Certain prescription medications and substances of abuse have been shown to diminish empathy as a potential side effect. This is often due to their effects on the brain's emotional processing centers.
As for why you might have difficulty feeling or demonstrating empathy, there are several reasons this might be the case. Sometimes it stems from an experience, such as trauma, illness, or burnout, where a person has a diminished capacity to take on another person's problems.
SSRIs are the antidepressant class most linked to emotional blunting. SSRIs include: Escitalopram (Lexapro) Fluoxetine (Prozac)
Psychedelics are a type of drug that changes a person's perception of reality. Also known as 'hallucinogens', they make a person see, feel and hear things that aren't real, or distort their interpretation of what's going on around them.
However, several reports have shown that the excessive use of amphetamines, cocaine, and other stimulants is associated with amotivational syndrome including symptoms of apathy, lack of motivation, loss of interest, and other depressive-like symptoms often leading to relapse in the addiction cycle.
Emotional numbness is typically an unconscious protective response to feeling difficult emotions, whether due to anxiety, stress or trauma. Chronic or acute trauma can trigger a stress response that swamps the system and triggers a state of collapse, including emotional numbness.
By far, alcohol is the most commonly abused substance in the United States.
Marijuana, hallucinogens like LSD, and certain stimulants may cause users to experience increased anxiety, fear, or even panic attacks. These emotional responses can be intense and frightening, particularly in unfamiliar or stressful environments.
Hallucinogens such as LSD and psilocybin cause emotions to swing wildly and real-world sensations to appear unreal, sometimes frightening. Dissociative drugs like PCP, ketamine, DXM, and Salvia divinorum may make a user feel out of control and disconnected from their body and environment.
Psychedelic and dissociative drugs temporarily alter thought patterns, mood, and perceptions of reality. People who use these substances report feeling strong emotions, ranging from intense happiness and a feeling of connectedness to fear, anxiety, and confusion.
Acetaminophen – a potent physical painkiller that also reduces empathy for other people's suffering – blunts physical and social pain by reducing activation in brain areas (i.e. anterior insula and anterior cingulate) thought to be related to emotional awareness and motivation.
Medicines that are known to cause low mood, depression or behaviour change for some people
Anti-anxiety medications help reduce the symptoms of anxiety, such as panic attacks or extreme fear and worry. The most common anti-anxiety medications are called benzodiazepines. Benzodiazepines are a group of medications that can help reduce anxiety and make it easier to sleep.
Narcissistic personality disorder is characterized by self-absorption, grandiosity, exploitation of others and lack of empathy. People with that disorder may switch from an overt form, mainly with grandiosity, to a covert presentation, with fears, hypersensitivity and dependence from others.
Signs of Lack of Empathy
Card 31 in the Surviving Narcissism Card is a powerful reminder that a lack of empathy is a significant red flag in any relationship, especially with a narcissist. Recognising this trait in others can help you set boundaries (card 12) and protect your emotional well-being.
#1 – LYSERGIC ACID DIETHYLAMIDE
LSD or acid, is possibly the most well-known psychedelic drug. It alters awareness and perceptions and may also cause hallucinations. It is not chemically addictive but can cause some negative effects like anxiety and paranoia.
Phencyclidine (PCP)
This drug causes involuntary rapid eye movements. An individual on PCP might also develop a blank stare.
Amphetamine, cocaine, and hallucinogens all affect the levels of norepinephrine, dopamine and serotonin in the body. Cocaine has a stronger effect on norepinephrine and dopamine than it does on serotonin. Amphetamines, like cocaine, have a stronger effect on norepinephrine and dopamine than it does on serotonin.
On a psychological level, drug use can alter mood, behavior, and personality. Users might experience heightened anxiety, depression, or aggression, and they may become socially withdrawn or lose motivation. These psychological effects can further encourage drug-seeking behaviors and perpetuate the cycle of addiction.
Some personality changes are specific to certain substances. For example, using illicit stimulants could lead to restlessness, aggression, delusions or anxiety, and depression, while some opioid misuse could cause problems with attention, memory challenges, lack of awareness and coordination, or agitation.
Across numerous drugs of abuse, including opioids, alcohol, cocaine and other stimulants, as well as polysubstance users, empathy is diminished in behavioral tasks and self-report (McCown 1989; McCown, 1990; Massey et al., 2018; Robinson et al., 2018; Carlyle et al., 2020).
Research shows that some of the most addictive substances include:
Methamphetamine is most frequently smoked but can also be snorted, injected, or administered orally3 or rectally. Methamphetamine use causes increased alertness and talkativeness and decreased appetite, as well as feelings of happiness and well-being, among other immediate effects.