic pain is worse. (I have a genetic disorder that impacts my joints and causes chronic pain among other things.) But it was the closest thing I found to a magic bullet.

This is all very off label and there's not a ton of research out there, but if you think some of the anhedonia might be related to dissociative symptoms, it might be worth looking into.
posted by litera scripta manet at 11:15 AM on March 25 [2 favorites]

In case you are finding that you're also lacking desires in general, you might also find some useful suggestions in this question from last year.

My tip for you would be: Is there is something you think could be pleasurable to try, but when you think of it the judgy part of your brain shuts it down because "oh but that is silly/wasteful/self-indulgent/trashy/needy/demanding"?

If so, then try accepting that feeling, letting it wash over you (being gentle with yourself -- that judge in your head is trying to protect you, after all), then maybe trying the thing anyway.
posted by brainwane at 11:16 AM on March 25 [2 favorites]

Wow, that list is already longer anything I could tackle. So my first suggestion is be realistic about what you have the time, energy and motivation to take on. Maybe 10 small things could work for you. Or maybe it needs to be just three. Or maybe you have a list of ten and pick one or two each day. Or maybe you and I are different enough that this breadth of effort works for you.

My second thought is to practice tuning into what you are actually feeling during each of these things. Don't make it just one blanket answer but think about most positive and most negative moments during each activity. Remember positive can be much broader than pleasure. It can include calm, focused, relaxing or productive as well as happy, silly, or pleased.
posted by metahawk at 11:48 AM on March 25 [4 favorites]

Just a really quick note that one kind of anhedonia can result from a goal-oriented mindset. Dodging this to get ease and openness back was one of the key things I learned (and regularly have to re-learn) both a) to do and b) how to do from the book The Mindful Way Through Depression.
posted by lokta at 12:04 PM on March 25 [2 favorites]

In the bigger picture, things that seem to help people feel better are movement (I'd say joyful movement, really) and community connections. I particularly note that all of your activities are about things you make yourself do, whether you want to or not, and are solo activities. They sound healthy, but not necessarily joyful. I also wonder if you get in a cycle sometimes of not doing them and then blaming yourself for feeling bad? Mixing things up and taking a class, as others have suggested, and particularly focused on movement, could be a really good change.

Have you considered taking a structured dance class? There's some research being done on dance as an intervention for mental health. Here's a recent meta-analysis that found "a statistically significant reduction in depression among older adults participating in dance interventions" and here's a press release from the University of Sydney summarizing an on-going study: "Preliminary evidence suggests that dance may be better than other physical activities to improve psychological wellbeing and cognitive capacity. ...These findings were not just seen in older adults, but also younger populations and people with clinical conditions as well." Anecdotally, I'll add that a friend of mine said that a weekly contra dance was the difference between horrible mental health one winter and feeling good and happy this past winter.

You could also go for a bike ride, particularly with someone else, not just your husband. Movement, with people, and outside could really be key.

Could you invite a neighbor or acquaintance to walk with you once a week? If you are going to do this alone, how about being in a natural setting? Could you ride a bike to a park and walk around there and look at the trees? You could leave your phone at home if you find that you're using it while you are walking. Alternatively, another way to provide some creative structure to a walk is to choose a color, and photograph interesting things in that color. So, the first day, you go for a red walk. Maybe even wear a red shirt, and take photos of flowers or signs or whatever you see in red.

I started off by saying you need joyful movement. Your morning routine right now sounds like a task-oriented to-do list, and isn't about playfulness. So now I think you need to have some time, especially with others, that's more focused on play. This might help you get out of your head and be in the moment.
posted by bluedaisy at 12:10 PM on March 25 [4 favorites]

I recently spent some time with a few other people, playing with twist crayons, which were a new medium for me, and unexpectedly fun; we weren't trying to make Art-with-a-Capital-Art, just experiment, and because we were giving ourselves and each other permission to build on each others' work, drawing on the same piece of paper, I had less of a sense than I often do that I was trying to make something specific. It had been a bad few mental health days, and the experience was really freeing and joyful.
posted by pollytropos at 12:31 PM on March 25 [1 favorite]

Start with things that are easy and obviously pleasurable, so your brain can get back in the habit of feeling pleasure and you can become attuned to noticing it. Candy. Flowers. Massages. I even tried some things that lots of folks like that I assumed I wouldn't but it turns out they're actually good (pedicures, candlelit baths). Once I had a good baseline of nice things happening on a regular basis, I put more effort into things with a higher effort level, like walks and hobbies and exercise. But it's important to feel good on a regular basis. You deserve it, just for existing. You don't have to earn it and the things you do for fun don't have to be virtuous or impressive.

