What Is Anhedonia?

Written by the Able Psychiatry clinical team

Updated September 27, 2026

Anhedonia is a reduced ability to feel pleasure or interest in activities that used to feel rewarding, including a reduced drive to seek those activities out in the first place. It is a core symptom of major depressive disorder and appears across a wide range of other psychiatric and neurological conditions.

Key takeaways

• Anhedonia has two recognized components: reduced anticipation, or “wanting,” of a reward, and reduced enjoyment, or “liking,” of it once it happens, per a 2026 international expert consensus report.
• It overlaps with, but is not the same as, apathy (loss of motivation). Factor analysis shows the two are at least partly separable.
• In a systematic review of pro-dopaminergic drugs for anhedonia in depression, six randomized trials (n=2,076) found only a small reduction in anhedonia symptoms — the biology involved is broader than dopamine alone.
• NIMH’s Research Domain Criteria frames the underlying processes as three constructs — Reward Responsiveness, Reward Learning, and Reward Valuation — within its Positive Valence Systems domain.

How anhedonia works

Anhedonia was originally defined simply as a reduced ability to experience joy or pleasure from previously enjoyable activities. Researchers now describe it as involving a dysregulated mesolimbic reward pathway — the brain circuit responsible for anticipating and responding to reward — likely including reduced dopamine signaling and blunted activity in the ventral striatum. In people with major depressive disorder, anhedonia is consistently linked to poorer psychosocial functioning, reduced quality of life, and a less favorable treatment course. Conventional antidepressants often improve mood without fully resolving anhedonia, which is one reason it’s tracked as its own symptom rather than assumed to follow mood.

Types of anhedonia

• Anticipatory anhedonia: reduced “wanting” — less drive or anticipation before an activity happens.
• Consummatory anhedonia: reduced “liking” — less enjoyment once the activity or reward is actually experienced.
• Social anhedonia: not enjoying social interactions, or feeling disconnected from others during them.
• Physical or sensory anhedonia: reduced pleasure from food, touch, music, or other sensory experiences.

Example of anhedonia

A living systematic review conducted for the Wellcome-funded GALENOS project illustrates both how anhedonia is measured and how much remains unresolved. Across six randomized controlled trials (n=2,076) of pro-dopaminergic drugs (amitifadine, bupropion) for anhedonia in major depressive disorder, researchers found only a small reduction in anhedonia symptoms (Standardised Mean Difference −0.24). In animal studies, the same drugs increased sucrose preference far more consistently (27 studies, SMD 1.34). Unexpectedly, a network meta-analysis of the human trial data found that antidepressants working through non-dopaminergic mechanisms produced a bigger reduction in anhedonia than the pro-dopaminergic drugs did — and that the anti-anhedonia effect looked independent of any improvement in mood. That combination of findings is why experts meeting on the topic in January 2026 concluded the neurobiology of anhedonia “remains poorly understood and likely involve[s] mechanisms and systems that include, but are not limited to, dopaminergic pathways.”

What people get wrong

Patients often describe anhedonia as “not caring,” and family members sometimes read it as laziness or lack of effort. It’s easy to miss for the same reason: someone can keep going through the motions of daily life while having genuinely lost the capacity to feel pleasure in it. Because standard antidepressants often lift mood before they touch anhedonia, we ask specifically about interest and enjoyment — not just mood — when checking how treatment is working, and consider augmentation therapy or a change in the medication management plan when anhedonia persists on its own.

Anhedonia vs. apathy

	Anhedonia	Apathy
Core feature	Reduced pleasure or interest in things once found rewarding	Reduced motivation or drive to initiate action
Overlap	Frequently co-occurs with apathy	Frequently co-occurs with anhedonia
Are they the same thing?	No — factor analysis shows the two are at least partly separable entities, and some people experience only one

A 2026 expert consensus report notes there is “considerable overlap in people with clinically relevant anhedonia and apathy, but there are also individuals who suffer from only one of these,” which is part of why the two are assessed and, increasingly, treated as distinct targets.

Frequently asked questions

Is anhedonia the same thing as depression?
No. Anhedonia is a specific symptom — reduced pleasure or interest — and NIMH notes that a depression diagnosis requires “a depressed mood or a loss of interest or pleasure in most activities.” It also occurs on its own or alongside other conditions, such as schizophrenia or Parkinson’s disease.

What’s the difference between “wanting” and “liking” in anhedonia?
“Wanting” (anticipatory anhedonia) is the drive or anticipation before doing something rewarding. “Liking” (consummatory anhedonia) is the enjoyment felt once it happens. The two can be affected separately, and researchers increasingly measure them separately.

Can anhedonia happen without depression?
Yes. Experts describe anhedonia as a transdiagnostic symptom found across schizophrenia, Parkinson’s disease, Alzheimer’s disease, ADHD, traumatic brain injury, and bipolar disorder, not just major depressive disorder.

Does treating anhedonia require a different approach than treating low mood?
Often, yes. Research shows conventional antidepressants frequently improve mood without fully resolving anhedonia, which is why clinicians track it as its own outcome rather than assuming it will lift along with mood.

The bottom line

Anhedonia is more than a low mood — it’s a measurable reduction in wanting and liking that can outlast standard depression treatment and shows up across many conditions beyond depression. Naming it specifically, rather than folding it into “feeling sad,” is what lets a clinician track whether it’s actually improving.

Sources

• Research agenda to advance anhedonia assessment, understanding and treatment: an ECNP-GALENOS expert meeting report (Penninx et al., 2026), BMJ Mental Health
• Depression, National Institute of Mental Health
• Positive Valence Systems, National Institute of Mental Health, Research Domain Criteria (RDoC)

Related terms

• Major depressive disorder
• Augmentation therapy
• Medication management
• Psychiatric evaluation
• Treatment-resistant depression
• What to expect at a TMS appointment

Not enjoying things the way you used to? Schedule an appointment to talk through what’s changed and what can help.