What Is Anhedonia?

Anhedonia is the inability or reduced ability to feel pleasure. When a person suffers from anhedonia, they lose interest in the activities, hobbies, or experiences they used to love.

It has been associated with many mental disorders, including depression, bipolar disorder, schizophrenia, and substance use disorder. People who have physical conditions like chronic pain and Parkinson's disease may also experience anhedonia.

This article discusses the types, causes, and symptoms of anhedonia. It also covers how it's diagnosed and treated.

Types of Anhedonia

Some researchers divide anhedonia into two types: social and physical.

Social anhedonia revolves around social situations. It causes a decreased interest in social interactions and reduced pleasure from engaging in social situations.

Physical anhedonia describes a person’s inability to feel pleasure from physical things that are normally pleasurable. This includes eating, touching a loved one, and engaging in sexual interactions.

Symptoms of Anhedonia

The symptoms of anhedonia depend on the type.

Symptoms of social anhedonia may include:

• Very few or no relationships at all
• Complete withdrawal from existing social relationships
• A diminished capacity to express emotions
• Fake emotions in social situations (e.g., pretending to be happy at a celebration)
• Preference for being alone

Symptoms of physical anhedonia may include:

• A complete loss of libido or interest in sexual interactions
• Frequent illness or other physical health issues

A person with anhedonia may miss out on big life events. By not maintaining their social connections, people with anhedonia may also have strained relationships and even a loss of social connections.

Complications

Studies show that those with anhedonia are more likely to be at risk of suicidal thoughts, suicide attempts, and death by suicide. This is especially the case among those with post-traumatic stress disorder (PTSD).

Research has also shown that anhedonia may be a risk factor for dementia-related diseases, such as Alzheimer’s disease. In a 2019 study, older adults with anhedonia were five times more likely to develop dementia than peers without anhedonia.

Anhedonia has also been associated with a heightened risk of adverse cardiac events among patients with heart conditions.

What Causes Anhedonia?

It's unclear exactly what causes anhedonia. Studies show that it may be closely tied to certain processes in the brain. Researchers found that the part of the brain that controls reward, decision-making, anticipation, and motivation is often involved in anhedonia.

They theorized that people with anhedonia may lack the ability to anticipate good things and find motivation. They also have problems accurately judging the effort required to achieve a certain reward.  

Anhedonia is linked to several mental health disorders. It is considered one of the core features of depression. People with schizophrenia often report both physical and social anhedonia.

Research has shown that depression in bipolar disorder is also associated with anhedonia. Doctors use the severity of anhedonia to determine how severe a case of bipolar disorder is.

Anhedonia-like symptoms may occur when using recreational drugs or when going through withdrawal. Also, researchers have found that those who already have anhedonia may be more likely to start taking recreational drugs. They may also be more likely to become addicted.

Other conditions associated with anhedonia include:

• Parkinson’s disease
• Chronic pain
• Diabetes
• Eating disorders
• Autism

The severity of anhedonia may be linked to the related health condition. A study found that people with schizophrenia, substance use disorder, Parkinson's disease, or chronic pain experience moderate levels of anhedonia. Those with depression have more severe anhedonia.

Diagnosis

Medical professionals often use anhedonia as a symptom to diagnose a mental health illness. For example, anhedonia may lead your healthcare professional to look into whether you have depression or bipolar disorder.

Anhedonia can be measured using a questionnaire. One of the most popular ones is the Snaith-Hamilton Pleasure Scale (SHAPS).

It consists of 14 statements about enjoyable situations typically encountered in daily life. This might include food or drinks and interests or pastimes. You're asked to rate how strongly you agree or disagree with statements based on your memories of the past few days.

Your healthcare professional may also perform a physical exam and blood tests to ensure your anhedonia is not caused by a physical condition.

Treatment

Treatment for anhedonia depends on the condition or mental disorder it's associated with.

For people with depression, antidepressants may be prescribed, while people with schizophrenia are often treated with antipsychotic medications. Treatment may also include psychotherapy.

Since anhedonia may be associated with deficits in the reward system of the brain, a different approach may be necessary for its treatment.

One study found that positive affect treatment (PAT) resulted in better outcomes than treatment focused on reducing negative feelings. This approach attempts to increase the brain's sensitivity to rewards.

Some medications may be able to help with anhedonia associated with physical conditions. For example, research shows that people with Parkinson’s disease experience a reduction in anhedonia after receiving treatment with dopamine agonist medications such as pramipexole.

Summary

Anhedonia is when your ability to feel pleasure is reduced or absent. You lose interest in the things that normally give you pleasure and may withdraw from social interactions.

Anhedonia has been associated with different mental disorders and physical conditions, including depression, bipolar disorder, and chronic pain. Treatment of anhedonia involves addressing the condition that it's associated with.

A Word From Verywell

Losing interest in the things you once loved can be difficult to experience. Remember that these feelings can be temporary and that anhedonia is treatable.

It's important to let your healthcare provider know what's going on. They can help you figure out what's causing your anhedonia. Your treatment may include medication, therapy, or a combination of both. With the right treatment plan, you can get back to experiencing pleasure in your life again.