A study finds that antidepressant treatment reduces empathy – but depression itself doesn’t impact empathy.
Key Facts:
- People with untreated depression showed normal empathy and brain responses.
- After 3 months of antidepressant treatment, they showed reduced empathy and brain responses.
- The more their depressive symptoms improved, the more their empathy decreased.
- Antidepressants specifically reduced emotional sharing of others’ pain, not cognitive evaluation of it.
- The effects were specific to empathy and not pain in general.
Source: Translational Psychiatry (2019)9:164
The Link Between Depression, Empathy, and Treatment
Empathy is the ability to understand and share the feelings of others.
Major depressive disorder (depression) could logically affect empathy.
Depressed people often show social impairments and negative thoughts about themselves.
However, most previous research on depression and empathy had a major flaw.
The studies included patients already taking antidepressants.
The drugs’ effects could not be separated from depression itself.
This study by Austrian researchers was the first to compare untreated patients to healthy people.
It also followed the patients before and after 3 months of antidepressant treatment.
Testing Empathy in Depressed and Healthy People
The study included 29 depressed patients and 35 healthy controls.
None of the patients had taken antidepressants before.
At the start, the patients showed typical depression symptoms.
But their empathy was normal. They gave similar ratings to videos of people in pain as the healthy participants.
Their brains also responded the same. Three key brain regions activate when we empathize with others’ pain.
These regions were just as active in the patients. This suggests depression does not directly reduce empathy.
Effects of Antidepressants Over Time
The patients took common antidepressants for 3 months.
Most took selective serotonin reuptake inhibitor (SSRI) drugs like escitalopram (Lexapro).
Some later switched to serotonin-norepinephrine reuptake inhibitors (SNRIs) like venlafaxine (Effexor).
After treatment, the patients’ depression symptoms improved.
At the same time, their empathy declined. They gave lower ratings when watching people suffer.
Their brains also became less active in the empathy regions.
Patients with the most symptom improvement showed the largest empathy decreases.
The antidepressants specifically reduced sharing others’ feelings, not just evaluating the situation.
Ruling Out Other Explanations
The study ruled out some other possible reasons for the results:
- Empathy ratings and brain responses were not linked to medication dosages.
- Switching medications mid-study did not change the effects.
- Remission of depression symptoms could not explain it.
- There was no decrease in pain responses in general.
The electrical pain part of the study confirmed this.
Brain activity when feeling pain did not change with treatment.
Only empathy-related pain responses declined.
Understanding How Antidepressants Affect Empathy
The researchers suggest antidepressants have a “protective” function.
They reduce negative emotional reactions to others’ suffering.
This could also apply to other negative social events.
The study found no impairment in evaluating how much pain someone was in.
But antidepressants made sharing that pain less unpleasant.
This emotional blunting could have pros and cons.
It may allow people to better help someone in distress.
But it could also reduce concern and care for that person.
Most studies on depression and empathy were flawed.
They attributed effects to depression that were actually from medication.
These results show treating depression does not necessarily increase empathy.
In fact, it can make people less emotionally sensitive to others’ pain.
Why the Study Matters
It is the first to show untreated depression does not reduce empathy, contrary to previous ideas.
The empathy decline after treatment had been wrongly blamed on depression alone.
Antidepressants specifically reduce emotional sharing of pain, not evaluation of it.
The effects were unique to empathy compared to pain responses in general.
Emotional blunting to others’ suffering may have pros and cons.
The common view that depression impairs empathy is incorrect. Treatment causes the decline.
More Research Is Needed
While insightful, more studies are still needed.
For example:
- Does emotional blunting affect how people treat others in real life?
- Do effects last or disappear over longer treatment?
- Do different antidepressants impact empathy differently?
- Can this change be avoided as a side effect?
For now, the study makes an important point.
Depression and medication affect empathy differently.
Their effects should not be mixed up when treating patients.
References
- Study: Antidepressant treatment, not depression, leads to reductions in behavioral and neural responses to pain empathy
- Authors: Markus Rutgen et al. (2019)
