Study: Parents show highest levels of hidden depression symptoms

A new study led by a local psychiatrist found that parents and caregivers reported the highest levels of anhedonia and high-functioning depression among the adults surveyed.

Dr. Judith Joseph, a psychiatrist, led the research team that examined the condition. The team published their findings in the peer-reviewed journal Cureus. The study used questionnaires to assess high-functioning depression, trauma, and anhedonia in a group of adults.

Joseph describes high-functioning depression as a state where individuals continue to meet their obligations at work and at home. However, they quietly lose the ability to feel pleasure. She calls anhedonia the silent sister of depression. Unlike classic depression, which involves crying and inability to get out of bed, anhedonia presents as numbness and quietness.

The study results supported the hypothesis that people with high-functioning depression have increased levels of anhedonia and trauma. Participants with higher anhedonia scores also had higher high-functioning depression scores. Joseph notes that high-functioning depression is not an official diagnosis in the DSM-5, the manual clinicians use to diagnose mental health conditions.

Joseph says she often sees this pattern in women who serve as the steady presence for everyone around them. These individuals focus heavily on their responsibilities at work and home. They may not realize they are burned out or close to it until a breakdown occurs. She has seen patients end up in the emergency room without understanding why, only to learn they had been carrying unresolved emotional pain.

Joseph believes the medical field focuses too much on crises like mania and psychosis. She argues there should be more focus on anhedonia, the loss of a sense of joy. In her book High Functioning: Overcome Your Hidden Depression and Reclaim Your Joy, she outlines a framework called the Five V's. These include validation, venting, values, vision, and vitals, which covers sleep, nutrition, and movement.

Joseph developed an anhedonia quiz based on the Snaith-Hamilton Pleasure Scale. This measure, published in the British Journal of Psychiatry, assesses the capacity to feel pleasure. The questionnaire asks about everyday experiences, such as enjoying praise, savoring meals, and feeling satisfaction in work. The quiz is not a diagnostic tool but an invitation to take stock of what might be standing in the way of a fuller life.

Joseph says anhedonia appears across many conditions and in people at various life stages, including midlife. She says it is a silent problem that needs to be detected. Individuals in crisis can call or text 988 to reach the Suicide and Crisis Lifeline.