AnhedoniaCauses, Symptoms, and Treatment

What is anhedonia?

Anhedonia is an inability to experience pleasure or enjoyment in activities that used to bring you joy. It can occur on its own, as a common symptom of major depression, or as a symptom of another condition, such as schizophrenia or Parkinson’s disease. When present on its own, anhedonia can look like a general lack of interest or pleasure in different areas of your life, such as school, work, relationships, and hobbies.

There are two main types of anhedonia: social and physical.

• Social anhedonia is a lack of interest or pleasure in relationships and social interactions. You may not see the point in spending time with others. Instead of involving yourself in friendships and dating, for example, you choose to isolate yourself, cutting yourself off from others.
• Physical anhedonia is a lack of pleasure from sensory experiences, such as touch, sound, and smell. While you used to enjoy live music and dining out, for example, they may no longer feel pleasurable to you. You may feel as if nothing you do brings you joy, so you don’t bother trying new things or look forward to the future.

Having anhedonia can make life feel dull and dreary. When everybody else seems to find pleasure in hobbies, relationships, and experiences like eating good food or having sex, you may wonder why you’re different, or if something is wrong with you. This can lead to you isolating from others and avoiding situations where you anticipate not feeling any pleasure. Eventually, this can take a toll on your relationships with friends and loved ones, and how well you’re able to perform at work or school.

Whether anhedonia is present on its own or is the symptom of another condition like depression, it is treatable. There are steps that you can take to help overcome anhedonia, feel more enjoyment in activities, and regain a sense of joy in life.

Anhedonia vs. depression

Anhedonia can be a symptom of depression, but it can also exist on its own, without other depression symptoms.

People with depression experience more than just anhedonia. They also feel sad most days for at least two weeks and may notice changes in appetite and sleeping patterns, lack of energy, and difficulty concentrating. They may also have suicidal thoughts.

When anhedonia is present without depression, it can feel like a lack of enjoyment and pleasure without the chronic sadness or helplessness.

Causes of anhedonia

There are several possible causes of anhedonia. For most people, anhedonia is caused by a combination of factors, rather than just one.

Biological causes refer to what happens inside your body. Experts believe that anhedonia may be related to brain structure and function. They have found that people with anhedonia show more activity in the prefrontal cortex of the brain and less activity in another part of the brain called the ventral striatum. This may contribute to imbalances in neurotransmitters that are involved in feeling pleasure, such as dopamine and serotonin.

Psychological factors, including underlying mental health conditions, can contribute to anhedonia. A lack of pleasure may be a symptom of depression or anxiety. It can also be a reaction to experiencing trauma. People who have experienced war, natural disasters, accidents, and other traumatic events often have less interest in activities that they once enjoyed and an inability to feel positive emotions.

Environmental factors refer to what happens in the outside world. Experiences like chronic stress, substance use, and social isolation can play a role in anhedonia. When you are in a state of constant stress, you are less motivated to seek out rewarding experiences. This is an adaptive behavior from an evolutionary perspective. Feeling less motivated to seek pleasure or be around other people can be helpful if you are stressed or ill so that you can focus on healing. However, if it becomes a pattern it can become detrimental to your well-being.

Substance abuse can also be both a cause and an effect of anhedonia. There is evidence to suggest that some people who turn to drugs and alcohol do so because they experience anhedonia. Substances can sometimes provide the pleasure that you’ve been missing. At the same time, substance use can also contribute to anhedonia because of its effect on the reward system of the brain. When you use substances repeatedly over time, you may experience less pleasure when engaging in ordinary, non-drug- or alcohol-related activities. Substance use can also cause inflammation in the body, which is linked to anhedonia.

