Anhedonia, the inability to feel joy or pleasure, is a common and dangerous symptom of depression that develops when the brain’s reward system (a network of neural structures) becomes less responsive to positive experiences. A recent study in JAMA Network Open reports that positive affect treatment (PAT), a 15-week psychotherapy targeting this reward system, effectively treats depression and anxiety. Training patients to find joy, connection and meaning significantly outperformed negative affect treatment (NAT), which focuses on reducing negative emotions.

During the study, 98 patients with moderate-to-severe depression and anxiety, along with severe anhedonia, were randomly assigned to receive weekly sessions of either PAT or NAT. PAT patients were instructed to initiate and deeply savor pleasurable activities, while NAT patients focused on threat processing and reducing negative emotions. Participants provided weekly reports on behavioral, physiological, reward and threat measures. The results demonstrated that PAT’s reward-focused intervention led to greater reductions in depression and anxiety symptoms than NAT.