I don't feel joy anymore. sometimes even laughing is an effort. i wasn't always like this but since about 3 years i feel like this all the time.ideas?

Depression: While the symptoms point to a major depression, it is best to get a complete evaluation. This would include a mental health evaluation , some blood tests and a recent physical evaluation. Depending on the diagnosis, a treatment plan would be developed. This most likely plan would include therapy with or without medication. Treatment can often be highly effective for these symptoms.