When Depression Affects Your Sex Life


Yes, it’s true — having depression impacts your sex life. But it’s not just because of medication.

Since 2004, I’ve dealt with the sexual side effects of taking antidepressants. Feelings of sluggishness. Lack of desire. Occasional discomfort during sex. It’s a trade-off I’ve been willing to make because being healthy and stable is my number one priority. And for the most part I’ve been able to cope with my muted libido and still have an active sex life.

But since having a major episode of depression, anxiety and PTSD, my sex drive has all but completely stalled out. As I struggle to deal with this I have been thinking a lot about how mental illness has affected my sexuality as a whole, not just in terms of medication and side effects.

For me, feeling sexy has a lot to do with confidence and vulnerability. In order to desire sex I need to feel desirable. In order to be vulnerable I need to feel safe. And going through two years of severe mental illness had a devastating impact on my sense of desirability, confidence and safety.

As I watched my life fall apart, I felt like I was regressing away from adulthood. Unable to handle even the most basic daily tasks, I seemed to morph into a dysfunctional teenager trapped in an adult’s body. I relied on other people to get through each day. My mom prepared my meals. My husband handled our household responsibilities. I had to resign from my job. I withdrew from friends. For a while I couldn’t even drive. Since my dad’s suicide I prided myself on being strong and responsible, but when I got sick I watched my sense of responsibility slip through my fingers like sand. Sex felt like one more “adult” behavior that went by the wayside.

My adult life shattered into a thousand pieces. I was in and out of a psychiatric hospital. In and out of a partial hospital program. I graduated from SSRI antidepressants and began taking benzodiazepines, mood stabilizers, atypical antipsychotics. Often all at the same time. These medications made the side effects of my previous drugs seem like a walk in the park. My body went through major turmoil as I struggled to find the right combination of meds. First I lost 30 pounds in one month due to anxiety. Then I gained almost 60 pounds due to Lithium. I lost clumps of hair and my skin broke out. I felt anything but desirable. In fact, I felt disgusting. I had absolutely no thoughts or feelings about sex.

Every day was a struggle to stabilize and complete basic tasks like eating, taking showers and sleeping. Sex was secondary to surviving. But I fought my way back. It was slow and painful. Only now, two and a half years after admitting myself to the hospital, am I able to think more deeply about sex. And I have realized something important: it’s not just that my new medications are stronger and have much more powerful side effects. It’s also that on a deep down level, I have come to feel like I don’t deserve to be sexy anymore.

Can people in mental hospitals feel sexy? Can people who have gained excessive weight due to medication feel physically desirable? Can people who have been abandoned and traumatized feel comfortable with intimacy? For me, answering “yes” to these questions takes a *lot* of work. It’s easy to flippantly say, “Yes, of course you should feel sexy,” but the reality is that I don’t. I avoid looking at my body in the mirror. I feel frustration at my weight gain. And I still feel some shame about my breakdown.

Because it’s hard to feel intimacy when you are afraid of abandonment. It’s hard to feel confident when you are struggling with guilt and shame. And it’s hard to feel good about your body when it’s been through hell.

But I’m not afraid of doing hard things. So I ask myself this question: Do you deserve to feel sexy again? And the answer is, yes. I deserve sex. I deserve intimacy. This part of me deserves to recover, too. My experience with recovery is that positive change happens slowly, as a result of deliberate choices made every day. So I am chipping away at the protective barrier that depression has built around my inner sexiness. As I have had to do many times before, I talk back to my depressed thinking.

I look in the mirror and say, “Amy, your body is beautiful just the way it is.”

I look into my husband’s eyes and say, “I want to be close to you.”

And I look into myself and say, “I love you, Amy. You are safe.”

Beautiful. Safe. Intimacy.

Yes.

I deserve to feel sexy again.

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