Depression And Relationship Sex
When people are depressed, sex could very well be the furthest thing from their minds, says Liesel Sharabi, PhD, an assistant professor of communications at West Virginia University.
In one of Sharabis studies, , one guy talks about how his depression makes it difficult for him to be around anyoneincluding his partner. I just want to be left alone so that I dont get in a bad mood, he says. Another man in that study says, Everything feels like an effort. That includes sex.
Interestingly, her research has also shown that couples in which one person, but not the other, is depressed tend to experience more sexual challenges than couples in which both people are depressed. The asymmetry depression creates can make it difficult for the depressed man and his mate to get on the same page sexually, she says.
When a man feels bad about himself, he might not feel confident or worthy of a connection with his romantic partner, adds Amy Delaney, PhD, an assistant professor at Millikin University in Illinois and author of a 2018 study on depression and sexual intimacy.
Depression can also leave men feeling alone and isolated, Delaney says, which can interfere with his desire or ability to be intimate with his mate.
The Effects Of Antidepressants On Sexual Health
Complicating sexual health problems for people with depression is this: A diminished libido, erectile dysfunction, delayed ejaculation and anorgasmia are also common side effects of antidepressants. But antidepressants are often highly effective and even lifesaving for treating depression.
Many of our medications to target depression can have sexual side effects, and the challenge we have as providers is always navigating the fact that depression in and of itself contributes to those symptoms, as do some of our medications, Dr. Frische says.
To help address these side effects, your provider may try to put you on the lowest effective dose of an antidepressant. Or your provider may try switching to a different medication with less likelihood to impact sexual health or add a medication that can counteract the side effects.
For example, Lexapro or Zoloft are common antidepressants. If they have an adverse side effect for your libido but are very effective in treating your depression, we dont necessarily need to stop the medication that works. We can actually add Wellbutrin, a different class of antidepressant, to counterbalance sexual side effects, Dr. Frische says.
In addition, your provider can determine if there are other factors affecting your sexual health, such as hormonal imbalances like decreased testosterone, or other medications you are taking, including birth control.
Causes Of Libido Loss
Medications that often drag down your sex drive include antidepressants and blood pressure medications, antihistamines and — ironically — oral contraceptives. But meds are just one of a myriad of libido busters. Other common culprits include:
Erectile dysfunction. ED might not cause a drop in your sex drive, but worrying about it sure can.
Menopause. Hormonal changes can make sex painful, but don’t ignore the other related causes that can sap your sex drive. Low self-esteem and body image blues are big turnoffs.
Depression. A vicious cycle, depression can cause your sex drive to dip precipitously, and that drop-off can further fuel your depression.
Stress. Worrying and wooing do not mix. Stress keeps you from focusing on your partner — and your pleasure — and saps the energy you need to perform.
Alcohol. You may feel like Don Juan after a couple of drinks, but alcohol can leave you feeling numb just when you need to be aroused.
Other causes include sleeplessness, lack of intimacy, obesity — we could go on. Sex drive killers are legion, after all. Rare, though, are doctors who ask their patients about their sex lives.
“Doctors are just not good at asking about it, even gynecologists,” says Carolyn Nemec, MD, a family physician who specializes in female sexual dysfunction and sexual medicine at the Cleveland Clinic.
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Talking With Your Partner
Communication is an important part of a healthy relationship. When you and your partner are dealing with sexual difficulties, its even more important that you can talk to each other.
Discussing these topics may be emotionally intense and will require both of you to find time for the conversation, but it’s important that you do. Maintaining open dialogue is part of keeping your relationship strong.
Together, you and your partner can create a space in which you both feel safe expressing your feelings. By the end of the talk, you will each ideally come away feeling heard, understood, and that you have the other person’s love and support.
Every couple has their own way of communicating and each person in the relationship has a different style of expressing how they feel. Your individual emotional and sexual needs are unique, but you may find these general guidelines can help you both communicate more effectively.
What Is Low Libido
Low libido is a decrease in an individual’s baseline sexual desire or desire for sexual activity. This level is different for different individuals and can even vary throughout an individual’s lifespan. It can be the product of a chemical imbalance produced by medications, physical illness, psychological diseases, or a physical problem with obtaining and maintaining an erection in the case of men or adequate lubrication in the case of women.
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Depression Is An Antithesis To Sex
Depression takes the fun out of everything. Things that used to be enjoyable spaghetti, a cup of coffee in the morning, listening to music, or bingeing on your favourite tv series just isnt the same anymore. It leaves you feeling hollow and empty inside.
Oftentimes, depression leads you to draw away from other people, too. You cancel dinner plans and stop moving your body, and if it gets really bad you end up isolating under your covers at home.
Add to this, difficulties sleeping, anxiety, and general feelings of numbness, and the question quickly goes from can depression affect sexual desire to: why wouldnt depression affect sexual desire?
