On Anhedonia: Shades of Grey · 11:00pm Feb 19th, 2016
DISCLAIMER: As always, I’m just an amateur idiot on the internet, so check this stuff out for yourself if it looks interesting.
There is very little that pleases me more than that occasional day when someone plows through Shades of Grey in one or two sittings. I’ve always said that I don’t mind if the majority of readers don’t ‘get it’ so long as it really lands for the few. To know that someone sat through 100k words of fanfiction in fairly short order is not a small thing and it doesn’t seem a stretch to think that there is another person who understood the core conflict either in part or in whole.
Yet, I would not be human if the number of people who feel that there is something they’re missing didn’t give me pause for thought. I suppose it doesn’t bother me a lot because I’ve always felt like I don’t see the world the same way as other people, so it actually feels right, in a way. But I’d never really imagine I would be able to bridge that gap… until now.
It started when I commented on a video about depression and SSRIs, and the host replied to me and said, “That sounds like anhedonia.”
I’ve read a lot or articles and studies on depression and related topics, probably thousands at this point, but that word hadn’t come up in any meaningful way that I had noticed. Upon Googling the term and ploughing through some articles, I discovered it appeared to explain how I see the world perfectly – and I do mean absolutely perfectly. Moreover, when I explained it to other people, it seemed to genuinely make sense to them with little effort. That, ladies and gents, is a rare thing.
At its most basic, anhedonia is the impairment of joy – literally the diminishment or absence of pleasure.
Like most things in the brain, however, it is not as simple as on and off:
“But depression may not shut down the pleasure circuits entirely. An alternative theory suggests anhedonia comes not from a reduced capacity to experience pleasure, but instead from an inability to sustain good feelings over time. In other words, maybe pleasure is experienced fully, but only briefly--not long enough to sustain an interest or involvement in life's good things.”
—Depression and Anhedonia, Psychology Today (December 2009)
In talking to a number of people in the last two weeks, I have found that everyone seems to fall into polarised opposites when it comes to answering a hypothetical that my counsellor posed: “If you could be completely and totally absent of all needs and drives, you wouldn’t want that, would you?”
He genuinely assumed that no-one would want that option – to essentially be content with laying down and dying without a care in the world or any bad feelings – but I jumped in very sharply with a “Hell yes, I would.” It was clear at the time that this response confused him, which angered me. On one hand, it annoyed me that he had assumed my position on the matter, but moreso it annoyed me that his way of seeing the very concept of existence itself could be so alien to my own. How could I work with someone so dismissive of something that was my day-to-day reality?
Naturally, this is where I started asking other people to see what they made of it. About 70% of people I talked to came out as yes, and both they and the no’s were equally emphatic on the issue. There was not a single person even close to fence-sitting or uncertainty – like an inverted bell-curve where the dead centre was absolute zero – which made sense, since the kind of people I tend to be around would be biased towards thinking and feeling a similar way to me. Still, what made it really interesting was the apparent emotional investment from either side. To all of them, the ‘correct’ answer seemed as obvious as the existence of gravity.
There seemed to be two fundamentally different experiences of life going on, and it directly correlated to what I’d been saying since the very first session of counselling I ever had: what I really wanted was to want to be alive. That was a feeling I’ve never had. Anhedonia, it seems, is the reason, and I think I can sum it up in a model that both camps can understand.
I think we all know that the brain operates on a pretty rigid carrot and stick arrangement. Usually, we talk about the ‘stick’ side of the arrangement, fear, but in this case we’re looking at the ‘carrot’ side, rewards: immediate pleasure stimulates the prefrontal cortex, while the expectation and anticipation of pleasure stimulates the nucleus accumbens, deep in primal ‘lizard’ part of the brain stem. Anhedonia appears to be the muting of one or both of these brain functions. In the prefrontal cortex, it can mean that the brain literally has to word harder to process positive emotions, and can easily find them overwhelming or simply produce a diminished effect because it can’t process all of it. In the nucleus accumbens, it means that emotions not occurring in real time become hollow and meaningless, thus providing no emotional impetus.
Person A has a fully-functional reward system and can experience great pleasure both sensually and conceptually. This is a positive model of experience. Having needs and desires creates an opportunity to fulfil those desires and thus have positive experiences. Moreover, those positive experiences can be just as powerful in the abstract as they are in the moment: knowing that he’s going out with friends at the end of the week may bring him just as much pleasure as actually going.
