Emotional blunting more a reflection that antidepressants don’t work than how they do

I’ve mentioned before my concerns about the notion that antidepressants work through being emotional suppressants (see eg. previous post). In fact, I’m more inclined to think antidepressants don’t work any better than placebo (see eg. last post), so there’s no need to explain how antidepressants ‘work’, as such. Although the emotional numbness theory has been promoted by Joanna Moncrieff, in her recent book she does qualify this hypothesis by saying she thinks “we should be cautious about assuming emotional numbing can be useful”. 

I’m more inclined to see emotional numbing as a reflection of the fact that antidepressants don’t work, than as an explanation for how they do. Many people are left feeling emotionally numb after being on antidepressants, particularly long-term (see eg. previous post). There is a sense in which taking antidepressants masks the real problem, particularly if depression is understood as physically caused, for example by a chemical imbalance, rather than having psychosocial origins. One’s view of oneself can be at stake in taking antidepressants (see eg. previous post). Undermining of emotional authenticity is not necessarily beneficial. Believing antidepressants are helpful may seem to produce apparent improvement, for example by counteracting demoralisation, but over the longer term such a perception may also leave people feeling dulled, numbed, flattened, blocked, blank, flat or apathetic, affecting their relationships with others and how they see themselves. Many people do initially feel released from these constrictions when they first stop antidepressants, but are then left with the difficulties of managing without them, which may well not be easy, because they have become so dependent (see eg. previous post).