Zeitgeist: How SSRIs Change What Women Want to Read

Zeitgeist Report

How SSRIs Change What Women Want to Read

According to CDC National Center for Health Statistics Data Brief No. 564, published June 25, 2026 from the 2024 National Health Interview Survey, 24.9% of U.S. women took medication for their mental health in the prior 12 months. Men sat at 13.4%. That count covers pills for depression, anxiety, and other mental-health uses. It is larger than the depression-only slice.

The Rise

NCHS Data Brief No. 377 tracked antidepressant use in the past 30 days. Women’s use moved from 13.8% in 2009–2010 to 18.6% in 2017–2018. Men moved from 7.1% to 8.7%. During 2015–2018, 17.7% of women and 8.4% of men used an antidepressant in the prior month. Women 60 and older reached 24.3%. NCHS Data Brief No. 528 put depression-specific medication in 2023 at 15.3% of women and 7.4% of men. A Cureus analysis of NHIS recorded female depression-medication use moving from 13.3% in 2019 to 15.3% in 2023.

What the Drugs Do to Personality

According to Tang, DeRubeis, Hollon, Amsterdam, Shelton, and Schalet in Archives of General Psychiatry, December 2009, 240 adults with major depression received paroxetine, cognitive therapy, or placebo. After the team matched patients on depression improvement, paroxetine patients reported 6.8 times as much neuroticism change and 3.5 times as much extraversion change as the matched placebo group. Placebo patients improved on the Hamilton depression scale by 1.2 standard deviations and moved 0.18 SD on neuroticism.

NIMH called that a drug effect on personality traits, separate from the lift in mood scores.

A four-week escitalopram trial in healthy relatives of depressed patients left neuroticism and extraversion in place. A five-year observational study of 237 patients tied personality-score movement to depression and anxiety symptoms.

What Patients Say They Feel

Price, Cole, and Goodwin in the British Journal of Psychiatry, 2009 interviewed 38 people on SSRIs, 28 of them women, median time on the drug 23 months. Patients described a drop in the intensity of everyday emotion, a sense of detachment, and a feeling of not caring.

Goodwin, Price, de Bodinat, and Laredo in the Journal of Affective Disorders, 2017 surveyed 669 treated depressed patients. 46% reported emotional blunting. 44% of the women in that sample reported it. 52% of the men did. Bupropion produced a lower signal.

Opbroek and colleagues in 2002 studied 15 patients who already had SSRI sexual side effects. 80% also reported blunting on crying, sadness, anger, surprise, care for other people, and creativity. Those scores did not track Hamilton depression totals.

A 2025 pilot in women remitted from depression on sertraline found 81.8% met criteria for sexual dysfunction. Emotional-intensity scores fell with sexual-function scores.

Who Buys the Books

NIQ’s write-up of Nielsen BookData’s UK Books & Consumers survey attributes 59% of UK book purchases since 2012 to women and 65% of e-book purchases. Vox’s 2025 fact-check found the circulating “women buy 80% of fiction” line lacks a clean U.S. BookScan source. Nielsen BookData’s confirmed 2017 UK fiction split sat near 63% women.

What Personality Predicts on a Shelf

Rentfrow, Goldberg, and Zilca in the Journal of Personality, 2011 sorted the entertainment tastes of more than 3,000 people into five clusters: Communal, Aesthetic, Dark, Thrilling, and Cerebral. Personality predicted those clusters after demographics.

Ng, Bos, Sigal, and Li matched Goodreads tags to Facebook personality scores. Extraverts tracked relationship tags, chick lit, celebrity romance, and memoir. Agreeable readers tracked family and religious themes.

Those papers measure personality. They do not measure a prescription.

The Open Question

The study that puts SSRI status on the same row as a genre log, a spice rating, a DNF rate, or a reread rate has not been run. Authors still wait for that dataset.

Two forces sit on the same reader. Depression steals focus and pleasure, which takes her out of the bookstore. A working antidepressant can put her back in the store with a flatter response to the scene that used to wreck her. Volume of books bought and intensity of feeling on the page are separate outcomes.

Marazziti’s 2014 sex-by-drug analysis found SSRIs hit the “love” domain harder in men. Women on SSRIs kept more of the attachment items. That finding sits in the way of a simple “pills killed romance reading” story.

Why Authors Care

The core fiction-buying sex is also the sex with the higher prescription rate. Heat, ache, dread, and catharsis are product features. A large slice of the female audience reports a lower volume knob on those features. Plot, joke, curiosity, and character still move a reader after intensity drops. Forum claims that SSRIs killed a taste for dark romance or sad literary fiction remain unverified social sentiment.

