Early Recovery and Anhedonia

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The process of substance abuse and addiction can wreak havoc on the brain’s natural reward system, impacting crucial brain neurotransmitters and altering how we deal with motivation, anticipation, and reward.  This explains why so many women who suffer from a substance use disorder are reluctant to initiate and stay in treatment.   For example, certain drugs can cause an increase in dopamine, a naturally occurring brain messenger that regulates reward-motivated behaviors like eating and sex.  The same drugs can also decrease the number of dopamine receptors available in the brain, not allowing the person to derive pleasure from once stimulating activities.

Once the sites in the brain have been depleted enough, people begin to struggle with “anhedonia”, or an inability to feel joy whatsoever without their drug of choice.  In contrast to physical withdrawal symptoms (vomiting, sweating, palpitations, etc…), the condition of anhedonia can be hard to articulate and understand; the individual may think there is something wrong with their brain specifically rather than viewing it as a well-known phenomenon post drug abuse and addiction.  Some might argue “See!  I must need the drug to feel pleasure, so I will continue taking it!”, believing that they will never be able to experience pleasure in the normal fashion again.  Anhedonia is most common in early recovery and can be an enormous setback in achieving sobriety.  It is important for those in recovery to understand that healing takes time, persistence, and dedication.  No two cases are alike—but the brain can and does heal damaged neurotransmitter receptors (usually within 6 to 12 months).  For someone who has become used to instant gratification, this can be a hard pill to swallow.

Fortunately, there are a multitude of ways to combat anhedonia and increase the likelihood of success in your recovery program.  These include:

  • Psychotherapy
  • Behavioral Activation
  • Milieu Therapy (therapeutic communities or groups)
  • Yoga
  • Exercise
  • Nature Therapy
  • Normalizing Sleep Patterns
  • Socialization
  • Goal Setting and Visualization
  • Eliminating processed foods

Simply understanding this condition can be the key to maintaining sobriety and pushing through the times of apathy, with a hope for the future and the knowledge that this condition will eventually resolve itself.  Joy will come back in time, so give recovery a chance today!