In psychology

Psychology

Psychology is the study of the mind and behavior. Its immediate goal is to understand individuals and groups by both establishing general principles and researching specific cases. For many, the ultimate goal of psychology is to benefit society...

 and psychiatry

Psychiatry

Psychiatry is the medical specialty devoted to the study and treatment of mental disorders. These mental disorders include various affective, behavioural, cognitive and perceptual abnormalities...

, anhedonia (icon ; Greek

Greek language

Greek is an independent branch of the Indo-European family of languages. Native to the southern Balkans, it has the longest documented history of any Indo-European language, spanning 34 centuries of written records. Its writing system has been the Greek alphabet for the majority of its history;...

: ἀν- an-, "without" + ἡδονή hēdonē, "pleasure") is defined as the inability to experience pleasure from activities usually found enjoyable, e.g. hobbies, exercise, social interaction or sexual activity.

Anhedonia can be a characteristic of mental disorders including mood disorder

Mood disorder

Mood disorder is the term designating a group of diagnoses in the Diagnostic and Statistical Manual of Mental Disorders classification system where a disturbance in the person's mood is hypothesized to be the main underlying feature...

s, schizoaffective disorder

Schizoaffective disorder

Schizoaffective disorder is a psychiatric diagnosis that describes a mental disorder characterized by recurring episodes of elevated or depressed mood, or of simultaneously elevated and depressed mood, that alternate with, or occur together with, distortions in perception.Schizoaffective disorder...

, schizoid personality disorder

Schizoid personality disorder

Schizoid personality disorder is a personality disorder characterized by a lack of interest in social relationships, a tendency towards a solitary lifestyle, secretiveness, emotional coldness, and sometimes apathy, with a simultaneous rich, elaborate, and exclusively internal fantasy world...

 and schizophrenia

Schizophrenia

Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...

. Affected schizophrenic patients describe themselves as feeling emotionally empty.

Mood disturbances are commonly observed in many psychiatric disorders. Disturbing mood changes may occur resultant to stressful life events and they are not uncommon during times of physical illness. While anhedonia can be a feature of such mood changes, they are not mutually inclusive.

Causes

Researchers theorize that anhedonia may result from the breakdown in the brain's reward system

Reward system

In neuroscience, the reward system is a collection of brain structures which attempts to regulate and control behavior by inducing pleasurable effects...

, involving the neurotransmitter

Neurotransmitter

Neurotransmitters are endogenous chemicals that transmit signals from a neuron to a target cell across a synapse. Neurotransmitters are packaged into synaptic vesicles clustered beneath the membrane on the presynaptic side of a synapse, and are released into the synaptic cleft, where they bind to...

 dopamine

Dopamine

Dopamine is a catecholamine neurotransmitter present in a wide variety of animals, including both vertebrates and invertebrates. In the brain, this substituted phenethylamine functions as a neurotransmitter, activating the five known types of dopamine receptors—D1, D2, D3, D4, and D5—and their...

. Studies by Paul Keedwell, MD, then of King's College, found that the brains of clinically depressed subjects had to work harder to process rewarding experiences.

Significance in depression

As a clinical symptom in depression, anhedonia rates highly in making a diagnosis of this disorder. The Diagnostic and Statistical Manual of Mental Disorders (DSM) describes a "lack of interest or pleasure" but these can be hard to tell apart given that people become less interested in things which do not give them pleasure. The DSM criterion of weight loss is probably related to it and many depressed people with this symptom describe a lack of enjoyment of food. People suffering from anhedonia in association with depression generally feel good in the morning and unhappy in the evenings and can portray any of the non-psychotic symptoms and signs of depression.

Sexual anhedonia

Sexual anhedonia in males is also known as 'ejaculatory anhedonia'. This condition means that the person will ejaculate with no accompanying sense of pleasure.

The condition is most frequently found in males, but women can suffer from lack of pleasure when the body goes through the orgasm

Orgasm

Orgasm is the peak of the plateau phase of the sexual response cycle, characterized by an intense sensation of pleasure...

 process as well.

Sexual anhedonia may be caused by:

• Hyperprolactinaemia
  Hyperprolactinaemia
  Hyperprolactinaemia or hyperprolactinemia is the presence of abnormally-high levels of prolactin in the blood. Normal levels are less than 500 mIU/L for women, and less than 450 mIU/L for men....
  
  
• Hypoactive sexual desire disorder (HSDD), also called inhibited sexual desire
  Inhibited sexual desire
  Hypoactive sexual desire disorder , is considered as a sexual dysfunction and is characterized as a lack or absence of sexual fantasies and desire for sexual activity for some period of time...
  
  
• Low levels of the hormone testosterone
  Testosterone
  Testosterone is a steroid hormone from the androgen group and is found in mammals, reptiles, birds, and other vertebrates. In mammals, testosterone is primarily secreted in the testes of males and the ovaries of females, although small amounts are also secreted by the adrenal glands...
  
  
• Spinal cord injury
• Multiple Sclerosis
• Use (or previous use) of SSRI antidepressants
• Use (or previous use) of antidopaminergic neuroleptics
• Fatigue
• Physical illness

It is very uncommon that a neurological examination and blood tests can determine the cause of a specific case of sexual anhedonia.

Patients may be prescribed sustained-release bupropion

Bupropion

Bupropion is an atypical antidepressant and smoking cessation aid. The drug is a non-tricyclic antidepressant and differs from most commonly prescribed antidepressants such as SSRIs, as its primary pharmacological action is thought to be norepinephrine-dopamine reuptake inhibition...

to aid in treatment, which has been shown to relieve sexual dysfunction even in patients without depression.

External links

• Anhedonia - Bipolar Disorder Symptoms
• No Pleasure, No Reward
• Forum: "Ejaculation without orgasm" forum (hisandherhealth.com) http://www.hisandherhealth.com/sexual-health-bulletin-boards/7-mens-sexual-health/39385-ejaculation-without-orgasm-ejaculatory-anhedonia
• Forum: "Ejaculatoryanhedonia.com" http://www.ejaculatoryanhedonia.com/