Anhedonia symptoms

Anhedonia is a common symptom of depression and often overlaps with other symptoms. If you have anhedonia, you may experience:

• Lack of enjoyment when doing activities that most people would find pleasurable. You find activities like socializing and hobbies to be boring or dull.
• Little interest in going out or pursuing pleasurable activities. You turn down social invitations, ignore friends’ calls, or have little interest in hobbies you used to enjoy.
• Sad mood. You experience a persistently low mood, hopelessness, or despair.
• Negative emotions like guilt, shame, or worthlessness. You feel negatively toward yourself often and struggle to acknowledge positive qualities about yourself.
• Low motivation. You feel unmotivated to care for yourself, others, or your daily responsibilities.
• Isolating yourself from social situations. You avoid situations where you would have to interact with other people.
• Emotional numbness. You feel disconnected from yourself or other people, or you don’t feel any emotions at all.
• Low energy. You feel tired often, even after a good night of sleep.
• Sleeping disturbances. You have difficulty falling or staying asleep, or you don’t feel rested after sleeping more than eight to 10 hours a night.

Many people experience temporary anhedonia from time to time, especially following a stressful event, such as bereavement from the loss of a loved one. When anhedonia persists for weeks or longer and impacts your ability to function in your life, then this could indicate a mental health condition like depression.

Diagnosis

Anhedonia is not a clinical diagnosis, although it can present on its own. It can also be a symptom of other physical and mental health conditions.

To diagnose anhedonia or depression, a mental health professional will conduct an evaluation, asking you about your symptoms and history. They may also have you complete questionnaires to better understand what you are experiencing. Based on this information, they will determine if you have anhedonia or any related condition.

Coping with anhedonia

Anhedonia is treatable, and there are steps that you can take on your own to improve how you feel. However, when you have anhedonia, it can often be a struggle to find the motivation or energy to take the first step.

Don’t try to tackle everything at once or set your goals too high. Rather, aim to draw on all your reserves and do one thing to improve how you feel, whether that’s taking a short walk in the park, reaching out to a friend, or reframing one negative thought. Taking the first step is always the hardest, but starting slowly can help you make the changes necessary to start to feel better.

Tip 1: Do things you enjoy (or used to)

It may seem counterintuitive, but reconnecting with the things that you once enjoyed can help you cope with anhedonia. This can be incredibly challenging if you’re feeling unmotivated, so starting small is a good idea. The benefits you feel from re-engaging in an activity can increase your motivation to keep doing more.

To get started, consider what hobbies or activities you used to enjoy. You could try:

• Playing a sport.
• Cooking a meal that you like or experimenting with a new recipe.
• Exploring your local library or bookstore.
• Going to the park or a cafe to people-watch.
• Watching a favorite movie.

Creative arts are another way to reconnect with old interests and passions. You could do something that you enjoyed in the past or try something new. The creative arts can take the form of mediums such as:

• Visual, such as painting, sculpting, or drawing.
• Music.
• Dancing.
• Theater.
• Literary, such as creative writing, poetry, or journaling.

You may not feel a lot better right away, but try to keep going. Even if you feel slightly better doing an activity, it becomes something you can build on.

Tip 2: Get moving

Physical activity, whether it’s in the form of exercise or movement that raises your heart rate, is a great way to combat anhedonia. Exercise releases endorphins, which can help to boost your mood.

Exercising when you’re experiencing anhedonia can be very difficult. When you’re not feeling pleasure, you may not have the motivation to get physically active, even though you know it’s good for you. Try to start small and work your way up from there. For example, take a walk around the block, do some light stretches, or just turn on some music and dance around your room. Even just ten minutes a day of physical movement is a good start.

There are lots of other ways to incorporate exercise and movement into your day.

• Try traditional workouts like running, swimming, or strength training.
• Stretching or yoga can help you incorporate mindfulness into an activity.
• Activities and hobbies that incorporate movement, such as roller skating, pickleball, or salsa dancing can add a fun element to exercise.
• If you exercise with other people, whether with a friend, in a team, or in a group exercise class, you get the added bonus of social connection.

Spending time in nature is also a way to cope with anhedonia. It is linked to lower rates of depression and anxiety and greater well-being. Consider combining nature and exercise by taking a walk or jogging outside, going on a hike, or doing outdoor sports.

Tip 3: Practice savoring

In everyday life, we rarely take time to truly appreciate our surroundings and what we are doing in the moment. Taking time to notice and fully enjoy small pleasures can enhance your positive feelings. This is a form of mindfulness or awareness of the present moment. When you are savoring an experience, you are focusing on really taking in everything about the experience.

