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Why do people get depressed in the days after taking ecstasy?

“Some people I know who use pills and caps on the weekend seem to get really depressed in the days after. I used to think it was just because they’d had a ‘big weekend’ but does it have something to do with the drugs they’re taking? Does MDMA cause depression?” 

Many people who use ecstasy (MDMA) report feeling down and depressed in the days following taking the drug. This often leaves them feeling as though they are unable to cope with everyday problems the way they normally would and, as a result, adversely affects their relationships, employment or education. In fact, this is one of the main reasons why many people make the decision to stop using MDMA.

When ecstasy is taken it increases the activity of a number of neurotransmitters (chemicals in the brain), including serotonin. Serotonin is the ‘feelgood’ transmitter, affecting things like mood, appetite and sleep. Increased serotonin levels are believed to be the main cause of the ‘ecstasy-effect’, and the reason why the drug is popular. At the same time, MDMA also depletes serotonin. This is because when large amounts of serotonin are released, it doesn’t just hang around and wait to be used again at a later date. It gets broken down or metabolised away – it’s been used up. As a result, your brain is left with less serotonin than it would normally have. Unfortunately it then takes some time for it to replenish its supply.

It is unclear as to how long it takes for serotonin levels to return to normal, but it is believed that it can take at least a week and, in some cases, even longer. As always, this depends on many factors including diet, frequency of use, dose level and what other drugs were used. During the time it takes for serotonin levels to return to normal, users may experience a range of adverse effects including depression, irritability and lethargy. These effects are more likely if ecstasy is used regularly.

Of course, some people never experience post-E depression. Everyone is different and each serotonin system is unique. It seems that some people are simply more sensitive to MDMA than others.

First published: July 2021

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