People who experience anhedonia have lost interest in activities they used to enjoy and have a decreased ability to feel pleasure. It’s a core symptom of major depressive disorder, but it can also be a symptom of other mental health disorders. Some people who experience anhedonia don’t have a mental disorder.
What are the symptoms of anhedonia?
The two main types of anhedonia are social and physical anhedonia.
Social anhedonia is a disinterest in social contact and a lack of pleasure in social situations. Physical anhedonia is an inability to feel tactile pleasures such as eating, touching, or sex.
The symptoms of anhedonia include:
- social withdrawal
- a lack of relationships or withdrawal from previous relationships
- negative feelings toward yourself and others
- reduced emotional abilities, including having less verbal or nonverbal expressions
- difficulty adjusting to social situations
- a tendency toward showing fake emotions, such as pretending you’re happy at a wedding
- a loss of libido or a lack of interest in physical intimacy
- persistent physical problems, such as being sick often
What are the causes of anhedonia?
Anhedonia is a core symptom of depression, but not everyone who’s depressed experiences anhedonia. Prescription medication, especially medications like antidepressants and antipsychotics used to treat depression, can cause anhedonia.
Schizotypy is a psychology theory that certain personality traits may be a risk factor for developing psychotic disorders, such as schizophrenia. Social anhedonia is a risk factor for schizophrenia.
Anhedonia may also occur due to recreational drug use or having a large amount of stress or anxiety in your life.
What are the risk factors for anhedonia?
If you have a family history of major depression or schizophrenia, you’re at an increased risk for anhedonia. Other risk factors include:
- a recent traumatic or stressful event
- a history of abuse or neglect
- an illness that impacts your quality of life
- a major illness
- an eating disorder
Females are also at an increased risk for anhedonia.
How is anhedonia diagnosed?
Your doctor will ask you questions about your symptoms and your general mood. Make a list of all of your symptoms before your appointment, including the loss of experiencing pleasure. Telling your doctor all of your symptoms will help them to see the full picture and make a diagnosis. Your doctor may perform a physical exam to determine if you have any physical problems.
Additionally, your doctor may draw blood to test and see if you have a vitamin deficiency or thyroid problem that may be contributing to your mood disorder.
How is anhedonia treated?
Anhedonia can be challenging to treat. You’ll need treatment for the mental disorder that's causing the symptom, such as depression.
As the first step in your treatment, you should seek the help of a psychiatrist. A psychiatrist is a trained professional who can listen to your issues and help put you on the path to experiencing joy in life again. You can trust that what you say to your therapist is confidential.
Your primary care doctor can refer you to a therapist, or you can call your insurance company and ask them to help you find someone. It’s important that you and your therapist have a good rapport. You may need to have initial consultations with a couple of psychiatrists before finding one who you think will be a good fit.
You may also receive a prescription for an antidepressant or antipsychotic medication. Take the medication as prescribed, and let your doctor know if you have any side effects. They may need to adjust your dosage or medication. These medications affect people in different ways. A medication that works for you may not work for someone else with the same symptoms.
Another type of treatment is electroconvulsive therapy (ECT). ECT is one of the most effective treatments for depression. During your treatment, your doctor will place electrodes on your head and apply an electric current while you’re under general anesthesia. This induces a small brain seizure. ECT is usually only used when other treatments don’t work.
Transcranial magnetic stimulation (TMS) uses a magnetic field to stimulate your nerve cells. It uses a smaller electric current than ECT and you won’t need to be under general anesthesia. TMS can treat major depression in people who have depression that isn’t responding to medication.
A final treatment option is vagus nerve stimulation (VNS). Your doctor will implant a medical device similar to a pacemaker into your chest. The wires of this device create regular electrical impulses that stimulate your brain. As with ECT and TMS, VNS can treat depression in people who have depression that hasn’t responded to other treatments.
What is the outlook?
An inability to experience pleasure can impact your quality of life. Contact your doctor immediately if you feel this way. Once you start treatment, you should be able to start feeling pleasure again. Anhedonia usually goes away once depression is managed.