I suffer from anhedonia in bipolar depression and this leads to a lack of motivation. And when I say “suffer” I mean freaking suffer. I mean it’s horrible. I mean it’s probably the worst part about my bipolar depressions. Anhedonia is the inability to experience pleasure. Most people cannot conceptualize of this, but believe me, anhedonia in depression is a real thing and a real problem.

Anhedonia and Major Depression

Anhedonia, the inability to experience pleasure, is not necessary for a diagnosis of depression, and most people don’t experience it. One of the gateway criteria for major depression (the same as bipolar depression) is “diminished interest/pleasure.” You must either have that criterion or a “depressed mood” before further symptoms and a diagnosis of depression are considered.

Again, that’s “diminished” pleasure, so not necessarily a complete lack of it. I have no doubt that “diminished” pleasure is bad enough, but a complete lack of it sucks even more.

What Anhedonia Feels Like

Anhedonia feels like an endless dribble of dirty dishwater. It feels like a constant, gray fog. It’s the experience of the word “bleh.” It’s nothing. I still have feelings, I guess, but they are so undifferentiated as they are unpunctuated by pleasure, they all feel the same. They all don’t “feel.”

People can’t understand a lack of feeling. Most people can get on board with your brain creating or intensifying feelings, but your brain deleting them seems just one step too far. I get it.

When things make you happy, it’s impossible to understand how things can’t make a person happy. Pleasure is a reflex. We don’t think about it, we just feel it. Something pleasurable happens, and we feel accordingly. I get it. I do. I just don’t feel it.

Why Anhedonia Matters to Motivation

What people also fail to realize is that if you don’t feel pleasure, you also have no motivation – this is because motivation and pleasure are inexorably linked in the brain.

It works like this:

Caveman is hungry and this is unpleasant.

Caveman works to find something to eat to make the hunger go away.

Caveman lifts up a rock and finds grubs to eat.

The caveman eats the grubs, the hunger goes away and this is pleasurable.

Because of this, the caveman is now motivated to look under rocks the next time he’s hungry.

But if the caveman didn’t find being full pleasurable, he would not necessarily have the motivation to find a rock to flip over to find grubs to eat the next time.

Taking this concept forward, if nothing feels pleasurable, then there is no motivation. I can’t say whether this connection is why a lack of motivation is part of depression or if a lack of motivation is simply its own symptom, but I know the connection is very real and debilitating.

Fighting Anhedonia and Lack of Motivation in Bipolar Depression

This is one of the reasons why people ask me how I do what I do. The answer is: I’m not sure.

I find intellectual motivation, I suppose. I still have that, even if I don’t have the feeling of pleasure. For one thing, I know that if I don’t do what I need to do, I won’t get paid, and that is critical, for obvious reasons. I also know that I, philosophically, “want” to do things. In other words, I know that if I did have a want, I would want this. Therefore I do it for that reason. I don’t know why that works, but I know it does for me.

Maybe I also have a hope that this will end and, so, I try to maintain a life that would bring me pleasure if I could feel it. I think I need a life that would make me happy so that when I feel happiness, one day, my life will support that. That hope is so tiny inside of me and yet so ingrained, that this just happens without my thinking about it.

As the above would suggest, I think it’s important to remember that bipolar depression anhedonia does end. I know it. I’ve felt it. It’s weird when medication works. It’s like a complete reversal of the suffering. And when that happens, it makes suffering through the anhedonia and fighting it and the lack of motivation worth it.

Banner image by Flickr user OUCHcharley.