What causes anhedonia

Anhedonia: Symptoms, Causes, Treatment

Written by Barbara Brody

In this Article

  • What Causes It
  • How It's Treated

Anhedonia is the inability to feel pleasure. It's a common symptom of depression as well as other mental health disorders.

Most people understand what pleasure feels like. They expect certain things in life to make them happy. Maybe you enjoy riding your bike, listening to the sounds of the ocean, or holding someone's hand. But some people lose the ability to feel joy. The things that once made them content are no longer fun or enjoyable. That's anhedonia.

There are two main types of anhedonia:

  • Social anhedonia. You don’t want to spend time with other people.
  • Physical anhedonia. You don’t enjoy physical sensations. A hug leaves you feeling empty rather than nurtured. Your favorite foods taste bland. Even sex can lose its appeal.

Anhedonia makes relationships, including those with friends and family members, a struggle. With the reward of enjoyment gone, it's hard to get motivated to spend time with others. You might turn down invitations and skip events like concerts, parties, and even one-on-one get-togethers because you no longer believe there's any benefit in taking part.

Or you could have social anxiety. You feel like you don't fit in, especially when meeting new people.

Relationships also thrive on positive feedback, and without it they can wither: Imagine not being able to tell someone you love them or that you had a great time spending the day with them. But if you have anhedonia, you can't, because you don't have those feelings. Meanwhile, loss of libido can take a toll on a romantic relationship.

It's also worth noting that some scientists believe anhedonia isn't always a black-and-white issue. You might feel no joy at all, or you could find that your positive emotions are dulled. In other words, it's possible to still like eating chocolate ice cream or listening to jazz; you just don't like those things nearly as much as you used to for reasons you can't explain.

What Causes It

Anhedonia is closely linked to depression, but you don't have to be depressed or feel sad to have it. It also affects people with other mental illnesses, like schizophrenia and bipolar disorder. And it can show up in people with seemingly unrelated health concerns like Parkinson's disease, diabetes, coronary artery disease, and substance abuse issues.

Scientists think anhedonia may be tied to changes in brain activity. You might have a problem with the way your brain produces or responds to dopamine, a "feel-good" mood chemical. Some early research (on rats) suggests that the dopamine neurons in an area of the brain called the prefrontal cortex might be overactive in people with anhedonia. This somehow interferes with pathways that control how we seek out rewards and experience them.

How It's Treated

Anhedonia can be tricky to treat. There’s no clear way to do it. The first step is generally to find any unknown cause, focus on treating that issue, and hope the anhedonia gets better as a result.

That's often true, especially when it comes to depression. People who take antidepressant medications (selective serotonin reuptake inhibitors, or SSRIs) may find that anhedonia improves along with the rest of their depression symptoms, but that's not always the case. Sometimes these medications blunt emotions and make this problem worse.

Scientists are working on new treatments for people with anhedonia who don't get better with treatments like SSRIs and talk therapy. One that shows promise is ketamine, a medication best known for being a party drug that also has an antidepressant effect. More research is needed, but at least one study found that people with bipolar depression who had anhedonia got relief from this symptom within 40 minutes of a ketamine shot.

SAMHSA’s National Helpline | SAMHSA

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  • SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.

    Also visit the online treatment locator.

SAMHSA’s National Helpline, 1-800-662-HELP (4357) (also known as the Treatment Referral Routing Service), or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations.

Also visit the online treatment locator, or send your zip code via text message: 435748 (HELP4U) to find help near you. Read more about the HELP4U text messaging service.

The service is open 24/7, 365 days a year.

English and Spanish are available if you select the option to speak with a national representative. Currently, the 435748 (HELP4U) text messaging service is only available in English.

In 2020, the Helpline received 833,598 calls. This is a 27 percent increase from 2019, when the Helpline received a total of 656,953 calls for the year.

The referral service is free of charge. If you have no insurance or are underinsured, we will refer you to your state office, which is responsible for state-funded treatment programs. In addition, we can often refer you to facilities that charge on a sliding fee scale or accept Medicare or Medicaid. If you have health insurance, you are encouraged to contact your insurer for a list of participating health care providers and facilities.

The service is confidential. We will not ask you for any personal information. We may ask for your zip code or other pertinent geographic information in order to track calls being routed to other offices or to accurately identify the local resources appropriate to your needs.