Person B has anhedonia: the impairment of both immediate and conceptual pleasure. He has a negative model of experience. When he experiences something good, he doesn’t feel a positive emotion, all he feels is a reduction of a negative emotion. A net of zero negative emotion is the absolute best state of existence he can perceive, and the conceptual things like love, family, the future, and that fun thing he did last week with a truckle of cheese are devoid of positive emotional context; he can definitely feel negative emotions just fine.
Both people feel that they have positive and negative experiences, but how they perceive those experiences is completely different. Where person A experiences a +1 in happiness, person B experiences a -1 in unhappiness. mathematically, these are identical, but in reality, they are night and day: person B has no idea what it physically feels like to experience a +1. Similarly, both have learned the same words to convey their differing emotions: both say ‘happy’ but one means plus one and the other means minus negative one.
From the outside, they appear the same – so much so that people don’t even know they’re having different experiences the vast majority of the time. Suffice to say that, based on whether a person has a positive or negative experience of life, my counsellor’s hypothetical either looks like perfect bliss or the total annihilation of all positive emotions. There is little middle ground possible, yet one is capable of real happiness and the other is merely surviving. Even someone who has previously seen the full-colour perspective of the world will not be able to remember those colours – those feelings – because the parts of the brain necessary to re-experience them are impaired.
In reality, anhedonia is more of a scale that I represented here, but I have shown it as such to make the case easier to see. Personally, I think I fall into the severe end of the anhedonia scale: I can have the best day in the world, and twenty seconds after it’s over, it might mean absolutely nothing. The idea of death means absolutely nothing to me except the absence of negative emotions: no fears, no unmet needs, no distress. It literally seems like perfection, but I also know that this isn’t all that there is because I also know that my brain is still capable of feeling those plusses. For a little while, a long, long time ago, it worked, so imagine my surprise when I read that this is actually normal for anhedonia.
You see, the impairment that is anhedonia is a biological function, not merely a by-product. Think of it as being a bit like shock: in the right circumstance it can save your life, but firing at the wrong time it can kill you. Anhedonia is just a system, and scientists have discovered that they can turn those brain functions back on with a small dose of ketamine. Unfortunately, ketamine will screw a person up pretty quickly, so it’s not much more than a suicide prevention tool at this stage, but it means that sufferers can be brain-scanned in fairly rapid succession while in pre- and post-hedonia states. At this time, therapy is the only known permanent cure for anhedonia, and the ‘permanent’ part is shaky at best. Anhedonia is generally understood to be a result of stress – cortisol, specifically – and one does not go away without addressing the reason for the other.
All of this brings me back to thinking about Shades of Grey and other writings. The fact of the matter is that I physically do not see the world as some 70-80% of the world does (yes, anhedonia is that widespread). I have friends who have read my work and understood what it means with absolutely no trouble at all. I suspect all of these people either have, or have experienced, anhedonia. Some may merely have experience with sufferers and thus recognise the effects and the patterns, even if they don’t understand it. But many, even most, will see characters acting bizarrely and nonsensically.
I wrote Shades of Grey to give voice to a clash of perception that I knew not many people would have ever experienced or thought about. I could not have known just how alien some of those feelings would seem to many people (thought I have been around the fandom long enough to guess that as much as 60% of it has experience with anhedonia, probably 30% severely so), or that that altered perception had a name. In the story, Rarity has a temporary case of anhedonia brought about by a magical malady during a time of great personal stress and self-doubt. She learns about herself through this shift in perception, and in time she recovers and is a better pony for it. For some, it will never end – until the end, at least.
For me, I know more than I did yesterday. It’s not a plus, but it is minus a negative.
I can fight it, but what really hurts is watching those who don't know how to. I can't imagine how hard it must be for those that don't even understand what it is their friends and family suffer from – those who see in colour that cannot see the world through the eyes of one who only sees in shades of grey.
-M
Thank you for that blog post. I'll make sure to remember that word, and maybe I'll be able to use your story to better understand how Anhedonia works.
Your last paragraph sure struck home for me - I think anhedonia and my inability to deal with it lost me a friend once.
We'd been able to talk about everything, because he was one of the rare persons that can put nearly every abstract thought into words, even if our opinions were on opposite ends of the spectrum most of the time. Even after the most light-hearted activities, we'd end up talking about the 'big questions'. Suicide was a recurring topic.
He said he didn't feel like it now, but he wouldn't rule it out completely, whereas my thoughts boiled down to: "Things suck? Quit what you're doing, move to a different city, start anew... there's always some fun to be had, right? No matter how hard a situation sucks, throwing away your opportunity to have things looking up again can't be worth it."
