Hedonic Tone and Its Relationship with Mental Health

Hedonic tone may be key in disorders as diverse as depression, ADHD, and substance abuse. Here, we'll tell you why.
Hedonic Tone and Its Relationship with Mental Health
Elena Sanz

Written and verified by the psychologist Elena Sanz.

Last update: 12 April, 2023

Psychological disorders are multifactorial. This means that variables of a biological, mental, and behavioral nature are involved in their genesis and maintenance. However, there are some elements that underlie several of them and help us better understand sufferers. Such is the case with hedonic tone. It seems to link disorders as apparently disparate as depression, ADHD, and addictions.

Hedonic tone is a concept that might especially appeal to those individuals who feel that nothing interests them, motivates them, or makes them feel rewarded. Even if they get involved in increasingly risky situations, it seems that everything around them has lost its ability to excite them. However, they didn’t always feel this way. It’s just that gradually, everything they previously enjoyed, no longer generates that effect.

If you feel that this has happened to you, keep reading. You’ll be able to identify its possible causes.

Hedonic tone

As a rule, the term hedonic tone is used as a synonym for valence to define the degree to which we like or dislike certain stimuli. For instance, a positive hedonic tone is associated with something that generates pleasure and reward. On the other hand, a negative hedonic tone is linked to something that causes displeasure and discomfort.

Therefore, emotions such as joy, satisfaction, and relief would belong to the first group. Others such as anger, sadness, and fear, would be classified in the second.

In this article, we’re interested in the concept of hedonic tone related to arousal or the degree to which an individual feels excited, interested, or activated by a stimulus. In this case, the positive and the negative aren’t defining in themselves, since they depend on the state of the individual.

Apter’s Theory of Investment

According to Apter’s Theory of Investment, there are two states in which we can find ourselves with respect to motivation. The telic state is linked to goals that are imposed on the individual. It correlates with a preference for low arousal. In this case, high arousal produces anxiety.

On the other hand, the paratelic state is related to chosen goals and a preference for high intensity. In effect, it’s the kind of arousal that causes discomfort, since it leads to boredom. On the contrary, the high is perceived as pleasant.

From this perspective, situations that we’d avoid a priori (because they generate fear, anguish, or are risky) become appetizing. That’s because they provide the activation with which we seek to avoid boredom and disinterest. We can all resort to these kinds of behaviors. For example, when enjoying horror movies or going on roller coasters. Problems only arise if we require increasingly more of them.

Girls on roller coaster enjoy the attraction
Some activities that can cause fear can end up becoming really pleasurable.

Hedonic tone and mental health

The previous situation happens when an individual has a low hedonic tone. This means they exhibit a decreased sensitivity to reward. In other words, their threshold to reach the desired and pleasurable arousal is higher. Consequently, they require a greater amount of positive stimuli to feel good and stay interested and motivated.

This behavior is typical of attention deficit hyperactivity disorder (ADHD. It leads sufferers to get involved in increasingly extreme and intense activities or those that are dangerous or irresponsible. It also manifests in depression. In this case, one of the main symptoms is anhedonia or difficulty feeling pleasure. Then, the sufferer’s interest in getting involved in anything decreases, while their feelings of apathy and passivity increase.


Some studies have explored the relationship between these two disorders. They found that hedonic tone is an element that underlies both conditions. In fact, it appears that a large proportion of sufferers of depression who don’t respond to treatment have undetected and undiagnosed ADHD.

Furthermore, both disorders are linked to an increased risk of substance use. This is a way of obtaining the intense stimulation they’re missing, which they can’t achieve by other means and whose absence causes them so much discomfort. Paradoxically, their brains become accustomed to these substances and they lose their stimulating and rewarding capacities. As a result, the sufferer requires increasingly more of the substance to feel satisfied.

Blond man in a gray shirt walks among several people and shows concern on his face
Hedonic tone can be both negative and positive and associated with disliking and liking, respectively.

Final recommendations

Research has demonstrated that low hedonic tone is related to the dysfunction of certain brain circuits involved in reward processing. In fact, this alteration is present both in ADHD and in depression and substance abuse. It explains why these three conditions appear together so frequently.

However, this doesn’t imply that nothing can be done about it. Considering low hedonic tone in the treatment of these conditions is a good starting point. After all, if it’s ignored, no intervention will be complete or effective. In addition, in the case of depression, not only emotional problems should be treated, but also possible undetected ADHD.

Finally, it’s important that the individual stops engaging in increasingly risky behaviors or increasing their consumption of substances, to stop the escalation that’s preventing them from feeling pleasure and satisfaction normally. Whatever the case, they must visit a specialist who can carry out a timely evaluation and propose the appropriate guidelines for them to follow.

All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.

  • Apter, M. J. (1982). The experience of motivation: The theory of psychological reversals. Academic Press.
  • Sternat, T., Fotinos, K., Fine, A., Epstein, I., & Katzman, M. A. (2018). Low hedonic tone and attention-deficit hyperactivity disorder: risk factors for treatment resistance in depressed adults. Neuropsychiatric disease and treatment14, 2379–2387. https://doi.org/10.2147/NDT.S170645
  • Sternat, T., & Katzman, M. A. (2016). Neurobiology of hedonic tone: the relationship between treatment-resistant depression, attention-deficit hyperactivity disorder, and substance abuse. Neuropsychiatric disease and treatment, 2149-2164.

This text is provided for informational purposes only and does not replace consultation with a professional. If in doubt, consult your specialist.