Is it anhedonia, depression, or both?

Anhedonia can rob you of pleasure. You might not be interested in activities that used to bring you joy, or you may find yourself withdrawing from relationships that were once important to you. Anhedonia can be a challenging emotion and may signal an underlying mental health condition, like depression. However, anhedonia and depression aren’t the same thing. It can be tricky to tell the difference between the two at a first glance. 

Many people with depression also experience anhedonia, and vice versa. But it’s possible to experience one without the other. Anhedonia is also related to other mental health conditions, including schizophrenia. It can appear differently depending on what’s causing it.

Regardless of what’s at the root of your anhedonia, you deserve to feel pleasure and joy. Professional mental health treatment can help you get your passion back and enjoy your life again.

Anhedonia vs. depression

Anhedonia is the emotional experience of not being able to feel pleasure or joy. Some signs of anhedonia include:

• Losing interest in hobbies or activities that used to feel fun or rewarding
• Feeling emotionally flat or numb, even during situations that used to excite you
• Withdrawing from relationships or social connection
• Feeling like nothing matters or that nothing can bring joy

Anhedonia is a core symptom of depression, and, for many people, they go hand in hand. However, they’re not the same. Anhedonia is a symptom or emotional experience, while depression is a clinical mental health condition. You can be diagnosed with depression but not with anhedonia alone. While anhedonia often is a symptom of depression, it can also be a symptom of other mental health conditions. 

Examples include:

• Schizophrenia: Anhedonia is part of the “negative symptoms” of schizophrenia — the absence of emotional expression, motivation, and pleasure. People with schizophrenia might feel disconnected from people or experiences that once mattered to them.
• Bipolar disorder: During depressive episodes, people with bipolar disorder might experience anhedonia. Even during periods of stability, some people notice a lingering lack of pleasure.
• Substance use disorder: Using certain substances — especially stimulants or “uppers” — can lead to changes in the brain’s reward circuitry that cause anhedonia. Your brain may start to rely on these substances to feel pleasure and stop feeling joy when you’re not using them.

Although it’s not a mental health condition, anhedonia can also show up in people with Parkinson’s disease. Parkinson’s affects the same parts of the brain that are involved in reward and motivation, which may explain why some people with Parkinson’s report feeling emotionally flat or like they’ve lost the ability to enjoy life.

Further, depression isn’t always associated with anhedonia. Anhedonia is one of several core symptoms of major depressive disorder (MDD). You need to experience five core symptoms to meet the diagnostic criteria for depression.

Other symptoms:

• Depressed mood most of the day, nearly every day
• Significant changes in appetite or weight
• Sleep problems (insomnia or oversleeping)
• Fatigue or loss of energy
• Feelings of worthlessness or guilt
• Trouble concentrating or making decisions
• Thoughts of death or suicide*

*A note on safety: The 988 Suicide and Crisis Lifeline provides 24/7, confidential support with trained crisis counselors. If you or a loved one is in emotional distress or a suicidal crisis, please call or text 988. If you’re experiencing a life-threatening emergency or you need immediate help, please call 911.

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Anhedonia and depression together

Anhedonia is listed as a core symptom of many different depressive disorders, including:

• Major depressive disorder
• Persistent depressive disorder (dysthymia)
• Premenstrual dysphoric disorder (PMDD)

When you’re depressed, you may lose interest in many things, including activities that you used to enjoy. Also, depression and anhedonia can reinforce each other. You’re depressed, so you don’t have any interest in doing the activities that you typically enjoy. But because you’re not doing those activities, you may end up feeling more depressed.

For example, let’s say that you used to enjoy going dancing with your friends. This activity brought a lot of joy into your life. Because you’re depressed and dealing with related anhedonia, you no longer have any desire to go out. You’re experiencing a loss of interest, and it feels like nothing will ever bring you pleasure or joy again.

But because you don’t engage in these activities, you may end up feeling even more depressed. This can make you feel even less inclined to do enjoyable things, until you’re trapped in a cycle.

Unfortunately, experiencing anhedonia can make treating depression more difficult, so it’s important to directly address this symptom.

Overcoming loss of interest with support

If you’re experiencing anhedonia, depression, or both — or if there’s another condition, like substance use disorder, behind your lack of interest and pleasure — mental health treatment can help. By working with a therapist, you can get your joy back and feel like yourself again.

There’s not yet a clearly established way to treat anhedonia specifically. Some targeted treatment methods that may help you overcome depression-related anhedonia include:

• Cognitive behavioral therapy (CBT): A specific strategy called behavioral activation in CBT helps you start doing meaningful or enjoyable activities again — even if you don’t feel like it right away — to help jump-start the brain’s reward system.
• Mindfulness-based cognitive therapy (MBCT): MBCT combines mindfulness practices with principles of cognitive therapy. It can help you stay present, notice small moments of pleasure, and break the cycle of negative thought patterns that often contribute to depression and anhedonia.
• Positive affect treatment (PAT): PAT is a therapy model developed to help people increase positive emotions and re-engage with rewarding experiences. It focuses on building up your capacity to feel joy, excitement, and motivation.
• Medication: Certain medications may help address the neurological side of anhedonia. A psychiatrist can help you figure out which treatment is right for you.

If a condition like substance use disorder or Parkinson’s disease is behind your anhedonia, you may benefit from additional and more specific treatment methods that can help you manage these symptoms.

Find care with Rula

Whether you’re dealing with depression, anhedonia, or another mental health concern, you deserve to feel joy and pleasure in life. Treatment can help you reconnect with the parts of life that bring you meaning, even if it doesn’t feel possible right now.

At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best. 

Rula makes it easier to find a licensed therapist or psychiatric provider who accepts your insurance so you don’t have to choose between affordable care and excellent care. With a diverse network of more than 15,000 providers, 24/7 crisis support, and appointments available as soon as tomorrow, we’re here to help you make progress — wherever you are on your mental health journey.

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