In April 2022, when I was 19 years old, I was prescribed 7.5 mg of mianserin twice a day for 3 weeks, followed by 7.5 mg once a day for 1 week. During that time, besides other side effects such as a fleeting attention span, blurred vision, and hypersomnia, I noticed that I could no longer become sexually aroused. I simply could not get turned on or horny. I told the doctor about it, but he convinced me to stick to the plan and complete the full 4 weeks of treatment.
Now, more than 4 years have passed. I am 23, and my ability to become sexually aroused has never returned. There was no window of improvement—not even a short one. I have not taken any drugs since mianserin.
For the past 4 years, I have been considerably athletic and active. I used to run around 60 km per week year-round, maintained a clean diet, and had healthy sleep habits. I have never been a smoker or a drinker. Yes, I have had my downs—I am talking about my mental health—but I have also had my ups.
I visited a GP recently and told him my story. He ordered a comprehensive hormonal panel and bloodwork. All the results came back perfectly normal. The doctor recommended that I see a psychotherapist, as if the issue were purely psychological.
Honestly, I am starting to give up hope. I thought about seeing a good psychiatrist, but I feel like it would probably be much the same as seeing the GP. The way I see it, the only way out for me is to forget what it was like to experience sexual arousal. Otherwise, I feel like the emotional pain will haunt me for the rest of my life.
I honestly have no expectations or hopes in posting this, but I really wanted to talk to somebody about it.
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I have PSSD since 2024. my PSSD symptoms were stable, and I was fine in terms of anxiety. Although I was emotionally numb, at least I was not feeling negative emotions.
So I had the stupid idea to try Bupropion, it gave me the worst anxiety and depression symptoms I ever had. I also got ear ringing, racing heart and even arrhythmia. I only took 8 extended release pills total (150mg /day). i’ve been off bupropion for 2 months now.
any tips on how to overcome this without psychiatric medication?
Galleria Women’s Health, an OB/GYN practice in Henderson, Nevada, has a page that acknowledges PSSD
https://galleriawomenshealth.com/services/sexual-dysfunction-treatment
Hi everyone, I have a few questions for you. I’ve been reading about a lot of PSSD cases, and I seem to have the main symptoms associated with it, but I also have some more specific symptoms. I was wondering if anyone here has experienced similar symptoms, or if I might actually be wrong about my medical diagnosis. For context, my symptoms started about a year ago.
I have severe emotional blunting and anhedonia (I can’t really feel emotions, laugh, cry, etc.), which have progressively gotten worse over the past few months. For example, about 3 months ago, I could still shed a few tears, laugh, and enjoy things at least a little bit.
I also have:
Brain fog (which I’ve had for a long time)
Almost complete loss of hunger and thirst (for about 11 months)
Extremely fragmented sleep (for maybe 10 months)
Chronic fatigue (for the past few months)
A relatively high heart rate for a 22-year-old, almost as if my body is stuck in fight-or-flight mode 24/7 (around 80–100 BPM while lying in bed) (for months)
My heart rate increases a lot during physical activity (for months)
Muscular intolerance during prolonged or intense physical activity (for months)
I also have a symptom that’s difficult to describe, but I just feel weird in my own body. Sometimes it feels like certain parts of my body are heavier than others or something along those lines (for months)
Constant nasal congestion. It switches sides, which I know can be normal, but my nose is basically always congested. I don’t know if this could be a sign of inflammation (for about a year)
Digestive issues, although those have actually been better recently
Just a week ago, I was still able to get an erection and ejaculate, but now I can’t anymore
I also feel a kind of numbness in my penis. I can still feel sensations, but it’s hard to explain — it mostly feels like I constantly have to stimulate it now, as if I can’t feel it as well as before (for about 2 weeks)
A strange nerve-like sensation around the upper left side of my chest/pectoral area, as if the overall sensation there isn’t the same as on the right side
The strange bodily sensations and chronic-fatigue-like symptoms also seem fairly unstable and fluctuate
I’ve seen a lot of doctors and have had most of my body investigated: a contrast-enhanced CT scan of my chest, abdomen, and pelvis, a brain MRI, gastroscopy, chest X-rays, and many other tests. Absolutely nothing significant has been found.
