Levels of Reported Depression,Boredom Salience,and Sexual Boredom as a Function of Length of Time on Antidepressant Medications

Abstract

Boredom is linked to numerous negative psychological conditions, yet remains critically under-researched. Individuals with depression frequently experience boredom, yet the relationship between boredom and antidepressants remains largely unexplored. We investigated the associations between antidepressants and various dimensions of boredom using an online sample (N = 251). This study focused on SSRIs, the most frequently prescribed antidepressant, to reduce variability across drug classes. Sexual boredom was of particular interest due to its association with both depression and SSRI-induced sexual dysfunction. Participants who reported using SSRIs for six weeks to two years reported higher levels of sexual, trait, and state boredom compared to non-SSRI users. However, no significant differences emerged between non-users and those on SSRIs for over two years. Clinical implications include the need for psychoeducation on boredom as a potential side effect influencing treatment adherence. Increased research is needed to explore the intersection of boredom and psychiatric treatment outcomes.

Keywords

boredom sexual boredom antidepressants SSRIs depression

Introduction

Boredom is a normative psychological experience of dissatisfaction that occurs in subjectively uninteresting environments (Todman, 2007). It is accompanied by feelings of attentional constraint (Eastwood et al., 2012; Todman, 2003, 2021), which can lead to both high (e.g., restlessness, agitation, frustration) and low levels of arousal (e.g., lethargy, depressed feelings) (Geiwitz, 1966; London et al., 1972; Merrifield & Danckert, 2014; Raffaelli et al., 2018; van Tilburg & Igou, 2017). Several conceptualizations of boredom stem from psychodynamic, existential, arousal, and cognitive theories, but all agree that boredom is characterized by an aversive state of wanting, but being unable to engage in a satisfying activity (Eastwood et al., 2012, p. 482).

Boredom can be classified through state versus trait distinctions (Fahlman et al., 2013; Todman, 2013). The recent and/or immediate experience of boredom is understood as ‘state boredom’ (Fahlman et al., 2013; Todman, 2013); it refers to transient feelings of boredom concerning a specific situation or time, and can be measured using the State Boredom Measure (SBM; Todman, 2013). Certain individuals are more prone to experiencing boredom, a presumably stable characteristic known as boredom proneness, trait boredom (Sundberg et al., 1991; Todman, 2007; Vodanovich, 2003; Vodanovich & Kass, 1990), or ‘situation-independent boredom’ (Todman, 2003). This trait can be assessed using the Boredom Proneness Scale (BPS; Farmer & Sundberg, 1986) or the Boredom Susceptibility Subscale within the broader Sensation-Seeking Scale, Form V (SSS-V; Zuckerman, 1979).

Boredom proneness correlates with a range of negative psychological conditions, including depression (Farmer & Sundberg, 1986; Goldberg et al., 2011; Gordon et al., 1997; LePera, 2011; Vodanovich, 2003), anxiety (Gordon et al., 1997), hopelessness (Farmer & Sundberg, 1986), aggression (Dahlen et al., 2004; Farmer & Sundberg, 1986; Gordon et al., 1997; Pfattheicher et al., 2021; Rupp & Vodanovich, 1997), and distractibility (Malkovsky et al., 2012; Todman, 2003). Boredom-prone individuals are likely to engage in addictive behaviors (Amos et al., 2006; Anshel, 1991; Blaszczynski et al., 1990; Lee et al., 2007; LePera, 2011; Mercer-Lynn & Eastwood, 2010), risk and sensation-seeking behaviors (Kılıç et al., 2020; Todman, 2003), and impulsiveness (Boden, 2009; Moynihan et al., 2017; Watt & Vodanovich, 1992). Boredom has also been shown to negatively impact educational and achievement-related outcomes (Bearden et al., 1989; Goetz & Frenzel, 2006; Goetz et al., 2007; Newberry & Duncan, 2001; Robinson, 1975).

Still, boredom remains a fringe topic within the literature despite its robust association with a host of suboptimal psychological outcomes, such as depression. For this reason, the present study investigates the relationship between antidepressant medications and dimensions of boredom. Specifically, this study examines the antidepressant class of selective serotonin reuptake inhibitors (SSRIs) because it is the most frequently prescribed class of antidepressant (Marasine et al., 2021) and aims to control for variability stemming from differences in antidepressant classes. However, these findings may generalize to other classes of antidepressants and provide novel insight into the relationship between antidepressants and boredom.

The first and only known study to investigate the effects of antidepressants on general boredom was conducted by Theobald et al. (2003) in a small sample of patients with cancer (N = 30). This open-label pilot study administered a two-month regimen of the SSRI Citalopram to participants who reported high levels of depressive symptoms. Out of the 30 patients, 21 completed the study protocol. Results indicated a significant reduction in depressive symptoms, along with notable improvements in boredom measured at weeks 6 (F = 5.266, p < .05) and 8 (F = 9.248, p < .01), suggesting that symptoms of boredom may be alleviated by antidepressants beginning at six weeks. A significant limitation of this study is that the researchers used a non-validated boredom scale created by the team. Still, the negative correlation between SSRIs and boredom suggests the necessity for further research using more robust research methods.

