'Til SSRIs Do Us Part: Falling out of love, an antidepressant side effect

Let me say something that might make you uncomfortable: sometimes what gets labeled as “stress” or “falling out of love” isn’t that simple—and getting that wrong can cost you everything. In my recent conversation with Sabrina Lane from Loving Through the Storm, we talked about how easily a life can unravel from one seemingly reasonable decision. Her story started the way so many do: a therapist suggesting Lexapro at a specific dose to “take the edge off.” It sounded harmless, responsible even. But what followed was a cascade—medication changes, emotional blunting, and a slow shift in personality that eventually led to something devastating: her partner saying he felt nothing for her anymore. Not anger, not conflict—just nothing. That’s the moment that stops people in their tracks, and yet so often the explanation they’re given is, “sometimes people just fall out of love.” But what if that’s not the full picture?

What Sabrina and I dug into is the reality that people often experience profound emotional and behavioral changes that don’t get fully acknowledged. Instead, they’re minimized or explained away in ways that make you question your own reality. We talked about personality shifts that can feel like you’re living with a completely different person—someone more impulsive, disconnected, or reckless—and how confusing it is when the outside world doesn’t see what’s happening inside the relationship. We also touched on how medication changes, like switching from an SSRI to an SNRI, can sometimes intensify instability rather than resolve it, creating a cycle of more symptoms, more confusion, and more interventions. One of the biggest misconceptions we addressed is the idea that once a medication is “out of your system,” everything should go back to normal. That’s not how the nervous system works. Withdrawal can linger, sometimes in ways that are mistaken for entirely new issues, and that misunderstanding can lead people further down a path that doesn’t actually help them.

We also got practical, because when your partner can’t access empathy or logic the way they used to, typical communication strategies fall apart. Sabrina shared approaches like “smart contact,” along with being intentional about timing and mirroring, to maintain connection when things feel almost unrecognizable. I know this is a controversial conversation, but I’m not here to make you comfortable—I’m here to get you thinking. If something in your life doesn’t quite add up, if the explanation you’ve been given doesn’t fully match what you’re experiencing, it’s worth asking deeper questions. These are the conversations people tend to avoid, and that’s exactly why I keep having them.