I Think I Have Anhedonia…But I’m Sure I Don’t Have Depression

Reader’s Question

I think I have anhedonia, meaning I can’t feel pleasure. Most pleasurable activities don’t feel any different from standing there and doing nothing. Yet, I am sure I do not have depression. I’m a high achiever, but I never feel good when I do something. It just happens and I don’t feel like I care. I don’t feel like I have any motivation, only habits that make me do things. I smile a lot and I joke a lot, goof around etc., and I can laugh. But things like going on a roller coaster, achieving things, sexual things, love, eating good food, etc. don’t make me feel any bit good. Strangely, I still feel like continuing doing those things despite that. I don’t understand this at all. I have never taken drugs or anything, and I think I have felt this way for a really long time. What does pleasure feel like? I don’t know if I am imagining it, or if this condition exists because I think it exists. What do I do!?

Psychologist’s Reply

If you ever attend a Bean Soup contest, you’ll see about 45 Bean Soups…but each will taste different. Why? All are Bean Soup, but each recipe is different. There are many types of depression — each with a different neurotransmitter recipe. When depression surfaces quickly — we have intense thoughts of death/dying/suicide. Other forms of depression are slow-cooking — gradually losing our humor, energy, motivation, pleasure, interests, and enjoyment. You are describing a chronic moderate depression. You’ve also made adjustments as the depression has continued, now living a depressed and anhedonic lifestyle. Sadly, this is not uncommon in high achievers who gradually burn themselves out due to their high personal expectations.

I would recommend a two-discipline approach — a therapist and the use of an antidepressant medication. Your situation is very common and hits about 25% of folks in high-stress or high-responsibility careers. When I see this in private practice, the client typically describes “I’m miserable, no energy, and I don’t know why!” On the bright side, this is very treatable and I’d recommend arranging for treatment as soon as possible. The sooner you begin, the quicker your life comes back and your light comes back on.

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