Also of interest is the dimension of ‘sexual boredom’ (Watt & Ewing, 1996) given the risk of reduced sexual functioning associated with both depression (Hartmann, 2007; Pesce et al., 2002) and the use of SSRIs across all genders (Angst, 1998; Clayton et al., 2014; Fava & Rankin, 2002; Ferguson, 2001; Werneke et al., 2006). Treatment-emergent sexual dysfunction has been reported with practically all brands and forms of antidepressants (Higgins et al., 2010), with incident rates of SSRI-induced sexual dysfunction ranging from 25 to 93% (Kennedy et al., 2000; Modell et al., 1997; Montejo et al., 2001; Rothschild, 2000). Consequently, whether antidepressants alter sexual boredom remains an unanswered but clinically relevant question regarding their side effects, given the robust relationship between antidepressants and sexual dysfunction. To the researchers’ knowledge, this is the first study to explore the relationship between antidepressants and sexual boredom.

Sexual Boredom

Sexual boredom is a presumably stable dimension of boredom defined as the tendency to experience boredom with aspects of one’s sexual life (Watt & Ewing, 1996). The first and inarguably most influential studies to focus on sexual boredom are those by Watt and Ewing (1996). The authors suggest that sexual boredom is best understood in the context of Zuckerman’s definition of boredom as “an aversion for repetitive experience of any kind, routine work, or dull and boring people and extreme restlessness under conditions when escape from constancy is impossible” (1979, p. 103) and Mikulas and Vodanovich’s definition of boredom as “a state of relatively low arousal and dissatisfaction, which is attributed to an inadequately stimulating situation” (1993, p. 3). Although the present researchers mostly agree with this conceptualization, we suggest two important points of distinction.

First, subsequent research has contested Mikulas and Vodanovich’s assertion that boredom is a primarily low-arousal state (Danckert & Allman, 2005; van Hooft & van Hooff, 2018). This is particularly relevant to sexual boredom because arousal is pertinent to sexuality, as it serves as a critical indicator of physiological and psychological indicators of sexual desire, motivation, and response (Toates, 2009). Elevated boredom levels have been associated with both high arousal states, such as restlessness, agitation, frustration, and low arousal states, such as lethargy and depressed feelings (Geiwitz, 1966; London et al., 1972; Merrifield & Danckert, 2014; Raffaelli et al., 2018; van Hooft & van Hooff, 2018; van Tilburg & Igou, 2017). Studies show that sexual boredom negatively correlates with sexual arousal (Koukounas & McCabe, 1997; Suschinsky et al., 2015), desire (Carvalheira et al., 2014), and orgasm (Apt & Hurlbert, 1994; Jonason, 2019; de Oliveira et al., 2021), although one study finds a positive correlation between sexual boredom and responsive sexual desire in men (Stulhofer et al., 2013). This suggests that sexual boredom can lead to both high and low arousal outcomes, similar to state and trait boredom. If sexual boredom functions similarly to general boredom, this parallel will align with broader findings on the arousal dynamics of boredom across contexts. However, further research is needed to clarify whether sexual boredom follows the same underlying mechanisms as general boredom or whether it reflects a distinct psychological process.

Second, Mikulas and Vodanovich’s view that boredom arises from an “inadequately stimulating situation” fails to highlight the reciprocity between person and environment. Individuals are not merely subjected to environments, rather they interact with them physically and psychologically (Csikszentmihalyi, 2000; Todman, 2003). This problem is circumvented by contextualizing sexual boredom within the definition of boredom provided by Todman (2003, p. 149) as the “psychologically normative experience of dissatisfaction attributed to subjectively uninteresting environments.” To refrain from pathologizing variations of sexuality that neglect to contextualize desire, arousal, and sexual behaviors, within sociocultural environments (Potts et al., 2006; Tiefer, 1996), we must foreground the subjectivity of “feeling of dissatisfaction” in our proposed definition of sexual boredom; this is to emphasize that there is a wide array of sexuality that is healthy, but it is this dissatisfaction that is clinically relevant. It is the conflicting nature of boredom, to yearn for but fail to achieve, that characterizes sexual boredom.

Research and theorization on sexual boredom are scarce, yet its relatedness with a host of adverse outcomes and behaviors warrants further attention (de Oliveira et al., 2021). Sexually bored individuals often experience negative psychological effects, such as sexual depression, general boredom proneness, and sexual and life dissatisfaction (Watt & Ewing, 1996; de Oliveira et al., 2021). They are likely to seek out opportunities for increased arousal, such as sexual fantasizing and the pursuit of novel sexual experiences (Watt & Ewing, 1996). This can significantly impact intimate relationships, as it may lead to negative emotions toward sexual monotony, routine, and constraints (Watt & Ewing, 1996). Sexual boredom has also been positively correlated with hypersexuality in men and women (Klein et al., 2015; Stulhofer et al., 2008, 2016), and paraphilic porn use in men (Stulhofer et al., 2010), further suggesting its clinical relevance. While this study does not directly test whether sexual boredom is best understood as a subset of general boredom, our discussion situates it within broader boredom research to explore potential conceptual overlap. Further empirical work is needed to determine whether sexual boredom operates under the same psychological mechanisms as general boredom or if it represents a more distinct phenomenon.

