Mental Health

Please don't ask random, uninformed people on the internet about your medical treatment plan. Talk to an actual psychiatrist about your concerns.

though it only coincidentally related SSRIs fucked me up in a different way (which still affected my libido tbf). i didn't even get to a month of treatment before i decided to quit - they were supposed to help with my anxiety, but instead of helping they made it significantly worse, to the point where i felt as if i was spending my time edging a panic attack at all times of the day. At first i thought i was just getting worse normally, but then i noticed i felt better in the evenings (i was taking them in the mornings). i just couldn't keep going it was awful

there's plenty of people for whom SSRIs are life changers, but sadly i'm not in that group

I have battled chronic clinical depression since 1989 and it is possible that I have been prescribed every SSRI ever at one point or another. Two have had pronounced sexual side effects but I cannot remember which did what any more, so I'll forgo names altogether.

The first, and most disturbing of all, gave me instant erectile dysfunction. I was in my thirties when I started the pill. After a few days my penis was dead to the world. What is sad is that it was really working on my depression and anxiety without the dreaded twitching. ED in my thirties was a non-starter (no pun intended).

The second one I took for years and was in fact the last SSRI I took before I took myself off them entirely and started doing my own thing. On this pill I sort of had the opposite problem, but still a big problem. I could not only get an erection, I could effortlessly maintain it at full strength indefinitely. Well, hours for sure, and if I wanted it back, it was back. The negative side effect was a near complete inability to ejaculate. I could have passionate sex for hours at peak performance, but I could very rarely reach the finish line. As far as clinical effectiveness, the pill was adequate but not great. The combination of only slightly dulled symptoms, sexual trauma, and a virtually unlimited capacity to perform can lead to some very unhealthy behaviors.

Just be mindful, listen to yourself, and make sure that what you are doing works best for you. Good luck.

PS: During the time I was on the last pill I also suffered from acute and chronic insomnia. At my worst I was getting 90 minutes of light sleep in a 24 hour period. I do not mention it as a side effect of the SSRI because I think that was caused by a combination of factors. The pills could have been one of the factors though. I am not sure.

Coupled with an excellent therapist, literally saved my life when I was struggling with depression. And my fertility has not been too hampered, if you know what I mean. It can surely have bad side effects for some people, but for others it is life-changing.

I have been on SSRIs for 20 years. For me they're a good idea, but I've known others who have had a terrible time with them.

Sexual dysfunction is definitely a thing: how much of an issue that will be is going to be a personal decision on weighing up pros and cons. If your sex drive is low as a part of your depressive symptoms or you're already experiencing anhedonia (inability to feel happiness/pleasure) or anorgasmia (inability to achieve orgasm) then going on SSRIs isn't going to make that any worse. But for others the risk of missing sexual pleasure might be an unacceptable trade-off.

For anyone starting SSRIs I think it's best to go slowly and keep in touch with your primary doctor throughout the process. There are a number of SSRIs available, and if one doesn't work out you can try others, and hopefully land on one that works for you.

With all that said, SSRIs don't work for everyone. It's not unusual to feel weird or like things are getting worse when you first start them: it takes some time for the effects to settle. But if you're having a really bad time on them, speak to your doctor about alternatives.

Personally, I was very resistant to try antidepressents until about a year ago (because I wanted to solve it myself and not be dependent on drugs), but tried them at a low point and they really helped. I'd recommend anyone curious about them to give them ago. If they don't work then at least you'll know, and as far as I'm aware, the side effects aren't permanent*.

However, I think there needs to be some other support in place, like therapy. It's not going to magically change your outlook and make you happy or give you the tools to deal with challenges. It just lifts your mood enough to be able to push yourself to make those changes. For me, it made me less stressed and anxious about everything, which means I can try and enjoy things more rather than worrying about things changing.

I know there are (or at least, I think there are) a lot of places out there which will prescribe just antidepressants and treat them as a magical cure-all. IMO that's not the best way of doing it. I think taking antidepressants should be normalized, but at the same time, for the love of god, actually try to treat the underlying issues.

Oh, and don't force people to take antidepressants without informed consent. I don't know why I have to clarify this, but I have a friend online who thinks people don't know what's best for them and it's appropriate for them to be forced to take meds. Stop that. People need to find what works for them and be engaged in the treatment process.

I have sadly noticed a reduction in, uh, "friskiness" since taking the meds. Not sure how much of that is because of the meds, and how much of it is because I psyched myself up so much thinking that I'd never orgasm again. Biggest sex organ is the mind and all that. Still, it's not as bad as I worried it would be, and there are plenty of people out there living with low libedos naturally anyway.

I also feel a bit... Fatigued? Tired? Not really sure how to describe it. Don't know if that's the meds or just as a result of bad habits I picked up while being in a bad spot.

* I am not a doctor. This may be false. Don't use the ramblings of some guy online as medical advice.

According to the book "Anatomy of an Epidemic" SSRIs (antidepressants) improve patient symptoms slightly in the short term compared to those who are not medicated. However, in the long term:

1. They do not solve the problem of anxiety/depression at the symptomatic level.

2. They hinder the patient's recovery and turn them into a chronic depressive or anxious individual.

In my experience, since I started taking SSRIs, I have been having more panic attacks, even though initially, about 5 years ago, they seemed to improve my symptoms of social anxiety and sadness.

Check this out: https://robertwhitakerbooks.com/anatomy-of-an-epidemic/antidepressantsdepression/

If you have experience with them, do you think they're a good idea?

If they help with treating one's illness, absolutely.

The paper does say "this effect does seem to be reversible", so if you stop SSRIs, your sex organs should apparently go back to normal. But still, some people are on SSRIs for long periods of time, right?

Correct on both points. There are a number of medications that have similar effects and similarly have good profiles for reversal (including TRT).

It's something that warrants more study, yes, but the risk vs benefit is a very good balance. If further study shows teratogenic effects, it should be widely communicated and handled appropriately. However, there are many lives saved.

If you're worried by being prescribed them, noone can tell you what's right for you and your doctor but, I'd probably not pay it any mind. They're not super scary things and don't say anything bad about you.

I think the main benefit of drugs is making new states of mind known, so they can later be sought organically.

One of my teachers said it’s like climbing a mountain in a rainstorm, and then suddenly there’s a flash of lightning and you see the whole mountain for a moment.

SSRIs and other antidepressants are good for people who’ve forgotten what it’s like to be at ease, who’ve been in the shit for so long that they don’t have any mental connection to a world outside of the shit any longer.

Then you just force the serotonin activity up, and this reintroduces the person to a better life. They can stay there for a while and become acquainted with it. It can give them a reason to try.

I didn't like SSRIs. I found the effects for me to be very, very marginal, and the side effects--weight gain, sexual dysfunction--to be very unpleasant. The Zyprexa I was given (an atypical antipsychotic, I believe) was even worse for weight gain and sexual dysfunction. I preferred bupropion, which had neither side effect. The effects were still very marginal, IMO.

A lot of people have a REALLY hard time getting off SSRIs if they it doesn't work, if the side effects are too serious, etc. Some people report 'brain zaps', and serious withdrawal. Like, really bad. It can take months for the withdrawal symptoms to ease or go away completely.

If it's for depression, I'd look into TCMS. It's probably more expensive up front, but supposedly you can have significant improvement in 50 or fewer sessions.