Anhedonia | 快感缺失
What Is Anhedonia?
什么是“快感缺失”
Anhedonia is the inability or reduced ability to feel pleasure. When a person suffers from anhedonia, they lose interest in the activities, hobbies, or experiences they used to love.
快感缺失，是指感受快乐的能力丧失或减弱。当一个人患有快感缺失时，他可能会对曾经热爱的活动、爱好或体验失去兴趣。
“Anhedonia, a term first used by Ribot in 1896, is a diminished capacity to experience pleasure. It describes the lack of interest and the withdrawal from all usual pleasant activities. Chapman et al. defined two different types of hedonic deficit: physical anhedonia and social anhedonia. Physical anhedonia represents an inability to feel physical pleasures (such as eating, touching and sex). Social anhedonia describes an incapacity to experience interpersonal pleasure (such as being and talking to others).”
快感缺失由 Ribot 于1986年首次使用，是指体验快乐的能力降低。它表述了对所有平时让自己感到愉悦的活动丧失兴趣且不再参与。Chapman 等人定义了两种类型的快感缺失：
生理快感缺失
社交快感缺失
生理快感缺失是指无法感受到生理愉悦，（如饮食、触碰和性活动等）。社交快感缺失是指无法感受到人际交往带来的愉悦（比如与别人共处和交谈）。
It has been associated with many mental disorders, including depression, bipolar disorder, schizophrenia, and substance use disorder. People who have physical conditions like chronic pain and Parkinson's disease may also experience anhedonia.
这已经被认为和众多精神障碍存在联系，其中包括抑郁、双相情感障碍、精神分裂和物质使用障碍等。患有慢性疼痛和帕金森等生理疾病的患者，可能也会有快感缺失体验。
Symptoms of Anhedonia
症状
The symptoms of anhedonia depend on the type.
不同类型快感缺失表现为不同症状：
Symptoms of social anhedonia may include:
社交快感缺失的症状可能包括：
Very few or no relationships at all
几乎没有或完全没有人际关系
Complete withdrawal from existing social relationships
从既有社交关系中完全脱离
A diminished capacity to express emotions
情绪表达能力骤降
Fake emotions in social situations (e.g., pretending to be happy at a celebration)
在社交情形中假装表现出某种情绪（比如在庆祝活动中假装开心）
Preference for being alone
更愿意独处
Symptoms of physical anhedonia may include:
生理快感缺失的症状可能包括：
A complete loss of libido or interest in sexual interactions
完全丧失性欲或对性活动的兴趣。
Frequent illness or other physical health issues
频繁生病或患上其他生理健康问题。
A person with anhedonia may miss out on big life events. By not maintaining their social connections, people with anhedonia may also have strained relationships and even a loss of social connections.
快感缺失患者可能会错过一些重大的人生事件。而且由于无法维持社交关系，他们可能还会陷入紧张的人际关系或甚至失去某些社交关系。
Complications
并发症
Studies show that those with anhedonia are more likely to be at risk of suicidal thoughts, suicide attempts, and death by suicide. This is especially the case among those with post-traumatic stress disorder (PTSD).
研究显示，快感缺失患者更易于产生自杀想法、尝试自杀或自杀死亡。PTSD患者中这种现象更显著。
Research has also shown that anhedonia may be a risk factor for dementia-related diseases, such as Alzheimer’s disease. In a 2019 study, older adults with anhedonia were five times more likely to develop dementia than peers without anhedonia.
研究还显示，快感缺失也可能是痴呆相关症状，比如阿兹海默症等的风险因素之一。在2019年的一项研究中，快感缺失患者患痴呆症的几率是非快感缺失患者的5倍。
Anhedonia has also been associated with a heightened risk of adverse cardiac events among patients with heart conditions.
在心脏疾病患者中，快感缺失也被认为与更高的不良心脏事件风险相关。
What Causes Anhedonia?
什么导致快感缺失？
It's unclear exactly what causes anhedonia. Studies show that it may be closely tied to certain processes in the brain. Researchers found that the part of the brain that controls reward, decision-making, anticipation, and motivation is often involved in anhedonia.
对其起因尚无明确结论。研究显示其可能与大脑中的一些过程密切相关。研究人员发现，大脑中控制奖励、决策、预期和动力的区域通常与快感缺失相关。
They theorized that people with anhedonia may lack the ability to anticipate good things and find motivation. They also have problems accurately judging the effort required to achieve a certain reward.
他们提出这一理论：快感缺失患者可能缺乏预测良好结果或找到动力的能力。他们同时还难以精确判断达成特定奖励所需要付出的努力。
Anhedonia is linked to several mental health disorders. It is considered one of the core features of depression. People with schizophrenia often report both physical and social anhedonia.
快感缺失被认为与数种精神健康障碍相关。它被认为是抑郁症的核心特征之一。精神分裂症患者也通常报告生理和社交快感缺失。
Research has shown that depression in bipolar disorder is also associated with anhedonia. Doctors use the severity of anhedonia to determine how severe a case of bipolar disorder is.
研究显示双相情感障碍中的抑郁症状也与快感缺失相关。医生根据快感缺失的严重程度来判断双相情感障碍的严重程度。
Anhedonia-like symptoms may occur when using recreational drugs or when going through withdrawal. Also, researchers have found that those who already have anhedonia may be more likely to start taking recreational drugs. They may also be more likely to become addicted.
