David W. Zierk, PsyD

A stranger to pleasure.

Anhedonia is the reduced ability to feel the depth of pleasure and joy while remaining distant from the rewards of being uplifted. This odd-sounding word, pronounced “an-hee-dow-nee-uh,” derives from the Greek prefix an, “not or without,” and when added to the Greek root Hedone, meaning “pleasure,” Viola!

People who are depressed are known to lose their capacity to experience positive emotions. It’s not that they don’t have emotions; they struggle to feel them—at least the better ones. Too often, people in the dumps become inundated with negative emotions that they know far too well. Being prone to judging themselves harshly and having disrupted sleep, with lowered energy and diminished interest in trying new things, doesn’t help.

According to the latest Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revised (DSM-5-TR, 2022), the core features of a major depressive disorder involve a one-two punch of depressed mood or loss of interest. But not everyone who’s depressed is anhedonic, and not all anhedonics are depressed.

This last statement bears repeating. While anhedonia may be closely linked to depression, you don’t have to be down or feel sad to be mired in the anhedonic muck.

For the non-depressed anhedonic (NDA), life goes on without much fanfare or hoopla. They go to work, pay their bills, put food on the table, plug into the digital world, and work out to stay in shape. In other words, they’re just like you and me. The difference is that they can’t put their finger on the je ne sais quoi of life—that pleasing quality that can’t be named or described.

When asked, “How are you doing? an NDA person will likely respond, “Okay.” Nothing more and nothing less better captures their felt sense of faraway emotions. Non-depressed anhedonics can come across as neuroatypical, which means that other people experience them as reasonably social but reserved, engaged but detached, and interesting but not easily accessible. In a word, the social signaling of “indifference” emanating from NDAs is what others find to be quizzical, sometimes unapproachable.

NDAs are not unfriendly; they’re observant. They often appear unresponsive, but in truth, they’re deep in thought, distracted by the “what if” and less interested in the “what now.” When you pick up on an NDA seeming a long way away, if you could hear what they cannot say, it might sound something like, “Unlike everyone else, I have no idea how to step into the space between me and others without revealing the social zombie inside me. And even if I knew the trick of the trade in mingling, remind me again, what’s the upside?”

Neuroscience continues to struggle with disentangling the cause of anhedonia. However, in attempting to dissect the neurocircuitry of anhedonia, neuroimaging studies have shown a lowering of activity in the ventral striatum portion of the brain and excessive activity in the ventral region of the prefrontal cortex.

Wow, that sounds impressive, but what does that mean?

To explain these vital brain regions, let’s begin with the ventral striatum. " Ventral” means toward the bottom, and “striatum” refers to a bundle of nerve cells deep in the brain. The ventral striatum is located behind your eyes and is closely linked with reward. The ability to predict and evaluate rewards and risks accurately, or at least confidently, is critical for executing a game plan and staying motivated to reach the finish line.

Next up is the ventral region of the prefrontal cortex (PFC). Since ventral refers to the lower or inferior part of the brain, this points us to a specific area of the PFC located behind your forehead. The PFC is the most evolved human brain region involved in executive function or cognitive control, among other functions. This includes following instructions, inhibiting impulses, regulating emotions, and the conscious experience of pleasure. Hold on to that last part; it’s essential.

So, when there is a lowering of activity in the ventral striatum, the NDA is less willing and able to stick their neck out, take chances, and stay motivated doing things that involve risk. In addition, an excess of activity in the ventral region of the PFC decreases the odds of the NDA being impulsive (they come across as inhibited), jumping for joy (they stay steady), and coloring outside the lines (they are riveted on following the rules, “Isn’t that why rules exist?).”

Putting a bit more polish on the function of the ventral PFC, Roy, Shohamy, and Wager (2012) proposed that this brain region is an integrative hub for processing emotional, sensory, social, memory, and self-related information. When this brain region is stymied, life can lose its luster.

Living with anhedonia may or may not bother you. If it does, and others have given you feedback about your lack of energy or spark, consider exploring options to find more sunshine.

A great place to start is having blood work done to determine your thyroid functioning and vitamin D level. Next, while first-line anti-depressants may not fit the bill, it’s possible that researching mood stabilizers may offer some relief. Beyond prescription medications, finding the right therapist may be highly effective. Chances are you will find working alongside a therapist and focusing on life skills and mood regulation helpful.

Here’s an NDA quick test. Your answers below may shed insight into whether your experiences mimic the symptoms of non-depressed anhedonia.

Your answers to this quick test suggest where you stand on the NDA spectrum. Answer each question on a scale of 1 to 5. Assigning a “1” means the situation doesn’t resonate with you. A 5 means this sounds like a bullseye

1. Do you struggle to feel your feelings?

2. Is there an emptiness inside you that is abundantly filled in most others?

3. More often than not, does a gray sky hover over you and only you that blocks the sunlight of your happiness?

4. Are your thoughts quite frequently cynical, with little interest in the optimistic side of life?

5. Are you challenged to feel “up” and, more typically, lack enjoyment or pleasure?

Now, total the above five questions. The lowest possible score is 5, and the highest is 25. The higher your score, the more likely you are a bonafide NDA, which may deserve your time and attention.

Press the button below to learn more about how your mind works as described in Dr. Zierk’s book, Mind Rules: Who’s in Control, You or Your Mind?