Incorporating your senses into your mindfulness practice can be especially impactful. Here are some ways to practice savoring using your five senses:

• Sight. Take in a beautiful painting or scenery in nature. Notice what you see, including the colors and shapes.
• Hear. Listen to a song by an artist or composer that you like or try a sound bath. Relax as you focus on the sounds and get swept away.
• Taste. The next time you are eating a meal, instead of rushing, slow down and notice the flavors as you take each bite.
• Smell. Light a scented candle or some incense and take note of the smells. You can also do this while cooking or out in nature.
• Touch. Wrap yourself in a cozy blanket and feel the texture of the blanket against your skin.

Gratitude is another way that you can practice savoring. It is an appreciation for what you have in your life. Write down all of the things that you are grateful for, whether big or small. You can include your family and friends, work, pets, and health. Try to take note of things you would not ordinarily think of, such as having access to clean drinking water, food, and shelter.

These are just some ways that you can practice savoring, but you can do this with any pleasant experience. The key is to slow down and take in the experience, without rushing through it or getting distracted. If your mind does wander, simply notice this and redirect it back to the activity.

Tip 4: Change negative thinking patterns

If you’re experiencing anhedonia, your thoughts could be the culprit. Identifying and changing negative ways of thinking, a process called reframing can be helpful. The goal of reframing is to replace your negative thoughts with more positive ones.

As cognitive behavioral therapy (CBT) illustrates, our thoughts affect our emotions, which affect our behaviors. Cognitive distortions are negative thinking patterns that contribute to negative emotions like sadness, fear, and anger. These distortions are not based on fact and often lack evidence to back them up.

Some common cognitive distortions include:

Catastrophizing. Expecting the worst outcome to happen. When you think about going on a job interview, for example, you picture embarrassing yourself by saying the wrong thing.

Mental filtering. Focusing only on the negatives in a situation while ignoring any positives. You only focus on the one question you got wrong on an exam.

Polarized thinking. Viewing situations in extreme black-and-white or all-or-nothing terms. When you get praise at work, you feel confident, but anytime you get constructive feedback, you feel like a failure.

Jumping to conclusions. Assuming that you know what the future holds or what other people are thinking. When your partner says that they “need to talk,” you assume that they are going to break up with you.

Dismissing the positive. Minimizing the positives in a given situation. You tell yourself that your neighbor only talks to you because they need something from you.

Identifying your negative thoughts

The first step involves identifying your negative thoughts and cognitive distortions. Journaling can be a good way to start noticing your thoughts. When you see your thoughts on paper, you may be able to go through and identify cognitive distortions that you are using.

You can also take a piece of paper and divide it into three sections. Label the different sections with the following:

• Old thought
• Cognitive distortion
• New thought

In the left column under “Old thought,” write down some of the thoughts that you find yourself thinking regularly. Then look at the list of cognitive distortions and see if any of them fit with your experience. Then you can work on reframing the cognitive distortion and replacing it with a “New thought.”

Reframing your thoughts

Once you are aware of your cognitive distortions, you can work on reframing or changing your thoughts. To do this, take some time to reflect on the following questions. You can even journal your answers. Ask yourself:

• Is this thought helping or hurting me?
• What is the evidence for this thought?
• What is the evidence against this thought?
• Is this thought true 100 percent of the time?
• What other ways can I think about this?

Now challenge yourself to come up with a new thought. Your new thought should be neutral or positive and flexible. For example, “My neighbor only talks to me because they need something” becomes “I enjoy talking to my neighbor and hope that they enjoy talking to me, too. I don’t know what they are thinking or feeling, but their tone and body language tell me that they enjoy our conversations.”

As you work on reframing your thoughts, try to incorporate self-compassion. Practicing self-compassion involves kindness toward yourself, recognizing your common humanity, and mindfulness. No one has positive thoughts all of the time. Rather than judging or shaming yourself, remember that falling into negative traps is normal and it’s about progress, not perfection.