What to Do

Write the emotional peak so the scene still works at a lower setting. Keep the plot engine loud enough to carry a flatter affect. Treat spice level as a dial with more than one paying audience, including readers whose bodies report less desire on an SSRI. Leave diagnosis to clinicians. This research describes published papers. It is not medical advice. A reader who wants to change a prescription talks to her doctor.

Sources:

Commentary

Jonathan: According to the CDC's National Center for Health Statistics, Data Brief number 564, published June 25, 2024, from the 2024 National Health Survey, 24.9% of US women took medication for their mental health in the prior 12 months. Men were only at 13.4%. That figure covers medication for depression, anxiety, and other mental health uses, so it is larger than the depression-only slice.

The NCHS also tracked antidepressant use specifically in the past 30 days. Women's use moved from 13.8% in 2009-2010 to 18.6% in 2017-2018. Men only moved from 7.1% to 8.7%. During 2015-2018, 17.7% of women and 8.4% of men used an antidepressant in the prior month, and women 60 and older reached almost 25%. A separate NCHS Data Brief, number 528, put depression-specific medication in 2023 at 15.3% of women and 7.4% of men.

Thomas: Almost 25% of women, one in four, are on mood-altering medication. Don't think that doesn't affect your readership. This isn't some niche slice like the 2% or 3% of people on GLP-1s. A quarter of your female readers are on drugs that alter mood, and that changes what they want to read.

Do antidepressants change personality?

Jonathan: According to Tang, de Ruberg, and colleagues in a December 2009 study out of Amsterdam, 240 adults with major depression received paroxetine, cognitive therapy, or a placebo. After the researchers matched patients on how much their depression improved, the paroxetine group showed 6.8 times as much change in neuroticism and 3.5 times as much change in extraversion as the matched placebo group. Placebo patients improved 1.2 standard deviations on the Hamilton Depression Scale and moved 0.18 standard deviations on neuroticism. The NIMH called this a drug effect on personality traits, separate from any improvement in mood.

Thomas: A 3.5-times shift in extraversion is enormous, and I'd assume that's a drop, not an increase. In the Big Five framework, extraversion isn't the pop-psychology idea of being popular and outgoing. It means you draw energy from being around other people. Introversion means you generate energy alone or with a small number of people. It's a spectrum, and outgoing behavior is a correlate of it, not the cause.

So if someone is suddenly on a medication that makes them want to be around other people much less, that has a real effect, multiplied across society, on why fewer of us have as many friends as we used to. Maybe that friend now wants their friends in books at home instead of at the bowling league they're no longer part of.

Jonathan: Four more studies back this up. Price, Cole, and Goodwin in the British Journal of Psychiatry, 2009, interviewed 38 people on SSRIs, 28 of them women, with a median time on the drug of 23 months. Patients described a drop in the intensity of everyday emotion, a sense of detachment, and a feeling of not caring. Goodwin, Price, De Bonet, and Lurito in the Journal of Affective Disorders, 2017, surveyed 669 treated depression patients: 46% reported emotional blunting, 44% of the women and 52% of the men. Bupropion produced a lower blunting signal than what patients had been on before. Ulbroek and colleagues, 2002, studied 15 patients who already had SSRI-related sexual side effects: 80% also reported blunting on crying, sadness, anger, surprise, care for other people, and creativity. A 2025 pilot study of women remitted from depression on sertraline found 81.8% met criteria for sexual dysfunction, and emotional intensity scores fell along with sexual function scores.

Why Nuanced Books May Be Losing Ground

Thomas: I wonder if this connects to nuanced books not selling as well. Authors want to write complicated books that blend genres, but a reader whose emotions are being chemically blunted isn't looking for nuance. They want louder, more extreme, more direct emotional appeal.

Here's a metaphor. I have no sense of smell. I can smell smoke and two or three other things, and that sounds like an advantage as a dad since I can't smell dirty diapers, but it also means I don't taste food well. Nobody likes the food I cook for myself because I drown everything in Costco sriracha just to taste anything at all. Someone with a delicate palate can taste the hint of nutmeg. I can't taste the hint of anything.

A reader with a blunted emotional range loses all the nuance in a book the same way. That may be part of why AI writing is doing so well with some readers: AI struggles with nuance, but it can pour on the sriracha. If your taste is chemically blunted, a strong, unsubtle emotional signal is more appealing, and that may explain the shift in what sells now compared to what sold 20, 30, or 40 years ago.

