PSSD and depression: coping day to day

Low mood can come with post-SSRI sexual dysfunction (PSSD), sexual and emotional changes that can last after stopping an SSRI antidepressant such as sertraline. You can get help with your mood even while the PSSD stays: from a GP who knows about it, talking therapy and other people who have it.

PSSD is more than sex. Doctors and researchers proposed a checklist in 2022 to recognise it. Its main sign is a lasting change in genital feeling, often numbness. It also lists emotional numbing (feeling flat inside) and problems with concentration and memory. SSRIs are prescribed for depression and anxiety, so low mood afterwards is easily put down to the old illness alone.

If low mood ever turns into thoughts of ending your life, call Samaritans free on 116 123, day or night. Our page on suicidal thoughts with PSSD lists more places to call.

Katie was 21 and going through a hard time when she was prescribed fluoxetine (Prozac). Here she says what doctors told her when her symptoms stayed after stopping.

Play video: Katie on being told it was depression (Moral Medicine, extract)

Her doctors put her sexual problems down to low self-esteem, trauma and depression. “Even when I was at my lowest point in life emotionally before SSRIs,” she says, “I still had feelings, a sex drive, and was sexually functional.”

Is depression part of PSSD?

Not officially. The 2022 checklist names emotional numbing instead. But low mood can come with it, and there can be more than one reason at once:

• The reason you took the medicine. Depression or anxiety can come back.
• Living with it. Lasting symptoms are hard to carry, and so is being brushed off. The researchers behind the UK study say both cause distress.
• Emotional numbing. Feeling flat can look like depression, even from the inside.

It can feel like grief as much as sadness. “It’s what [PSSD] has removed,” said a woman called Jo in the UK study, “then it’s also what it’s forced me to become.”

Rosie, president of the PSSD Network, first went for help with depression during the Covid lockdowns. Before that, she says, life was “so in color and so vibrant”. Now “everything’s just very numb and very kind of gray”. Here she talks about both.

Play video: Rosie on life before and after PSSD (Moral Medicine, extract)

No reliable figure exists for how often low mood comes with PSSD. The surveys so far asked people from forums and support groups, who may be the worst affected. Our page on PSSD or depression explains how to tell them apart, but you don’t need to settle that before asking for help.

What should I tell my GP about feeling low?

Tell them about the PSSD first, so it’s part of any decision about your mood. SSRIs are usually the first antidepressant doctors offer, the NHS says, so your history matters to that choice.

When doctors in England offer a medicine for depression, their guidance says they should talk through your past treatment. They should also cover any side effects you’d like to avoid, such as effects on sex. The NHS says to see a GP if your low mood has lasted more than two weeks.

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

Bring your dates (“Sertraline 50 mg from January 2023, last tablet March 2024”) and your leaflet’s warning. Many people say it took time to be taken seriously. You can report it without a doctor agreeing.

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

Can talking therapy help with PSSD?

It can help with low mood and with living with PSSD, though it doesn’t treat PSSD. In England you can refer yourself to NHS Talking Therapies without seeing a GP. The NHS says it covers low mood and coping with a long-term health condition.

Experiences differ. In the UK study, Lucas found six counselling sessions useful. Stacey felt she spent her sessions explaining PSSD to her therapists. “Not denying your experiences is really important,” she said.

So open the first session with the facts: the leaflet’s warning, your dates, what changed. Then the time can go on you.

Yassie Pirani, a therapist who works with people with PSSD, ended a Moral Medicine interview by telling them their suffering is real. It isn’t their fault, she said, and it’s no sign of weakness.

What helps on a bad day?

Small, steady habits, and people who get it. The NHS suggests talking to someone you trust, regular exercise, and support from people who’ve been through it.

In her first year with PSSD, Stacey “just could not get out of bed”, she told the researchers. Now she keeps a routine and exercises as a distraction. “It’s better than laying in bed all day,” she said.

Tony, who has had PSSD for many years, found others like him in the PSSD Network. “They’re the only people that I […] can really understand me,” he said.

• WhatsApp groups: our peer support groups, where an admin approves every member.
• A weekly call: the PSSD Network runs a Zoom group, led by people with PSSD.

Our pages on finding PSSD support and social isolation have more ideas.

What else do people ask?

Does PSSD depression go away? For some people PSSD has lasted years after stopping. Nobody knows yet who will be affected, or whether it will ease. You don’t have to wait for that answer to get help with your mood. Tony said that after a long time with PSSD, he can deal with it “a lot better now”.

Is anxiety part of PSSD too? The 2022 checklist doesn’t list it, but lasting symptoms can be frightening, and anxiety you had before can return. NHS Talking Therapies covers anxiety and panic as well as low mood.

