Depression And Sex: How Depression Affects Your Sex Life

Depression has an impact on many facets of daily life. Work, school, friendships, family relationships, and more. But for many, its impact is felt most significantly in matters of sexuality and intimate relationships. Its effects can be felt twofold: not only do the symptoms of depression often decrease libido and drive, but sexual dysfunction is counted among the many side effects of common depression medications (particularly SSRIs). 

For some relationships, sexual intimacy isn’t as important for establishing and maintaining connection- but for many, a healthy sexual connection is critical. Although depression often affects sexual relationships, it’s prudent to note that it can also result in loss of interest in any type of sexual activity, including masturbation and sexual fantasies. 

Regardless of how low libido affects you, it can create a negative cycle of feelings of guilt and frustration that feed depression. In this post, we’ll examine the symptoms of depression,  how they affect sexual libido, and what you can do to recover your sexual desire and build healthy sexual relationships again.  

Depression Symptoms And Risk Factors

Understanding the relationship between sex and depression begins with recognizing its most common symptoms. According to the Diagnostic Statistical Manual of Mental Disorders (DSM-V), major depression disorder diagnosis is concluded when five or more of the symptoms below last for two weeks or more and have a marked impact on daily functioning. Symptoms can range from mild to severe and may include:

• Intense feelings of sadness and low mood

• Feelings of excessive guilt or shame without cause

• Feelings of hopelessness, unworthiness

• Loss of pleasure or interest in formerly enjoyed activities

• Fatigue, loss of energy

• Changes in appetite leading to weight fluctuations

• Sleep disruptions

• Difficulty concentrating

• Persistent thoughts of  death, suicidal ideation

If you or a loved one are experiencing suicidal thoughts, reach out for help immediately. The National Suicide Prevention Lifeline: can be reached at 1-800-273-TALK (8255) and is available 24/7.

In most cases, signs of depression appear in the late teens throughout the 20s. While there are many risk factors for depression, it appears to be highly inheritable from first-degree relatives (parents, siblings). Also, studies suggest that women are more likely to experience depression. 

Other Risk Factors Include, But Aren’t Limited To-

• Past trauma

• Compulsive drug and alcohol use

• Devastating loss or tragedy

• Chronic stress

• Chronic physical health conditions, particularly involving frequent or constant pain

Translating Symptoms Of Depression To Loss Of Libido

Every symptom of depression impacts sexual health in some way, some more than others (the inability to find pleasure or happiness in things you once enjoyed is a big one). Here are some common ways that depression symptoms cause issues of sexual desire and intimacy:

Depression Impacts Self-Esteem

From feelings of hopelessness to body image issues potentially resulting from weight fluctuations, almost every symptom of depression can negatively affect our self-esteem, which directly impacts our libido. It can make people frequently avoid sex and/or have reluctance initiating sex. When sex does occur, many people experiencing low self-esteem are less likely to enjoy it or help their partner achieve satisfaction. Part of the reason for this is chronic rumination during sex- where instead of being “in the moment,” the mind focuses on worries over sexual proficiency and physical appearance. 

Feeling Sexually And Emotionally Distant

Often depression causes feelings of emotional disconnection, which can often lead to sexual disconnection. Again, the reason for these feelings may be seeded in the symptoms of affect, but also because of the loss of concentration often associated with depression. If your mind is elsewhere during sex, your partner will likely register this as detachment, potentially causing you both difficulties achieving sexual satisfaction. 

Feelings Of Guilt And Shame

Societal and familial stigma about sex may be difficult to cope with, but when we add baseless feelings of guilt and shame to the equation, it can interfere with the way we think about sex in general. When we feel guilty about having sex, it feeds the symptoms of guilt associated with depression, causing a negative cycle. Also, a hallmark of depression is reliving past perceived “transgressions” and the negative feelings associated with them, causing problems for people who feel as if they’ve done something “wrong” in their past sexual relationships. 

Impact Of Past Trauma

When an individual has depression as a result of a traumatic experience, particularly related to physical and/or sexual abuse, it can have a seriously negative impact on sexual desire and the ability to feel sexual pleasure- with one 2018 study from the University of Texas, Austin identifying “comorbid PTSD and depression as correlates of sexual dysfunction.”