Jonathan: It has to hit harder. It has to be spicier, which is the actual term the romance genre uses now, to reach desensitized receptors looking for the same dopamine or adrenaline hit.

How Romance Fiction Absorbed Erotica

Thomas: This connects to the sexual dysfunction numbers from that 2025 study. Something that would have been far too explicit for a reader in the '80s or '90s who wasn't on SSRIs may now read as tame. The level of eroticism in current romance is genuinely shocking. I was in a group with romance writers, some of whom have sold successfully for a decade or more, who were frustrated that their genre was being colonized by erotica wearing a romance cover. It isn't a romance book, it's erotica with a YA-style cover, but the content is extremely explicit.

Jonathan: That shift created a whole new vocabulary among romance readers: what's the heat level, is it closed door, is it fade to black. None of those terms had heavy usage before, because romance and erotica were considered separate genres. Some of that traces back to Amazon banning erotica as an advertisable category. The category still technically exists, but it's shelved out of sight.

So erotica moved into other genres like fantasy and romance, and readers built a new vocabulary to describe what they were reading and explain it to each other.

Thomas: Now you have to go looking for it, the same way X handles adult content. X doesn't block it, but you won't stumble on it unless you go looking, unlike Instagram or old TikTok, where the algorithm would actively try to zero in on what you might be into. It's harder to reverse-engineer X's algorithm, but one benefit of X open-sourcing it is that government censorship becomes part of the public record, which I suspect is the real motive, since X exists with a political agenda of its own.

Who actually buys books?

Jonathan: NIQ's writeup of Nielsen BookData's UK Books and Consumer Survey found that 59% of UK book purchases in 2012 went to women, and 65% of e-book purchases. A Vox 2025 fact-check found that the widely circulated claim that women buy 80% of fiction lacks a clean US BookScan source. Nielsen's confirmed 2017 UK fiction split sat near 63% women, not as high as the 80% figure but still a clear majority.

Thomas: BookScan doesn't track indie sales or most LitRPG, so I wouldn't be surprised if the real number is closer to 80% once you count those, especially given how female-focused traditional publishing has become. And SSRI prescriptions keep climbing. Once someone starts, they tend to stay on them for life, since getting off an SSRI can be difficult.

I know a woman near one of our local parks who is an evangelist against SSRIs. She tells anyone who'll listen that the drugs ruined her life and to keep the women in their life off them. None of the women in my life are on prescriptions to speak of. We come from a suspicious-of-doctors, unvaccinated part of Texas, and we see doctors more as drug salesmen than not.

A Tangent on Food, Fundamentals, and Earning Your Audience

Jonathan: As predicted, most of the comments are unhappy with us, accusing us of saying women belong in the kitchen. For the record, I'm the one who cooks dinner in my house.

Thomas: I cook for myself because my wife cooks for our kids, who want the blandest food imaginable. One night she made boiled chicken, white rice, and broccoli, no sauce, no pepper, maybe some salt, and the kids devoured it while we just stared. My kids have sensitive enough palates to taste the nuance between boiled chicken and boiled rice. I don't have that problem. I drown everything in Costco sriracha because my own palate is blunted, same as the readers we've been talking about.

My wife is a much better cook than I am. She made something genuinely delicious recently, but it was too complicated and exotic for the kids, and it caused a whole scene. They came around to it eventually.

The deeper problem is that young people aren't being made to read Aristotle, Shakespeare, or Dostoevsky anymore, so they never develop an intricate palate for anything, food or books. In our house the kids get what they want for breakfast and lunch, and dinner is where we try to expand their horizons.

Jonathan: I do the same thing, sneaking better ingredients into what I cook. Once I was short on time and just threw frozen chicken fingers in the oven with no seasoning, and my kids loved them just as much, because all they wanted was a vehicle for ketchup. Depressing, since I want to give them something better.

Thomas: That's the literature parallel. When I talk about what readers want, I'm speaking as a marketer describing the market as it is, not as a philosopher saying how it should be. I'd love it if more people read Aristotle and Shakespeare. I'm even building a podcast called The Daily Aristotle. Half our everyday turns of phrase, including the name of the bone-broth product I put in my food, trace back to coined terms Shakespeare invented.