Sex is all about joining together with other and creating intimacy and connection. Its about experiencing pleasure, losing yourself in the moment, and feeling good about yourself.
Sex is like a mini-celebration of life, tying together both physical and mental enjoyment.
Depression wants none of this for you and so you experience a drop in desire.
Talk To A Medical Professional
Talking to a medical professional can be a good first step when you are experiencing issues with depression and libido. You might choose to talk to your family doctor or you might want to consult with a sex therapist or a psychiatrist.
The Blueheart App was created by therapists that specialize in libido problems. Developed using the latest research on the matter, 93% of respondents have found it to be effective.
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Ask About A Lower Dose
With your doctor’s guidance, you may be able to take a lower dose of your antidepressant. Some people find this change is enough to reduce the sexual side effects while still effectively treating their depression.
Research has shown that some people with depression prescribed a standard dose of 20 milligrams of Prozac per day felt their symptoms were as well-managed when they only took 510mg a day. Plus, they experienced fewer side effects on a lower dose.
Take Steps To Relieve Stress
In some cases, stress contributes to feelings of low libido and depression. This can lead to a cyclical pattern, where having a low libido causes even more stress. Taking time for stress-relieving activities often makes a difference. Consider meditating, journaling, exercising, or listening to music. Finding ways to relax as much as possible may help reduce symptoms of both conditions.
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When It Is More Than Just A Bad Day
Everyone can have a bad day or even a bad week – especially these days. However, when these feelings persist and are prolonged, accompanied by loss of appetite, weight loss or gain, trouble sleeping, difficulty concentrating, low energy levels and loss of sex drive or libido, you might be dealing with depression.
In times of stress, sadness, or grief some crave more physical intimacy and closeness while others desire less sexual or physical connection. Both responses are okay. There is no right way to navigate through pain or loss. For those of us who find their sexual expression closely linked to their self expression, this shift can have a significant impact on romantic relationships.
The whole process of sexual arousal starts with the ability to anticipate pleasure, which is lost with depression, says Frederick K. Goodwin, MD, who serves on the scientific council for the National Alliance for Research on Schizophrenia and Depression. People who are depressed are locked in the moment of their suffering and for most of us thats not where the erotic lives.
Along with treating your depression there are ways to navigate both loss of your own sexual appetite or your partner.
Low Sex Drive In Women
Various types of sex drive affect nearly 40 percent of women overall and about 12 percent of women in the United States.
Cultural aspects of a persons upbringing, such as religion and subtle messages about female body anatomy passed through generations, can affect someones perception and understanding of their sexuality. Familial and cultural influences have a lot to do with the psychological aspect of sexuality.
Having a background and upbringing that included body shame or messages that having sexual desires is wrong or immoral can lead someone to experience a low sex drive.
Here are the five most common reasons that lead to low libido in women.
Stress is one of the most frequent causes of low sex drive. Common stressors that can affect a persons overall well-being, including their sex drive, include:
- Financial problems such as debt or low income
- Stress at work such as a hostile or dysfunctional work environment, long hours, overworking, and a lack of motivation or appreciation for efforts
- Relationship problems such as unaddressed relationship issues, lack of communication about sex, and lack of emotional support
- Family issues such as parenting and pregnancy and not having enough help or support with children and housework
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Lean Into Other Relationships
If your relationship construct supports multiple intimate connections, then lean into those relationships for sexual play while remaining emotionally and mentally engaged in your other relationship, as well as emotional support if you are the one struggling with depression.
Remember that no matter your situation, you are not alone. According to the National Institute of Mental Health an estimated 17.3 million adults in the United States had at least one major depressive episode and over 40% of those report loss of libido. Seek help. Connect with friends, family, and community. You can feel better with some time, support, and curiosity.
Still have questions? Check out the podcast, or find community on and . You do not need to figure this out on your own stay find and connect with a curious community of friends.
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The Effect Of A Low Sex Drive On A Relationship
When one or both partners experience low sex drive, it can definitely have an effect on the relationship. After all, sex is a big part of romantic relationships, and when theres a strain on your sex life, its likely to carry over and strain the relationship as a whole.
Oftentimes, someone may take it personally if their partner has a low desire for sex and think that theres something wrong with them, when this certainly isnt necessarily the case. As discussed above, there are plenty of reasons someone might have a low sex drive, and a lot of them arent related to the other partner at all.
The myths associated with sex drive can often lead to confusion, frustration, and hurt feelings within the relationship, says Talkspace provider Rachel ONeill, Ph.D. Instead of discussing sexual desire and things that make an individual feel sexually aroused, individuals may internalize the issue of low desire as some sort of personal shortcoming on their part. Often, an individual who experiences low sexual desire may begin to believe that there is something wrong with them, which can lead to feelings of shame and guilt.
