When Depression Affects Your Sex Life

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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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Negotiating With the Voice of My Depression in the Morning

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It’s morning, and my alarm just went off for the third time. I don’t remember what time I fell asleep, but I know it was late. Two a.m., maybe? I know I woke up around 4:30 a.m., tossing and turning because I couldn’t get comfortable.

I look at the clock; it’s 8:30. I see my running clothes laid out over the chair, and I roll over. My alarms rings again, this time with an annoying fire alarm sound, and I know it’s time to get up. I reach for my phone and see that it’s now after 9 a.m. Instead of getting out of bed, I unlock my phone and scroll through my email, deleting 30 or so spam and junk emails. Still not ready to face the day, I open Facebook. Somehow another 25 minutes go by. Now it is nearing 9:30, and I know that if I want to accomplish anything today, I have to get out of bed.

I look over to the nightstand and see that my fiancée has brought me a cup of coffee. I notice she used my favorite mug, and I smile. Then the guilt hits me. She has been awake long enough to make breakfast and coffee, and likely she has already ran two miles and is back, ready to face the day. I feel worthless. I have slept in yet again, and I’m on my way to wasting yet another day. I know that if I want to keep the anxiety, guilt and depression away, I have to get up.

I move slowly, throwing the blankets off and then sitting up. My heads pulses with the lack the sleep; my body feels weighed down. I put my feet on the floor using all my strength to stand. As I stumble out into the kitchen, my fiancée is there greeting me with a cheery, “Good morning.” I somehow make it to the couch, coffee in hand. Still arguing with myself about going for my morning run, I brush my teeth and put my contacts in. I head to the bedroom and stand in front of the chair, staring at the leggings and sports bra I laid out in hopes that they would motivate me. To be honest, they have been there for three days, and with each passing morning, they become more a symbol of guilt then of motivation. I know that in order to move out of this depression, I have to do the work. I have to get moving, I have to exercise, and at the very least, I have to get out of bed and get dressed.

With every fiber of my being, and with my brain screaming insults, I begin to get dressed. Maybe I’ll just take a walk, I tell myself. I don’t have to run, or maybe I can just do a short run. I am negotiating with the voice inside my head that tells me I don’t have to try, the voice that tells me I am in fact worthless and no amount of effort will have any effect on this reality. But still I push through.

Suddenly I am lacing my shoes. I don’t remember actually making the decision to run, but here I am, lacing my shoes and grabbing my headphones. Once I am outside, I do feel better. I take a deep breath, roll my ankles a few times and start running. The first few steps are torture, every cell in my body screaming at me. The voice in my head gets louder at first, but as the pavement moves beneath my feet, the voice loses power.

Suddenly it is silent; the sound of my breathing drowns it out. By the time I finish, I have gone further then I planned.

The rest of the day still looms in front of me, and I am anxious about how I will get through it. But the cobwebs are gone, and the voice is quiet for now.

Image via Thinkstock Images

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When Depression and Anxiety Double Team You

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Depression is a b*tch. And she lies. A lot. She tells you all the right things to make you feel like the worst person in the world. She knows which buttons to push and which wounds to poke. She fills your head with horrible things and convinces you they are absolute truth. Sometimes, she even tells says you don’t deserve to be here anymore.

And you believe her.

She tells you your children would be better off without you. That they deserve a mother who is better, who is “normal.” She tells you your husband hates you and you don’t deserve to be loved. She says you will never have a real friend who cares about you because you are fundamentally flawed, and of course, no one will ever like you. Depression will whisper in your ear you are bad, you are broken and you are unworthy.

And you believe her.

Depression takes over your brain and your heart. She fills all the holes in your soul with sadness, making it hard to raise your head, impossible to look people in the eye. She sneaks into your subconscious until you think it’s you having these thoughts, not her. She makes you believe she is you, until you don’t feel like you even exist anymore. You are just a husk of yourself. She is inside, taking over your mind and your heart and your soul.

