Depression Treatment Medication Emotional Blunting: Causes, Symptoms & Treatment By Nancy Schimelpfening Nancy Schimelpfening Nancy Schimelpfening, MS is the administrator for the non-profit depression support group Depression Sanctuary. Nancy has a lifetime of experience with depression, experiencing firsthand how devastating this illness can be. Learn about our editorial process Updated on November 09, 2021 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Rachel Goldman, PhD, FTOS Medically reviewed by Rachel Goldman, PhD, FTOS Facebook LinkedIn Twitter Rachel Goldman, PhD FTOS, is a licensed psychologist, clinical assistant professor, speaker, wellness expert specializing in eating behaviors, stress management, and health behavior change. Learn about our Medical Review Board Print cnicbc/Getty Images Table of Contents View All Table of Contents Symptoms Prevalence Causes Treatment When first starting antidepressants, you may suddenly find that you don't feel like yourself anymore. Though your depression symptoms may have improved, the overwhelming waves of gloom can sometimes be replaced by an emotional inertness in which are neither able to cry nor share a real belly laugh. If you feel this way, you are definitely not alone. In fact, there's a term used to describe this feeling—called emotional blunting—which aptly captures the dulled emotional state many people experience while on antidepressants. Symptoms of Emotional Blunting Emotional blunting means that your feelings and emotions are so dulled that you neither feel up nor down. You simply feel "blah." People who experience emotional blunting will often report: Being less able to laugh or cry even when appropriateFeeling less empathy for othersLoss of motivation and driveNot being able to respond with the same level of enjoyment that you normally would Emotional blunting often co-occurs with other symptoms such as slowed thinking, decreased libido, and loss of concentration. Prevalence of Emotional Blunting Studies from Oxford University have shown that between 46% and 71% of antidepressant users have experienced emotional blunting during treatment. According to the research, the antidepressants most commonly associated with emotional blunting fall into one of three classes: Selective norepinephrine reuptake inhibitors (SNRIs) such as Cymbalta (duloxetine), Pristiq (desvenlafaxine), and Effexor XR (venlafaxine) Selective serotonin reuptake inhibitors (SSRIs) like Lexapro (escitalopram), Prozac (fluoxetine), Zoloft (sertraline), and Paxil (paroxetine) Tricyclic and tetracyclic antidepressants like Elavil (amitriptyline) and Remeron (desvenlafaxine) Though the percentage of people who experienced emotional blunting was similar between the three drug classes, there were variations. On the one end, only 33% experienced emotional blunting while on Wellbutrin (bupropion) while, on the other end, 75% experienced the same effect on Cymbalta. This is an interesting fact given that Wellbutrin is a different class of drug known as a dopamine and norepinephrine reuptake inhibitor. Unlike the others, Wellbutrin does not target a chemical transmitter in the brain—known as serotonin—that all of the other drugs so. What this suggests is the inhibition of serotonin may be one of the prime causes of emotional blunting. 1:44 Click Play to Learn More About Emotional Blunting This video has been medically reviewed by John C. Umhau, MD, MPH, CPE. Other Findings According to the Oxford study, men experienced blunting more than women (54% vs. 44%, respectively). Moreover, the severity of depression before treatment directly corresponded to the severity of the emotional blunting during treatment. By and large, those who no longer needed antidepressants experienced a reversal of emotional blunting, confirming the role that the drug plays in the side effect. Surprisingly, not everyone viewed emotional blunting in the same way. Of the 819 people included in the study, 38% regarded it as a positive outcome of treatment, while 37% viewed it negatively. Generally speaking, those with more severe blunting symptoms viewed it more negatively. Symptoms of Severe Depression Supporting Evidence Similarly, an online survey of 1,431 antidepressant users from 38 countries aimed to identify the most common adverse side effects of treatment. "Emotional numbness" was ranked number one, with 70.6% experiencing the symptom. "Feeling distant or detached" was a close second at 70%, while "not feeling" like yourself was third with 66.2%. The study didn't specify which types of antidepressants were used. All three of the most commonly reported negative side effects of antidepressants can be considered forms of emotional blunting. A smaller study from New Zealand involving 180 people on long-term antidepressant therapy found that 64.5% experienced emotional blunting. Related side effects included sexual difficulties (71.8%), not feeling like yourself (54.4%), and a reduction in positive feelings (45.6%). Finally, a Canadian study involving 896 participants, 49.9% of whom had major depressive disorder (MDD) and 50.1% of whom had bipolar disorder (BP), found that emotional blunting was one of the main reasons for the discontinuation of therapy. In fact, after weight gain and excessive sleepiness, emotionally blunting ranked third in the reasons to