The subscales of the Sexual Boredom Scale (SBS; Watt & Ewing, 1996) consist of (1) Sexual Monotony (sexual routine and tedium) and (2) Sexual Stimulation (aspects of sexual excitement and constraint). The Sexual Monotony subscale examines the repetitive and routine elements of an individual’s sex life with statements such as: “I require very little change and variety in a relationship to feel sexually satisfied.” As such, in a qualitative study with 12 men, sexual boredom was defined as “boredom with boring sex, as in dull, routine and over-rehearsed sex” (Tunariu & Reavey, 2003). Furthermore, the SBS does not include any items relating to the “performance” aspects of one’s sex life, such as erection, orgasm, and so on, and instead focuses on one’s subjective feelings and beliefs. These distinctions differentiate sexual boredom from sexual dysfunction, defined by the DSM-5 as “a clinically significant disturbance in a person’s ability to respond sexually or to experience sexual pleasure” (American Psychiatric Association, 2013, p. 423). However, sexual boredom may be a symptom of sexual dysfunction and is associated with hyper sexuality (Klein et al., 2015).

Rationale - Boredom and Depression

Although the association between depression and boredom has been substantiated robustly (Farmer & Sundberg, 1986; Goldberg et al., 2011; Gordon et al., 1997; LePera, 2011; Vodanovich, 2003), the exact relationship between the variables remains unresolved in terms of directionality, mechanisms, and mediators. It is not clear whether boredom acts as a contributing factor to depression or if high levels of state boredom are indicative of underlying depression. Individuals naturally exhibit varying levels of trait boredom attributable to trait dimensions, but whether this predisposes one to experience depressive symptoms has not been empirically explored. This confusion is compounded by the difficulty in discerning higher-than-normal rates of state boredom that last for extended periods from dispositional trait factors of boredom (Todman, 2003, 2007, 2021).

Boredom is distinct from other phenomenologically related states such as depression, apathy, and anhedonia (Goldberg et al., 2011), suggesting that its relationship with depression is separate but related. This distinction extends to domain-specific forms of boredom, including sexual boredom (Vodanovich, 2003). Sexual boredom reflects diminished psychological stimulation or engagement within sexual experiences, despite an intact capacity for sexual functioning and pleasure (Watt & Ewing, 1996). This differentiates sexual boredom from sexual apathy, which is characterized by reduced sexual motivation or interest (Leiblum, 2002), and from sexual anhedonia, which involves a diminished capacity to experience sexual pleasure (Chapman, 1983).

Relatedly, a meta-analysis by Atlantis et al. suggests a robust bidirectional association between sexual dysfunction and depression (2012). Results revealed that sexual dysfunction predicts the onset of depression, and depression predicts the onset of sexual dysfunction. Sexual boredom, however, may represent a related but distinct experiential pathway, one characterized less by impaired sexual functioning and more by reduced psychological engagement and stimulation. A similar bidirectional relationship between sexual boredom and depression is hence worthy of investigation, distinct from sexual dysfunction.

We theorize that if SSRIs can reduce boredom, a reliable indicator of depression, they are likely helping to alleviate a key feature of depression and related variables (such as sexual boredom) separate from apathy and anhedonia. Therefore, this paper seeks to explore the effects of SSRIs on state, trait, and sexual boredom as a potential intervention for managing symptoms of depression.

Aims and Hypotheses

This study aimed to investigate the relationships between self-reported levels of recent boredom salience (state boredom), boredom proneness (trait boredom), sexual boredom, depression, and the duration of antidepressant use through an examination of self-reported SSRI use. We hypothesized that longer SSRI use would negatively correlate with depression and trait and state boredom, but positively correlate with sexual boredom, attributable to antidepressant-related sexual dysfunction. In the control group (non-SSRI use), we anticipated that recent boredom salience, boredom proneness, sexual boredom, and depression scores would all be positively correlated, consistent with existing literature (Watt & Ewing, 1996).

Method

Participants

This study consists of data collected online using Amazon’s Mechanical Turk (MTurk) from December 2, 2022, to July 12, 2024. MTurk is an online crowdsourcing platform widely used in psychological research for obtaining diverse and geographically dispersed samples (Buhrmester et al., 2011). All anonymized data from this study are publicly available on the Open Science Framework (Riccardi, 2025). All data were de-identified before sharing; IP addresses were removed, and indirect identifiers were reviewed to minimize re-identification risk. The BRANY Institutional Review Board approved this study (Protocol #22-165-1244) on November 17, 2022. All participants provided electronic informed consent prior to beginning the survey.

A total of 251 individuals participated in the study, of which 50 reported taking SSRIs with regular adherence. Inclusion criteria required participants, and to improve data reliability, we restricted participation to U.S. residents fluent in English. The investigation of the effects of antidepressants was limited to SSRIs to avoid potential confounds that could arise from including a more heterogeneous group of antidepressants. Furthermore, SSRIs are the most commonly prescribed type of antidepressant. Participants who reported taking SSRIs in combination with other psychotropic drugs or who had not taken SSRIs for at least four weeks were excluded. Informed consent was obtained from all participants before data collection, and participants were assured of the confidentiality and anonymity of their responses.

The sample included participants ranging from 21 to 75 years of age (M = 43.5, SD = 12.1), with a nearly equal distribution of men and women, and a small percentage identifying as non-binary or preferring not to disclose their gender. The majority (81.3%) of participants identified as White or Caucasian. Marital status was varied, with the majority of the sample married (45.7 %) or single (30.5%), and the remainder either in a partnership, widowed, or divorced. In terms of sexual orientation, the majority of participants identified as heterosexual (81.3%), while smaller proportions identified as homosexual or bisexual. Educational attainment varied, with about half of (50.3%) participants holding a bachelor’s degree. Income was relatively evenly distributed, with the largest group reporting an income between $25,000 and $74,999 (50%). Detailed information on gender, ethnicity, marital status, sexual orientation, educational attainment, and income is presented in Table 1.

