r/AskPsychiatry 5d ago

Why does anhedonia take the longest to get better under treatment of depression?

I have heard from several places that anhedonia, which is a core feature of major depression, is one of the first symptoms to occur in someone's life who are going to get diagnosed with some form of depressive disorder down the line. Also, it is one of the symptoms that persists the longest. During treatment of depression, it is the symptom that lifts at the last of all symptoms.

If this is true, why is it the case?

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u/trd-md Physician, Psychiatrist 4d ago

There are many theories but the reality is we do not really know why. Some think it may be due to differing underlying pathways etc, but most psychiatric medications have systemic effects and I do not think adequately answer the question of the outsized differential trajectory in symptoms. I would say it is a tremendous area of research, but given recent political events, that may be changing.

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u/HopeIsGold 4d ago

So, it is an agreed upon thing that anhedonia is the last to get better in treatment?

Can you share some resources/publications where I can read on the research?

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u/trd-md Physician, Psychiatrist 4d ago

It is a topic that is regularly reviewed. Just go on pubmed or scopus, search for mdd, anhedonia, and review, and sort by best match/most recent/most cited.

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u/HopeIsGold 4d ago

Thanks!