Tip 5: Make healthy lifestyle changes

Making certain lifestyle changes can also help improve your anhedonia. Consider changes in the following areas:

Diet. Eat a healthy balanced diet that includes fruits, vegetables, protein, and complex carbohydrates. Avoid processed foods, refined sugars, alcohol, and too much caffeine. If you’re unsure about what dietary changes to make or how to do them, consider meeting with a nutritionist or dietician.

Sleep. Lack of sleep can put you at risk for depression and other physical and mental health conditions. Most adults require eight hours of sleep a night. If you’re not getting adequate rest, you can work on improving your sleep hygiene by creating a relaxing bedtime routine and a comfortable sleep environment.

Social connection. If you’re feeling isolated or lonely, consider taking steps to reconnect with other people. You could call an old friend that you haven’t spoken to in a while and plan a day to get together. You could also attend a support group or sign up for a class. It can be uncomfortable to take these steps but remember that other people attending these events are also seeking social connection and likely feel just as uncomfortable as you.

Social media. Social media can provide many benefits, but sometimes too much time spent on social media can become detrimental to your mental health. If you suspect that your social media use is having a negative effect, consider taking a digital detox for a few days. If that feels like too much, you could unfollow accounts that don’t make you feel good and set limits on how long you spend on social media each day.

Stress. If you’re feeling overwhelmed or stressed, you could benefit from stress management techniques like relaxation and meditation. These activities are a part of a healthy lifestyle and can help you feel calmer and more centered. You can even start small with just five minutes of meditation a day.

Tip 6: Know when to seek professional help

While you may be able to manage mild cases of anhedonia on your own, there are times when anhedonia may need to be treated by a mental health professional. You should consider seeking professional help for your anhedonia if:

• You are experiencing other symptoms of depression, such as a sad mood for at least two weeks, changes in sleep and appetite, and difficulty concentrating.
• Your anhedonia is impacting your daily life or having a negative impact on your health, relationships, work, or other important areas of your life.
• You are having thoughts of hurting yourself or suicide.
• You don’t notice any improvement from coping with anhedonia on your own.

Anhedonia treatment options

Anhedonia is treated with psychotherapy and sometimes medication. With treatment, your anhedonia can improve and you can begin feeling more joy and pleasure again.

Psychotherapy, or talk therapy, is often used for treating anhedonia. Cognitive behavioral therapy (CBT) is the most common therapy for treating anhedonia. CBT helps you identify and change negative thoughts that contribute to negative emotions. It teaches coping skills and relaxation techniques so you can more effectively manage your emotions. You can find a CBT therapist in-person or through an online therapy platform.

CBT can also be combined with behavioral activation, a type of treatment that helps you engage with rewarding activities to improve your mood. Both of these therapies are effective treatments for anhedonia.

Interpersonal therapy (ITP) is another form of psychotherapy that can treat anhedonia related to depression. ITP is a brief, time-limited therapy that can help address unresolved grief, difficulty with life transitions, relationship conflicts with members of your support system, and other interpersonal struggles.

Medications may also be used to treat some cases of anhedonia. Antidepressants like selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are often prescribed for depression, but there is some evidence that they can worsen anhedonia and cause emotional detachment. Researchers believe that certain antidepressants that work on the dopaminergic system may be more effective than others when it comes to improving anhedonia.

Other medications have been studied less extensively but show promise for targeting anhedonia. Ketamine is a dissociative anesthetic that has antidepressant effects. It is also used as a treatment for depression. Stimulants used to treat ADHD have also been shown to help improve anhedonia.

Transcranial magnetic stimulation (TMS) is a treatment for depression that delivers magnetic pulses to the brain. These pulses stimulate nerve cells that are involved in mood. Current research shows promise for TMS as a treatment for anhedonia.

Improve your mental health today

If you feel a lack of pleasure or enjoyment in things you do or in your relationships, life can feel dull. Along with taking steps to cope with your anhedonia, treatment can target your symptoms so that you can start feeling enjoyment again. If you think you may be experiencing anhedonia, reach out for help today.

Last updated or reviewed on October 2, 2024