She is persistent and stubborn. She holds on tight when you try to fight her and whispers her lies more insistently. Her whispers become shouts as you get closer to defeating her. Pills, meditation, exercise, mindfulness, supplements, sunshine, therapy, a million things to try, but if you loosen your grip, even just a little, then she weasels her way back into your brain and you spin out into that black space.

Depression has a sister. Anxiety. Anxiety whispers worst case scenarios into your ear and won’t let up. The phone rings with a number you don’t recognize. It must be a collection agency or the hospital calling to tell you a loved one has died. Or the bank. Or the IRS. Or. Or. Or.

Your friend hasn’t returned your text. So she has decided she doesn’t like you anymore or to stop lying about liking you in the first place. Your car made a funny noise so you and your children are going to die in a fiery explosion. A person smiled at you at the grocery store so they must feel sorry for you. And on and on and on.

When depression and anxiety double team you, you spiral, completely out of control. Anxiety says your friend doesn’t like you and depression says of course she doesn’t. You are completely unlovable and why would she? Anxiety says your husband is late because he’s having an affair and depression says you deserve it because you are a horrible wife. Anxiety tells you not to go to a mom’s night out or play date because they won’t like you. Depression tells you you are fat, ugly and stupid and they are better than you. Anxiety tells you something is wrong with your kid. Depression tells you you are unfit and don’t deserve to be his mother.

Anxiety says horrible things and depression validates them. They get put on an internal loop and all you hear in your head are a thousand nasty things. You can’t turn it off. You become a shell, filled with fear, sadness, blackness and doubt. You want to hide, but you can’t. You want to run away, but you don’t.

You keep on going, doing what you can to make it through each day. You take your meds, you meditate and you practice mindfulness. Maybe, if you’re lucky, depression and anxiety leave you alone for long enough that you can claw your way out of the spiral and be a mother, a wife, a daughter and a person. Not a ghost. Not a shell. You.

If you or someone you know needs help, visit our suicide prevention resources page.

If you need support right now, call the Suicide Prevention Lifeline at 1-800-273-8255. You can reach the Crisis Text Line by texting “START” to 741-741

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The Homework Assignment That Made Me Question the Purpose of My Depression

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I want to share with you some of my homework from a course I’ve been taking. The homework assignment was: “Write five successes you have had today, from the smallest to the biggest.” I wrote all five with ease, but as I looked back and read what I wrote, tears came to my eyes.

Here’s what I wrote:

1. I got out of bed and walked the dog — in the morning (not the afternoon).

2. I got through a whole day of work.

3. I didn’t cry.

4. I didn’t cut or hurt myself in any way.

5. I kept myself alive.

All five of these things can be challenges for people facing challenges with depression — or any other mental illness for that matter — but they’re things “normal” people take for granted. And it got me thinking: Why me?

Why do I have to struggle with an invisible illness that has no real cure?

Why does this silly thing exist anyway? Why can’t I just be healthy like everyone else? Why do I have to be so overly sensitive?

But then I decided to stop asking more and more questions and start answering them instead. Why me? Because I have a writing talent and can use it to spread my knowledge of the illness to other people. Not something just anyone can do.

Why does depression exist? To teach us how to make the most of every good moment of our lives. These moments rarely come along for us, but when they do, we appreciate them so much more.

Why can’t I be healthy? Because if I were, I wouldn’t be the strong, young lady I am today.

Why do I have to be so sensitive? Because if I weren’t, I wouldn’t be able to love the way I do, understand others pain like I do or even just feel the way I do.

So if you’re facing challenges with a mental illness like I am, I want you to know that although our lives may be harder than others, we have character traits many people don’t. We’re stronger than most people — even though we don’t always realize it. You can get through this, and you will get through it — I promise you — so don’t give up now.

Lead photo source: Thinkstock Images

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When Depression Is Your Reality – and It Sucks

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I know, clinical word, right? “Sucks.” But it does. Depression sucks. I’ve seen many people in my practice who struggle with depression, and there’s nothing easy about it. One day you feel pretty OK, and another day you’re suddenly having a hard time getting out of bed again. You may feel like you’re just going through the daily motions, even if you’re out of bed. It can last for days, weeks, months or years. It is not a fun condition, nor is it something any person should take lightly.

