Emotional blunting — an overall unfeeling or numbness — is a common complaint of depression patients prescribed to certain antidepressants. This diminished capacity to have feel-good emotions during positive moments can be a significant side effect for some people taking selective serotonin reuptake inhibitors, or SSRIs.
And when research supporting the idea was first discussed at a national conference in 2002, mental health professionals nodded in agreement over the existence of this unwanted side effect, recalls psychiatrist Heidi Combs, MD, an assistant professor of psychiatry at the University of Washington in Seattle.
SSRIs are a class of antidepressants that affect the way the brain uses the neurotransmitter serotonin. Their effect is intended to relieve the symptoms of depression — and they’re often successful in doing so. Unfortunately, explains Dr. Combs, the drugs also act on the reward pathways in the brain — the pathways that bring us pleasure. For some people, this means that they experience emotional blunting, or the sensation that all their emotional responses are dulled.
“If something positive is going on, these patients might not have the full response,” Combs says. Though there are many case studies, the lack of large clinical studies makes it difficult to predict which people will experience this side effect — and which ones won’t.
Part of the problem is the very nature of depression. People struggling with depression often complain that they have lost some of their ability to respond emotionally to events and people around them. So for a long time, emotional blunting caused by antidepressants was written off a as symptom of hard-to-treat depression.
However, says Combs, it’s fairly easy now for physicians to tease apart the symptoms of depression itself and this antidepressant side effect. If the depression symptoms have improved, but emotional blunting persists, it’s likely due to the antidepressant. If, on the other hand, the emotional blunting continues alongside unrelieved sadness, weepiness, and other depression symptoms, then it’s more apt to be part of the original disorder, she explains.