Table 1.

Participant Demographics (N = 251)

Demographic	N	Proportion of total (%)
Gender
Women	133	53.0
Men	115	45.8
Non-binary or prefer not to disclose	3	1.2
Ethnicity
White or Caucasian	204	81.3
Asian	23	9.2
Black or African American	14	5.6
White & Asian	6	2.4
Native Hawaiian or Pacific Islander	1	0.4
Asian & Native Hawaiian or Pacific Islander	1	0.4
Prefer not to disclose	2	0.8
Marital status
Married	115	45.7
Single	76	30.5
In a partnership	32	12.7
Widowed	10	4.0
Divorced	18	7.2
Sexual orientation
Heterosexual	204	81.3
Homosexual	9	3.6
Bisexual	32	12.7
Educational attainment
Bachelor’s degree	126	50.3
Some college	45	17.9
Associate’s or technical degree	37	14.6
Income
Less than $25,000	37	14.7
$25,000–$74,999	125	50.0
$75,000–$149,999	62	24.7
$150,000 or more	27	10.6
SSRI type*
Fluoxetine (Prozac)	13	26.0
Paroxetine (Paxil)	12	24.0
Escitalopram (Lexapro)	8	16.0
Sertraline (Zoloft)	8	16.0
Citalopram (Celexa)	5	10.0
Other	4	8.0
SSRI duration*
2–10 years	17	34.0
2–12 months	12	24.0
1–2 years	9	18.0
10+ years	8	16.0
6–7 weeks	4	8.0
SSRI dose*
20 mg	9	18.0
40 mg	5	10.0
50 mg	3	6.0
Other doses (ranging from 10 mg to 462 mg)	33	66.0
Disorder type
Comorbid anxiety & depression	60	24.0
Anxiety disorders	40	16.0
PTSD	17	6.7
Eating disorders	13	5.3
Autism spectrum disorder	7	2.7
Bipolar disorder	4	1.6
Borderline personality disorder	4	1.6
Schizophrenia spectrum disorders	4	1.6
Psychotherapy engagement
Yes	76	30.3
No	175	69.7
Length of Psychotherapy^
Less than 1 month	8	10.5
1–12 months	31	40.8
1–5 years	28	36.8
Over 5 years	9	11.8

*Among SSRI users.

^Among psychotherapy engagers.

SSRI use varied, with participants using a range of SSRIs, the most common being Fluoxetine (Prozac) and Paroxetine (Paxil). SSRI duration ranged from 6 weeks to more than 10 years, and doses varied widely (10 mg–462 mg). Detailed information on SSRI type, duration, and dose is presented in Table 1.

Participants reported a range of mental health diagnoses, with comorbid anxiety or depressive disorder being the most common. Diagnoses related to post-traumatic stress disorder, eating disorders, and autism spectrum disorder were also reported, along with less frequent diagnoses such as bipolar disorder and schizophrenia spectrum disorders. Detailed diagnostic information is presented in Table 1. Approximately 30% of participants reported having received psychotherapy, with the length of psychotherapy varying from less than one month to more than five years. The full details of psychotherapy engagement are available in Table 1.

Measures

Boredom

The Boredom Proneness Scale (BPS; Farmer & Sundberg, 1986), a validated, self-report 28-item questionnaire, was used to measure participants’ tendency to experience boredom (trait boredom). The BPS is measured on a 7-point Likert scale ranging from highly disagree to highly agree. Eighteen items directly measure boredom proneness, and ten items are reverse-scored. Reliability for this version of the BPS has correlational coefficients ranging from .72 to .75 (Ahmed, 1990), and its test-retest reliability ranges from .72 to .91 (Vodanovich, 2003). The BPS demonstrated excellent internal consistency in the current sample (Cronbach’s α = .907).

The State Boredom Measure (SBM; Todman, 2013) is a validated, self-report 8-item measure assessing frequency, intensity, duration, and attributions of boredom salience over the past two weeks (state boredom). The SBM is measured on a 7-point Likert scale. A total score is obtained by summing the responses for a maximum possible score of 56. Higher scores on the SBM indicate a higher salience of state boredom over the past two weeks. The SBM has good psychometric validity (Todman, 2013) and positively correlates with measures of trait boredom, such as the BPS (Farmer & Sundberg, 1986), and the Boredom Susceptibility Scale (Vodanovich, 2003). The SBM demonstrated excellent internal consistency in the current sample (Cronbach’s α = .915).

Sexual Boredom

Watt and Ewing have developed the only validated measure of sexual boredom, the Sexual Boredom Scale (SBS; 1996). The measure comprises 18 items across two subscales: sexual monotony (sexual routine and tedium) and sexual stimulation (aspects of sexual excitement and constraint). The SBS demonstrates high internal consistency (rs = .92 to .95) and one-month test-retest (r = .81; Watt & Ewing, 1996). In the current sample, the SBS demonstrated excellent internal consistency (Cronbach’s α = .932).