No, we do not provide counseling. Trained information specialists answer calls, transfer callers to state services or other appropriate intake centers in their states, and connect them with local assistance and support.

  • Suggested Resources

    What Is Substance Abuse Treatment? A Booklet for Families
    Created for family members of people with alcohol abuse or drug abuse problems. Answers questions about substance abuse, its symptoms, different types of treatment, and recovery. Addresses concerns of children of parents with substance use/abuse problems.

    It's Not Your Fault (NACoA) (PDF | 12 KB)
    Assures teens with parents who abuse alcohol or drugs that, "It's not your fault!" and that they are not alone. Encourages teens to seek emotional support from other adults, school counselors, and youth support groups such as Alateen, and provides a resource list.

    After an Attempt: A Guide for Taking Care of Your Family Member After Treatment in the Emergency Department
    Aids family members in coping with the aftermath of a relative's suicide attempt. Describes the emergency department treatment process, lists questions to ask about follow-up treatment, and describes how to reduce risk and ensure safety at home.

    Family Therapy Can Help: For People in Recovery From Mental Illness or Addiction
    Explores the role of family therapy in recovery from mental illness or substance abuse. Explains how family therapy sessions are run and who conducts them, describes a typical session, and provides information on its effectiveness in recovery.

    For additional resources, please visit the SAMHSA Store.

Last Updated: 08/30/2022

causes, symptoms, treatment in Moscow, making an appointment and consultation


Anhedonia is a mental state of the patient, which is often found in mental disorders. Anhedonia is characterized by a complete or partial loss of the ability to experience pleasure. The pathological state of the psyche leads to a loss of motivation to do what you love, hobbies, sports, music, interest in sexual life, social contacts is lost. Anhedonia is a symptom of various mental disorders such as: schizophrenia, depression, personality disorder, Parkinson's disease, post-traumatic stress and others. Anhedonia is most often diagnosed in patients with depressive disorders.

Anhedonia is being treated at the Yusupov hospital. The neurology clinic of the Yusupov Hospital specializes in the treatment of Parkinson's disease, various types of depressive disorders, Alzheimer's disease, dementia and other neurological diseases. The Yusupov Hospital uses innovative medicines certified in Russia, modern methods for diagnosing and treating depression and various mental disorders. The reasons for the development of anhedonia can be psychological and physiological. In the brain, “happiness hormones” (serotonin and dopamine) cease to be produced in the right amount, norepinephrine and adrenaline, “stress hormones,” are produced in large quantities.

Anhedonia can develop as a result of prolonged stress, brain diseases, after a brain injury, severe viral diseases and infections. Anhedonia accompanies various mental disorders - depression, schizophrenia, bipolar disorder, paranoia. The development of anhedonia is promoted by psychological reasons - pessimism, workaholism, nervous shocks. Characteristic features of the patient, busy work schedule, chronic stress do not allow to see the world in all colors, make life monotonous, dull, joyless.

CAC anhedonia

Different tests measure anhedonia differently. Anhedonia as a symptom is not included in the PANSS (Positive and Negative Syndrome Test), the SANS test does not distinguish between anticipatory and consummatory anhedonia, the symptom of anhedonia is considered together with asociality. In the BNSS scale, the symptom is considered as three separate components, a general analysis of the patient's behavior is carried out according to his demographic indicators. In the GAINS scale, anhedonia is defined by five points, there is no item on physical pleasure. Other tests based on self-assessment have been created that serve to determine anhedonia in any mental disorder:

  • SAS (SAS) - a scale for determining social anhedonia.
  • PAS - physical anhedonia scale.
  • TEPS - Temporal Pleasure Experience Scale.
  • ACIPS - Anticipatory and Consumatory Interpersonal Pleasure Scale.

Inability to get joy and pleasure from life due to psycho-emotional clamps, loss of interest in people, lack of attention and love for relatives, social isolation, rupture of social contacts - this is social anhedonia.

Anhedonia: how to treat

Several types of anhedonia are described:

  • Social. Social anhedonia is manifested by a loss of interest in people, including close people. Social contacts are broken, the quality of life decreases, the patient has no goals in life.
  • Physical. Physical anhedonia is characterized by a violation of sexual feelings, a decrease in the desire for intimacy (orgasmic anhedonia), the patient is not attracted to tasty food, pleasant aromas.
  • Intellectual and aesthetic. Anhedonia of this type is characterized by a lack of interest in hobbies, the patient stops doing his favorite activities, loses interest in books, music, television, loses interest in everything that pleased before.

