To anyone who has happened to meet people who cannot feel pleasure or show themselves insensitive to situations once considered rewarding.
Perhaps we also crossed us similar periods; And we met, or collided, with the many: “Why?”. Or maybe we have liquidated everything by putting it under the umbrella of the so -called anedonia.
It is known that learned people like the learned terms; I would be more curious to listen to something about Annedonia from someone able to Define what “pleasure” is first.
Sant’Agostino said, reflecting time: “I know what it is until nobody asks me”. Not having the greatness of the saint and not knowing how to define, spontaneously or on request, with convincing arguments, what is pleasure – despite knowing it – I entrust myself to the reflections of others.
The pleasure and the absence of pleasure: Anedonia
I believe it cannot be defined term aedonia If we don’t agree first on What we mean by “pleasure”.
Pleasure has always been considered central to understanding human behavior, however focusing attention, from the era in the period, on the excesses or defects of this state of mind and on the “right” relationship that everyone should have with it, rather than define what the pleasure in itself is.
In the 4th century BC Epicuro believed pleasure a “supreme good”, origin and ultimate end of a happy life. For the Athenian philosopher the real pleasure It consists in gratification of natural desires. Hunger, thirst, shelter from heat and cold. The only ones who can be completely satisfied and of which a full realization is possible.
Contrary, others more complex forms of pleasure – See luxury, wealth and fame – always generate new needs and, over time, sensations of lack and chronic dissatisfaction determining the disturbance of the soul and pain.
Epicurus had understood in advance the law of Weber (19th century): we are more sensitive to the variation of a stimulus than to the persistence of this. That is, the natural ability to adapt to Levels of pleasure Of the human mind generates the risk that every new stable condition of pleasure acquired tends to move the threshold of the actual hedonica experience higher (thus also happens in an area of our current hedonist society?).
The definitions of pleasure
The natural and necessary pleasures represent the emotional process that mediates the adaptation and survival of the subject. A praise of Atarassia, the detachment from everything, including the pleasures, we find it on the average and late Stoà – Chrysippus, Panezio, Polybius, Cicero, Plutarch, Epitiate, Seneca, Marcus Aurelio – with the translation of the Greek term Ataraxia in Latin tranquility.
Christian thought has tried to define the areas in which it is lawful feel pleasure; The eighteenth -century libertine morality focused on the ilceity of not feeling pleasure; And so on in the various eras.
Beyond how it is intended, progressively to feeling of pleasure (opposite to that of anedonia) the role of associating the ability to satisfy a biological or motivational need to lead to a reward was recognized.
In this meaning, pleasure is an emotional marker of the behaviors that responds to the needs of organisms, including humans, to guarantee survival and psychophysical well -being.
It is the experience of pleasure that leads to learning these behaviors and putting them back in place in the face of stimuli that recall their experience.
The components of pleasure
The experience of pleasure was broken down into two components: anticipatory and consumers.
Previous pleasure is linked to the representation of the rewarding experience, fueling desire and supporting the motivation so that the organized action necessary for its achievement is implemented.
The consumer pleasure is instead the one felt in the meantime, and immediately after, the satisfaction of desire is implemented: a lack is filled, the tension is subjected and the action is extinguished. In this it stands out from the anticipatory pleasure, which instead generates tension and movements aimed at the satisfaction of desire.
To these two types of pleasure corresponds to the activation of different brain systems: mainly those in dopamine in anticipatory pleasure and the system of endogenous opioids in consumer pleasure.
The comparison between anticipatory pleasure and the consumption – the gratification lived – is a fundamental element in learning instrumental behaviors, as it allows the measurement of the effective value of a circumstance, an experience or a relationship.
When it comes to aedonia
We can thus start to guess the power that derives from being able to feel pleasure. Becomes one powerful social force even moreù that something limited to the simple individual. Aedonia, compromise in feeling pleasureis well beyond the simple emotional flattening or the expression of an “empty existence”.
From Annedonia a real can derive impediment to our skillsto to learn and interact socially. Understanding the mechanisms of pleasure helps to understand what happens when they alter and flow into anedonia.