Depression

The Beck Depression Inventory–II (BDI–II; Beck et al., 1996) was used to measure depressive symptoms. The BDI–II is a validated, 21-item scale that asks participants to self-rate their depressive symptoms over the past two weeks on a scale of 0–3. The scale assesses common symptoms of depression, including appetite, energy levels, sleep, and mood changes. The BDI-II demonstrated excellent internal consistency in the current sample (Cronbach’s α = .958).

Duration

Duration of SSRI use was assessed through self-reported data. Participants indicated the length of time they had been adhering to SSRI treatment from a list of five predefined intervals, ranging from 6 to 7 weeks to 10+ years (see Table 1). Due to the small cell sizes for three of the duration categories, the five duration categories were collapsed into two categories for the analyses: (1) short-term SSRI use, ranging from 6 weeks to less than two years, and (2) long-term SSRI use extending beyond two years, thereby comprising two groups of 25 participants each. The remaining participants who reported that they were not taking antidepressants were assigned to the control group, identified as the “no SSRI use” group.

Statistical Analysis

A thorough check for missing data was conducted before analysis. No missing values were identified for any of the key variables, indicating complete data across all participants. Forced responses were enabled in the survey design as a requirement for receiving monetary compensation, which resulted in complete data. Accordingly, no imputation or additional missing data handling procedures were necessary.

Normality of continuous variables (BDI–II, SBM, BPS, and sexual boredom) was assessed using Shapiro–Wilk tests (see Table 2 for results), along with examination of skewness and kurtosis. Depression symptoms (BDI–II), state boredom (SBM), and sexual boredom scores deviated were not normally distributed, whereas trait boredom (BPS) approximated a normal distribution. Further investigation into the skewness and kurtosis showed that BDI–II was moderately positively skewed, while SBM, BPS, and sexual boredom had skewness within acceptable ranges. None of the variables exhibited significant kurtosis issues.

Table 2.

Descriptive Statistics and Normality Test Results for Psychological Measures

Variable	M (SD)	Min-max	W	p	Skewness	Kurtosis
BDI–II	12.13 (12.4)	0–60	0.86	<0.001	1.11	0.6
SBM	25.43 (11.3)	8–55	0.94	<0.001	0.67	−0.39
BPS	71.49 (18.18)	32–127	0.98	0.054	0.22	−0.27
SBS	40.69 (15.13)	18–90	0.92	<0.001	0.76	−0.25

Note. BDI–II = depression; SBM = state boredom; BPS = trait boredom; SBS = Sexual Boredom. Boldface indicates p < .05.

Spearman’s rank-order correlations were conducted to examine the associations between SSRI duration and boredom-related measures. To examine differences across SSRI-use groups (no SSRI use, short-term SSRI use, long-term SSRI use), Welch’s one-way analyses of variance (ANOVAs) were conducted to account for unequal group sizes and potential heterogeneity of variances (see Figure 1). When omnibus effects were significant, Games–Howell post hoc tests were used.

To assess whether group differences in boredom outcomes persisted after accounting for depressive symptoms and other boredom constructs, analyses of covariance (ANCOVAs) were conducted. Depression severity (BDI–II), trait boredom (BPS), and state boredom (SBM) were entered as covariates in separate models to examine their independent contributions. When ANCOVA omnibus effects were significant, Tukey’s Honestly Significant Difference (HSD) tests were used for post-hoc pairwise comparisons. Effect sizes are reported using partial eta squared (η²).

Finally, exploratory ANCOVAs were conducted to examine whether boredom constructs were stronger predictors of depression severity than SSRI duration. Statistical significance was set at p < .05 for all analyses.

Power and Sensitivity Analysis

Using G*Power 3.1 (Faul et al., 2009), we conducted sensitivity and post hoc power analyses to contextualize detectability given our observed group sizes. For two-sample comparisons with unequal groups (non-users vs short-term SSRI: n = 201 vs n = 25; α = .05, two-tailed), sensitivity analysis indicated the minimum detectable effect of approximately d ≈ 0.60 at 80% power; comparisons within SSRI subgroups (short-vs long-term: n = 25 vs n = 25) required d ≈ 0.80 for 80% power. For the omnibus three-group ANOVA (N = 251; k = 3), the detectable effect was approximately f ≈ 0.20 (η² ≈ .04) under equal-n approximation. For correlations with N = 251, power exceeded 0.80 for r ≈ .18–.20 at α = .05 (two-tailed). These calculations are provided as post-hoc sensitivity/achieved-power estimates for a completed study and are not a substitute for prospective sample-size planning (see Quach et al., 2022, for discussion of post-hoc power as sensitivity).

Results

Main Analyses

Hypothesis 1: SSRI Duration, Depression, and Boredom

We hypothesized that longer SSRI use would negatively correlate with depression (BDI–II), trait boredom (BPS), and state boredom (SBM) while positively correlating with sexual boredom due to antidepressant-related sexual dysfunction. Spearman’s rank order correlation results indicated significant positive correlations between SSRI duration and all variables, including depression (ρ = .166, p = .008), state boredom (ρ = .194, p = .002), trait boredom (ρ = .183, p = .004), and sexual boredom (ρ = .160, p = .011). These results indicate that longer SSRI use is associated with higher levels of depression, boredom proneness, state boredom, and sexual boredom, contradicting our hypothesis that SSRI use would be associated with a reduction in these symptoms over time.

