Chronic pain and the inability to feel pleasure (anhedonia)

Chronic pain and the inability to feel pleasure (anhedonia)

There is an established connection between chronic back pain and depression, which is believed to be both situational and biochemical. A symptom that can occur in depressed individuals but is not as well known as other symptoms is called anhedonia.

Anhedonia is the inability to experience pleasure, especially from activities you once enjoyed. For example, a mother who doesn't like playing with her baby may be suffering from anhedonia. This is a particularly devastating condition. Not only does this make life joyless, but those affected may feel “crazy” or are bad people who no longer love those close to them. Understanding the mechanisms of anhedonia helps people with chronic pain cope.

Chronic pain and your brain

Anhedonia has a clear biochemical cause. To understand this condition, you must first understand a key component of the brain's reward processing mechanism, the neurotransmitter dopamine.

Dopamine fulfills many functions in the body. Most relevant to our topic is the task of triggering the reward/pleasure response in the brain. This motivates us to seek further rewards and pleasure by engaging in activities that elicit this positive response.

Dopamine is also part of the body's response to stress. It is responsible for the release of adrenaline, which occurs during physical or psychological stress and makes us ready to act. Chronic pain is both physically and mentally draining, meaning your stress response is constantly being triggered. Over time, the constant release of dopamine can affect your brain's supply. A lack of dopamine leads to a lack of pleasure.

Anhedonia is not a sign of madness or apathy. It is the result of your body's continuous efforts to respond to the stress of chronic pain. See http://www.netdoctor.co.uk/special_reports/depression/anhedonia.htm for more about biochemistry and anhedonia.

Effective treatment

If you go to a doctor or psychiatrist with anhedonia or other symptoms of depression, you will likely be offered an antidepressant right away. However, most antidepressants used today do not increase dopamine in the brain. An older class of drugs called MAOIs interfere with the breakdown and recycling of dopamine. However, this is believed to result in long-term neurotransmitter depletion.

One way to increase dopamine in the central nervous system is to supplement its precursors. Tyrosine is an amino acid that leads to the development of levodopa, which is converted into dopamine. Supplementing L-Tyrosine may help people with anhedonia. Levodopa can also be taken as a medicine in combination with another compound called carbidopa, which it delivers to the central nervous system. Finally, Levidopa can be found in the herb Mucuna pruriens.

Lifestyle and dietary changes can help increase your dopamine levels naturally. Being physically active can be beneficial because exercise stimulates endorphin release and dopamine production. For people with anhedonia, it is recommended to eat more protein as tyrosine is found in protein-rich foods such as eggs, cheese, almonds, fish and poultry. Finally, it is recommended to maintain healthy levels of D and B vitamins, which interfere with the proper functioning of dopamine.

Of course, one of the best ways to combat anhedonia is to manage the stress that caused it. It's difficult to keep up with your pain management plan when motivation is lost, but it's necessary to continue. Fear of activities associated with back pain and other conditions often leads to worse pain because the body's structures require movement to be replenished with fresh blood flow and maintain conditioning. If you're not responding to your current pain management efforts, look for new ones. There are many alternative options that go beyond conventional medicine. See http://nccam.nih.gov/health/whatiscam Further information on complementary and alternative medicine.

Understanding the cause of anhedonia and its connection to your chronic pain is the first step toward treatment. There are many natural treatment options for both back pain and its psychological and emotional effects.

Inspired by Amee LaTour