Communication Barriers

Communication is key in any relationship, including communicating about sex. Depression can result in anxiety about communicating with your partner, leading to avoidance. Depression is also an isolating disorder, causing many who have it to feel as if no one will understand their experiences and difficulties. 

Physical Causes

Many people experiencing physical disorders report comorbidity with depression that may negatively impact sexual function. For example, high blood pressure, fluctuating hormone levels, physical discomfort due to headache and gastrointestinal distress, and more. In addition, sleep disruptions and drug and alcohol use commonly associated with depression can have a biological influence on sexual desire. Research also cites depression, anxiety, and other mental health issues as potential causes of erectile dysfunction (ED). Some anti-depressants such as SSRIs and other prescription medications can contribute to ED and decreased sexual desire for women, too. 

Recovering Your Sex Life

Although symptoms of depression can often make people feel hopeless to fix the problems in their lives- it is possible to recover your libido and heal your relationship with your partner:

Visit Your Doctor First 

While depression is a common cause of sexual dysfunction, it’s important to visit your primary care physician (PCP) to address and/or eliminate any physical causes. Consider getting a complete physical examination including lab work and an evaluation of your family medical history. Communicate with your doctor about your symptoms and depression, and partner with them on a course of treatment. 

Many find it difficult to talk openly about sex, particularly on topics of sexual dysfunction, but it’s important to remember that your doctor is there to help. Whether they find a physical condition causing your lack of sex drive, or they eliminate physiological reasons all together, they’ll likely recommend open communication with your therapist, especially before changing any medications you might be taking.

Talk To Your Therapist

After potential physical causes have been addressed, you should speak candidly with your therapist about your libido issues. Again, it may be difficult, but healthy sexuality is holistic and both physical and mental variables must be addressed for proper treatment of sexual problems. (If you aren’t seeing a therapist, now is a good time to seek help.) Your therapist will likely address your decrease in sexual desire using psychotherapy, most commonly cognitive behavioral therapy (CBT) with the goal of changing the way you think about sex and your relationship with your own sexuality. If necessary, your mental health professional will also partner with your PCP or psychiatrist to adjust any medications you may be taking if they establish that it’s contributing to your low libido. 

Consider Couples Therapy 

Couples therapy is an effective way to address and resolve issues of sexual intimacy, with research indicating a positive impact on roughly 70% of couples who adhere to treatment. Couples often find it easier to communicate openly with the mediation of a mental health professional, not only about thoughts and feelings but sexual desire and interaction. A relationship therapist can help the couple uncover the root causes of their relationship difficulties, actively listen to each other’s perspective, and learn how to understand them in a nurturing way. 

Therapists who specialize in helping couples often use the same, or similar methods of treatment that individual therapists employ. One of the most common is cognitive behavioral therapy (CBT), a method of treatment that focuses on helping the patient recognize “thought distortions,” or the unhealthy thoughts the individual has that lead to troubles with behavior and emotional processing. Once thought distortions are identified, the patient and therapist work together to reframe them in a way more aligned with outside reality. Changing these perspectives changes the individual’s relationship to their thoughts, improving overall mental well-being. 

Takeaway

If you have symptoms of depression, including waning sex drive, you’re not alone- research indicates that one in six people will experience depression at some point in their lives. Despite its pervasiveness, it’s estimated that only 66.0% of adults in the U.S. seek treatment. The reasons for this are varied, ranging from familial/societal stigma, inaccessibility to a therapist in the area, difficulty scheduling and keeping appointments, and more. In the case of couple’s therapy- coordinating busy schedules around sessions, discomfort over talking to a therapist in person,  and worries over the affordability of therapy provide unique boundaries. 

Online therapy through platforms like BetterHelp offers an effective solution to such obstacles, providing people with convenient, affordable therapy that’s as effective as traditional therapy. For example, one study measuring the self-reported experiences of 318 individuals with depression found that “Users of BetterHelp experienced significantly reduced depression symptom severity after engaging with the platform.” Online couples therapy is also as effective as traditional therapy for helping partners resolve and move beyond relationship difficulties.

You can speak to a BetterHelp therapist online at your convenience, from the comfort of home via text, phone, online messaging, and video chat- and if you need assistance between appointments, you can message your therapist any time 24/7. Online therapy is also often more affordable than traditional therapy without insurance. 

If you’re ready to renew your connection with your partner and your sexuality, help is available. Contact a BetterHelp therapist to get started.