A Welch’s one-way ANOVA revealed significant differences for state boredom (F (2, 40.5) = 8.32, p < .001), trait boredom (F (2, 42.3) = 7.43, p = .002), and sexual boredom (F (2, 38.6) = 6.89, p = .003), but no significant differences were found for depression. Post-hoc Games-Howell tests showed that short-term SSRI users (6 weeks to 2 years) reported significantly higher state boredom, trait boredom, and sexual boredom compared to non-users (p < .05 for all comparisons). However, no significant differences were found between short-term and long-term SSRI users, and long-term SSRI users did not significantly differ from non-users in any of these variables.

To determine whether group differences in sexual boredom persisted when controlling for depressive symptoms, a one-way ANCOVA was conducted. The model was significant (F (3, 247) = 40.82, p < .001), indicating that SSRI duration and depression together explain variance in sexual boredom scores. Depression was a strong predictor (F (1, 247) = 102.50, p < .001, η² = .284), but SSRI duration remained a significant predictor of sexual boredom even after controlling for depression (F (2, 247) = 5.47, p = .005, η² = .030). Post-hoc Tukey’s comparisons indicated that short-term SSRI users reported significantly higher sexual boredom than non-users (Mdiff = −8.73, p = .003, d = −0.70). Short-term SSRI users also reported significantly higher sexual boredom than long-term SSRI users (Mdiff = 8.70, p = .038, d = 0.70). Long-term SSRI users did not significantly differ from non-users.

Further ANCOVAs were conducted to examine the role of SSRI duration in state boredom when controlling for other covariates. The ANCOVA for state boredom with depression as a covariate was significant (F (2, 247) = 3.70, p = 0.026, η² = 0.015), indicating that SSRI duration remained a significant predictor after accounting for depression. Post-hoc comparisons showed that short-term SSRI users reported significantly higher state boredom than non-users (Mdiff = −4.48, p = 0.024). No significant differences emerged between short-term and long-term SSRI users.

Additionally, when controlling for trait boredom, the ANCOVA for sexual boredom was significant (F (2, 247 = 3.70, p = 0.026, η² = 0.019). Post-hoc comparisons revealed that only short-term SSRI users differed significantly from non-users (Mdiff = −6.73, p = 0.025). SSRI duration was not a significant predictor of state boredom when controlling for sexual or trait boredom.

Overall, these findings indicate that while SSRI use is associated with increased boredom and depression, the effects differ by duration. Short-term SSRI users report the highest levels of state, trait, and sexual boredom, but long-term SSRI users do not differ significantly from non-users. Sexual boredom remains significantly elevated in short-term SSRI users even after accounting for depressive symptoms and trait boredom.

Hypothesis 2: Non-SSRI Group Correlations

Spearman’s correlations indicated strong positive associations between depression and state boredom (ρ = .66, p < .001) and depression and trait boredom (ρ = .69, p < .001). Sexual boredom was also significantly correlated with depression (ρ = .44, p < .001) and both boredom measures.

Exploratory Analyses

Given the observed relationships between SSRI use, boredom, and depression, exploratory analyses examined whether boredom proneness (BPS) and state boredom (SBM) were stronger predictors of depression than SSRI use (see Figure 2), suggesting that sexual boredom may align more with general boredom tendencies than with depression.

ANCOVAs controlling for state and trait boredom confirmed both were strong predictors of depression (SBM: F (1, 248) = 237.04, p < .001, η² = .489; BPS: F (1, 248) = 180.03, p < .001, η² = .421), while SSRI use was not significant (p > .80). Additionally, when controlling for sexual boredom, SSRI duration remained non-significant (F (2, 247) = 0.826, p = .439, η² = .005), whereas sexual boredom itself was a strong predictor of depression (F (1, 247) = 102.498, p < .001, η² = .292). These findings suggest that sexual boredom, like state and trait boredom, is more strongly linked to depression than to SSRI duration.

Discussion

SSRI Duration, Depression, and Boredom

Our findings indicate a positive relationship between the duration of SSRI use, boredom, and depression. The most straightforward explanation is that SSRIs, as the first-line psychopharmacological intervention for clinical depression (Luo et al., 2018), may not directly alleviate boredom. Instead, the elevated rates of boredom and depression among long-term SSRI users could reflect expected differences between depressed individuals taking SSRIs and non-depressed, non-SSRI users. Given copious research establishing a strong association between boredom and depression (Farmer & Sundberg, 1986; Goldberg et al., 2011; Gordon et al., 1997; LePera, 2011; Vodanovich, 2003), it is unsurprising that our results similarly indicate a positive correlation between state, trait, and sexual boredom and depression levels, regardless of SSRI use. These findings provide further support that boredom, along with depressive symptoms, may be an important clinical indicator of an individual’s psychological functioning and a useful gauge of treatment response.

