Hello, black649. I'm really glad to hear that you are getting help and that your mood has gotten somewhat better. That is a major improvement.

You asked:
My understanding is that it's both. I also think that it doesn't necessarily get better at the same rate as other dysfunctions that may come along with depression. (I read that somewhere, too, in addition to experiencing it myself.)

It has been several years since I experienced severe anhedonia. I do remember what it felt like, because it feels so abnormal if you've had a normal pleasure response before.

At the moment, I am dealing more with severe avolition than with anhedonia. Generally, if I can convince myself to do something, it goes fairly well.

I think that it's possible that your anhedonia will improve on its own with time, as long as your other depressive symptoms stay better and don't start to get worse again.

From what I've read about anhedonia associated with depression, if the depression improves, the anhedonia usually improves as well. This apparently isn't true of anhedonia associated with schizophrenia. That can be a stable personality trait. (I read that in the article I linked to further down in this reply.)

There are medications that can cause anhedonia as a side effect, so you want to make sure that you don't have that going on.

SSRIs can cause sexual anhedonia. I already knew that. I just read, though, that some antipsychotic medications can cause general anhedonia as a side effect. So it seems possible that if you were taking one of these medications, it could prevent your preexisting anhedonia from improving.

Dopamine. I don't know how valid the science is, but it's generally believed that increasing dopamine in the brain will improve the ability to feel pleasure. This can be done through medication or nutritional supplements.

Rewards. Are there any things (doesn't have to be objects) that you still enjoy or want (or don't want?) A reward can also be not having to do something that you don't want to do.

In trying to deal with my avolition, I have started examining the idea of rewarding myself for doing things that are important to my recovery but which I have no desire to do.

Pushing my trash bin to the curb on trash pickup day seemed, a few months ago, as difficult to do and about as appealing as going for a colonoscopy. (Which I also need to do.) I am doing better with the trash now but still having problems with more complicated behaviors.

I am somewhat of a proponent of the "fake it until you make it" school of thought. I think that if we do things routinely, it can often change the response in our brains eventually.

Here's a link to a fairly technical article about the neurobiological aspects of anhedonia. I don't know if you'll want to read it. It discusses how lack of brain function in expected areas can be seen through imaging in people who suffer from anhedonia.

It also discusses the individual psychological and cognitive steps involved in performing an action and how lack of chemical reward by the brain interferes with this process.

I don't know what level of medical care you have access to. If you have very good health insurance, you might look into seeing a psychopharmacologist.

If your current meds provider is a smart one, if you haven't already discussed your concerns about anhedonia with him/her, an addition to or change in your medication might help you.

I have one more suggestion, which is totally my own. I have no basis other than personal experience for recommending it. If you can afford to get regular massages, I would highly recommend that. In my experience, depression is very much a bodily illness as well as one of the brain. I have found in the past that regular massage can help to improve recovery from depressive symptoms.

Thanks for your question. I hope that you'll post again at Psych Central to let us know how things are going with you.

P.S. There is a new forum on this site called "Habits". I don't know if you've read any of the many books and articles out at the moment about how forming habits affects our brains.