Anhedonia: Symptoms, Causes and Treatment

Quick answer

A core symptom of depression; treatable with behavioural activation, therapy, medicines and lifestyle changes

People with anhedonia often describe feeling flat, numb or empty, not looking forward to things, losing interest in hobbies, food, sex or socialising, and feeling disconnected from others. Researchers distinguish anticipatory anhedonia, reduced motivation and looking forward, from consummatory anhedonia, reduced enjoyment in the moment, and research suggests motivation and reward-learning problems play a large role. Anhedonia is common in depression and can also occur in bipolar disorder, schizophrenia, post-traumatic stress disorder, substance use, chronic stress and some physical illnesses. NICE recommends treatments for depression including guided self-help, behavioural activation, cognitive behavioural therapy, exercise and antidepressants. A clinical trial found that a therapy targeting positive emotions improved positive affect more than a standard approach.

Important. If you feel hopeless, think about self-harm or suicide, or cannot manage daily tasks, contact a doctor urgently, call emergency services or a crisis line. Anhedonia lasting more than two weeks should be discussed with a doctor.

Signs of anhedonia

Losing interest in hobbies, music, films or activities you used to enjoy.
Feeling flat, numb or emotionally blunted.
Not looking forward to plans or events.
Withdrawing from friends and family.
Reduced interest in sex.
Food tasting bland or eating without enjoyment.
Feeling detached from loved ones.
Difficulty feeling positive emotions even when good things happen.

Types of anhedonia

Social anhedonia: little interest in social contact and relationships.
Physical anhedonia: reduced pleasure from physical sensations such as food, touch or sex.
Anticipatory anhedonia: difficulty looking forward to or feeling motivated for rewards.
Consummatory anhedonia: reduced enjoyment while doing something pleasurable.
Research suggests that “wanting” and motivation are often more affected than “liking” in depression.

Causes and associated conditions

Depression, where it is one of the two core symptoms alongside low mood.
Bipolar disorder during depressive episodes.
Schizophrenia and related conditions.
Post-traumatic stress disorder.
Substance use and withdrawal.
Chronic stress and burnout.
Physical conditions such as Parkinson’s disease, chronic pain and thyroid problems.
Side effects of some medicines, including emotional blunting with some antidepressants.

What happens in the brain?

Anhedonia is linked to changes in the brain’s reward system, including circuits that use dopamine. A review on anhedonia in depression highlighted that depression often affects the motivation to seek rewards, the effort people are willing to make and learning from rewarding experiences, rather than only the capacity to enjoy. This helps explain why people with depression often find it hard to start activities, even ones they might enjoy once they begin.

Anhedonia and depression

Loss of interest or pleasure is one of the main symptoms used to diagnose depression. Other symptoms include low mood, tiredness, changes in sleep and appetite, poor concentration, feelings of worthlessness and thoughts of death. The NHS lists losing interest in things you used to enjoy as a key sign of depression. If you notice anhedonia alongside these symptoms for more than two weeks, speak to a doctor. Our guide to anxiety and depression covers how they often occur together.

Treatment options

NICE guidance on depression recommends a range of treatments depending on severity and preference, including guided self-help, group exercise, behavioural activation, cognitive behavioural therapy, interpersonal therapy, counselling and antidepressant medicines. Behavioural activation, which involves gradually scheduling meaningful and enjoyable activities, directly targets the cycle of withdrawal and low reward. A randomised trial of positive affect treatment, a therapy focused on increasing positive emotions through savouring and rewarding activities, found greater improvements in positive affect than a therapy targeting negative emotions. If antidepressants cause emotional blunting, discuss alternatives with your doctor.

Steps that can help

Schedule small activities each day, even if you do not feel like them; enjoyment often follows action.
Start with easy, short activities: a 10-minute walk, a phone call, listening to one song.
Notice and write down any moments of pleasure or interest, however small.
Practise savouring: slow down and pay attention to positive experiences.
Exercise regularly; it can improve mood and motivation.
Keep regular sleep and meal times.
Limit alcohol and recreational drugs.
Stay in contact with people, even briefly.

How long does it take to improve?

Anhedonia can be one of the slower symptoms to improve. Some people notice changes within weeks of starting treatment, while for others it takes months. It is common for activity and motivation to improve before the feeling of enjoyment fully returns. Keeping up with activities and treatment even when progress feels slow is important.

Anhedonia, stress and burnout

Prolonged stress and exhaustion can also make life feel flat and joyless. Rest, reducing demands, setting boundaries and reconnecting with meaningful activities help. Our guides to burnout and emotional exhaustion explain the signs.

Three common situations

No longer enjoying hobbies for a month, with low mood and poor sleep: speak to a doctor about depression.
Feeling emotionally flat after starting an antidepressant: discuss with your doctor rather than stopping suddenly.
Feeling joyless during a period of overwork: rest, boundaries and support; seek help if it persists.

Supporting someone with anhedonia

Invite them to low-pressure activities, without taking refusals personally.
Avoid telling them to “cheer up” or “just enjoy yourself”.
Offer practical help, such as company on a walk or help booking an appointment.
Encourage them to talk to a doctor if it has lasted more than two weeks.
Look after your own wellbeing as well.

Key points to remember

Anhedonia is reduced interest or pleasure in life.
It is a core symptom of depression but has other causes.
Behavioural activation, therapy and medicines can help.
Seek urgent help if you have thoughts of self-harm.

Questions about anhedonia

These answers are general information and do not replace an examination or individual medical advice.

Can anhedonia go away?

Yes. With treatment of the underlying cause, most people regain enjoyment, though it may take time.

Is anhedonia the same as depression?

No. It is a symptom that often occurs in depression but can also have other causes.

Can antidepressants cause anhedonia?

Some people experience emotional blunting with certain antidepressants. Talk to your doctor if this happens.

What is the best treatment for anhedonia?

It depends on the cause. Behavioural activation, CBT, exercise and medicines are commonly used for depression-related anhedonia.

How do I know if I have anhedonia?

If you have lost interest or pleasure in most things for two weeks or more, speak to a doctor.

Sources

This guide is for general information and does not replace medical advice. How a problem is diagnosed and treated depends on your examination and medical history. If you think you have an emergency, contact your local emergency services.