Boredom, Depression, and SSRI-Response Over Time

While our results partially support our hypothesis that SSRI use is associated with increased sexual boredom, when participants were categorized based on the duration of SSRI use, we found notable differences in rates of state boredom, boredom proneness, and sexual boredom among non-SSRI users, short-term SSRI users (6 weeks to 2 years), and long-term SSRI users (over 2 years). Specifically, short-term SSRI users reported significantly higher rates of state boredom and sexual boredom than individuals who were not taking SSRIs, even after controlling for depression. However, differences in boredom proneness were no longer significant after accounting for depression, suggesting that trait boredom is more closely linked to depression symptoms than SSRI use. This aligns with the expectation that SSRIs primarily target depression (Vaswani et al., 2003). As such, it is possible that as symptoms of depression diminish due to continued SSRI use, improvements in psychosocial functioning allow SSRI users to engage meaningfully with their environment, which leads to a consequent alleviation of boredom. In other words, while improvements in depression may contribute to reductions in boredom-related distress, our findings suggest that boredom does not remit solely as a function of depression improvement. Instead, the differences in boredom seen between short-term and long-term SSRI users may reflect a separate process of adaptation over time. This aligns with prior research suggesting that boredom and depression are closely linked, yet distinct experiences (Goldberg et al., 2011; Merrifield & Danckert, 2014; van Hooft & van Hooff, 2018; Wolff et al., 2022). While depression may amplify boredom, it does not appear to be the sole precursor, as some boredom symptoms persisted even after controlling for depressive symptoms. This contributes new insight into the directional relationship between boredom and depression.

Comparisons within the SSRI group (short-vs long-term) were underpowered unless effects were large (minimum detectable d ≈ 0.80). Therefore, the absence of differences between short- and long-term users should be viewed as inconclusive rather than as evidence of equivalence. Our inferences are strongest for contrasts that our sample could detect with reasonable sensitivity (non-users vs short-term SSRI). Claims about stability or remission of boredom among long-term users should be tempered pending adequately powered replication.

Boredom and Barriers to SSRI-Treatment Adherence

Alternatively, our findings suggest that individuals with elevated levels of boredom may struggle to maintain long-term SSRI treatment, which points to the possibility that boredom may drive SSRI treatment dropout. If elevated levels of sexual and state boredom persist for up to two years of SSRI treatment, it is possible that individuals who find boredom to be especially aversive, or those whose boredom was previously masked by depression, may be inclined to prematurely discontinue their use of antidepressants due to a misattribution of their experiences to boredom as a side effect of their antidepressants. This explanation is even more compelling when coupled with the high prevalence rates of antidepressant-attributable sexual dysfunction (Kennedy et al., 2000; Modell et al., 1997; Montejo et al., 2001; Rothschild, 2000). Sustained high levels of boredom combined with treatment-emergent sexual dysfunction may exacerbate negative feelings towards antidepressant use, create barriers to medication adherence, and may lead individuals experiencing lower boredom levels to stay on SSRIs longer.

Short-term SSRI-related boredom may be linked to emotional blunting (Opbroek et al., 2002), a commonly known side effect of SSRIs, which may also drive treatment dropout. It is possible that as SSRIs inhibit emotional responses to sadness, they inadvertently diminish emotional responses to creativity, pleasure, motivation, and interest, which may in turn induce feelings of boredom. Unfortunately, however, due to the limits of the cross-sectional design, we are unable to discern whether SSRIs contribute to increases in boredom. This is something that should be explored in future longitudinal studies.

SSRI Use, Depression, and Sexual Boredom

Our findings indicate that sexual boredom may have less in common with depressive symptomatology and may be more closely linked with pathological expressions of boredom and boredom-coping. When state and trait boredom measures are controlled for, group differences in sexual boredom disappear. These results indicate that sexual boredom may align more closely with a general disposition toward boredom rather than depressive symptomatology, supporting the hypothesis that boredom and depression, while related, are distinct affective experiences. It is also possible that short-term antidepressant users experiencing aversive boredom may be at greater risk for adopting behavioral coping strategies that involve sexual and non-sexual risk-taking and sensation-seeking in an attempt to self-regulate and mitigate their unfavorable experiences of boredom, an explanation that is theoretically supported by decades of research linking boredom with risk-taking and sensation-seeking behaviors (Kılıç et al., 2020; Todman, 2003), impulsiveness (Boden, 2009; Moynihan et al., 2017; Watt & Vodanovich, 1992), hypersexuality (Klein et al., 2015; Stulhofer et al., 2008, 2016) and paraphilic pornography use in men (Stulhofer et al., 2010). While our findings indicate that state boredom and sexual boredom are elevated in short-term SSRI users compared to non-users and long-term users, future research should investigate whether impulsivity and sensation-seeking moderate this effect. Understanding whether individuals experiencing heightened boredom during early SSRI treatment turn to risk-taking behaviors as a means of coping may have important implications for treatment adherence and long-term outcomes.

Clinical Implications and Future Directions

Although boredom is not a listed diagnostic criterion for Major Depressive Disorder (MDD; ICD-F32; American Psychiatric Association, 2013), our results indicate that boredom can serve as an adjunctive transdiagnostic cue that may alert clinicians to the possible presence of depressive symptomatology. This claim is embedded within a larger literature linking boredom and depression (Goldberg & Danckert, 2013; Lee & Zelman, 2019; Mercer-Lynn et al., 2013). Clinicians treating SSRI users should provide psychoeducation around boredom and implement interventions aimed at coping with aversive boredom. Should future longitudinal work provide further support for our findings, which suggest that SSRIs may have delayed effects on addressing boredom, providing strategies to cope with boredom could encourage SSRI treatment compliance. The findings also hint at the possibility that in formal drug trials involving antidepressants, outcome measures specifically designed to assess changes in boredom should be included, as it may be an underappreciated lagging indicator of depression-related distress. However, these are tentative conclusions that require future studies utilizing a prospective, longitudinal design.