I’ve also had a lot of blood tests. The only real abnormalities were total IgE around 3,000 about 5 months ago, which increased to around 4,000 about 2 months ago, as well as a severe vitamin D deficiency. My vitamin D levels have since been corrected. My vitamin B12 was also relatively low — technically still within the normal range, but near the lower end.
At this point, I’m wondering whether everything I’m experiencing could really be explained by PSSD alone, whether there could be another functional disorder involved, or whether I could have multiple things going on at the same time.
Anyway, thank you very much for any responses!
Hey i posted abkut 20 days ago about feeling some improvement taking porbiotics. Ive been taking probiotics daily and continuing too. No more than the recommended dose for an adult. It has helped alot with stomach issues i had with pssd. Unsure if its sibo or what the issue is. But it has improved much. Still need to do some more research and be more vigilante with my diet to hopefully go back to normal. But huge improvements.
But this in turn has helped me mentally alot. Less fatigued when i wake up. Had some more natural drive to do things and feel like some of my anhedonia had healed. I joke around with friends and coworkers like I used to. I question some of the things I did when I was fully anhedonic and running on autopilot. But I do find some joy in things and look forward to certain things now, rather than dreading everything. It has given me hope for more healing.
Dm me if you want to know my protocol.
Ive been on trt for 3 years now. Taking pde5 inhibitors, gluten free diet, probiotics 3 times a day. Basic vitamins and some exercise at work and gym sometimes.
My mood has improved huge from where I was say 2 momths ago.
Please tell me if anyone has tried HBOT for PSSD and if so what were the results?
Based on the claims, it may be helpful for a number of pssd symptoms.
It claims to:
Reduce inflammation
Increase blood circulation
Increase rate of healing and tissue repair
Among others ….
Could this possibly help with genital numbness??
Por lo visto es un efecto secundario común en personas con PSSD y no sé si hay alguna forma de recuperarlo? Tocas el músculo pero está falto de tono, he probado la creatina y la citrulina malato pero no hacen el efecto de antes, pueden mejorar algo el rendimiento pero no las sensaciones y a nivel físico.
Al igual que con la disfunción sexual implica que no haya ese pump característico que da el gym y las pesas. Esto implica que no podemos ganar masa muscular y fuerza?
Hi everyone,
I would like to know if anyone here has managed to partially or fully recover from consummatory anhedonia?
To give you some context, I am currently experiencing:
A total inability to feel any kind of pleasure in the moment (from, music, social interactions, etc.).
substance blockage, meaning stimulants like caffeine, nicotine, and other substances are severely blunted or have absolutely no effect on me.
Severe emotional blunting (feeling completely numb like a robot).
I am especially interested in hearing from those who recovered naturally. If you have been through this, could you please share:
How long did this state last for you?
How long did it take before you started noticing the very first signs of improvement?
Thanks in advance
Hi, I’m writing this because I strongly suspect that I have PSSD. I took fluoxetine over the course of about a year: for three months at first, and then I tried restarting it twice, taking about four pills each time, with roughly six months between those attempts.
I’ve spent a lot of time reading forums, and I’ve noticed that many people who recover seem to reach a point where they’ve accepted their situation. I believe we have to learn to live with it, keep doing the things we used to do, and give the brain reasons to make the changes that could eventually give us our humanity back.
I’m not trying to discredit PSSD as a real condition, but in my opinion, cortisol levels and chronic stress can seriously interfere with recovery. We have to understand that the body and brain prioritize survival over things that are less essential for immediate survival, such as pleasure, sex, and so on. When we’re constantly obsessing over the condition, the brain can remain in a state where it perceives danger, which may negatively affect these circuits.
Stress can also contribute to neuroinflammatory processes in the brain. I believe this kind of low-grade inflammation could potentially interfere with receptors and the circuits involved in emotions and pleasure.
Research also shows that neuroplasticity gives the brain an incredible capacity to adapt. This is one reason I find the “windows and waves” that some people experience interesting. From a logical perspective, it could represent the brain trying to adapt and return toward its previous state. Cortisol and neuroinflammation can negatively affect neuroplasticity, so if we want to create the best possible conditions for it, we should eat properly, get outside, stay active, and keep living.
