When it comes to depression, medications called antidepressants are the first line of defense. Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressant that are some of the most commonly prescribed medications in the United States.
While SSRIs can be extremely effective in treating depression, anxiety, and other mental health conditions, antidepressants also come with a range of side effects. One potential but relatively rare side effect of SSRIs is something called “emotional blunting” or “apathy.”
Let’s take a closer look at what emotional blunting is, how SSRIs can cause it, and what you can do if you think you’re experiencing it.
What are SSRIs?
SSRIs are a type of antidepressant that affects the brain’s serotonin system. When a person takes antidepressants, the drug inhibits the reuptake of serotonin in the brain, causing more serotonin to be freely available in the body. Serotonin is a neurotransmitter that plays an important role in mood and emotion. Because there is more serotonin in the body when taking antidepressants, your mood and emotions are affected.
Some common SSRIs include:
- Fluoxetine (Prozac)
- Paroxetine (Paxil)
- Sertraline (Zoloft)
- Escitalopram (Lexapro)
While SSRIs are generally considered safe, they can cause a range of side effects. Emotional blunting is one potential, but uncommon, side effect.
What Is Emotional Blunting?
Emotional blunting is a side effect of some antidepressants, including SSRIs. People who experience emotional blunting may feel that their emotions are dulled or that they can no longer feel strong emotions or intense romantic love.
In some cases, people may also find that they’re less able to experience pleasure from activities that they usually enjoy. For example, you might no longer enjoy your favorite foods or hobbies as much as you used to. You may also experience reduced sexual desire in your romantic relationships.
Emotional blunting can also cause problems in social and interpersonal relationships. People who experience this side effect when taking antidepressants may have trouble connecting with others or feel less interested in socializing. They may also experience more obsessive thinking.
Some people may also find that while taking antidepressants, they no longer feel romantic love or are sexually attracted to their partner, or that they can’t reach orgasm during sex.
It’s important to note that emotional blunting is different from feeling emotionally flat or numb. People who feel emotionally flat or numb may still be able to experience some emotions, but they tend to be less intense.
In contrast, people who experience emotional blunting may find that they no longer feel strong emotions at all.
Why Do SSRIs Cause Emotional Blunting?
The underlying mechanisms of how SSRIs lead to emotional blunting are still unclear. What we do know is that these medications have a profound effect on areas of the brain responsible for controlling emotion, thus potentially affecting an individual’s reduced capacity to feel pleasure.
A recent study1 found that SSRIs affect something called “reinforcement learning” in the brain. Reinforcement learning is how we learn from positive and negative experiences in our environment. When people took escitalopram (a common SSRI), they became less sensitive to rewards and less able to use feedback to guide their behavior in tasks.
This discovery helps explain why some people on antidepressants might feel less pleasure from activities they usually enjoy. It’s a trade-off: the medication reduces negative emotions associated with depression, but it can also dampen positive emotional experiences.
This blunting is also a side effect of other antidepressant medications, such as tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs).
Who Is at Risk?
Emotional blunting is a relatively rare side effect of SSRIs. It’s thought to affect around 1 percent of people who take SSRIs.
However, some people may be more likely to experience this side effect than others. Factors that may increase your risk include:
- Taking high doses of SSRIs
- Having a history of emotional difficulties
- Having a family history of emotional difficulties
What Should You Do If You Think You’re Experiencing Emotional Blunting?
If you think you may be experiencing emotional blunting, it’s important to talk to your psychiatrist. They can help you determine whether the cause is your medication or something else. If it is your medication, they may be able to adjust the dosage or switch you to a different drug.
It’s also important to remember that emotional blunting is not permanent and is often the result of a temporary change in brain chemistry. If you stop taking the medication, your emotions should return to normal. Always consult with a psychiatrist before changing your dose or stopping antidepressants entirely.
Can Antidepressants Cause Emotional Detachment?
Another similar potential side effect of SSRIs is something called emotional detachment. This can manifest itself in a variety of ways, but the general idea is that you might have trouble feeling emotions, both positive and negative. And in some cases, people taking SSRIs report feeling less intense romantic love and sexual desire for their partner.
It’s important to remember that emotional detachment is just a potential side effect of SSRIs. It’s not experienced by everyone who takes them, and it’s not necessarily a permanent condition. If you’re concerned about emotional detachment, talk to your doctor. They can help you weigh the risks and benefits of SSRIs and make the best decision for your health.
What is Emotional Detachment?
Emotional detachment is a lack of emotional connection with other people. It can be mild, like feeling disconnected from your emotions or the emotions of others, or more severe, like being unable to form attachments with other people or feeling emotionally numb.
Emotional detachment is a potential side effect of SSRIs because they increase levels of serotonin in the brain. Serotonin is a chemical that helps regulate mood and emotions. When serotonin levels are off-balance, it can lead to feelings of detachment.
Emotional detachment can manifest in different ways for different people. Some people might feel like they’re unable to form attachments with other people. It may affect your sex drive. Others might feel emotionally numb or disconnected from their own emotions. Still, others might find that they don’t feel the same love for their partner that they used to.
