- Reduced ability or complete inability to experience pleasure from activities once found enjoyable
- It encompasses deficits in multiple facets of reward, including:
- Reduced motivation or anticipatory pleasure ("wanting")
- Reduced consummatory pleasure ("liking")
- Impairments in learning from rewards
- Considered a key symptom in [[Major Depressive Disorder|Major Depressive Disorder (MDD)]] and other psychiatric and ![[neurological]] conditions
- May also be linked to emotional numbing, affective blunting, or flat affect in certain disorders
## Types
- Physical Anhedonia: decreased pleasure from physical sensations such as food, touch, or sex
- Social Anhedonia: reduced pleasure or interest in social interactions and relationships
## Symptoms
- Feeling emotionally numb or disconnected
- Loss of interest in hobbies, social interaction, and activities previously enjoyed
- Apathy and lack of motivation
- Reduced emotional responses or pleasure in response to rewarding stimuli
- Difficulty planning or initiating activities
- Feeling "empty," "off," or detached from emotional experiences
- May include changes in libido and sleep patterns
## Causes and Risk Factors
- Often associated with [[Depression]] but also present in:
- [[Schizophrenia]], [[Bipolar Disorder]], [[Post-Traumatic Stress Disorder (PTSD)]]
- Neurodegenerative diseases like Parkinson’s and Alzheimer’s
- [[Substance Use Disorder|Substance Use Disorder (SUD)]]
- Chronic physical illnesses and brain injuries
- Neurobiological basis linked to dysfunction in brain reward circuitry, especially:
- [[Ventral tegmental area (VTA)]]
- [[Nucleus accumbens]] and [[ventral striatum]]
- [[Prefrontal Cortex]], [[Amygdala]], and [[Hippocampus]]
- Thought to involve dopaminergic and serotonergic [[neurotransmitter]] imbalances
## Diagnosis
- Assessed clinically as a symptom of underlying mental or medical conditions
- No standalone diagnosis; part of broader syndromes like [[Major Depressive Disorder|MDD]]
- Differentiation from other symptoms like social anxiety important
## Treatment
- Focused on underlying disorders (e.g., antidepressants, [[psychotherapy]] for [[Depression]])
- Neurofeedback and attention training may be adjuncts
- Emerging treatments targeting brain reward pathways (e.g., [[ketamine]])
- Treatment can be challenging due to complexity and persistence of symptoms
## Impact
- Significantly impairs quality of life, social functioning, and motivation
- Can worsen prognosis of primary psychiatric or medical disorders
- May contribute to relapse and chronicity in [[depression]] and other illnesses