Why does the brain recover after hard drugs, but not after SSRIs/PSSD?
I’ve been thinking about something and I genuinely want to hear different opinions from people here.
We know that people who abuse opioids, stimulants, or other hard drugs can eventually recover over time. Dopamine systems often seem to normalize again even after severe depletion or long term dopamine agonist use.
So why does recovery seem so different with PSSD?
I know a lot of theories exist epigenetic changes, androgen receptor issues, gut microbiome changes,dopamine receptor desensitization, etc.
But in my case, I only took sertraline once. Literally just two pills (200mg total combined), and since that day I’ve had persistent PSSD symptoms for over a year and a half.
To be completely honest, during this time I’ve occasionally felt very small “windows” where pleasure or libido slightly came back, but they never lasted.
I should also mention that this period has been one of the worst years of my life emotionally because I went through a very painful breakup around the same time.
So my question :-
Could PSSD in some cases actually be more related to depression, chronic stress, or emotional trauma rather than the antidepressant itself?
And if SSRIs mainly alter serotonin signaling, why don’t the brain pathways and neurotransmitter balance eventually return to baseline after such a long tim