>>12331708>why do SSRIs have the complete opposite effects like emotional detachment and lower empathy?I took LSD twice and was on Lexapro briefly. It could be placebo (nocebo?), but I feel like the detachment from both was kind of similar.
My theory that just occurred to me a second ago while writing this is that almost any serotonergic substance may at least temporarily disrupt the sense of self and attachment to the world around you, until your neural circuits adapt to the shift (if they can; with sufficient LSD taken daily, maybe they can't).
Serotonin receptors appear important for lots of fundamental consciousness-related processes in a way that dopamine and (nor)adrenaline receptors aren't. Consciousness and the sense of self may be a carefully constructed semi-illusion/delusion that's built over time from birth and maintained in part by these complex serotonin receptor networks. This may also partly explain their relevance to dreams.
SSRIs are complex and poorly understood and appear to affect many things, but the serotonergic aspects may be a little like a general system shock which causes your brain to try to adapt and, in the process, maybe kind of inadvertently undo baked-in things that contribute to a state of depression. It's also possible that any kind of ego disruption tends to reduce depression symptoms.
As for why MDMA doesn't make you feel detached: maybe it does, but maybe the burst of serotonin is so sudden and acute (rather than gradual) and maybe it does so many other things, like release oxytocin and dopamine, that the detachment effect is very small, brief, and outweighed by the other effects.
I also think that detachment and empathy actually may be positively correlated. I felt increased, visceral empathy when I experienced ego disruption/death from LSD. I felt less like myself and more able to really think from others' perspectives.
Are SSRIs actually associated with decreased empathy, or is it just the detachment and numbness?
