When nothing in life feels good or sparks joy, you may have anhedonia, a core symptom of depression

• With anhedonia, even your favorite people, places, and hobbies may no longer bring pleasure or joy.
• The world may feel empty, dull, and flat, and you might avoid spending time with other people.

Losing interest in certain things is normal. For example, you might get bored with golf and take up birdwatching instead.

But when even small joys — like watching your favorite show, eating a delicious meal, or watching a beautiful sunset — no longer excite you, that's called anhedonia.

Anhedonia is one of the most common signs of a major depressive episode. But this symptom may also show up with a number of other conditions, including:

• Bipolar disorder and related conditions, like cyclothymia
• Schizophrenia
• Substance use disorders
• Parkinson's disease
• Autism
• Premenstrual syndrome (PMS)

Latest research: A 2021 review found that nearly 75% of people with major depression and 50% of people with bipolar disorder have anhedonia.

Below, mental health professionals describe the signs, causes, and coping strategies for anhedonia.

Signs of anhedonia

Common signs of anhedonia include:

• Social withdrawal: You have little interest in connecting with or conversing with others, from loved ones to new friends.

• Less interest in previous hobbies: You lose the joy or motivation for your go-to activities. As a result, you may feel generally indifferent to the world and not want to do anything at all most of the time.

• Reduced sensory pleasure: For example, foods you previously enjoyed may not taste as good, and listening to music no longer brings pleasure.
• A drop in libido or no desire for physical intimacy: Sex no longer feels good, and you may not feel comforted when your partner hugs you, kisses you, or holds your hand.

• Difficulty feeling self-compassion: You criticize yourself more than you usually would or blame yourself for your low mood.

According to research involving adolescents who experienced anhedonia as a symptom of depression, many reported feeling:

• "Empty" and "flat" with dampened emotions overall — "like everything is gray"
• A lost sense of belonging and connection
• Detached from the world around them
• As if they're on "autopilot" or "going through the motions"

Note: Anhedonia isn't the same as social anxiety. With social anxiety, you might withdraw due to fears of criticism and negative judgment. But with anhedonia, you withdraw simply because you don't have any motivation or interest in socializing.

What causes anhedonia?

While the exact causes of anhedonia remain unclear, studies have linked this symptom to:

• Decreased activity in regions of the brain: Anhedonia may happen when certain parts of your brain involved in processing rewards and experiencing emotions — like the prefrontal cortex, amygdala, and striatum, don't function as they should — according to Cynthia King, a clinical psychologist and co-founder of FemFwd.
• A shortage in dopamine production: This brain chemical is responsible for feelings of pleasure.
• Chronic use of substances: Using marijuana, alcohol, nicotine, and benzodiazepines may play a part in anhedonia.
• Stressful and upsetting life events: Things like traumatic experiences and grief from suddenly losing a loved one may also trigger anhedonia.

Risk factors

Certain risk factors can raise your risk of experiencing anhedonia, according to Steve Carleton, a licensed clinical social worker and the Executive Clinical Director at Gallus Detox. These factors include:

• Having an eating disorder or post-traumatic stress disorder (PTSD)
• Having chronic pain or a chronic illness that lowers your quality of life, like cancer, endometriosis, multiple sclerosis, or chronic fatigue syndrome
• A family history of mental health conditions, especially depression or bipolar disorder

"Anything that predisposes you to depression — like low self-esteem or adverse childhood experiences — can lead to anhedonia," says Elena Touroni, a clinical psychologist and co-founder of The Chelsea Psychology Clinic.

How to get support

If you think you're experiencing anhedonia, Touroni highly recommends consulting a therapist or psychiatrist to get a diagnosis since this symptom often suggests an underlying mental health condition.

Anhedonia doesn't typically go away on its own. That's why a diagnosis is important — it can help you and your doctor to identify the root cause and treat it.

Quick tip: You can find a therapist in your area by using the databases at GoodTherapy, PsychologyToday, Zencare, or TherapyTribe. Consider filtering results by therapists who specialize in treating depression.