Can I report low mood? Yes. A Yellow Card report can include anything you think the medicine caused. The UK regulator asks for the start date and your treatment dates.

Nobody told Katie it could be the medicine, so she believed something was wrong with her. If you’re feeling low with PSSD, tell one person this week: your GP, a friend or someone in a peer group.

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 genital sensation after treatment stops; ancillary non-sexual symptoms “may include: emotional numbing, depersonalization, other sensory problems involving skin, smell, taste or vision, cognitive impairment”. Depression is not listed for PSSD. “Emotional numbing or depersonalization may be a person’s main complaint in primary care.”
2. Lustral (sertraline) 50 mg and 100 mg film-coated tablets, patient leaflet, Electronic Medicines Compendium (EMC 2835), last revised December 2025. Section 2, “Sexual problems”: “In some cases, these symptoms have continued after stopping treatment.”
3. MHRA, Antidepressants: new safety measures for all patients to improve communication of the risk of suicidal thoughts and behaviours and persistent sexual dysfunction, Drug Safety Update, 15 October 2026. The term “Post SSRI Sexual Dysfunction” (“PSSD”) “will be added to the PILs of antidepressants associated with a risk of sexual dysfunction that may continue even after the drug is stopped”. Reporting advice: “please provide as much information as possible, including information about medical history, any concomitant medication, onset timing, and treatment dates.” UK.
4. Brugi S, Budd B, Mackie C, Fish S. “It’s taken away the most fundamental things about being human”: the lived experience and impact of post-SSRI sexual dysfunction. Int J Qual Stud Health Well-being 2026;21(1):2717470, published online 13 August 2026. University of East Anglia; interviews with ten people in the UK, recruited through the UK PSSD Association; names are pseudonyms. Themes: “distrustful of professionals”, “a changed me” and “living with the impact”. Full text also on PubMed Central (PMC13474523). Quotes from Jo, Lucas, Stacey and Tony as published. The authors note the distress caused “both by persistent side effects and any automatic rejection of those side effects”.
5. Studt A, Gannon M, Orzel J, Vaughan A, Pearlman AM. Characterizing post-SSRI sexual dysfunction and its impact on quality of life through an international online survey. Int J Risk Saf Med 2021;32(4):321-329. Abstract: 239 responses from an online PSSD support group; effect on quality of life “extremely negative (59%) or very negative (23%)”. Self-selected sample.
6. Ben-Sheetrit J, Aizenberg D, Csoka AB and colleagues. Post-SSRI sexual dysfunction: clinical characterization and preliminary assessment of contributory factors and dose-response relationship. J Clin Psychopharmacol 2015;35(3):273-8. Online survey of 532 people from a PSSD forum, with depression and anxiety scores; the authors say selection and report biases “do not allow generalization or estimation of incidence”.
7. NHS, Antidepressants: overview, page last reviewed 12 June 2025: “SSRIs will usually be the first type prescribed.”
8. NICE, Depression in adults: treatment and management (NG222), 2022. Recommendation 1.4.1: when considering treatments, “take into account previous treatment history”. Recommendation 1.4.10: “When offering a person medication for the treatment of depression”, discuss the harms, “including any side effects they would particularly like to avoid (for example, weight gain, sedation, effects on sexual function)”. Guidance for England.
9. NHS, Low mood, sadness and depression, page last reviewed 29 July 2026: see a GP if “you’ve had a low mood for more than 2 weeks”; things to try include talking to someone, “peer support, where people use their experiences to help each other”, and regular exercise.
10. NHS, NHS Talking Therapies, page last reviewed 5 November 2025: “you can refer yourself to NHS talking therapies without speaking to a GP”; you need to be registered with a GP and aged 18 or over (16 or over in some areas). Helps with low mood, depression, anxiety and panic, and “coping with a long-term health condition”. NHS Talking Therapies is an England service.
11. Samaritans, Contact a Samaritan, checked 28 October 2026: free calls from any phone, any time, day or night.
12. PSSD Network, Join our community, checked 28 October 2026: a Zoom group “held weekly by fellow sufferers”.
13. Moral Medicine, I Lost My Sexual Identity After Prozac, interview with Katie, 26 May 2026. Extract 4:40 to 5:46; prescribed at 21 for “challenging temporary life events” (1:50); quote at 5:36.
14. Moral Medicine, Interview with PSSD Network President Rosie, 9 July 2024. Extract 1:30 to 2:13.
15. Moral Medicine, interview with Yassie Pirani on YouTube, 28 July 2025. Paraphrased from the closing minutes (50:20 to 52:12). Our page: Yassie Pirani on the psychological toll of PSSD.

Sources checked on 28 October 2026. AI-assisted writing and review, not clinical review.