In my endless internet research on various mental health topics, I recently found an article on Huffington Post that talked about how one could have depression without actually feeling sad. This struck a chord with me because often I feel “depressed” in the essence of the word, as in something is simply holding me back, without the sense of sadness that we are conditioned to think accompanies depression.
Anyways, as I have mentioned before, mental illness manifests itself differently from person to person. The article pointed out:
To have a diagnosable ‘major depressive disorder’ (sometimes called ‘clinical depression’), you must have at least one of two particular symptoms– called ‘cardinal’ symptoms. Deep sadness (‘depressed mood’) is one of the two cardinal symptoms. The other is called ‘anhedonia’ (Greek for ‘without pleasure’), which means not taking pleasure in pretty much anything, even in things that used to give you pleasure– your work, your hobbies, your grandchildren, your friends, etc.
I mentioned this to my boyfriend; recently in a disagreement, I was called out for not being able to show happiness for a truly victorious moment in his life. A moment, was I not in the midst of my depression, that I would celebrate. I found myself giving the scripted reaction: I know what the appropriate response should be, so I offered that. But my boyfriend, being the intuitive person he is, was quick to point out that my response was not genuine. Which brings us back here.
My own depression manifests itself in this way. I know when good things are happening and I often scramble to find the appropriate conditioned response that I have developed over the last 28 years. More often than not, my responses are not genuine. I know I should be happy for the person so I say, “I am so happy for you!” or “That’s so awesome!” When really, I do not feel any such thing. When the external stimulus does not match my internal response, I know something is going on in my head.
Anhedonia manifests itself in multiple ways as well. In addition to not being able to feel this genuine happiness for others (including myself), I find myself unable to make decisions. Simply put, nothing sounds good. Favorite TV program? Seen it. Favorite activity? Done it. Take the dogs out? That might mean interacting with others (something I have an extreme aversion to in my depression). Favorite food? Not really anything special. In the words of the article, I become “bored to death.”
Indecision and weight fluctuation root themselves in my anhedonia. I find it hard to make decisions because nothing sounds interesting; I fear I will pick the decision no one else will like (and while people do not interest me much, their opinion of me does). I find it hard to eat properly because no food sounds good, even foods I previously loved. Instead I binge on what is around, mostly because it all tastes the same anyways.
So what is the solution for this? No medication offers a quick cure for anhedonia. Antidepressants are dangerous to people (such as me) who have bipolar disorder. Antipsychotics repress mania, but can actually cause anhedonia as a side effect. Recent studies are actually finding that ketamine (known recreationally as “Special K”) can help to treat anhedonia, but since ketamine has a high abuse potential, many more studies must be done before dosing and releasing it as a feasible form of treatment.
To answer my own question, there is no quick solution. For my own sanity, I still seek pleasure in the things I enjoyed before: a movie, a video game, a walk with my dogs, a trip to the beach. Some of these things find a renewed joy in me– especially those things that do not force interactions with others. Most of these things are stymied by my indecisiveness. I guess as long as we are willing to try, we are not truly lost to our depression.
Please leave any comments below. -A