Anhedonia Makes It Hard for People to Feel Joy—Experts Explain More

How to best treat it depends on what's causing it.

In life, there are good days, bad days, and meh days—those are the kind of days where nothing really exciting or awful happens. But for people with a condition called anhedonia, most of their days are very meh; they've lost the ability to feel joy or pleasure, and the things that used to bring them contentedness or even excitement don't elicit those same feelings anymore.

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Anhedonia—which can be a common symptom of depression or other mental health conditions—can make it hard to maintain relationships with friends and family, and lead to difficulties doing tasks at work. But, for those with the condition, it's not something they have to live with forever. Mental health professionals explain what you need to know about anhedonia, including symptoms, causes, and treatment options.

What Is Anhedonia?

According to the American Psychological Association, anhedonia is described as the inability to enjoy experiences that would normally bring pleasure. "People who have anhedonia basically have lost the ability to experience pleasure or things they enjoy," Susan Albers-Bowling, PsyD, a psychiatrist at Cleveland Clinic, told Health. "You feel 'blah' about things that would traditionally make you happy or excited, [and] you don't care about much and your reaction to things is flat or nonexistent."

There are two main types of anhedonia— social and sensory. Social anhedonia occurs when a person doesn't get pleasure out of social situations—talking to friends, having new experiences, or even competing with others—like they used to. Sensory anhedonia—also called physical anhedonia—describes people who have lost pleasure from physical sensations, like the smell of freshly baked cookies or even sexual stimuli (also known as sexual anhedonia).

What Does Anhedonia Look Like?

Do you remember Eeyore from the book, Winnie the Pooh? That's what anhedonia can look like, according to Dr. Albers-Bowling. "Eeyore was a character who displayed a lot of [these] characteristics: He was pessimistic, gloomy, and didn't enjoy much."

However, anhedonia can present in a variety of ways and depends on which type of anhedonia the person is experiencing. Generally speaking, people who have anhedonia will feel a sense of numbness or lack of feeling. They'll also have an overall negative outlook, will stop smiling or reacting to things that would normally cause joy, and will exhibit more feelings of hopelessness, Dr. Albers-Bowling said.

Those who experience anhedonia, however, likely don't notice the change overnight, Jessica Stern, PhD, a psychologist at NYU Langone, told Health. "What oftentimes happens is that people will slowly start to disengage from or step away from things that used to bring them enjoyment or pleasure [after they] find they're feeling a disconnection," Stern explained. These activities might include going for a run or reading a book or even talking to a friend on the phone—any safe and healthy activities that you used to find enjoyable but don't anymore, Stern said.

What Causes Anhedonia?

Anhedonia is most often a symptom of depression, Stern said. But that isn't the only cause. "People can experience anhedonia outside depression, [but] it's not a diagnosis on its own," Stern explained.

Stern added that grief and anxiety can cause anhedonia. And the condition has been linked to anorexia, schizophrenia, substance abuse disorders, Parkinson's, PTSD, and other mental health conditions, Dr. Albers-Bowling said. According to a 2015 review of 168 studies published in the Journal of the American Medical Association, anhedonia was highest in people with major depressive disorder compared to several other health conditions.

It's not clear what mechanisms in the brain induce anhedonia, but experts do have some ideas. "Some theories point to a reduction in dopamine, the pleasure neurotransmitter in the brain," Dr. Albers-Bowling said. She added that much of the brain is involved in allowing a person to experience enjoyment, and the thinking is that, when these fail, that's when anhedonia can set in. "There are several parts of the brain believed to also be involved in the ability to experience joy and pleasure like the amygdala, which processes emotions, [and] the prefrontal cortex, which plans and processes rewards. These brain systems basically shut down."

Friends and family members often play a crucial role in the diagnostic process. According to Dr. Albers-Bowling, "Family members and friends often pick up on these symptoms and express concern." Stern added that, even if nobody has mentioned to you that you seem a little off, it can't hurt to seek out treatment from a mental health professional if you notice nothing is bringing you joy anymore.

How Is Anhedonia Treated?

Before you can be certain you're experiencing anhedonia, a healthcare provider will need to make sure you don't have another condition that presents in the same way. "First, a doctor will typically rule out any medical condition or vitamin deficiency that might be causing low energy and lack of motivation," Dr. Albers-Bowling said.

Oftentimes the treatment plan will revolve around whatever condition is causing the anhedonia, like depression, for example. "There is no direct treatment for anhedonia itself. In part, it is recognizing that anhedonia is often linked to other mental health conditions and treating the primary issue," Dr. Albers-Bowling said. "By treating the depression or mental health issue as a whole, the anhedonia tends to disappear or dissipate." This could mean going to therapy or taking an antidepressant, depending on what the cause of the anhedonia is, Albers-Bowling explained.

Stern added that if you do seek help for anhedonia, a mental health professional might suggest a practice called behavioral activation. "We describe anhedonia in the healthcare profession as feeling deactivated," Stern explained. Behavioral activation revolves around slowly taking steps to "reactivate" areas of your life you once found fun or joyful, and it's not necessarily a quick process. "Sometimes you might need to recondition yourself to find joy," Stern said. If a patient used to love going on runs, for example, they might be advised to take a short walk to get back into the habit, with the hope of finding enjoyment or pleasure during the process. The key here is to go slowly, rather than jumping back into your pre-anhedonia routine, which might be overwhelming. "Pacing is definitely very helpful," Stern said.

Fortunately, experts do know that working with a mental health professional can alleviate anhedonia, so you can get back to enjoying what you used to love to do. Dr. Albers-Bowling explained: "The good news is that anhedonia doesn't have to be permanent. When treated, people are like a wilted flower coming back to life, interested in doing things and engaging in life again."

If you or someone you know shows symptoms that could be related to anhedonia, talking with a healthcare provider might be a helpful first step.

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