When someone internalizes and conflates their partners low sex drive with their own attractiveness or desireability as a partner, it can really put a damper on their self esteem. The partner may feel extra self conscious thinking that they are the problem.
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What To Do If Depression Affects Your Sex Life
For some depressed men, the solution really is as simple as changing medications, Delaney says.
For others, professional counseling is the way to go. But if youre in a relationship, its important to include your partner. Standard treatment protocols really only focus on the individual, she says. But solo therapy often ignores the effects a mans depression is having on his partner and their relationship as a whole, she adds.
I’d advocate for a treatment approach that widens the lens to include , she says. If couples can work together . . . they may be able to better address the sexual intimacy challenges that accompany one or both partners’ depression.
Taking a break from sex may also help, Kerner says. He explains that, if youve been struggling in the bedroom, taking sex off the table can help relieve some of the pressure. Especially if you have a tremendous amount of anxiety around sexif its something youre feeling very stressed or guilty or ashamed abouttaking a sex break can help.
Instead, you and your partner could experiment with other forms of intimacystuff like holding hands, kissing, and outercourse, he says. Not feeling that one? Maybe try the exact opposite approach: Just do it, regardless of how you feel. You may quickly come around to sex once youve initiated it, Kerner says.
Take A Medication Holiday
If your doctor would prefer to stay on the same dose of your medication, you may be able to talk to them about taking periodic breaks or “drug holidays.” Some people find that scheduling a day or two off from taking certain antidepressants, such as Zoloft and Paxil, allows them to get relief from the side effects without interrupting the therapeutic benefits.
However, this strategy may not work with every antidepressant. Prozac, for example, has a much longer half-life than most antidepressants, which means the level of the drug remains consistent in your body for an extended period of time after you stop taking it.
The drugs long half-life can be beneficial when youre trying to stop or switch antidepressants . But, it also makes taking a holiday from the medication more difficult.
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Try Exercise If Its Safe For You To Do So
A study in 2004 found that both aerobic and non-aerobic workouts improved depression symptoms. And the benefits were long-lasting.
So, if its safe for you to exercise, lacing up a pair of workout shoes and heading to the gym might not only help your physical fitness, but also have a positive effect on your sex-related depression symptoms.
Your Medicine Is Affecting Your Libido
Certain medications have a side effect of reducing your sex drive, especially some commonly prescribed antidepressants.
SSRIs, which are used to treat depression, often reduce your libido, says Dr McClymont. Corticosteroids, blood pressure medications particularly diuretics and antipsychotic drugs can all also affect libido. There are various other medications that may also have an impact too.
If youre concerned about a particular medication, it is best to speak to a doctor.
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Do Antidepressants Hurt Sex Drive Scientists Split Fact From Fiction
Antidepressants can be lifesaving. But some men with depression are worried about the sexual side effects.
Most antidepressants warn of two potential side effects: low libido and difficulty reaching orgasm.
Peter, a 34-year-old man who lives in Oregon, knew this. Itâs exactly why he wasnât sure if he wanted to take the antidepressants his psychiatrist recommended.
âObviously, I wanted to do something that would help my depression,â Peter tells Inverse. âBut I didnât want to lose my sex life in the process.â
Seth Norrholm, a translational neuroscientist and expert in stress and trauma disorders, says Peterâs concern is quite common.
âBoth scientific journal reports and anecdotal case summaries have identified hesitancy to take antidepressants because of sexual side effects,â Norrhold tells Inverse.
Itâs a tough call: Antidepressants can be lifesaving for some people, but many also donât love the idea of sacrificing their sex life.
If you’re questioning what’s right for you, consider this: You have options. No one is affected by an antidepressant in exactly the same way, and no one will force you to stick with a treatment that doesn’t work. Consider the research and what your body needs.
Hereâs the science behind some of the biggest questions you’re likely asking.
Hormones: Helpful And Harmful
Finasteride is a 5-alpha reductase inhibitor these types of drugs can affect the way hormones are processed and transformed by our bodies. The male sex hormone testosterone helps men build muscle and have a healthy sex drive, but it also produces hair loss in genetically susceptible individuals. Finasteride blocks the conversion of testosterone to its more potent cousin, dihydrotestosterone . High levels of DHT can cause hair loss, so drugs that halt that hormones production can help combat it.
Finasteride was first marketed over 20 years ago as a treatment for urinary symptoms in men with enlarged prostate glands. Since then, the drug has also found use as a treatment for male pattern baldness. Many men who are losing their hair can slow or even reverse the process by taking a much lower dose of finasteride than is used to treat an enlarged prostate.
Reggie had obtained his finasteride from an online pharmacy after hed noticed his hair was falling out and became worried about his appearance. Since taking the drug, his hair loss had largely stopped. In addition, he told me that he was definitely starting to see some new hair growth a welcome sight.
Regardless, the symptoms Reggie was describing to me sounded like they could be attributed to the adverse side effects of finasteride.
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