If you’re concerned about emotional detachment, talk to your doctor. They can help you weigh the risks and benefits of SSRIs and make the best decision for your health.
Can Antidepressants Cause Relationship Problems?
In addition to the common side effects of taking SSRIs like nausea, weight gain, and dry mouth, some people also experience sexual side effects. In this way, antidepressants can also cause relationship problems.
There are a few different ways that antidepressants can impact your relationships. Antidepressants can cause sexual side effects, which may make it difficult to feel close to your partner. Some patients find that by taking an SSRI, they are putting their partner in a difficult position with their inability to orgasm or experience romance. Additionally, some antidepressants can cause you to feel less emotional connection with others, which can make it hard to maintain close relationships. Finally, some antidepressants can cause you to feel more anxious or agitated, which can lead to arguments and conflict with your partner. In this way, some people believe that antidepressants can cause people to fall out of love.
In cases like these, although the SSRI has the ability to act on your brain chemistry, it may also be responsible for interfering with your libido, sex drive, ability to orgasm, and your ability to fall in love. If you are suffering more than you are benefitting from a medication, you may end up feeling more depressed than you were before.
How Does Emotional Detachment Affect Relationships?
If you’re in a relationship, depression can be a real problem as it can impact your feelings of romantic love. It can make you feel like you’re not really connected to your partner, even if you’re physically close to them. And it can make it hard to feel love or intimacy. It can also impact sexual performance.
Emotional detachment can also affect how you relate to other people in your life, like friends and family members. You might find it hard to connect with them emotionally, or you might feel like you’re not really invested in the relationship.
What Can You Do About Emotional Detachment?
If you’re concerned about emotional detachment, the first step is to talk to your doctor. They can help you figure out if the problem is due to an underlying medical condition or if it’s a side effect of medication. And they can help you find ways to cope with emotional detachment and improve your relationships when you’re dealing with depression.
There are also some things you can do on your own to improve emotional detachment. Some patients find it helpful to:
Connect with people
Spend time with friends and family members, even if you don’t feel like it. Talk to them about your feelings and let them know what you’re going through. When you’re depressed, sometimes your loved ones can be a distraction.
Get regular exercise
Exercise can help improve your mood and make you feel more connected to your body. Exercise can also help you focus on something other than what you are feeling depressed about.
Eat a healthy diet
Eating nutritious foods can help improve your overall health and well-being. Nutrient-rich, healthy foods can help support a healthy brain and body which can counteract some of the sex-related side effects of depression medication. Good, healthy food can also be a source of dopamine.
Practice mindfulness
Mindfulness can help you be more aware of your thoughts and emotions. It can also help you connect with the present moment and may provide a partial answer to some of your symptoms.
Antidepressant Alternatives
At Neuro Wellness Spa, we won’t give up if antidepressant medications aren’t working for you. If you are unhappy with the results of your antidepressant prescription or are dissatisfied with the side effects of your medication, consider trying alternative treatments for depression.
Transcranial Magnetic Stimulation (TMS)
Transcranial magnetic stimulation therapy, or TMS therapy for short, is a non-invasive, non-medication, FDA-approved medical procedure used to treat depression and other psychiatric conditions. The procedure involves using a magnetic coil, placed on the scalp, to deliver targeted electro-magnetic pulses to specific areas of the brain that are associated with mood regulation. It has far fewer side effects compared to some other treatments for depression, like SSRI medications, and can be just as, if not, more effective than medications.
Talk Therapy
Psychotherapy, particularly cognitive-behavioral therapy (CBT), can help you develop coping strategies to manage emotional blunting. Our therapists can work with you to identify and challenge negative thought patterns that may be exacerbating the feeling of emotional numbness. Additionally, therapy can focus on behavioral activation, encouraging you to engage in activities you previously enjoyed, even if you don’t feel the same level of pleasure initially. This can help retrain the brain’s reward system over time.
Mindfulness techniques taught in therapy can also help patients become more aware of your emotions, potentially allowing them to experience a fuller range of feelings. In some cases, a therapist might work with you and your psychiatrist to adjust medication dosage or explore alternative treatments that maintain the antidepressant effect while minimizing emotional blunting.
Treatment for Emotional Blunting in California
Overall, it’s important to remember that everyone experiences emotions differently. If you’re concerned about emotional detachment or emotional blunting, reach out to Neuro Wellness Spa today. Our team of mental health experts can help you determine if the problem is due to an underlying medical condition or if it’s a side effect of medication. We will help you find ways to cope with the side effects of SSRIs or determine if alternatives such as TMS therapy, talk therapy, or MeRT are right for you.
References
- Langley, C, Armand, S, et al. Chronic escitalopram in healthy volunteers has specific effects on reinforcement sensitivity: A double-blind, placebo-controlled semi-randomised study. Neuropsychopharmacology; 23 Jan 2023; DOI: 10.1038/s41386-022-01523-x