PSSD and social isolation: how to cope

Many people with post-SSRI sexual dysfunction (PSSD) pull away from friends, because the symptoms can last after stopping an antidepressant and are hard to explain. Small, low-pressure contact and talking to people who have PSSD too can make the isolation easier to carry.

PSSD is more than sexual problems. The 2022 diagnostic criteria describe a lasting change in genital sensation, often numbness, and also list emotional numbing, problems with thinking and changes in other senses. When you can’t feel much, a night out can feel pointless, and that’s often where the withdrawal starts.

The UK leaflet for Cipralex (escitalopram) says sexual problems have, in some cases, “continued after stopping treatment”. Most of your friends will never have read that line.

Why does PSSD make people withdraw?

Withdrawal usually comes from the symptoms themselves. Emotional numbing can make time with people feel flat. Brain fog can make a busy conversation hard to follow. And a condition that has “sexual” in its name is hard to bring up at all.

Being doubted makes it worse. In a 2019 study of 62 people who had reported PSSD, one participant wrote:

“I feel that repeatedly not being believed has significantly increased the distress that living”

Participant 25, quoted as published, cut where the study’s extract ends. The people in the study had reported PSSD through a drug-safety website, so it doesn’t tell us how everyone with PSSD is treated. It does show the pattern many describe: they stop talking about it, and then they stop going out.

Our articles on brain fog and anhedonia go into those symptoms in more detail.

Who should I tell, and what do I say?

Start with one person you trust, and tell them only as much as you want to. You don’t have to explain the sexual side to be understood.

A short version is enough: “I had a reaction to a medicine. It changed how I feel things, and it hasn’t gone away since I stopped. Some days I’ll cancel. It isn’t about you.”

If they want to know more, send them the leaflet line or our PSSD page. That way the facts come from a source, not just from you. Our guide on talking to family and friends about PSSD has more ways to say it.

How can I stay in touch when I have no energy?

Make contact small and easy to cancel. A walk, a coffee for half an hour or a message every few days still counts.

• Pick quiet settings: one friend, not a group, somewhere you can leave.
• Set one small goal a week: “Text Sam on Sunday.”
• Use what already works: the NHS suggests that “regular chats with friends and family” help with loneliness.

Some weeks you’ll manage none of it. That’s part of living with a condition that changes from day to day.

Watch: what living with PSSD is like

Rosie, president of the PSSD Network, talks about her own PSSD in her interview on our site. Watch this extract if you want to hear someone describe it in their own words, or to show a friend.

Play video: Interview with Rosie, PSSD Network President

Other people with PSSD often understand without needing the explanation. That can be a relief when friends don’t.

Our WhatsApp peer support groups and the SIDEfxHUB community are places to start. You can read for a while before you say anything. Our guide to finding support in the PSSD community lists more options.

Peer groups offer support, and they can’t replace your GP. If a post makes you feel worse, step away for a while.

Watch: a psychiatrist on PSSD

This short video is useful to share with someone who doubts you. Professor Joanna Moncrieff, a psychiatrist at UCL, talks about PSSD and how aware doctors are of it. It’s background on PSSD, and it says nothing about isolation.

Play video: Professor Joanna Moncrieff discusses Post-SSRI Sexual Dysfunction (PSSD)

Some people will brush it off or give advice that doesn’t help. That says more about how little is known about PSSD than about you.

You don’t have to keep convincing anyone. Spend your energy on the people who stay. If someone close keeps doubting you, the leaflet line and the video above can do the explaining for you.

When should I get help for how I feel?

Get help if the isolation turns into hopelessness, or you stop looking after yourself. Talk to your GP and say clearly how long it has lasted and how it affects your days.

If you’re struggling to cope or have thoughts of ending your life, call Samaritans free on 116 123, any time. In an emergency, call 999.

These medicines help many people. If you have side effects, that’s a decision for you and your prescriber. Don’t stop suddenly.

Report it: it helps everyone

A doctor’s note helps you. A report to the medicines regulator helps everyone else: it is how patterns get noticed.

• No proof needed. A suspicion is enough, even years after stopping.
• Where: the Yellow Card scheme in the UK, MedWatch in the US. Our Yellow Card guide for PSSD shows each step.
• Use the right words. If symptoms continued after stopping, write Post-SSRI sexual dysfunction (MedDRA 10086208).

Our reporting guide walks you through it

What else do people ask?

Is it normal to lose interest in friends with PSSD? Many people with PSSD describe it. The 2022 criteria list emotional numbing as one of the symptoms, which can make time with others feel flat. It’s worth telling your GP, because low mood can also be treated on its own terms.

Should I tell my employer? That’s your choice. You don’t have to name the condition. You could say you have a health problem that affects your energy and ask for flexible hours. In the UK, Citizens Advice can explain your rights at work.

Will the isolation last for ever? For some people PSSD has lasted years after stopping. Nobody knows yet who will be affected, or whether it will ease. Small steps still count.

Pick one person and send one message this week. Our PSSD page is there when they ask what it is.

Sources

1. Healy D, Bahrick A, Bak M and colleagues. Diagnostic criteria for enduring sexual dysfunction after treatment with antidepressants, finasteride and isotretinoin. Int J Risk Saf Med 2022;33(1):65-76. Proposed criteria developed through expert agreement. Section 3: “An enduring change in somatic (tactile) or erogenous (sexual) genital sensation after treatment stops”; ancillary non-sexual symptoms “may include” “emotional numbing”, “other sensory problems” and “cognitive impairment”.
2. Healy D, Le Noury J, Mangin D. Post-SSRI sexual dysfunction: patient experiences of engagement with healthcare professionals. Int J Risk Saf Med 2019;30:167-178. Questionnaire answered by 62 people from 23 countries recruited through RxISK.org. Quotation from participant P25, section 3.9.
3. Lundbeck Limited. Cipralex (escitalopram) patient information leaflet, electronic Medicines Compendium. Section 2: “In some cases, these symptoms have continued after stopping treatment.”
4. NHS Every Mind Matters. Loneliness.
5. GOV.UK. Report a problem with a medicine or medical device.
6. Moral Medicine, Interview with PSSD Network President Rosie, 9 July 2024.
7. PSSD Network, Professor Joanna Moncrieff discusses Post-SSRI Sexual Dysfunction, June 2026. Used for general context, not as evidence about isolation.