What if that sense of blah you’ve been feeling could be something more?

A lot of people are struggling with depression and never realize it. The pleasure has drained from things they once enjoyed – from the big stuff, like time with loved ones, to the little things, like that random TV show that used to spice up Tuesday nights.

But because they never feel sad, they don’t recognize the warning signs.

It’s a problem that Valeria Martinez-Kaigi, PhD, clinical health psychologist at the Institute of Living, wants more people to understand.

“Someone might say, ‘I don’t feel sad,’ and never reach out to get help for depression,” says Dr. Martinez-Kaigi. “Meanwhile, they’re going misdiagnosed, undiagnosed, untreated.”

Lack of pleasure can be a clue you’re clinically depressed.

Here’s a term to learn: anhedonia. It’s a lack of interest, motivation or pleasure in doing things you once enjoyed. In the mechanics of the brain, it relates to how we seek out and process rewards. And with or without sadness, it can signal major depressive disorder.

There’s a severity range to anhedonia, says Dr. Martinez-Kaigi.

Say you normally love kayaking. If you have mild anhedonia, you may have trouble motivating yourself to get out on the water, but once you do, you’ll probably enjoy yourself. With more severe anhedonia, you wouldn’t even enjoy the activity.

Look for anhedonia in the little things – and the big things too.

Maybe you used to love puttering in your garden, but now the beds are overgrown. Maybe you used to feel energized from catching up with friends, but now that feeling is dull. Or perhaps you used to avidly follow your favorite baseball team, but you haven’t caught a game all summer.

Bottom line: Anhedonia shows up differently for everyone, depending on what everyday life looks like to you.

“My patients often tell me that no one has ever explained their mental health symptoms in detail. They feel appreciative and find it helpful when I take the time to help them understand their symptoms in the context of their lives,” says Dr. Martinez-Kaigi.

Look for other warning signs of depression, too.

If you’re experiencing anhedonia, your doctor or mental health professional will evaluate you for other symptoms of major depressive disorder too. These might include:

  • Sleep issues.
  • Increased or decreased appetite (often with weight gain or weight loss).
  • Feeling restless, jittery.
  • Feeling lethargic, heavy-limbed.
  • Feeling guilty, worthless.
  • Lack of confidence.
  • Difficulty concentrating.
  • Having thoughts of not wanting to live.

If you are experiencing suicidal thoughts, call the National Suicide Prevention Life Line at 1.800.273.8255 or text “HOME” to 741741.

Why reach out for help?

If you think you might be experiencing anhedonia, or any of the above signs of depression, talk to your primary care physician or call your insurance company for a list of behavioral health providers.

“There are so many people who live life in an anhedonic state and attribute it to their personality. However, with an evidence-based treatment, they could really improve their quality of life and find more enjoyment,” says Dr. Martinez-Kaigi.

Within weeks of starting psychotherapy or an antidepressant, you might rediscover all the little things in life that make you happy – and the big things too.