Sexual Problems and Depression

If you are depressed and have sexual problems as well, you're not the only one. Sexual problems, such as erectile dysfunction (ED) or lack of orgasm - anorgasmia - often exist alongside depression. Happily, doctors can treat sexual problems at the same time as depression.

How are sexual problems and depression linked?

The brain is a very sensitive sex organ. Indeed, sexual desire begins in the brain and flows along neural pathways thanks to special chemicals known as neurotransmitters. These increase communication along nerve cells and work to stimulate blood flow to the sexual organs. But when a person's depressed, brain chemicals become out of balance.

Many women and men who are depressed speak of low or absent sexual desire. Of course this can be troubling for sexual partners in intimate relationships.

Are sexual problems caused by antidepressants?

Antidepressants can be very useful to help improve mood or sense of self-worth, but it is also true that some antidepressants - especially selective serotonin reuptake inhibitors (SSRIs) can have some bad side effects which cause sexual problems.

Antidepressants will boost emotional mood in many people with depression by affecting brain chemical balance. But since these chemicals are associated with the sexual responses of men and women alike, antidepressants effect on them can cause sexual dysfunction. In particular, erectile dysfunction and premature ejaculation are affected by these compounds. The sexual side effects of antidepressants appear to increase as the dose of medication increases.

What sexual problems are linked with antidepressants?

Sexual problems that you may experience on antidepressants include:

an inability to initiate or enjoy sex
erectile dysfunction (ED) for men
decreased sexual desire
an inability to achieve an orgasm

How can these sexual problems be treated?

There are several ways to manage the side effects of these antidepressant medicines while still allowing treatment of the depression. Some of the more recent antidepressants work differently, and as a result may not affect your sexual function. A doctor may change your prescription to some other type of antidepressant, so that your sexual ability is less affected. And there are some medications which can be prescribed together with antidepressants that may improve a person's sexual function.

Without you telling him about sexual issue like this, a doctor is obviously unable to help. So it's essential to talk openly with your sexual partner and your medical doctor. Ask your doctor for advice! And as for your partner, when they understand that the sexual problems associated with depression medication can be treated, they will be more supportive; as a result people with sexual problems who are on antidepressants continue taking them.

How does depression affect a person's sexuality?

The brain is our most sensitive "sex organ." Sexual drive or desire starts in the brain so any mood problem affects our sexual functioning. About 35 percent to 45 percent of people with depression experience some kind of sexual problems. Of course, the severity of the sexual problem depends on the severity of the depression and whether or not you have any anxiety. For those people who have a more severe form of depression, as many as 60 percent have sexual problems.

Most men and women have difficulty discussing their depression induced sexual dysfunction (including decreased libido, erectile dysfunction and retarded ejaculation) and even accepting they have decreased sex drive may be difficult. Patients tend not to report sexual problems resulting from medications. And it's often the case that only the partner complaining can make them admit there is a problem. Even then, it may be rationalized away, as the product of social values and practices, and this is especially true in the elderly. Sexual problems may not be the subject of enquiry by doctors: in one study patients taking SSRI were four times as likely to mention sexual dysfunction when asked directly by their doctor.

Thus baseline information about sexual dysfunction is essential, and that includes around low libido, so that the effect of treatment can be assessed. There must be adequate assessment of sexual function before and after treatment is initiated.

More information on depression and sexual function

Depression affects every part of our lives - including our sexual relationships - and if your partner is depressed, your sexual and emotional relationship may suffer very badly. Of course the irony is that a good relationship is really helpful for anybody with depression, because they need expression of support and closeness more than ever. So if your partner has depression, they will feel withdrawn. They will have low energy, perhaps so little they cannot do all they normally do with the family or in their relationship. This can cause the partner who isn't depressed to feel unwanted or unloved. They may misinterpret the depressed person's moods as anger or evidence that the depressed person wants to end the relationship.

But being the partner of someone who is depressed is extremely challenging. This is especially true around sexual issues: if you're desperate and your loved one cannot focus on anything positive, they may also find their depression affect all their bodily systems, most marked around sleep and sex.

A lot of people who are depressed lose interest in sex. Even though this isn't always so (a few depressed people have normal sex lives) in most men, the general slowing down of brain activity is associated with loss of libido and erection problems. In women, there is often lack of interest in sex, and difficulty in reaching orgasm. As you may expect, all these issues get better as the depressive illness reduces in severity.

Both the illness and antidepressant medicines such as Prozac can affect sexual function. One of the most common effects is that orgasm is delayed or doesn't happen at all. If this happens, and you want to have sex, ask the doctor about changing medication. Depressed people can help their relationship by making an effort to show appreciation to their partner.

Here are some self help ideas for depression

Go for a walk every day with your partner. Walking gives you a bit of a lift, and releases endorphins in the brain
Practice gratitude for small moments like a bird singing or the warmth of your fire. Every day you can find several things for which you are grateful - research shows this helps lift people's mood.
Eat a balanced diet and in particular consume five pieces of fruit a day.
Listen to music that is important to you.
Have faith that your depression will pass, as it will.
If full-on sex does not appeal, at least cuddle. Touching and closeness like this will keep a relationship intact.
For the partner:
Don't claim you understand your partner's experiences. Just be alongside them.
Many depressed men and women lose interest in sex. This loss of sex drive is not personal!
Don't despair. But hang on in there. Love and constant support will help your partner more than anything.
Get professional help available. Alternatives to anti-depressants include cognitive behavior therapy (CBT). Many doctors provide CBT. This can have a good effect quickly in many cases.
Act as if your partner is recovering from physical illness or from surgery with tender loving care.
Do nice things for yourself. Being around someone who's depressed is very draining, so look after yourself: take time alone, see a movie, see friends. Do not stay home and do nothing!
This period in your life will eventually pass and that your partner will be the same person as before.
Take exercise together - depressed people usually feel their mood improves when they do something physically demanding that raises the heartbeat – and this will help you too.

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