When dreading the thought of getting clean, a lot of the concern centers around the painful process of detox. Opiate withdrawal in particular is so miserable that it’s earned the name “dope sick.” But this phase of recovery ends relatively quickly (7-9 days on average). The feelings of emptiness that follow present a more perplexing problem. Many recovering opiate addicts find it difficult to experience joy in early recovery. There may also be some disconnect from naturally expressing the Anhedonia describes the inability to experience pleasure after quitting heroin.
Symptoms of Anhedonia
Anhedonia manifests in two main ways: socially and physically. Social anhedonia happens when a person no longer experiences pleasure in social situations. They tend to display a disinterest in social gatherings overall as well. Physical anhedonia covers the more visceral symptoms. This includes the inability to feel the physical pleasure one normally gets from things like eating, taking a relaxing bath, and of course sex.
People who experience anhedonia have lost interest in activities they used to enjoy and have a decreased ability to feel pleasure. It’s a core symptom of major depressive disorder, but it can also be a symptom of other mental health disorders. Some people who experience anhedonia don’t have a mental disorder. (Source)
The main symptoms of anhedonia include:
- Reduced ability to feel and/or express emotions
- Withdrawal from friends and relationships
- Changes in social interactions
- Showing fake emotions to avoid concern from others
- Lack of interest in intimacy or being around others
Link to Mood Disorders
The DSM-V lists anhedonia as a symptom of several mood disorders. It occurs in 70% of people with a major depressive disorder, including bipolar. Since dual diagnosis is so common among people in recovery, it’s important to recognize if an unaddressed mood disorder is actually the culprit.
Some common mood disorders that display anhedonia are:
Several other risk factors for anhedonia are: a recent traumatic event, major illness, a history of abuse/neglect, and having an eating disorder. But being in early recovery from substance abuse can cause anhedonia on its own, particularly in the case of opiates.
Why Everything Feels So Numb
Mood disorders aside, you may wonder, “What causes anhedonia when you get off opiates? Why doesn’t the brain snap back to normal once the chemicals all get flushed out?”
Unfortunately, brain chemistry doesn’t change back immediately once the opiates are out of your system. After a long history of substance abuse, the neural pathways that facilitate mood have rearranged. These pathways need time and attention to re-establish order and have synapses firing normally again.
Avoid Relapse: How to Experience Joy Again
Strategies exist to rebuild those old neural pathways which created joy in response to joyful activities. Those methods are highly individualized, so it helps to talk to a mental health professional to assess each individual case of anhedonia. But since idle hands don’t tend to fare well in early recovery, the effort is an important step to avoid relapse.
In most cases when it’s due to substance abuse, anhedonia just takes time to fade. Exposure therapy helps many individuals speed up this process. Physical exposure can take the form of working out (many recovering addicts become gym regulars), extreme activities like skydiving or indoor track racing, or taking on a new hobby such as biking. Social exposure is built into the 12 step fellowship through meetings. If you’re concerned about how to rebuild those old neural pathways (i.e. how to feel normal again), fellowship meetings offer a forum (with a low barrier of entry) to ask for help.
If you or a loved one needs help for a substance abuse problem, our addiction counselors are available 24/7 by phone: 855-737-7363