当服用娱乐型药物或在戒瘾阶段时也可能会出现类似于快感缺失的症状。另外，研究人员也发现已经患有快感缺失的人更可能会开始服用娱乐型药物。另外他们也更可能对其成瘾。
Other conditions associated with anhedonia include:
其他与快感缺失相关的疾病包括：
Parkinson’s disease/帕金森症
Chronic pain/慢性疼痛
Diabetes/糖尿病
Eating disorders/饮食障碍
Autism/自闭症
The severity of anhedonia may be linked to the related health condition. A study found that people with schizophrenia, substance use disorder, Parkinson's disease, or chronic pain experience moderate levels of anhedonia. Those with depression have more severe anhedonia.
快感缺失的严重程度可能与相关健康症状有关联。一项研究发现，患有精神分裂、物质滥用障碍、帕金森病或慢性疼痛的患者更可能会产生中度的快感缺失症状。而抑郁症患者的快感缺失症状则较为严重。
Diagnosis
诊断
Medical professionals often use anhedonia as a symptom to diagnose a mental health illness. For example, anhedonia may lead your healthcare professional to look into whether you have depression or bipolar disorder.
专业医疗人士通常将快感缺失作为一种症状来诊断某种精神健康疾病。例如，你如果患有快感缺失，你的医生可能会考虑你是否患有抑郁症或双向情感障碍。
Anhedonia can be measured using a questionnaire. One of the most popular ones is the Snaith-Hamilton Pleasure Scale (SHAPS). It consists of 14 statements about enjoyable situations typically encountered in daily life. This might include food or drinks and interests or pastimes. You're asked to rate how strongly you agree or disagree with statements based on your memories of the past few days.
对快感缺失的评测可以采用问卷形式。其中最普遍使用的是斯奈思—汉密尔顿快感量表（SHAPS）。该量表包含了14项日常生活中常见的愉悦情形，其中包括饮食、兴趣或消遣活动等。你需要根据自己近期情况，对每一项的认同程度打分。
Your healthcare professional may also perform a physical exam and blood tests to ensure your anhedonia is not caused by a physical condition.
你的医生可能还会对你体检和验血，确保你的快感缺失并非因生理疾病而导致。
Treatment
治疗
Treatment for anhedonia depends on the condition or mental disorder it's associated with. For people with depression, antidepressants may be prescribed, while people with schizophrenia are often treated with antipsychotic medications. Treatment may also include psychotherapy.
对快感缺失的治疗取决于与其相关的疾病或精神障碍。对于抑郁症患者，医生可能会开具抗抑郁药物，而精神疾病患者则通常会被开具抗精神病药物。治疗方式也可能会包含心理治疗。
Since anhedonia may be associated with deficits in the reward system of the brain, a different approach may be necessary for its treatment.
由于快感缺失可能与大脑奖励系统缺陷相关，那么其治疗方式可能就需要一种不同的思路。
One study found that positive affect treatment (PAT) resulted in better outcomes than treatment focused on reducing negative feelings. This approach attempts to increase the brain's sensitivity to rewards.
一项研究发现，正面情感疗法（PAT）要比旨在减少负面感受的疗法要更为有效。这一疗法试图增加大脑对奖励的敏感性。
Some medications may be able to help with anhedonia associated with physical conditions. For example, research shows that people with Parkinson’s disease experience a reduction in anhedonia after receiving treatment with dopamine agonist medications such as pramipexole.
一些药物可能会对生理疾病导致的快感缺失有效。例如，研究显示，帕金森患者在服用多巴胺激动剂药物，如普拉克索后，快感缺失症状会减轻。
You should never quit taking your prescribed antidepressant without speaking to your healthcare provider first. Let them know if it's not helping or you’re experiencing unwanted side effects. They will determine whether your medication dose needs to be changed or if you need a new medication (and how to safely make the change).
如果没有先咨询你的医生，则不应停止服用被开具的抗抑郁药物。如果这些药物并没有效果，或给你造成不良副作用，则应告知你的医生。他们会判断是否需要改变你的药物剂量或为你开具新的药物（以及如何安全地切换至新药物）
Summary
总结
Anhedonia is when your ability to feel pleasure is reduced or absent. You lose interest in the things that normally give you pleasure and may withdraw from social interactions.
快感缺失，是指感受快乐的能力降低或缺失。对通常能带给你愉悦的事情，你丧失兴趣，而且可能会不再参与社交互动场合。
Anhedonia has been associated with different mental disorders and physical conditions, including depression, bipolar disorder, and chronic pain. Treatment of anhedonia involves addressing the condition that it's associated with.
快感缺失已经被显示与不同精神障碍和生理疾病相关联，其中包括抑郁、双相情感障碍和慢性疼痛。对快感缺失的治疗需要针对与其相关的具体疾病。
Losing interest in the things you once loved can be difficult to experience. Remember that these feelings can be temporary and that anhedonia is treatable.
对曾经所热爱的事物失去兴趣，这种感觉并不好受。但记得这些感受可能会是暂时的，而且快感缺失是可治疗的。
It's important to let your healthcare provider know what's going on. They can help you figure out what's causing your anhedonia. Your treatment may include medication, therapy, or a combination of both. With the right treatment plan, you can get back to experiencing pleasure in your life again.
告诉你的医生你的真实体验，这至关重要。他们能够帮助你找出快感缺失的原因。你的治疗方法可能包括药物、心理治疗或二者兼用。在合适治疗方案下，你就能够重新体验生活中的乐趣。