But if you're trying to make a living as an author, you write the kind of book people already want to read: simpler, more direct, squarely in the middle of the genre, not the innovative, "truffle oil mac and cheese" book. You can't force anyone to read your work. Aristotle is often credited with the line that education forced on someone benefits them nothing. You have to win readers over. The strategy is to build a large audience with accessible books, then gradually make your own work more sophisticated over your career. You'll lose some ability to attract brand-new readers as you do, but you take the readers you have somewhere better, the way Moses led one group out of Egypt rather than saving everyone still there. Write as many accessible, mass-market books as you can early on to build the largest possible audience, then introduce that audience to more ambitious work, and eventually to something like Dostoevsky, later in your career.

Jonathan: The Clone Wars did exactly this. It started as simple kids' entertainment with lightsabers and funny robots, and by the end of season seven it had become a serious meditation on PTSD and the horror of war. My own kids just want to see Ahsoka fight Darth Maul, not sit through the emotional payoff, because you have to grow with the series to earn that ending. That's the model: open with the accessible version, the Kraft Mac and Cheese, and slowly upgrade it.

Thomas: You have to earn that right by mastering the fundamentals first. If you want to be the chef cooking $100.00 Wagyu steaks, you don't start there. You start on cheap ingredients, learn to chop vegetables without losing a finger, and study under someone who already knows the craft. I see a lot of arrogant, prideful writers in Christian fantasy who assume that because they've read and loved C.S. Lewis and Tolkien, they're already qualified to write at that level, without studying the market or their genre's fundamentals. They charge in like unarmed soldiers in World War I and get slaughtered: dozens of sales after thousands of hours of work.

I built a five-year training plan with one of the most successful Christian fantasy authors by sales and awards. He didn't write epic fantasy. He read comic books and wrote for boomer women, adapting to what the market wanted, but he'd mastered the fundamentals first. If you haven't read Brian Godawa, the top-selling Christian fantasy author every month, you're not ready to write in that genre. I've interviewed him, and you can listen for free. I'm using Christian fantasy as the example because it's the biggest slice of my own audience, but the principle holds everywhere: assuming your talent alone will carry you, without learning the fundamentals or reading the bestsellers in your genre, doesn't work. I've watched plenty of overconfident authors publish, discover the market doesn't care how many YouTube subscribers they have, and quit within five years, bitter about it.

Seth Ring, another guest of mine, writes Christian LitRPG and outsells MrBeast's pre-order and review numbers in an opening week, because he learned to play the game rather than just charging the line unarmed. You have to learn the actual craft: taking cover, coordinating your resources, using the tools available, not just charging straight at the market with nothing.

Breaking News: A Murder Case and the Insanity Defense

Jonathan: There's a court case we've covered before that's back in the news today. A woman strangled her three children, one after another, and left them in her basement. There's been a strange public reaction treating what she did as not wrong, and the jury nearly returned a not-guilty verdict.

One juror held out, arguing that murdering your children is wrong regardless of drugs or mental state.

Thomas: If you kill someone, you should die for it, and it doesn't matter whether you have an excuse of being mentally ill. Being mentally ill is more reason to execute someone, not less. We can have a world free of murderers by executing murderers, the way it's been done for most of human history.

Jonathan: That just makes more murderers.

Thomas: That's the Batman fallacy: if Batman would just let the Joker be executed, more people would be saved. It is good and right for the government to use force against evildoers so the evildoers no longer exist. The idea that "it was just their body, their heart was good, we're only executing the body" doesn't hold up. This isn't the only world. God will know his own.

I'm getting more agreement on this in the comments than on any of the SSRI material.

Jonathan: Give it time. This will be the clip they roast you over.

Thomas: If you don't know the case: a woman strangled her oldest child in front of her other two, then strangled the next, then the next, and left all three dead in the basement.

There's a real social-psychosis element to the public reaction treating this as somehow not her fault. You chose to take the drugs, if drugs are the excuse. I was pressured to get vaccinated and didn't. You can say no. If we want a better world, we have to hold people responsible for their actions, which means murderers don't get a pass. That hasn't been a controversial position for most of history.

Any time a society carves out an exception, "it's fine to kill this class of person," that's the same principle our country was founded on rejecting. You don't get to murder people, whether or not you're mentally ill, and it doesn't matter if the victims are your own children.

Jonathan: A commenter asked why we even have an insanity plea. The Fat Electrician did a good video on its origin: a US congressman shot and killed the son of the man who wrote the Star Spangled Banner, in front of the White House, after finding out the man had an affair with his wife.

Thomas: His lawyer invented the insanity defense to get him acquitted, and it worked.