These popular therapy approaches may prove especially effective for treating anhedonia:

• Positive affect treatment: This intervention is specifically designed to treat anhedonia and depression by increasing your brain's sensitivity to rewards and encouraging positive emotions. Emerging research suggests that using virtual reality (VR) technology in this approach — for example, viewing positive scenes through a VR headset — may reduce symptoms of anhedonia.
• Cognitive behavioral therapy (CBT): According to Carleton, this approach aims to help you identify and change unhelpful thought patterns that may contribute to anhedonia by sabotaging your motivation and pleasure. A 2022 study found CBT can improve anhedonia, and a small 2021 study suggests these benefits may extend to virtual CBT.
• Acceptance and commitment therapy (ACT): Touroni says ACT can help you reconnect to your true values and goals so you can experience more fulfillment and pleasure in everyday life.
• Schema therapy: According to Touroni, this approach focuses on digging into the behavioral patterns currently compromising your ability to make life decisions that fuel joy and happiness.
• Interpersonal therapy (IPT): This short-term treatment focuses on identifying and changing unhelpful behaviors in your relationships that may negatively impact your mood. To date, no evidence supports IPT as a treatment for anhedonia specifically, but research does suggest it's effective for treating depression.

Note: Your doctor may also prescribe an antidepressant medication to help reduce the severity of your symptoms if your anhedonia stems from depression or bipolar disorder.

If therapy and medication don't make much difference, you might also consider electroconvulsive therapy (ECT). In an ECT session, electrodes applied to your head will trigger mild seizures that can prompt beneficial changes in brain chemistry that improve anhedonia. While this approach may seem somewhat scary, ECT is safe and effective when used as a brief intervention for treatment-resistant depression symptoms.

What about ketamine therapy?

In 2019, the Food and Drug Administration approved a prescription esketamine nasal spray for treatment-resistant depression — but your doctor can also prescribe ketamine in other forms, including intramuscular injections and intravenous (IV) infusions.

A small 2021 study found that after people with treatment-resistant depression received eight IV ketamine infusions over four weeks, their symptoms of anhedonia — and overall depression — significantly improved.

This approach isn't right for everyone, however. If you're interested in trying ketamine for depression, talk to your psychiatrist or primary care doctor. They can determine if you're a good candidate and refer you to a ketamine therapy specialist.

Regardless of whether or not you choose to pursue therapy or take medication, Carleton, Touroni, and King also suggest trying these coping strategies for managing anhedonia:

• Keeping a daily written record of your emotions so you can better identify what triggers or reduces your anhedonia.
• Journaling about positive experiences and events.
• Making a daily list of all the things you're grateful for.
• Using mindfulness and meditation exercises to boost your awareness of your emotions in the present.
• Getting 7-9 hours of sleep per night, and 20 minutes of daily exercise, or 140 minutes per week. Keep in mind, too, that exercise doesn't have to be grueling to make a difference: A 2022 review found that adults who performed physical activities equivalent to 1.25 hours of brisk walking per week had an 18% lower risk of depression compared with those who did not exercise.

"Anhedonia symptoms can take time to improve and recovery is often a process, so have patience and self-compassion and set small, achievable goals to increase your motivation and pleasure," Carleton says.

Insider's takeaway

Anhedonia, or an inability to feel pleasure from things you'd usually enjoy, is a very common symptom of depression — but it can also relate to other mental health conditions like schizophrenia, bipolar disorder, PTSD, and eating disorders.

According to Carleton, you have hope for an improved quality of life and the ability to experience pleasure again, and finding the right treatment can help.

The best approach for you depends largely on the cause of your anhedonia. For example, if it stems from a substance use disorder, treating both conditions at the same time could have the most benefit. If your anhedonia relates to prolonged grief from losing a loved one, bereavement-focused therapy and support groups may prove helpful.

"Above all, remind yourself that you are not broken, and your anhedonia is not your fault," King says.