I Asked 100 Spouses What Antidepressants Did to Their Marriage

Added: 2026-05-11

[00:00:00]I've been a psychiatrist for the past decade and I've helped multiple people come off antidepressant medications. And one of the most overlooked reasons why people want to come off is the effects that they can have on their relationships. And so today I want to talk about the two biggest ways that I've seen antidepressants affect marriages and long-term partnerships.

[00:00:17]And so if either you or your partner is taking one of these medications, these are the changes I would watch for closely. So the first are personality and emotional changes. One of the best-known side effects of antidepressants is that they can narrow emotional range. And for a lot of people, this is actually the therapeutic effect of the medication. This is why they feel less depressed and less anxious on these medications. But sometimes that beneficial effect of blunting can actually spill over and it can damage your relationship. And so at the milder end, what this can often look like is emotional distance. Your spouse may seem flatter, less emotionally attuned. You might come home and instead of them noticing right away, they miss the cues completely. They might have said, "Hey, what's wrong? Can you tell me about it? Something seems off about you." Picking up on these subtle cues.

[00:01:04]But now that they're on the medications, they may be able to respond to you and you're going to sense that it's really coming from their rational mind, but that the emotional responsiveness that you used to feel from them has kind of gone away. And this can create a very lonely dynamic inside a relationship because that emotional connection, that emotional connectedness, is really important. And so that's the first thing to worry about. Now the second thing is much worse, but thankfully it's a lot less common. It occurs in a smaller number of people. And that is that some people when they get on antidepressants, they can start to develop an increase in mood swings, irritability, agitation, and instability. And so what you might notice is that your partner who used to be patient and grounded can start seeming constantly overwhelmed or easily provoked. They might ask for space all the time. They might say they feel suffocated by you. Or they might go on the offensive and say things that they never said to you before. They might say things like, "I'm not in love with you anymore and I've wanted to leave a long time." and it feels like you're completely blindsided and it's coming out of the blue. And all of a sudden it can feel like you're suddenly living with a different person. They might storm out, act impulsively, or react to normal conflict as if it's completely intolerable. And the spouse on the receiving end, they just start to feel like they're walking on eggshells all the time because almost anything can trigger criticism, hostility, or withdrawal. And one of the hardest parts about this is that the person taking the medication often has very little in- sight into how they've changed because from the inside, their reactions feel completely justified. But from the outside, their personality shift can be obvious and deeply alarming. Now there is a term that we use for this and we call it spellbinding and that is that the person who's under the influence of the drug often doesn't realize their personality has changed. The best metaphor I can give you for this is that, you know, you're in college and you're with a bunch of your friends and there's one guy in your group and he's had a bit too much to drink and all of a sudden he thinks he's like God's gift to women and that he's really charming and you're just like, "No, he's slurring, you know, he's got stuff spilled on his shirt." He just doesn't see it. And that's because the person who is intoxicated by the drug effect often isn't able to self-assess in a very accurate way. Now if the irritability wasn't enough, I've actually seen very severe cases of this where the antidepressant use has led to reckless behavior. It's led to affairs, heavy drinking, and abrupt life-altering decisions that do not fit the person's prior character. And this can be absolutely devastating to a marriage and frightening to the children who are watching their parents change before their eyes. And you know, kids, they need emotionally stable parents. Now to take a step back for a second, I want to be clear, not every conflict in a relationship is caused by medication if someone's on these drugs. But what I have noticed a lot is that medication is often completely left out of the conversation when it absolutely should be considered. And so here's what you should do if you suspect a medication may be involved. Look at the timeline.

[00:03:58]When did their personality start to change? Was that, you know, within a couple months of starting a medication or going up on the dose? That's usually a clue that it's drug-induced. I would also bring in a family member like a parent or a sibling if you really think something is going wrong and bring up your suspicions with them and see if they've noticed any personality change as well. And the final thing that I want to say here is that if this is happening to you and maybe you are the person who is like medicated or your spouse is the person that's medicated, what I would say is, please do not make any life-altering decisions while you're on this medication if you think the drug may be involved. You may want to come off the medication first or lower it because that's the last way you're going to be able to tell if the drug is involved because you typically when people come off these medications, usually within a couple of months, the effects go away. And that's really the place you should be if you're going to make a decision about divorce or separation or something like that. You want to be in a state where you've ruled out the fact that the drug might be changing your personality or your spouse's personality. Now second major problem is sexual intimacy. And antidepressants interfere with this in three major ways. First, they reduce libido and this means you simply want less sex. You're less interested in it.

[00:05:08]And over time often the partner on the other side of this can start to feel undesired, rejected, or even disconnected. The second thing these drugs do is that they actually interfere with the physical experience of sex.

[00:05:19]They can reduce arousal, decrease pleasure. They can delay or mute orgasm or cause them to not happen at all. For men, sometimes it can get in the way of them being able to sustain an erection.

[00:05:29]And when sex starts feeling less enjoyable and more stressful because you're worried about all of these things, people naturally will just begin to avoid it. And this will can create a cycle of frustration and tension and distance. And the third thing is that antidepressants, they can also cause weight gain. Sometimes it could be 10 or 20 lb, sometimes even more. And even when the partner is still attracted to the person who's taking the meds and may have gained a little bit of weight, the person on the meds may feel less confident in their body and less comfortable and then less interested in intimacy. Now let me be clear. Sex is not the only part of a relationship, but it is an important part. And when a medication consistently disrupts desire, pleasure, connection, that can become a long-term emotional strain. And so what's the takeaway from all of this?

[00:06:14]What I want you to know is that these are not casual medications. These can have serious effects on your relationships. And while this is always a trade-off and there can be some relationships where, you know, the reduced impact of the anxiety and depressive symptoms are actually improving the relationships, for a lot of relationships, the side effects simply outweigh any of the benefits there. And so because of this, what I always believe is that you should avoid taking antidepressants if you can. Okay, so then what's the alternative then because I don't want people just to be there suffering. Well, the alternative is that you need to address the root causes of what's going on. Ask what else could be driving the anxiety or depression. A lot of doctors, they sidestep this. They just tell you have genetics or a chemical imbalance. They don't look at all the the reasons why people become unhappy. Got to look at your sleep. You have to look at stress, trauma, diet, relationship issues, substance use, underlying medical problems. You need to find a doctor that's actually going to take the time with you to go into these things. You know, not that psychiatrist that sees you for 15 minutes or the family medicine doctor that sees you for even less. Like actually a holistic doctor that's going to dive into these things.

[00:07:16]And if you do get on a medication, don't get on a medication without a plan to come off. I see so many people that just get started on it and then the doctor sees them like every two to three months and then they just talk to them about the dose and then before you know it, someone's on it for like 30 years.

[00:07:30]That's not good medical care. Anytime one of these drugs get started, it needs to come along with a plan to come off the medication and a whole list of things that you're going to do right now, get up and running so you can transition off the med hopefully within six months or maybe even a year. And finally, one last thing, if you want to come off this medication safely, I've put down everything that I know about safe, comfortable tapering into this free guide below this video. I've developed it after working with 400 patients over the last six years and it is the safest, most comfortable way off these meds and it's completely free and it's for you. So click below the video to get a copy.