Why Are Depressed People So Hard to Motivate?

Depression is associated with impairment of reward processing, which is the ability to use the expectation of reinforcement to guide one's own behavior. To examine the components of this deficit, U.K. researchers conducted a meta-analysis of 48 studies involving 1767 people with major depression and 1387 healthy controls.

As expected, the depression group had deficient reward processing overall, compared with the control group. The largest impairment was in the component of reward bias, indicating difficulty in choosing frequently rewarded stimuli (without a general deficit in perception). There were small-to-medium deficits in reinforcement learning (modifying one's behavior in the light of similar experiences) and option valuation (compari…