stop treatment among people with MDD. Long-Term Effects of Antidepressants Causes of Emotional Blunting Given that not everyone on antidepressants will develop emotional blunting, it has been difficult for scientists to tease out a precise reason for this effect. Some experts have even questioned whether blunting is a side effect of antidepressant treatment or perhaps a partial failure of the drug itself. While it would seem fair to assume that serotonin plays a role in the effect (given the lower incidence among Wellbutrin users), most scientists believe that a single hormone cannot be to blame. It is likely that the imbalance of all three key hormones—serotonin, dopamine, and norepinephrine—may trigger the effect of emotional blunting and that those with an underlying hormonal deficit will fare worse. Others still have suggested that emotional blunting is more of a symptom revealed, meaning that once the antidepressants are able to alleviate depression, the underlying symptoms of emotional blunting are revealed rather than caused. Much more research is needed before any conclusions can be drawn. Treatment for Emotional Blunting The good news is that emotional blunting can be treated. Among some of the options to consider: You can engage in exercise and outdoor activities, both of which may stimulate serotonin and elevate your mood. Eating healthier and avoiding alcohol (a mood depressant) can also help.You can work with your therapist to find ways to elevate your mood since there may be a psychological component to your condition as well as a pharmaceutical one.Your doctor can lower your dose or switch you to a different antidepressant (say, from an SSRI to an SNRI).Your doctor may also be able to add other medication to offset the emotional blunting. If you find the side effect intolerable, do not stop treatment without first speaking with your doctor. Doing so may lead to a rebound of depression symptoms or trigger the opposite effect, including anxiety, agitation, and sleeplessness. What to Know About Antidepressant Withdrawal A Word From Verywell Experiencing emotional blunting while on antidepressants doesn't mean that you can't reap the benefits of treatment. In some cases, a simple dose reduction may help clear some of the numbness. At other times, you can learn to cope by making some positive lifestyle changes that enhance your physical fitness and, in turn, your emotional well-being. Continue working with your doctor to find the right formula of medications, therapy, and lifestyle to overcome and manage your depression over the long term. Can SSRIs Make You Fall Out of Love? 10 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Price J, Cole V, Goodwin GM. Emotional side-effects of selective serotonin reuptake inhibitors: qualitative study. Br J Psychiatry. 2009;195(3):211-7. doi:10.1192/bjp.bp.108.051110 Aydemir EO, Asian E, Yazici MK. SSRI induced apathy syndrome. Psychiatry and Behavioral Sciences 2018;8(2):63-70. doi:10.5455/PBS.20180115111230 Goodwin GM, Price J, De bodinat C, Laredo J. Emotional blunting with antidepressant treatments: A survey among depressed patients. J Affect Disord. 2017;221:31-35. doi:10.1016/j.jad.2017.05.048 Patel K, Allen S, Haque MN, Angelescu I, Baumeister D, Tracy DK. Bupropion: a systematic review and meta-analysis of effectiveness as an antidepressant. Ther Adv Psychopharmacol. 2016;6(2):99-144. doi:10.1177/2045125316629071 Read J Williams J. Adverse Effects of Antidepressants Reported by a Large International Cohort: Emotional Blunting, Suicidality, and Withdrawal Effects. Current Drug Safety. 2018;13(3):176–186. doi:10.2174/1574886313666180605095130 Cartwright C, Gibson, K, Read, J. et al. Long-Term Antidepressant Use: Patient Perspectives of Benefits and Adverse Effects. Patient Preference and Adherence. 2016;10:1401–1407. doi:10.2147/PPA.S110632 Rosenblat JD, Simon GE, Sachs GS, et al. Treatment effectiveness and tolerability outcomes that are most important to individuals with bipolar and unipolar depression. J Affect Disord. 2019;243:116-120. doi:10.1016/j.jad.2018.09.027 Sadock BJ, MD, Sadock VA, MD. Kaplan & Sadock’s Concise Textbook of Clinical Psychiatry (3rd edition). LWW. 2017. Jones JD, Butterfield LC, Song W, et al. Anxiety and Depression Are Better Correlates of Parkinson's Disease Quality of Life Than Apathy. J Neuropsychiatry Clin Neurosci. 2015;27(3):213-8. doi:10.1176/appi.neuropsych.13120380 Weir K. The exercise effect. American Psychological Association. 2011. Additional Reading Read J, Williams J. Adverse effects of antidepressants reported by a large international cohort: emotional blunting, suicidality, and withdrawal effects. Curr Drug Saf. 2018;13(3):176-186. doi:10.2174/1574886313666180605095130 Rosenblat JD, Simon GE, Sachs GS, et al. Treatment effectiveness and tolerability outcomes that are most important to individuals with bipolar and unipolar depression. J Affect Disord. 2019;243:116-120. doi:10.1016/j.jad.2018.09.027 By Nancy Schimelpfening Nancy Schimelpfening, MS is the administrator for the non-profit depression support group Depression Sanctuary. Nancy has a lifetime of experience with depression, experiencing firsthand how devastating this illness can be. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist for Depression Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.