Limitations

Though this study is the first of its kind to explore the relationship between SSRI use and experiences of boredom, there are several notable limitations. First, the cross-sectional nature of this study means that we are unable to draw causal inferences about the directionality of our findings. Another limitation is the small (n = 50) number of participants who reported SSRI use, which presents an obvious challenge in terms of generalizability; our power and sensitivity analyses clarify that while the comparison between short-term SSRI users and non-users was sufficiently powered to detect the observed moderate effects, comparisons within the SSRI-using subgroup (short-vs long-term) were underpowered unless effects were large. As such, null differences within SSRI users cannot be taken as evidence of equivalence, and longitudinal designs or larger clinical samples will be needed to characterize boredom trajectories over longer SSRI treatment durations. A third limitation is the fact that the study utilized an online sample, which means that all data, including information on SSRI use, adherence, and psychiatric diagnoses, were obtained via self-report and thus subject to the types of biases and unreliability that are typical of such data. However, care was taken to ensure response integrity. For example, although there is no way to guarantee the veracity of the responses provided by the participants, the internal consistencies (i.e., Cronbach’s α values) for each of the measures used in the study were observed to be uniformly robust.

As we previously noted, in the current study, we only included participants who were taking one class of antidepressants (SSRIs), thereby limiting our ability to generalize the current findings to another class of antidepressants. Nonetheless, it is our belief that the loss in generalizability is more than compensated for by the protection gained against the potential confounding that would arise from the inclusion of multiple classes of antidepressants. Also, SSRIs are the most widely prescribed class of antidepressants and have higher rates of treatment-emergent sexual dysfunction than several comparators (e.g., bupropion; Pereira et al., 2014). Lastly, our study did not control for past antidepressant exposure, which could influence the data through post-SSRI sexual dysfunction (PSSD). PSSD is characterized by persistent sexual dysfunction extending beyond discontinuation of SSRIs (Reisman et al., 2022), but is notably difficult to study incidence rates (Healy & Mangin, 2024). Given these unmeasured factors and our cross-sectional design, our research should be interpreted as conceptual, exploratory, and hypothesis-generating rather than causal.

Future Directions

In future studies, we recommend recruiting from clinical populations where medication adherence can be verified and where diagnoses can be confirmed by healthcare professionals. Incorporating randomized question order and attention checks in future iterations of the survey will further enhance data quality. Future surveys should also include the Sensation Seeking Scale (Zuckerman, 1979), which contains a subscale that measures the trait of boredom susceptibility, upon which the Sexual Boredom Scale was conceptualized (Watt & Ewing, 1996). Furthermore, future investigations should explore the effects of a broad range of antidepressant classes.

Future studies should also consider a longitudinal approach to better understand how antidepressant use impacts experiences of state, trait, and sexual boredom over time, and how common side effects such as emotional blunting and sexual dysfunction impact boredom levels. Relatedly, studies should explicitly capture lifetime antidepressant exposure, including class, dose, timing, and previous SSRI usage, as well as screen for PSSD. While the present study provides useful insights into some of the lesser-known effects of SSRIs, it would also be useful to investigate whether faster recovery from sexual and state boredom is possible with alternative, faster-acting antidepressant interventions like ketamine and electroconvulsive therapy (ECT). Finally, because boredom proneness is presumed to be a trait variable, future longitudinal studies should be used to explore whether higher levels of boredom proneness are a risk factor for sexual boredom and other depressive features.

Footnotes

ORCID iDs

Juliana Riccardi

Emily Weiss

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was supported in part by grant funding from the International Honor Society in Psychology (Psi Chi) and by a departmental research award from The New School’s Department of Psychology.

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Data Availability Statement

The datasets generated and analyzed during the current study are available in the Open Science Framework repository (Riccardi, 2025).

Author Biographies

Juliana Riccardi (BA) is an Associate Researcher at Jamaica Hospital Medical Center in Queens, New York. She has a BA in Psychology from The New School, as well as extensive research experience across the fields of health science, and clinical and applied psychology.

Ali Revill (MA) is a Doctoral Candidate in Clinical Psychology at The New School. Her research focuses on psychopathology, psychological boredom, and addictive behaviors.

Sally McHugh (MA) is a Doctoral Candidate in Clinical Psychology at The New School. Her research focuses on the role of boredom in clinical settings.

Emily Weiss (PhD) is an Associate Research Scientist in Psychiatry at the Yale School of Medicine. Her publishing record spans areas of psychopathology, with an emphasis on hoarding and eating disorders, as well as boredom proneness.

Panteá Farvid (PhD) is an Associate Professor of Applied Psychology withing the School of Public Engagement and the chair of psychology in the Bachelor's Program for Adults and Transfer Students (BPATS). Dr. Farvid is also the Vice President of Democracy and Culture in the New School's Office of University Initiatives. She teaches courses in social and applied psychology, psychology for social change, reseach methods, psychology of gender and sexuality, and psychology and technology.

McWelling Todman (PhD) is a Professor of Clinical Practice at the New School for Social Research. Dr. Todman has an extensive publishing history focusing on psychopathology along the schizophrenia spectrum, chemical and behavioral addictions, psychotic and addictive behavior, the assessment and classification of psychiatric disorders, and the psychological derivatives of boredom and boredom proneness.

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