Anhedonia scores highest among parents, study finds

Researchers have identified a strong link between high-functioning depression and anhedonia, a condition characterized by a diminished capacity to feel pleasure. A peer-reviewed study published in the journal Cureus indicates that individuals who maintain their professional and personal responsibilities while suffering from this mental state often score high on measures for both anhedonia and trauma.

The study, led by psychiatrist Dr. Judith Joseph, interviewed adults using standardized questionnaires to assess these specific symptoms. The data supported the hypothesis that high-functioning depression correlates with elevated levels of anhedonia and trauma. Participants who reported higher scores for anhedonia also recorded higher scores for high-functioning depression. Among the demographic groups studied, parents and caregivers posted the highest combined scores for both conditions.

The research team notes that high-functioning depression is not a formal diagnosis listed in the DSM-5, the standard manual used by clinicians for mental health conditions. Joseph argues that this lack of official classification contributes to the issue. People who continue to function effectively may not recognize their symptoms as depression. They often delay seeking treatment until they reach a state of burnout.

Joseph describes anhedonia as the "silent sister" of depression. While clinical depression is often associated with visible distress, such as crying or difficulty getting out of bed, anhedonia presents as numbness and quiet withdrawal. "The other one is quiet and numb," Joseph said. She characterizes the condition as an existential crisis that is frequently ignored because it does not look like a traditional breakdown.

Joseph frequently observes this pattern in women who serve as the steady presence in their households and workplaces. These individuals focus intensely on their responsibilities, often failing to notice their own declining well-being. "But eventually something's gonna give," Joseph said. She explains that the eventual result is either a clinical depression episode that halts functioning, a physical breakdown, or a crisis of distress.

The psychiatrist has treated patients who arrived at emergency rooms without understanding their physical symptoms. These individuals often discovered they had been carrying unresolved emotional pain for extended periods. Joseph notes that this dynamic is common in professions that discourage vulnerability, including medicine. In medical training, crying after a patient dies has historically been viewed as a sign of weakness.

"In medicine, we focus on the crisis," Joseph said. "You're [taught] to look for the mania, for the psychosis." She advocates for greater attention to anhedonia, or the loss of joy, rather than focusing solely on acute episodes of mania or psychosis.

To help individuals identify these symptoms, Joseph developed a self-assessment quiz based on the Snaith-Hamilton Pleasure Scale. This scale, published in the British Journal of Psychiatry, measures the capacity to feel pleasure. The quiz asks about everyday experiences, such as whether a person enjoys praise, savors meals, or finds satisfaction in work accomplishments. The tool is designed as an invitation to take stock of one's emotional state, not as a diagnostic instrument.

In her book, "High Functioning: Overcome Your Hidden Depression and Reclaim Your Joy," Joseph outlines a framework she calls the Five V's. These include validation, venting, values, vision, and vitals. The framework encourages individuals to name their feelings, express emotions, prioritize what matters, maintain a sense of future hope, and care for their physical and mental health through sleep, nutrition, and movement. Joseph states that anhedonia appears across many conditions and is common in midlife. "It's something that we need to learn how to detect," she said.

For those in crisis, the Suicide & Crisis Lifeline is available by calling or texting 988.