More Australians than ever rely on antidepressant medication to manage depression and anxiety. Recent national data show that about 4.7 million people were dispensed a mental health-related prescription in 2021–22, and nearly three-quarters of those medicines were antidepressants. Like any treatment, these drugs can come with side effects. One that is getting more attention from researchers and clinicians is “emotional blunting” – feeling emotionally flat, numb or disconnected.
A recent placebo-controlled study looked at 66 healthy volunteers. Thirty-two people took a commonly prescribed selective serotonin reuptake inhibitor (SSRI) called escitalopram, while 34 took a placebo. Participants stayed on their assigned capsule for at least 21 days, then completed questionnaires and computer-based tasks that measured learning, inhibition and decision-making.
People in the SSRI group showed reduced “reinforcement sensitivity”. In simple terms, they were less likely to use positive or negative feedback to adjust their behaviour during tasks compared to those on placebo. The researchers suggested this dampened response to reward and punishment could help explain why some people describe feeling less joy, less sadness and generally more “muted” on SSRIs – the classic emotional blunting effect.
Participants taking the SSRI were also more likely to report difficulty reaching orgasm than those taking placebo, a well-recognised sexual side effect of this class of medication.
Emotional blunting does not mean the medicine is “not working”, and it does not happen to everyone. SSRIs can be life-saving and remain a first-line treatment for many people with moderate to severe depression. If you notice feeling unusually flat, indifferent or disconnected after starting or increasing an antidepressant, it is important to talk to your GP or psychiatrist rather than stopping the medication suddenly. Together you can review the dose, look at psychological therapies, or consider alternative treatments while still keeping your mental health well supported.
What is emotional blunting, exactly?
Emotional blunting is a side effect estimated to affect 40 to 60% of people who take SSRIs for major depressive disorder, and it is one of the most common reasons people stop these medicines.
At its core, emotional blunting is a sense of numbness to both positive and negative feelings. “Emotional blunting is basically trouble experiencing emotions,” says pharmacology expert Jamie Alan. “When people experience emotional blunting, they typically experience a dulling of all emotions, both ‘good’ and ‘bad,’” adds clinical psychologist Hillary Ammon.
The term can sound more dramatic than what some people actually feel. “The phrase sounds a lot more intense than what it sometimes really is,” says clinical psychologist Thea Gallagher. People who experience emotional blunting may notice that feelings are not as strong as they were before but “in some ways, that’s part of the goal” for people who benefit from antidepressants, particularly those living with anxiety and depression, Gallagher explains.
Sometimes it is simply an adjustment from how emotions were experienced in the past, even if it feels unfamiliar. Gallagher notes that there is a spectrum with emotional blunting. For example, if someone with generalised anxiety disorder is not as distressed by everyday events, that shift can be helpful. “But if you feel like you’re a zombie, you want to talk to your doctor,” she says.
While the recent research focused on escitalopram, Alan emphasises that emotional blunting “can happen with any SSRI.”
Signs of emotional blunting
Emotional blunting can look different from person to person, but experts say these are common signs that it may be happening:
- Not reacting to something that would usually spark excitement or joy
- Feeling little or no response when something upsetting happens
- Not feeling love or affection as strongly as before
- Not getting as angry or worked up as in the past
“This can obviously be a frustrating side effect for an individual, particularly for the ‘feel good’ emotions,” says Ammon. “It may also negatively impact interactions or relationships with others for that person. Not only does it impact internal emotional responses, but can also impact body language, creating a flat effect in your facial expressions.”
Emotional blunting is not the same as apathy. Apathy involves a lack of feeling or emotion, whereas emotional blunting is more about muted intensity rather than complete absence.
What should you do if you’re experiencing emotional blunting?
Most medicines come with some side effects, and part of treatment involves working out which ones feel manageable. If previous anxiety symptoms have eased and day-to-day life feels more stable, a slight softening of emotional intensity might be acceptable.
If emotional blunting feels disruptive or makes life feel muted or “zombie-like,” experts recommend speaking with a doctor rather than stopping treatment alone. “There can be consequences if you stop your medication abruptly,” notes Alan. A doctor can help adjust the dose, switch to another antidepressant, or suggest additional treatments such as therapy.
“It’s important to remember that medications are not a one size fits all treatment,” Ammon says. “Each person may react differently to a prescribed medication. There may be some trial and error when finding the medication that works best for you.”
If a selective serotonin reuptake inhibitor (SSRI) has only recently been started, it may be worth giving it a little more time, Gallagher suggests. Many SSRIs take four to six weeks to reach full effect. If the sense of numbness continues or worsens, a review with the prescriber is important to explore alternatives.
If you or someone you know is in crisis or at immediate risk of harm in Australia, call 000. For 24/7 mental health support, contact Lifeline on 13 11 14 or use their online chat, or reach out to Beyond Blue on 1300 22 4636.
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