I know that’s incredibly difficult. I potentially have this myself, or at the very least I have many of the horrible symptoms associated with it:
I don’t feel pleasure anymore.
I can’t cry.
I can’t feel love emotionally (only intellectually, in a way).
Watching a YouTube video is almost impossible — I can physically watch it, but it makes me feel absolutely nothing.
Loss of hunger and thirst.
Strange sensations throughout my body.
Brain fog and anxiety.
I clearly have other symptoms too, but at this point I don’t care as much about those. The most important things to me are the anhedonia and the emotional blunting.
But the neural circuits aren’t necessarily “dead.” And if people can recover, then clearly recovery is possible. When I say “functional,” I mean that I believe this could involve dysfunctional brain processes rather than neurons simply being destroyed. The human brain isn’t random. The human body is incredibly complex, and I hope that one day, for all of you, things will return to normal.
It’s also possible to imagine future treatments for these problems. PSSD is becoming increasingly recognized, and although PSSD itself may not be one of the most heavily researched areas right now, there is a lot of research being done on the brain’s reward circuitry, and that is a very active field.
Maybe PSSD itself is currently under-researched, but perhaps in the future we’ll become much better at manipulating and treating anhedonia and emotional dysfunction more broadly. The discoveries are becoming increasingly interesting.
It’s 2026, guys. AI is improving every day, and our scientific knowledge keeps expanding. We could see technological or medical breakthroughs that we don’t expect, and they might happen sooner than we think.
Keep hope. ❤️ You are strong, and you are not alone.
My functional nutritionist ordered a Genova Diagnostics Metabolomix+ test, including the toxic elements add-on.
I've had PSSD since January of 2023. It has gotten worse over time but has largely stabilized over the past six months. My main symptoms are genital and whole body numbness, fatigue, memory and cognitive issues, visual snow, mild to moderate emotional numbness. I am a 21 year old male.
The test has markers for energy metabolism and mitochondrial function, oxidative stress, glutathione levels, neuroinflammation, toxins and detoxification, amino acids levels, malabsorption, gut dysbiosis, neurotransmitters, and others. For transparency, I paid 520 euros for the test.
Here are the main findings:
The biggest issue is a mitochondria stall. As you can see in the first picture, the Krebs cycle intermediates (energy metabolism section) are all non-detectable or low, except for one. So I'm in a hypometabolic state. This can be caused by environmental toxins among others. Probably the SSRI's harmed something in my cells they couldn't recover from on their own.
There are also some signs of malabsorption, such as elevated Phenylacetic Acid, low urea, relatively low amino acids (some). Even though that could also mean not enough protein intake. It's probably both.
Then I got elevated benzoic acid and non-detectable hippuric acid. That indicates a glycine deficiency, as glycine helps benzoic acid convert to hippuric acid to be excreted through urine. This is also indicated by high serine and low glycine in the amino acids panel. The serine to glycine conversion isn't working well. That makes sense since I'm borderline folate deficient and folate is required for the conversion. (Supplementing with folinic acid rn so it's getting fixed). Glycine deficiency can cause fatigue, slow mental processing etc so that could be contributing to my symptoms. It can also cause lower quality sleep, makes it harder to fall asleep, inclination towards fight or flight rather than rest and digest, worse detoxification. It's also one of the three building blocks of glutathione, the body's master antioxidant, which leads us to the next point.
As shown by my low Pyroglutamic Acid, my glutathione is low. My oxidative stress is also low, however. So it seems more glutathione isn't needed. However, energy production is what creates oxidative stress, which glutathione fixes. So it could be that the reason or one of the reasons I'm not producing enough energy is that I don't have enough glutathione to deal with the oxidative stress it would cause.
Finally, some of my neurotransmitters are low. Homovanillic Acid indicates low dopamine and low 3-Methyl-4-OH-phenylglycol indicates low norepinephrine. My serotonin seems completely normal. That's a whole body measure though, not brain specific, so I guess it could theoritically still be imbalanced in the brain.
My Quinolinic Acid is non-detectable so I don't seem to have inflammation in the brain which is great.
Here is what my functional nutritionist gave me based on these results, along with some reasoning behind those decisions.