When he got toyed with by a girl and shit hit the fan in his work at university, discussions revolved more and more around how he couldn't be positive about anything anymore, even about resolving his most immediate issues. Trying to be a good friend, I tried to set things in a more positive light and help him come up with ideas, but that didn't really help.
It got so bad that one evening, when he'd hit me with another torrent of negativity and self-loathing (which is probably unrelated to the anhedonia thing), I kinda broke down infront of him and said "you need help, but I can't help you" in between sobs.
I started avoiding him, and to some degree, I think it was mutual; maybe he'd been disappointed in me. Last thing I know, he actually went into counselling, but I don't know what for specifically. At that time, the relationship had deteriorated beyond the point that would make talking about things such as counselling feel natural. Haven't talked to him in 3 years now.
Had I read such a blog post earlier, things would have made more sense. Would I have been able to help... probably not. Please tell me, Scott, how do you fight it? Is there even any way for a friend or family member to assist? How should Person A deal with Person B? How do you deal with A-people -- they must feel like obnoxious Pinkie Pie-ish characters to you, don't they?
This is a very interesting perspective. It probably explains how comedians can suffer from crippling depression, and still make others laugh: They get how to make things "better", even if they don't experience it in the same way.
3765312
Yeah... I wouldn't put it quite like that. Maybe it'll help someone see a different kind of perception, but I didn't know enough back then to make it explain much.
That is to be expected. What most people can't see when they don't understand depression (and by extension, anhedonia) is that suicide is a logical endgame, not necessarily an emotional one. Some people will immediately think I'm talking bollocks on that point and they are simply wrong.
Of course, I have the breadth of knowledge to understand why that is, so it doesn't annoy me, but go back maybe six or seven years and that kind of think really fried my rice. Unfortunately, it is also inevitable in a society that doesn't understand mental health.
Entirely normal. Entirely predictable.
And this is exactly the rough part. I know someone who suffers as much, maybe even more, than I do. My wealth of knowledge and experience is insufficient to help her feel good when she feels bad. But, being able to give her an experience where what she says actually makes sense, rather than being deficient, or broken, or a weirdo, is a gift that no-one else in her life can give her. I think people have an instinctive resistance to not challenging those feelings because of the attachment to suicide, and people don't understand that understanding and normalising how they feel is more likely to pull them away from it than drive them towards it. Feeling that we are understood by someone is one of the most grounding and connecting experiences a person can have.
I would beg to differ, but I don't know the details. However, I would point out that in clinical trials using ketamine, positive self-image could be seen to re-appear in at little as forty minutes.
Please note: this does not mean anyone should run out and try to score some ketamine.
In case it needs saying, cut yourself some slack over this; it was probably the right thing to do. If you can't handle the emotional baggage, you're going to be hard-pressed to help anyway. Pretending you can understand something you don't is demeaning to everyone.
That would be why I wrote it as soon as I knew how :)
It may seem odd, but it's really hard for me to say this: living with anhedonia is literally torture. I have torn my leg open on a gatepost and needed eighteen stitches to sew it back up, and that was a cakewalk next to the any one of my bad days. Think back to how bad it seemed for that friend of yours and imagine that he was probably holding 90% of how he felt back because he knows intuitive that other people can't handle it. if you want to deal with someone like that, you have to handle all of it, and you have to be the one to prove it. You can't fix them, but you can give them a space to be absolutely 100% honest about how they feel, no matter how deep that rabbit hole goes. And when they're done, you need to go back for more because they will assume that you won't want to go near them again.
You also need to be able to express the thoughts that they can't, and that's where philosophy comes in. You cannot go in with preconceptions about emotions: family has no inherent meaning or validity, love is just an empty word, life is not a gift. When it comes to matters involving positive emotions, understand that the sufferer probably has a better perspective on reality that you because he is not as biased as you by irrational positivity, but likewise, you have to hold them to the same standard regarding irrational negativity.
Finally, get them angry. Somewhere inside every sufferer is a catalogue of things that have lead to their biological defence posture. The only way out is anger because that is what anger is for. Work out what it is they are most angry about and be angry on their behalf – don't try to fix it, just show them that it is worth being angry over. The day they feel comfortable getting angry over it is the day the real recovery starts; everything up to that point is just symptom management (which is not to say that that isn't necessary and important, but these are the facts). Anger isn't what fixes the problem, but it sure as hell opens to door to being honest about what the problem actually is and how much it hurts them. Ideally, this is what counselling is for, but getting people to go to counselling is hard.
As to how I fight it?
Barely.