The biological bases
I can feel pleasure if there is a good function of a set of neurochemical processes mediated by the cortic-virus basal ganglia. These include:
- the orbitofrontal cortex
- the cinged front cortex
- The ventral striped body
- The ventral pale core
- The streets that start from the Tegmental Ventral Area and cross the Accumens Core.
Cortico-vetral basal ganglia, dialoguing with other areas of the cerebral cortex, mediate the implementation of motivated and oriented behaviors towards achieving a purpose.
The reward system is at the center of this system. Constitutes the basic motivational element for conduct aimed atobtaining pleasure or gratification: instrumental behaviors.
The neural circuits engaging to the organization and expression of the motor component of the behavior associated with the reward; The prefrontal cortical circuits, connected to the base ganglia, encode the value of the reward; They evaluate the relationship between cost and benefits of the action and the possible social or moral opportunity of the conduct.
The cortical regions, based on previous memories and experiences, evaluate the strategies that optimize the value of the reward compared to the motivational investment – of physical and psychological energy – necessary to obtain it and in this way regulate the decision -making processes in the behaviors associated with the rewards.
Experimental research found that low levels of activation of the medial prefrontal cortex associate with Annedonia. The reasons for this dysfunction are different and range from genetics to environmental factors such as chronic stress, emotional trauma, substances abuse.
Is it a disease?
Over time, environmental situations may determine functional and/or microstructural lesions in these cortical areas, leading the brain’s ability to mediate the rewards. Having said that: Can anedonia be considered a disease?
Let’s try to see how the concept in psychopathology has developed. In 1897 Ribot employed the term to describe a “Pathological insensitivity to pleasure“, Referring to incapable subjects to feel pleasure in sexual, food, relational and emotional activities.
In 1911 Bleuler I considered theanedonia as a characteristic of schizophrenic disorder. Kraepelin, in 1913, spoke of Annedonia as a symptom of the “dementia precox” in which patients were to have “indifference to human relationships with loss of satisfaction in the activities of normally considered pleasant and recreational.
In the years to follow Aedonia, he was connected to mood disorders, so much so that the DSM-IV, in 1994, considers it a symptom of major depression, understood both as loss of reactivity to pleasant stimuli and as a decrease in interest or emotional flattening.
The difficulties of classification
Ambiguity on the theme remain. In fact: we can consider theanedonia like inability to desire contact with rewarding stimuli; or the inability to feel pleasure once they come into contact with them; For some we mean a condition or a “discreet” psychopathological state, for others it is a trait of personality.
There are those who consider the temporal element relevant, distinguishing one State of chronic aedonia – psychopathological symptom – from transient states; for example linked to momentary phases of life or health (I have mine well Moments of aedonia during a banal seasonal influence).
As in all psychiatric conditions, it is appropriate to always evaluate the seriousness of the symptom from degrees starting from “physiological” and transient levels to chronic and disabling paintings.
Anedonia and Diedonia
I find the proposal of some scholars interesting to replace the term “aedonia”which recalls the only “absence of pleasure” on the semantic level, with the term “snack“. This would include the possible qualitative and quantitative variations of the subject’s gratification skills.
In fact, clinically and neuro-biologically, qualitative and quantitative modifications of the hedonic function can be distinguished. This can be compromised in different components:
- appetitive (desire)
- motivational (activation, excitement and approach)
- consumers (pleasure and satisfaction once the goal is achieved)
- or in all these
The term aedonia It must be understood as a symptom, not a primary condition. We find it in many medical conditions (as a doctor I think primarily I think of hypothyroidism or the debut of neurodegenerative paintings) and psychiatric. For example, depression, psychosis, some personality disorders, post-traumatic stress disorder (PTSD), substances use disorders and more.
For this reason, aedonia is usually treated in relation to basic diagnosed disorder rather than as a disease in its own right.
I would find very interesting to reflect on the “Anedonia” phenomenon from the perspective of our historical period. Can there be a Annedonia linked to the type of society and the scheme of values to which we are obliged to submit to us?
Unfortunately I have already abused the space concessioned to me and your patience. It could be a starting point for a next article.