There are a number of factors that influence the development of a mental disorder:

  • Violation of neuroendocrine regulation. Lack or excess of neurotransmitters leads to a loss of feelings of joy and happiness.
  • Traumatic injury. The negative impact of the injury can take several years to show.
  • Age changes. With age, changes occur - the hormonal system is rebuilt, brain cells lose their adaptive properties, regeneration properties, all processes in the body proceed slowly, the structure of nerve fibers changes, cognitive properties and emotionality are disturbed.

Anhedonia often develops in people who are conscientious and responsible, people who are used to solving their problems themselves and do not accept outside help. Among workaholics, women are more likely to suffer from the disorder. This is due to hormonal fluctuations in the body of a woman. In some cases, anhedonia develops with the use of antipsychotics. Treatment of the disorder will be more effective when the patient's attitude is positive. There are a number of recommendations that should be followed in order to achieve a positive result:

  • Sleep at least 7-8 hours a day.
  • No more than 8 hours a day.
  • Strict daily routine with observance of hours of work and rest.
  • Daily outdoor walks.
  • Complete nutrition.
  • Sports, dancing.
  • Watching positive programs and films.
  • Concentration of attention on positive emotions.

If you cannot cope with the disorder on your own, you should contact a specialist - a psychotherapist. The disease is difficult to treat, the restoration of the level of “happiness hormones” is required.

Paranoia and anhedonia: diagnosis and treatment

Paranoia is a mental disorder characterized by impaired cognitive functions, thinking, accompanied by obsessive-compulsive states. Paranoia is caused by brain disorders. Subject to paranoia are people with damage to the vessels of the brain, the elderly. Most often, paranoia accompanies diseases - Parkinson's disease, Alzheimer's disease, Huntington's disease, bad habits - alcohol, drugs, some medicines - can provoke the development of the disorder. Paranoia in some cases may be accompanied by depression with symptoms of anhedonia - loss of interest in life, the ability to enjoy.

The patient becomes distrustful, touchy, secretive, does not trust even the closest people. Unlike schizophrenics, the paranoid most often lacks the progression of negative symptoms, personality changes, hallucinations and illusions. Paranoids are able to function normally in society, unlike schizophrenics. The patient's condition may worsen after a stressful situation, he becomes more suspicious, aggressive, loses social skills, breaks social ties, paranoid delusions increase. The patient is in conflict with other people, repetitive stressful situations worsen the condition.

The development and course of anhedonia depends on the personality of the patient and the type of depressive disorder. An important role in the treatment of anhedonia is played by effective diagnosis and psychopathological analysis. If anhedonia is diagnosed, treatment can be done in specialized hospitals and clinics, medical centers, as well as in the Yusupov hospital. The Yusupov hospital is equipped with modern diagnostic equipment, the hospital includes a laboratory, a diagnostic center, various clinics, a rehabilitation center, and a hospital. You can make an appointment to see a doctor by calling the hospital.

Psychologists Seek Treatments for Anhedonia

Although the general public has become more aware of mental health issues such as depression and anxiety in recent years, some psychological symptoms remain a mystery to many. Case in point: anhedonia.

Anhedonia, defined as “a psychological state characterized by an inability to experience pleasure from normally pleasurable activities”, means the absence of good feelings that one would expect from things and activities that they once enjoyed, such as friendship, food , sex or music.

“Anhedonia is the absence of joy or pleasure,” says Los Angeles-based psychotherapist Alissa Mass. "It's usually considered a symptom of depression, although it can also be self-diagnosed."

In addition to depression, anhedonia can accompany other mental health problems such as schizophrenia, anorexia nervosa, and substance abuse disorders. It can also signal problems such as Parkinson's disease. For some people, anhedonia can be social (meaning they no longer feel joyful in the company of friends or acquaintances) or physical (touch can feel dull and food tastes weak).

The causes of anhedonia can vary, and a person does not need to be depressed to experience anhedonia. Experts believe that anhedonia may be due to changes in brain activity and an inability to produce or respond to the "feel good" hormone, dopamine.

Some studies (conducted on rats) show that anhedonia is associated with an overactive prefrontal cortex, affecting dopamine neurons and impairing desire and reward seeking.

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