Can Depression Ruin Your Sex Drive?
Take a breath and think back over the last week. Try to find a moment of pleasure in it. A good smell, maybe. Something you saw that struck you as beautiful. A bite of food that tasted exactly right. If nothing comes to mind, if you catch yourself staring at the floor thinking you have no idea what could make you feel happy anymore, that blankness is one of the quieter signs of depression. It tends to arrive as a slow pulling-away from the world, from your own feelings, from other people, from the things you used to do without thinking.
That disconnection isn't imaginary. There's a physical reality to it, and part of what it does is strip the enjoyment out of activities that used to reliably please you. Depression doesn't stay in one corner of your life. It reaches into everything, and sex is no exception.
When researchers have asked people why they have sex, two answers keep surfacing: for the pleasure of it, and to feel close to another person. Men and women say roughly the same thing. So consider what happens when the capacity for pleasure itself gets dimmed. Libido drops, partly because motivation of every kind drops, and the wish for sex goes down with it. Even sexual fantasies start to fade. Given that, the fact that so many people with depression report a lower sex drive isn't surprising at all.
Now stack that on someone who already feels swamped, who is worn out, who struggles to get through an ordinary day. Sex becomes one more thing they move through on autopilot. Partners often notice this and want to fix it. They ask what they can do to bring back some fun, and frequently the depressed person can't answer. They've lost the thread to their own pleasure and can't point toward it.
Stress, depression included, doesn't land on everyone the same way. There are people with depression who say their sex drive actually goes up. Sex gives them a physical lift and a feeling of being wanted and accepted. That makes sense when you think about how all of us handle bad feelings. By the time we're young we've already picked up tricks for soothing ourselves, and we keep collecting them: flip on the TV, go for a run, eat something sweet. Depression means feeling low most of the time, so these self-soothing habits get worn into deep grooves and run almost without permission. Some of them genuinely help. Some quietly make the situation worse.
Reaching for sex can land on either side of that. It can feel good emotionally and physically, which is real relief. But some people with depression say it doesn't hold up over time, because what they feel about performance, about pleasure, about love, ends up pulling against itself. That tension can turn into a loop: the sex deepens the depression, the depression sharpens the urge to escape it, and around it goes.
Talk with people who are depressed and you often find yourself in conversation with a sharply self-critical mind. There's a habit of holding high, sometimes impossible expectations, and a pull toward replaying the worst parts of past experiences. Plenty of sex therapists will tell you perfectionism works against sexual satisfaction. Loading a sexual encounter with unrealistic standards breeds pressure and stress, and that makes it hard to just be there for the pleasure of the moment.
It's fairly well known by now that some widely used antidepressants can lower sex drive as a side effect. The cruel part is that for certain people, that side effect can feed back into the depression it was meant to treat.
There's another side to this. Not everyone gets those side effects, and some of the newer antidepressants are actually gentler on sexual function. If you're on medication for depression, raise it with your doctor. Be specific about what you're hoping for sexually and about the symptoms you're noticing. The medication may still be your best option, and there are usually ways to blunt its effect on your sex life.
If you're depressed, getting help matters. Find a therapist you feel at ease with and say out loud the things worrying you about your sexuality. And if you're in a relationship, remember your depression touches your partner too, which is why couples therapy can be a useful place to talk through sexual concerns together.
Begin small. Call up one moment of pleasure and let yourself smile at the memory of it. That's a fine place to start.
Jeff Stein, drawing on Dahlen, D. (n.d.), Relationships / Blog, retrieved December 9, 2014, from PBS, This Emotional Life.