"Medication helped to blunt my anxiety – but it also extinguished any sparks."
That excited but nervous, fluttery feeling you get in your stomach when you’re crushing hard on somebody? My body can’t tell the difference between that sort of “good” anxiety and regular old bad anxiety. A cute guy can become a panic attack trigger, leaving me to flee mid-date to avoid a public meltdown.
A little over a year ago, with life as a cat lady looming in my future, I finally decided to take my doctor’s advice and try antidepressants to manage my anxiety, specifically a selective-serotonin reputake inhibitor (SSRI), which helps balance the chemicals serotonin and dopamine in the brain. I had been reluctant to previously because I just didn’t like the idea of being dependent on medication on a daily basis. Almost immediately though, I stopped having panic attacks in situations that would normally make me uncomfortable.
Soon after, I met Dan (not his real name) online. I found him incredibly attractive, funny, and engaging. I thought he was perfect for me, and we transitioned from dating to a relationship with no panic attacks. Sleeping over or meeting his friends would have previously led to extreme anxiety, but it felt, for the first time in my life, easy. In fact, I was even comfortable enough to tell him about my anxiety and medication. To his credit, he was incredibly supportive. I thought I had found a magical solution to all of my problems.
As the weeks progressed, though, I started to realize things just didn’t feel right. While my doctor had warned me the medication would likely dampen my sex drive, it wasn’t just my lack of interest in sex that was an issue. The blasé emotional scale I’d initially welcomed dimmed any spark I felt for Dan. And the relationship started to feel the strain.
While Dan would constantly text me sweet notes throughout the day, something I’d normally be giddy over, I’d often forget to even look at my phone or think beyond texting the logistics of our dates. I showed a general lack of enthusiasm for events that Dan would get super excited about, from celebrating Valentine’s Day to meeting his family. I just couldn’t feel or show as much excitement as him, and then had a hard time sympathizing when he got mad that I didn’t. Dan often felt like I didn’t care, and I struggled to explain my feelings because I didn’t understand them myself.
I fell down a Google hole of research trying to figure out what was going on and soon realized it was the meds dulling my emotions.
“It’s like putting a pillow between you and the world, it cushions the blows but it also means you don’t feel the highs in the same way," says Marianne Goodman, M.D., professor of psychiatry at the Icahn School of Medicine at Mount Sinai, who gave me this analogy about taking medications like SSRIs.
Helen Fisher, Ph.D., a biological anthropologist and senior research fellow at the Kinsey Institute explains, “If you drive up serotonin activity in the brain, you dampen the dopamine system. The dopamine system is associated with intense feelings of romantic love, so it seems logical knowing this, that under many circumstances as people take a drug that drives up serotonin, it will in some way jeopardize [these feelings].”
In one instance, Fisher met a man who started SSRIs midway through a marriage and thought he no longer loved his wife and children. It was only after he stopped the medication that he realized that was not the case.
Eventually after speaking with my doctor, I decided to taper off my medication after about seven months on the drug. Even with a gradual taper, I experienced unpleasant withdrawal symptoms such as migraines and “brain zaps,” a weird sensation that feels almost like an electric pulse in my head, which put added stress on the relationship, another side effect I hadn’t truly anticipated.
After several weeks, they subsided and I felt “normal” again, but while Dan and I resolved to try to start fresh, we realized we couldn’t recreate the initial sparks of a brand new relationship or erase the number of times I had hurt Dan with my apathy.
It’s been a few months since we broke up, and I’ve come to terms with it. While I would never encourage people who need medication to not take it, I do think it’s important for people to have a full understanding of the effects of medication in order to be able to manage their experience.
It’s a matter of clear communication with your doctor about your options.
“Not every medication has the same exact profile depending on people, so you can shift according to your reaction. If a person is feeling better I might lower the dose or try a more activating medication,” Goodman says.
I’ve decided to stay off my medication since I don't need it to function on a daily basis. While I appreciate the fact that the medication helped me get past years of dating roadblocks, and allowed me to be more open and comfortable with my partner about my situation, I’d prefer to try alternative methods to managing my anxiety for now.
Navigating relationships is tough enough, navigating them while dealing with mental health issues can be much tougher. I realize now that getting educated and feeling knowledgeable about my medication and empowered about my options was an important piece missing in my experience so I encourage others to do so. While dating without being on medication is a little scarier than it was before, I’m looking forward to feeling the highs, the lows, and maybe even falling in love.