Closing down?

~ Jason Schwartz

closing_downFindings from a study of adverse interpersonal effects from antidepressants were recently published online. The adverse interpersonal effects we reported by more than half of the subjects, though more than half of the subjects were on them for 3 years.

The gated, full article described a cluster of reported side-effects that it described as “closing down”. Note the last sentence. [emphasis mine]

Our findings, from the largest sample to date, suggest that it may be important to follow up results from smaller, qualitative studies, with large-scale surveys. All four of the emotional or interpersonal effects identified in previous qualitative studies (Gibson et al., 2014, Goldberg and Moncrieff, 2011 and MIND, 2012) were reported to be very common: Feeling Emotionally Numb (60%), Feeling Not Like Myself (52%), Reduction In Positive Feelings (42%), Caring Less About Others (39%). Between 16% and 35% experienced these four effects as either ‘moderate’ or ‘severe’. Furthermore, all four effects were strongly associated with the belief that suicidality was experienced ‘as a result’ of the ADs, as was Agitation. This is consistent with a study that found suicidality associated with the adverse effects ‘emotional blunting’ and ‘emotional instability’ (Goldberg and Moncrieff, 2011).

Younger people were more likely to experience Feeling Emotionally Numb and Feeling Not Like Myself, and men were more likely to experience Reduction In Positive Feelings and Caring Less About Others.

This diminished capacity to experience feelings, positive or negative, and to care about other people, might be characterized as a sort of ‘closing down’, a withdrawal from the emotional and interpersonal world. This might be considered an exacerbation of the problems for which ADs are prescribed in the first place. These effects may also reduce the probability of using other pathways to recovery.

The continued use of the drugs makes one wonder if some of these adverse effects, like numbing, aren’t also experienced as a benefit.

Published by Jason Schwartz

I have been an addiction professional and social worker since 1994. I started blogging in 2005 as the Clinical Director at Dawn Farm. I no longer work at Dawn Farm and am now the Director of Behavioral Medicine at a community hospital, and a lecturer at Eastern Michigan University’s School of Social Work. Views expressed here are my own. Keep in mind that the field, the contexts in which the field operates, and my views have changed over time.

3 thoughts on “Closing down?”

  1. Good one. Also experience d as a benefit .

    Jennifer Lindsey Cooper Sent from my iPhone

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  2. I have long held the impression that antidepressants make you care less and that this can be an advantage as well as a disadvantage. The issue of caring (in a painful way or a positive way) and motivation to move on is interesting. If you fall down a hole and don’t much care, you’re not likely to put much effort into getting out. For many folk with addiction, the painful consequences can be a positive motivator. I think the benefits of antidepressants are hugely over emphasised, though that’s not to say they are without value.

    Do antidepressants enhance or restrict recovery? I guess the answer may be ‘both’ in different circumstances and people at different times. I do know how anxious people get when discussion is had about the right time to come off them.

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