It shouldn't be a defense. Being insane is more reason to execute someone, not less. Do you want a world full of people who murder because they claim demonic possession or mental illness? The purpose of government is to remove people like that from society. People could leave their houses unlocked in the 1950s because a century earlier, horse thieves were hanged. I'm not calling for the "bloody code" of 1650s England, just for executing murderers, which every successful civilization in history has done: China, Rome, Greece, Anglo-Saxon England, the Normans, the Goths, Egypt. Name a historic people who thought murder was fine as long as you had a good excuse. You'll only see that right before a civilization collapses.

Civilization is what keeps any of us fed. I don't grow my own food. If civilization fails, I watch my children starve, and the only people who survive that are the most ruthless and violent. That's the outcome to avoid at all costs, even if avoiding it means executing murderers.

Jonathan: When a government chooses to be mentally stunted as a matter of policy, this is what you get.

Thomas: Jesus wasn't just a peacemaker either. Revelation describes him returning on a white horse with a sword, judging the unrighteous. He said plainly he didn't come to bring peace but a sword. "Hippie Jesus" who only preaches gentleness is a boomer-era invention, not a biblical one. There's a time for justice and a time for mercy, and a worldview that's all mercy, all the time, hands control of your life to the most ruthless people around you.

Jonathan: He also said it would be better for someone to be thrown into the sea with a millstone around their neck than to harm a child, and followed it with the most extensive description of hell in the New Testament. That's the same message either way: don't hurt kids, or there's a reckoning after death too.

Thomas: Which is the more merciful system: justice in this life, or only facing justice in the next one?

Justice, Vengeance, and the Death Penalty

Thomas: I realize this is now a controversial position, but I'll hold it. If we let people get away with murder, there's nothing we won't eventually let them get away with. We live in a society where half the country already believes it's fine to end a defenseless life as long as it happens before birth. That standard has since expanded. Now the bar for taking a life can be as low as the mother being unhappy or on the wrong medication.

Killing is wrong. Murder is wrong. But there are times when killing is justified: in war, and when a neutral government executes a murderer. It's better for a murderer to be executed than to keep murdering or spreading evil in prison. A life sentence is still a kind of execution, just a slower and more torturous one that doesn't lead anywhere near repentance. If you want to save the person's soul, the more merciful path is to give them time to make things right with God and then carry out the sentence. This isn't a call to revert to 1650s brutality, just to roughly where things stood 100 years ago. And on wrongful convictions: we now have far better forensic science than we used to, so that risk is much lower than the old objection assumes.

Jonathan: If we're focused on justice, we can do a decent job of getting it right.

Thomas: What people usually call "social justice" is the government taking someone else's money and redistributing it, which isn't the same thing as justice. Justice is an eye for an eye, a tooth for a tooth: the punishment fits the crime. That standard is written on the human heart and shows up across every civilization throughout history, which is why it's universal. People recoil from it because they've absorbed the idea that it's just about revenge, but it isn't. Nobody is calling for the aggrieved party to take justice into their own hands. This is specifically about a neutral third party administering it. Otherwise, you get a cycle of revenge, back and forth.

I see this at home. When one of my children is violent toward another and I don't step in with consequences the wronged child sees as fair, that child retaliates, and it escalates. As the head of my household, I have to step in and administer justice or the cycle keeps going.

Jonathan: Just put fluoride in the water, Thomas.

Thomas: I'm not vaccinated, and my family's ranch exists partly because my grandfather, a medical doctor, didn't trust fluoridated water even decades ago. He served as an anesthesiologist, including during the Korean War, and kept his own well water instead of drinking from the Austin city supply. He never accepted what's now fairly well established, that fluoride lowers IQ. It was never controversial among people willing to look at the research.

Ritalin, Height, and the Dating Market

Jonathan: We had this same argument 15 years ago about Ritalin, when the answer to managing boys in school was to drug them into being calmer and easier to handle, more like the behavior expected of girls. We medicated a whole generation of kids, and it hasn't worked out well.

Thomas: It also stunted their growth. Caffeine doesn't stunt growth, but Ritalin does, and height has become the top status differentiator in dating. Women increasingly won't date short men, and some of those men are short because their parents put them on Ritalin as kids. Mothers who thought they were helping their sons may have unintentionally taken them out of the dating pool entirely, which means no grandkids.

Jonathan: Your parents sexually disadvantaged you. That's a fun one to bring up in therapy.

Thomas: In our defense, Jonathan gave a real trigger warning at the top of this segment, which he normally mocks me for doing. He told anyone sensitive to log off now, no apologies.

We've said enough. In a multitude of words, sin is not lacking, and we've produced a multitude of words today.

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Zeitgeist: How SSRIs Change What Women Want to Read

Zeitgeist Report