Yes and no. The positivity isn't the problem, in fact, even in my state, positive people are still the nicest people to be around, but only if they're appropriate open minded. Pinkie Pie is obnoxious to me because she is dogmatic: X is good therefore you should feel good if you do X. That whole way of thinking is anathema to people like me. But when someone like that is actually paying attention to me and listening to what I'm saying and how I feel, that is the best combination in the world.
I have met one such person in all of my days, and two weeks time, I start working for her because I trust her. Sure, she can be oblivious on occasion, but when I need her to stop and listen to me, I know I have her absolute attention and understanding.
These people are rare as rockinghorse shit. But they exist. The rest? Yeah, they come off as pretty obnoxious. But to me, they mostly come off as really dumb.
ADDENDUM: To clarify a point that now realise I made a long time ago, anger is the emotional response to a lack of negotiation. Getting someone angry is a path to understanding that they have not been treated fairly in some manner; getting them to let go of that baggage is a whole different ball game best left to professionals.
3766142 Moreover, the crippling depression is often the exact reason why they can make people laugh. They draw attention to commonplace insanity because it is that very perspective that allows them to see it in the first place. Bear in mind that, as a personality trait, comedy is usually a system of deflecting from one's perceived inferiority.
3765312 Actually, scratch the first part of my reply:
Do so, but note that Rarity is the anomaly in the story. If you want the story of an anhedona sufferer, pay careful attention to Luna: she is the truly afflicted character. Take what I've written in this blog, re-examine Luna in both Shades of Grey, and realise why I thought the epilogue from Luna's perspective was absolutely necessary to rounding out the story: Celestia could not see through Luna's eyes and thus played here part in Luna's fall.
3766143 Thank you for your reply and added perspective. I said the self-loathing was probably unrelated because I didn't want to attest too much to anhedonia, and I didn't really see the connection there. There were other factors in his past that I saw contributing to this, like catholicist indoctrination paired with early-adolescent homoerotic experiences, or the "never getting recognition for anything" syndrome of being the youngest of 5 sons.
How does self-loathing relate to anhedonia for you? Does society thinking there's something wrong with you translate into that?
Thank you for that. I still feel bad about it, because he had issues with showing vulnerability, and I kept signalling "don't fret, I'll hear you out," yet when he actually did, I couldn't handle it at all.
In our social circle back then, so many guys shared my first name that we had to use prefixes: There was the small wyvern, the pierced, the bald... me, I was the strong one. After the incident, he said he'd never have expected to see the 'strong wyvern' cry, which kinda meant that I wasn't who he'd hoped I could be for him.
Then again, bursting that bubble of his was probably for the better... he sought professional help at last.
I will. If I need some clarification, may I write questions in the comments or shall I take it to pm?
3766481
For me, it's that I have being human at all: the chaotic amalgam of wants and needs and desires just makes me feel like I'm in everyone's way all the time and the world would be better off if I wasn't around. No amount of conscious thought changes that I feel that way. But what really makes things difficult is that I know all too acutely that I'm the one that's ostensibly broken. I don't work properly – I am defective. I don't feel like I contribute anything meaningful because the emotion requires is either chronically diminished or simply absent.
This actually means that I get the most positive reinforcement from people in a similar position to me. It's not just that I can connect with them through shared experience, it's that I can't conceive of how someone else feels about me if I am literally devoid of the feelings that would guide me. With someone who is lacking those feelings, I can actually believe that I understand them and they understand me.
But I think the crux of it is, I'm sad to say, somewhat bleaker still. Without the sense of feeling loved, a person starts to assume that they are not lovable. The fact that the 'not feeling loved' part has no direct correlation to whether anyone actually does love me is irrelevant; if I can't feel it, it basically doesn't exist. Think about how many people have said 'everyone would be better off without me' when talking about suicide and you'll quickly see that this isn't specific to me at all.
Either/or. I'm more than happy to have question on public display in the comments section so long as you're comfortable asking them in such a manner. People should know to stay away from comments sections to avoid spoilers :)
Huh. Learned a new word today. Don't have Anhedonia nearly as bad as you do, but it certainly seems to be a major component of my own mental glitches. Or at least something very similar. Only skimmed the post right now, but I've got it on my list of things to read more in-depth later when I'm in the right mindset to sit down and read.
As for this:
I would want a bit more definition of needs and desires, but probably in the same camp as you. I just have a hard time seeing the brain as modular enough to actually accomplish it even with imagination magic. Too much interconnected systems that my imagination just kind stalls out if I try to think of any version of it besides the most basic surface-level situation. Does amuse me that the person you heard that from assumed everyone would react the same way, given what I take to be his job.