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Symptoms

Anhedonia

Shariq Refai, MD, MBA, board-certified psychiatrist and the reviewer of this article.

Reviewed by Shariq Refai, MD, MBA·Updated March 15, 2026·About 3 minutes

About this term

Quick definition
A reduced ability to feel pleasure or to anticipate pleasure.
Full clinical definition
Anhedonia is one of the two core symptoms of major depressive disorder in the DSM-5-TR. To meet criteria for a major depressive episode, a person must have either depressed mood or anhedonia for most of the day, nearly every day, for at least two weeks. Anhedonia is also seen in persistent depressive disorder, bipolar depression, schizophrenia, post-traumatic stress disorder, and several medical and substance-related conditions.

Researchers separate anhedonia into two related parts. Consummatory anhedonia is a reduced ability to feel pleasure in the moment. Anticipatory anhedonia is a reduced ability to look forward to a coming pleasure. The anticipatory part is hit first in most patients with depression, which is why the motivation to start an activity often disappears before the activity itself stops feeling good.

Epidemiology
Anhedonia is reported in roughly 70 percent of patients with major depressive disorder in clinical samples (Cao et al., 2019). It is one of the most common symptoms across the depression spectrum and is also reported by an estimated 30 to 50 percent of people with schizophrenia and a substantial proportion of people with chronic pain conditions.
What it can feel like
Food without taste. Music without pull. A favorite show that plays in the background while the mind goes elsewhere. Sex that feels mechanical or stops mattering. Holidays, weekends, and time with family that pass without the usual lift. Patients commonly describe it as flatness rather than sadness.
Overlap with emotional numbness
Emotional numbness in depression usually overlaps with anhedonia. Many patients also describe a wider blunting that dampens sadness, worry, and anger along with pleasure.
Why it matters
Anhedonia is one of the most reliable markers of depression in research and in clinical practice. It often predicts a slower response to standard antidepressants and a higher risk of relapse. It is also one of the most disabling parts of depression, because it touches the parts of life that usually keep people going.
How clinicians assess it
A psychiatrist asks about pleasure and interest in specific activities the person used to enjoy. The Snaith-Hamilton Pleasure Scale (SHAPS) is a research tool used in some settings. Item 1 and item 2 of the PHQ-9 also screen for anhedonia and depressed mood.
Treatment implications
Behavioral activation, a structured form of therapy that rebuilds connection to activities before the pleasure returns, is well-suited to anhedonia. Bupropion is sometimes chosen when anhedonia and low motivation dominate. Ketamine, esketamine, and other treatments studied in treatment-resistant depression have shown specific signals on anhedonia in research.
Related terms
Depressed mood. Emotional numbness. Major depressive disorder. Behavioral activation.
Related articles
Emotional numbness. Loss of interest. Low motivation.

Sources

  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th edition, Text Revision (DSM-5-TR).
  • Treadway MT, Zald DH. Reconsidering anhedonia in depression: lessons from translational neuroscience. Neurosci Biobehav Rev. 2011.
  • Cao B, et al. Pharmacological interventions targeting anhedonia in patients with major depressive disorder: a systematic review. Prog Neuropsychopharmacol Biol Psychiatry. 2019.

Frequently asked questions

What is anhedonia?
Anhedonia is a reduced ability to feel pleasure or to anticipate pleasure. It is one of the two core symptoms of major depressive disorder in the DSM-5-TR; either anhedonia or depressed mood, present for most of the day nearly every day for at least two weeks, can anchor the diagnosis.
What does anhedonia feel like?
Patients commonly describe flatness rather than sadness. Food without taste, music without pull, sex that feels mechanical, time with family that passes without the usual lift. The motivation to start an activity often disappears before the activity itself stops feeling good.
How common is anhedonia in depression?
Anhedonia is reported in roughly 70 percent of patients with major depressive disorder in clinical samples (Cao et al., 2019). It is also reported by an estimated 30 to 50 percent of people with schizophrenia and by a substantial share of people with chronic pain conditions.
What is the difference between anhedonia and depressed mood?
Depressed mood is a present feeling of sadness or low mood. Anhedonia is the absence of pleasure or interest. Both are core symptoms of major depressive disorder, and many patients have both. Anhedonia is often slower to improve with treatment than mood.
How is anhedonia treated?
Behavioral activation, a structured therapy that rebuilds connection to activities before the pleasure returns, is well-suited to anhedonia. Bupropion is sometimes chosen when anhedonia and low motivation dominate. Ketamine, esketamine, and other treatments studied in treatment-resistant depression have shown specific signals on anhedonia in research.

Last reviewed March 15, 2026.

Every clinical page on DepressionResource.org is written in plain language, dated, and reviewed by a board-certified psychiatrist against current clinical guidelines. See our editorial standards and medical review process.