Note that these are personalized to me. There are other supplements great for mitochondria such as CoQ10, PQQ and others which he didn't give me. I tried CoQ10 months ago and it increased my brain fog and derealization. Liposomal glutathione did as well, to a larger degree. Many of these are also relatively small doses, that's also because I'm very sensitive.
He did say that this is just to start pushing the system to the right direction. He had mentioned red light therapy once. It's great for mitochondria. I'll discuss it with him next time.
Feel free to ask any questions or share your thoughts.
Im just wondering what was everyone’s experience? Did you get any improvements/worsening from it (I mean while on AND after coming off). Have you guys used EQ (boldernone)? Did u find it good or bad? Just because I’m wondering how it may affect me because of my PSSD. Also when you came off of hormones did you PCT or just come off naturally?
This is a small thank you note to this community that I've been thinking about writing for some time.
Yesterday, I went to buy a spectrophotometer I'd found on Craigslist from a scientist. He asked what I wanted it for and although I didn't feel comfortable casually mentioning I was going to use it for at-home semen analysis, I did mention that I was suffering from PSSD and the device was related to a double-blind study I was working on. He was sympathetic and posited that SSRIs may suppress serotonin output in the long term, upsetting the balance of your neurochemistry. It's always refreshing to see someone who doesn't dismiss your experience with PSSD out of hand because it doesn't match their own experience or what's in the literature. He worked for over an hour to set up the system for me and eventually said: "You know what you really need is to find something you like to do and pursue that."
I took it well. I've heard it before too many times from family, friends, dates, etc. Sometimes people are too forceful about their advice and it ends up blowing up. One woman I was hitting it off with kept insisting that I should try Viagra. Another woman I dated kept interrupting me and telling me to try other antidepressants, group therapy, or finding new hobbies. It's exhausting taking advice from people who fundamentally don't understand what it's like to lose all motivation. Do they think I want this? I have one shot at life and do they honestly think I want to go through it in a joyless haze?
I've come to expect unsolicited advice from people I bring up PSSD to. Most of that advice boils down to "just try harder", as the title of this post suggests. But I'd like to extend my appreciation to this subreddit that as we've all actually lived through this hell, I don't think I've ever seen someone here espouse that anyone suffering from PSSD just needs to dig deep and find new motivation or inspiration or joy. I mean, I'm sure someone here has said it, but it's exceptionally rare.
It's tricky because I want to better myself just like everyone else here. I've dispensed advice, some of which hasn't gone great. I've seen that there are widespread disagreements on what PSSD is or how to treat it. Underneath all these disagreements, however, I sense that there's a shared experience that PSSD strikes your very core in a way that many of us never thought was possible.
Likewise, I try to take it well when others lean in with their advice regarding PSSD. I want to talk to people about the condition because we need to raise awareness. I'm also in therapy and it's frustrating because I want to look out for my mental health despite it being entagled with PSSD, but almost the entire premise of therapy is that there are some magic words that a therapist can say that will set you on the path to fixing things. It was an awkward introduction to my new therapist to tell her, in short, "I have PSSD. I'm going to talk about it a lot. You can't help with it. You can try and I'll generally take it well, but I've heard it all before and it can be tiresome." I've known people who vented to me about things that I can't empathize with-- multiple sclerosis, PCOS, bipolar disorder, etc.-- and I suppose I can't say for certain that I never once offered advice or expressed skepticism, but because PSSD is invisible, there seems to be an assumption among non-sufferers that it's purely psychological and can be overcome through sheer willpower, willpower that people with PSSD know that we sorely lack.
So again, thank you for being a safe haven from the "just try harder" mentality. I don't think anyone should give up, but I don't think any outsider really knows what effort looks like under this condition.
I have very much pleasurable orgasm, libido depends highly on gut situation but still very very low than the baseline. Erection back even with low libido can hold the erection while sex. Porn masterbation feels quite good but vaginal penetration feels numb. What could be the reason? And most importantly, even if I rub ice in my glan, no cold sensation. Please, comment,🙏🙏
I've been suffering from this condition for 3+ years now, oscillating between periods of near total remission and crashes (windows and waves). I find this pattern pretty common among those suffering from PSSD.
But then there are people claiming that they've experienced 0% recovery. I take these people at their word and do not want to invalidate their position, but I just want to tease out the full state of their condition.
