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Patient information - Mental anaemia

Date Created: 26/05/2002   Last Modified:    Last Checked: 21/10/2002

Mental anaemia

A new illness has recently been described. In medical terminology it is referred to as "idiopathic hypomonoaminosis" although the term 'Mental anaemia' is easier to use and remember. The main symptoms are impaired mental concentration and energy and a reduced ability to experience pleasure. It is like having a flat battery.

The latest research indicates that the key changes in this illness are of two sorts. The first is a general and persistent reduction in motivation, enthusiasm and interest in usual activities. This is frequently experienced as a feeling of having to push yourself to do things that are usually easy and also losing interest in things you usually would be enthusiastic about. The change is consistent and persistent over a few weeks (not just a few days). These changes are unrelated to any loss or trauma (such as bereavement, relationship difficulties, job loss).

A way of visualising this lack of enthusiasm and motivation is to think of it as mental anaemia. That conveys the essential quality of reduction of mental energy. Frequent symptoms include poor concentration, poor memory, indecisiveness and other manifestations of inefficient thinking. Another important aspect of the view conveyed by the term mental anaemia is that it is a reminder that an effort of will, or pulling yourself together, is not sufficient to get over it. If you had anaemia of the blood, going on an exercise program will not cure your anaemia. So it is with mental anaemia, making an effort and pulling yourself together will not produce a lasting improvement. People with moderately severe degrees of this illness find that making an extra effort to do things can make them worse. This is probably because the lack of results from the extra effort that has to be made simply highlights the inability to do it properly which is like “rubbing salt into the wound”.

The above is multiplied as a result of the second major change: that of a generally reduced ability to get pleasure, enjoyment and satisfaction from those everyday activities which usually produce such feelings. It is a reduced ability to get positive feedback from activities. However, it can be hard to estimate changes in the extent to which you get pleasure from things; and it comes on slowly, so it is harder to notice.

Because everyone is different in their personality and character as well as their present situation and past life experiences these changes, described above, can effect people in many different ways. That is why having an understanding of the condition enables people to see how those changes effect them in particular.

An example may help to illustrate this. Anxiety symptoms, indecisiveness and loss of confidence are almost universal changes that are experienced in this condition. If motivation and enthusiasm are reduced, you will either have to push yourself harder to carry on, or actually finish up doing less. When you do things, the extent to which you feel good about what you have done is less than usual. For all of us, our confidence is continually reinforced by doing things and feeling successful about them. So not doing things, and not feeling good about it either, makes your confidence drain away.

Low confidence means that things that you would normally take in your stride become a hurdle to get over. Decisions become an effort and a burden to make. Which particular area of your thoughts or functioning this decreased confidence and increased anxiety mostly effects will depend on what sort of person you are. It may show itself in one hundred and one different ways and although anxiety may be especially troublesome in one particular area of your life it is usually possible to see that it is having some effect on many other aspects of life and functioning.

Summary

This condition is represented by a consistent and persistent set of changes, usually lasting for at least two weeks, which are different to normal for a particular individual (taking into account their life circumstances).

The two main changes are:--

1. Reduced mental energy and efficiency, indicated by a reduction in motivation and enthusiasm (mental anaemia) related other changes.
2. A reduction in the ability to get pleasure and enjoyment from things.

The above is, of course, just a different way of talking about the medical illness that is, most unfortunately, called 'depression'. However it is worth noting that many people have said to me over the years that the illness model it describes, and the anaology with anemia, has help them understand how it all adds up.

All text ©Dr Ken Gillman MRC Psych - PsychoTropical Research®


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