Lingering Shadows: The New York Times Explores Post-SSRI Sexual Dysfunction, November 21, 2023
A recent feature in The New York Times, “After Antidepressants, a Loss of Sexuality,” has brought much-needed attention to a rarely discussed but deeply impactful side effect of antidepressant medications: Post-SSRI Sexual Dysfunction (PSSD). However, as highlighted by journalist Azeen Ghorayshi, a subset of individuals experience persistent sexual side effects—sometimes for years—after discontinuing these medications.
What Is Post-SSRI Sexual Dysfunction (PSSD)?
PSSD refers to a constellation of sexual symptoms that persist after stopping SSRIs. These can include:
- Genital numbness
- Loss of libido
- Anorgasmia (inability to orgasm)
- Pleasureless or muted orgasms
While sexual side effects during SSRI use are well-known, the persistence of these symptoms after stopping the medication is less recognized and often misunderstood. Some patients also report emotional blunting, cognitive difficulties, and a diminished capacity for pleasure, further impacting their quality of life.
The Human Impact
The New York Times article shares the stories of individuals whose lives and relationships have been deeply affected by PSSD. Symptoms like genital numbness and anorgasmia can disrupt not only sexual function but also the ability to form and maintain intimate relationships. Many patients report feeling isolated, misunderstood, and dismissed by healthcare providers who may attribute ongoing sexual dysfunction to underlying depression rather than the medication itself.
Why Is PSSD Overlooked?
Several factors contribute to the under-recognition of PSSD:
- Complexity of Depression: Depression itself can cause sexual problems, making it difficult to distinguish between medication side effects and the illness.
- Lack of Research: There is limited research on the long-term effects of SSRIs, and the true prevalence and mechanisms of PSSD remain unclear.
- Medical Skepticism: Some psychiatrists question whether PSSD is caused by SSRIs or is a manifestation of unresolved depression, further complicating diagnosis and treatment.
What Does the Research Say?
Scientific literature confirms that sexual side effects can begin within 30 minutes of SSRI intake, often described as genital “numbing” or a loss of pleasurable sensation. While these symptoms typically resolve after discontinuing the drug, a subset of patients experience persistent dysfunction—sometimes lasting years or even decades. Recent research suggests that neuroimmune processes and small fiber neuropathy may play a role in PSSD, but more studies are needed to fully understand the condition.
No universal treatment exists.
The Importance of Informed Consent and Open Dialogue
The New York Times article underscores the need for open communication between patients and healthcare providers. Discussing potential side effects—including the risk of PSSD—empowers individuals to make informed treatment decisions and manage expectations. For those already experiencing PSSD, validation and support are critical, as is continued advocacy for research and recognition of the condition.
Are There Alternatives to Antidepressants?
Emerging evidence suggests that lifestyle interventions, such as exercise and dietary changes, can be highly effective in managing depression. A comprehensive review published in 2023 found that physical activity is 1.5 times more effective than medication or counseling for improving symptoms of depression, anxiety, and distress. A personalized, holistic approach to mental health care is optimal.
Moving Forward: Hope Through Awareness and Research
By bringing PSSD into the public conversation, The New York Times article helps reduce stigma and encourages those affected to seek help. Increased awareness can drive research into the causes and treatments of PSSD, offering hope to those living in its lingering shadows.
If you or someone you know is struggling with persistent sexual side effects after antidepressant use, consider reaching out to a mental health professional familiar with PSSD and explore holistic approaches—including EMDR, Brainspotting, my Infinity-Brain Method and lifestyle changes—that support overall well-being.