To those of you that claim 0 progress over 2-3+ years, do you actually mean that your symptoms have been consistently terrible since the onset of PSSD? Or do you understandably mean that the improvement has just not been anywhere close to your pre-PSSD state? Have all aspects of the condition remained stagnant or just certain aspects (sexuality, anhedonia, motivation?)
If you are claiming 0% recovery, have you experimented with any medications that crashed you and you never recovered or have you naturally been in this state without any intervention (just quitting SSRIs)?
I appreciate your responses. I also know this condition takes an indescribable toll and understand if people don't want to go into detail about their current state.
If you did, which parts recovered? I’m especially interested in anhedonia improvements.
If you used something for recovery, what was it that helped?
I’m interested in partial recoveries and improvements as well.
If you didn’t recover at all, but had/have these sick windows, please comment as well.
I suspect there are diff kinds of pssd profiles/types and I’m trying to find people who match mine the most.
Also if you experience(d) any or a few of:
-developed pssd AFTER quitting,
- anhedonia/emotion blunting
-decreased sweat and body smell
- lack of feeling fatigue like before pssd (can do things easily but with no pleasure)
- lack of interoception (bodily cues of thirst, hunger, bowel movements, heartbeat,)
-do feel slightly better in the evenings or when sleep deprived;
-are a female and lost symptoms of pms/they got diminished;
-had reinstated/crashed on different med
AND improved with time/with substance, please share if you did.
If anyone would find this interesting, I recently had vaginal infection (mostly likely candida) which gave me a good window (only symptom was burning sensation while before pssd when I was still on meds, I would also get discharge and odour as well and the discomfort would be much more intense. Besides, back then candida would also cause fatigue and apathy/blunting as opposed to now.)
Was afraid to treat it with antifungals, so just used my daily acerola and it went away after a few days. But despite of it, I had a window in my overall wellbeing, emotion-wise, I was able to feel my surroundings better, more reactive to stimuli, both positive and negative. Not quite like my pre-pssd state but pretty good, in comparison to it. The window is over now.
I had a couple of other times where a basic cold gave me a relief. Again, not a full pre-pssd state, but enough relief to feel good enough and thank God for it. I also had a sunburn window which felt more like reduction of a negative undertone and made me less depressed/more neutrally apathetic about things.
I have also noticed that I can have negative or positive undertone anhedonia/emotional blunting : I feel no good emotions but have an undertone of bad emotions (possibly induced by the lack of any feeling itself) OR feel no good emotions, nor bad ones (which is easier on me.)
Thank you and take care.<3
I (22F) got off Lexapro (10mg) August of 2024 with a doctor advised taper (mind it didn't seem like he knew what he was talking about) after panic attacks and depression came back and complete loss of libido. Prior to Lex, I was hypersexual which, with my OCD, caused a lot of issues socially in conjunction with my anxiety.
Anywho, I've been off for almost two years now and seen no improvement libido-wise. I can orgasm and have sex dreams with my partner semi often, but cannot initiate sex and often and uncomfortable saying yes to sex when he wants it because I'm not as into it as I used to be. I'm very frustrated as he is hypersexual and I'm bordering on asexual because of PSSD.
Did anyone have their libido come back after 2 years or am I fucked?
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Hi everyone. I’m experiencing several symptoms that I believe may involve autonomic dysfunction after taking antidepressants, and I’m wondering if anyone here has experienced something similar.
I currently have almost complete loss of sweating, blood pressure regulation issues, a weak urinary stream, and general physical weakness. I also seem to have reduced awareness of the sensations that normally occur before fainting.
The lack of sweating has become particularly concerning. The last time I was at the beach, I became extremely unwell in the heat and believe I may have experienced heat exhaustion or heatstroke. Since then, I’ve been much more careful about heat exposure.
I also feel that my body often remains in a state of high activation, and recently some anxiety symptoms have started returning.
Has anyone with PSSD experienced a similar combination of sweating problems, blood pressure issues, urinary symptoms, altered fainting sensations, and difficulty regulating the body’s response to heat?
I’d also be interested in hearing whether anyone has found treatments or strategies that have helped with these autonomic symptoms.
Thanks to everyone who shares their experience or information.
almost more than 1 year i stoped ssri's.