Can Antidepressants Make You Feel Emotionally Numb?

Emotionally Numb
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Perhaps you have noticed that you simply don't feel like yourself on your antidepressant. You might notice your sadness is better, but you feel devoid of emotion.

If you feel this way (or something like this), you are not alone. In fact, there is actually a term used to describe this "numb" feeling—it's called "emotional blunting."

Let's learn more about emotional blunting, including what it feels like, and how you and your doctor can best manage and hopefully, eliminate it.

Understanding Emotional Blunting

Emotional blunting means that a person's feelings or emotions are dulled down, so a person often feels "flat." People who experience emotional numbness or blunting from their antidepressant may report symptoms like:

  • Being less able to cry when it would be an expected reaction
  • Feeling less empathy for the feelings of others
  • Not being able to respond with the same degree of positive emotion that they normally would

In addition, emotional blunting often occurs with other symptoms like slowed thinking and decreased sexual pleasure and interest.

Prevalence of Emotional Blunting

According to a study in the Journal of Affective Disorders, emotional blunting occurs in about half of people taking an antidepressant, within one of the following three classes: 

  • Selective Serotonin Reuptake Inhibitors (SSRIs) like Lexapro (escitalopram)
  • Selective Norepinephrine Reuptake Inhibitors (SNRIs) like Cymbalta (duloxetine)
  • Tricyclic Antidepressants like Elavil (amitriptyline)

Although, in the study, there were two outliers: Wellbutrin (bupropion) and Cymbalta (duloxetine)—emotional blunting was less common in those taking Wellbutrin (about 30 percent) and more common in those taking Cymbalta (75 percent).

Cause of Emotional Blunting

Experts question whether emotional blunting is a true side effect of taking an antidepressant or whether it's a residual symptom of depression, meaning a symptom of a person's depression that does not get better with treatment (a partial failure of the medicine).

With this conundrum, it's been difficult for experts to tease out the precise "why" behind emotional blunting. Even so, there is scientific evidence that a decreased positive affect is associated with dysfunction of the dopamine and noradrenaline pathways.

As an aside, dopamine and noradrenaline are two chemical messengers in the brain (called neurotransmitters) that play a role in mood (along with serotonin, which is the chemical, SSRIs target). 

On that note, some experts believed that antidepressants that increase serotonin levels in the brain (for example, SSRIs) may dull the activity of dopamine and noradrenaline, which then leads to emotional blunting. Other experts suggest that an antidepressant may "overshoot" or increase serotonin levels too much, and this leads to an emotional numbness or that flat feeling. 

These two theories, though, do not fit perfectly with the study mentioned above, as emotional blunting occurred with all antidepressants, not just the SSRIs. Although, interestingly, emotional blunting was lowest in those taking Wellbutrin (which works on dopamine and noradrenaline pathways in the brain, not serotonin). 

Managing Emotional Blunting

The good news is that if emotional blunting is problematic for you or a loved one, there are ways to treat it.

One strategy is that your doctor may lower your medication dose or change you to a different antidepressant (for example, from a SSRI to a SNRI).

Your doctor may also consider adding another medication to offset the emotional blunting you are experiencing. 

On the flip side, it's worthy to note that some people actually view emotional blunting as "helpful" in terms of how they feel—and this is OK. For some, it may be seen as a welcome relief from the extreme emotion that the person was previously feeling. Or it might not be severe enough to really interfere with a person's quality of life. 

A Word From Verywell

All in all, emotional blunting is a complex phenomenon that appears to be linked to a person's actual depression, a lingering symptom, so to speak.

Please know that you deserve to feel well and "normal" on your antidepressant. It may take some patience, therapy, and medication tweaks along the way, but you can experience and enjoy life fully. 

Sources:

Borchard TJ. (2009). Do Antidepressants Dull Your Emotions? An Interview with Ron Pies, M.D..  Psych Central.  Psych Central.  

Goodwin, G.M. Emotional blunting in anxiety and depression: neurobiology and psychopathology.  Medicographia. 34 (2012):295-299.

Goodwin GM, Price J, De Bodinat C, Laredo J. Emotional blunting with antidepressant treatments: A survey among depressed patients.  J Affect Disord. 2017 Oct 15;221:31-35.

Price J. and M. Goodwin.  Emotional blunting or reduced reactivity following remission of major depression.  Medicographia.31 (2009):152-156.

Sansone RA, Sansone LA. SSRI-Induced Indifference. Psychiatry (Edgmont). 2010 Oct;7(10):14-18.

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