Also going to tuck in Wild Geese by Mary Oliver here, because watching animals do their thing makes me happy and helps me figure out how to make myself happy.
posted by momus_window at 1:13 PM on March 25 [3 favorites]

I listened to a podcast episode on this last month from Mel Robbins where she interviewed Dr. Judith Joseph about anhedonia. Dr. Joseph talked through a few exercises to find happiness and joy in everyday things. Here's a link to the episode.
posted by pumpkinlatte at 1:22 PM on March 25 [1 favorite]

Your examples seem mostly to be geared towards things you should be doing to raise your mood in the long term. One piece of advice I've found useful is to also try to tune into what feels good now, with the understanding that these moments may be VERY fleeting, but are probably not completely non-existent. I found I had to focus on simpler and simpler experiences before hitting anything that worked -- it ended up being things like 'being warm', 'eating chocolate', 'looking at rain' etc -- and sort of teach my brain to remember what happy felt like from those. So instead of enjoying the feeling of knowing you have a certain level of athletic skill, it might be noticing a moment when one particular stretch felt good, something like that. I found that making a note of fleeting happy feelings any time they came up helped me work up to enjoyment of more complicated experiences.

It was also a frustrating and slow process -- I wish you the best with it and hope you can be gentle with yourself through it.

On preview, what momus_window said!
posted by pandabanter at 1:32 PM on March 25 [4 favorites]

One of the exercises I was given to do coming out of a burnout situation was a very specific gratitude exercise to be included in my daily meditation/journal/whatever/round-up and/or my sleep wind-down: pause and clear some emotional space, and then try to call up the feeling of gratitude. But not just like "oh, this is nice." Like, "WHEW, HOO-EEE, HOLY SHIT" like someone just saved your ass from physical danger, social mortification, panic-level emergency. Someone letting you know you dropped your wallet, the doctor calling with unexpectedly FINE test results, calling the electric company about the $4000 bill you just got and them immediately telling you they had a little decimal whoopsie and it's actually $40. The kind of gratitude where a whole situation has turned around.

The kind of gratitude where you get a little adrenaline tingle in your fingertips.

But you don't have to feel it FOR anything. Just try to fill your body with the sensation. Help your cells re-learn how to feel that feeling.

THEN, start using it, and over-use it. Muster up that big-feel gratitude for the simplest pleasures - that the temperature in this room is perfect, the smell of that soup is gooood, these clean sheets are satisfying, that rearranged drawer is so much nicer to use now. Like, literally apply some love to your life, at an everyday level. Don't save it all up for some tremendous Gratitude Event you assume should happen eventually. You have an infinite amount, you won't use it all up; it's not printer ink. Or maybe it's a little like printer ink, in that if you never use it you run the risk of it drying up.
posted by Lyn Never at 4:55 PM on March 25 [12 favorites]

My daily checklist includes:

*Connecting with another human (online is fine but it needs to feel like a connection)

*Learning something (this is intended to engage curiosity as others have suggested above; instead of just ignoring something I don't understand because I don't really care, I look it up. This can be as simple as looking up where Estonia is on a map, and I don't need to remember it afterwards; the point is just to encourage myself to ENGAGE.)

*Seeing something aesthetically beautiful or interesting (I'll usually do this on a walk outside but if that doesn't happen I'll look up some art)

I recommend picking out a checklist/ habit app and start with just ONE thing you think is most likely to help you move your needle. Wait at least a week before adding another, and remember you can drop any habits which aren't serving you.
posted by metasarah at 10:34 AM on March 27

Anecdotally, i have ADHD and found CBT to be specifically frustrating and not useful for how my brain works. I've had a lot better luck with Internal Family Systems.

My tip around all this is that you can make all the lists you want but if you are going to shame yourself or feel like crap if you don't check all the to-do boxes every day, you're not going to progress. Give yourself some grace around this process, it's a marathon not a sprint.
posted by softlord at 11:20 AM on March 28