People who are depressed tend to have some things in common. They often tend to feel like an outsider, not good enough, not likable, like they are always doing something wrong and like they will fail or be rejected if they try. People who are depressed often question why people like them when they do receive positive attention. They often don’t trust the positivity, and may reject the care they so greatly crave. The vulnerability of receiving the care and attention is almost more uncomfortable and scary than not receiving care. (The threat looms that they could always lose the care again.)

Depression can be biochemical at times, but it can also be from relational failures growing up. For example, this could appear as parents or even siblings who were shaming, misattuned, emotionally absent, abusive or unable to communicate in a healthy manner. This can also include peers who were bullying, demeaning or in some other way were unsupportive. Teachers who allowed bullying and parents who were too engaged in their own worlds to the point where you ended up taking care of them emotionally (parentification) can also fall under this category. The list can go on and on.

The depressed person often wonders on some level if it’s worth getting out of bed, expecting they will fail. They wonder perhaps if it’s better to stay in bed (literally and figuratively) and fail without the possibility of success. The assumption is they will fail anyway. It’s easier to remain in control by causing the failure themselves, rather than enduring the ego injury of actually trying and not succeeding in the way they’d hoped.

People with depression can also quickly lose themselves in relationships. The need and desire to feel understood, supported and truly connected with someone becomes so great they almost want to devour it when it’s finally available. However, resentment starts to kick in when they realize the other person can never fully meet the need they desire, when they realize the other person can’t always be well-attuned or unconditionally loving and supportive.

It’s a dilemma, often an unconscious one that is acted out in different ways. Is it safer to be cared for and let someone in or to stay at arms’ distance without the emotional risk? Is it safer to get out of bed (apply for the job, go on the date, etc.) and have a shot at success or to stay in bed, certain to fail, without having to risk your ego in the process? This is where depression often reinforces itself. This is the dilemma between pushing forward or remaining in the known and familiar place. Sure, it’s not the greatest place. For many, it feels easier to stay in it than experiencing the pain of the rejection or neglect all over again.

Does this mean all is lost? Not at all. The answer for how to approach depression varies for everyone. Either way, a person struggling with mild, moderate or severe depression needs a foundation of support. Tough love doesn’t always work with depression. People with depression might have grown up in some way feeling neglected, not good enough, like an outsider, alone, scared, beaten down (emotionally and/or otherwise) or generally not supported by others. In my experience, tough love tends to push people further into their depressed state, rather than create a safe space to bring them out.

It is possible to have new safe, supportive and attuned relationships, but it’s not easy to use those new relationships to make up for the pain of the old injuries. This is often where disenchantment and disappointment happens in new relationships. This is where there is a realization it can’t completely make up for the old pain. This puts many on an endless pursuit of the perfect relationship.

The common mistake people make (which is a symptom of depression) is the idea that they are doomed to their depression. Those who can muster up some energy and courage to get in the door for professional help have a good chance to get themselves moving forward. (They certainly have a better chance than those who don’t.) Even though the process is not overnight, if you’re struggling with mild, moderate or severe depression, then don’t hesitate to get professional support and help. Talking to friends is good for support, but it’s not the same as professional help. Patterns of reinforcing depression can be broken and rewired to create the space for life fulfillment to be experienced. You may feel like it won’t work for you, but what if it does?

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A Transcript From the 2016 Depression Olympics

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Commentator 1: Welcome back to the 2016 Depression Olympics, where you’re joining us live at the Women’s “Getting Out Of Bed” Final.

Commentator 2: And what a final we have for you today. We have some strong contenders from the U.S., U.K., South Korea and Hungary, all vying for that sweet Depression Gold. We heard just this morning that the Swedish team has been banned from the competition after testing positive for feeling positive. A real shame.

Commentator 1: It really is. But now, all eyes are on Team Great Britain’s surprise choice, Amanda Rosenberg.

Commentator 2: That’s right, after a successful run at London’s 2012 “I’m Fine” Tournament, Rosenberg failed to qualify at the World Anxiety Championships last year. She placed sixth in “Crying at Work,” fifth in “Crying Everywhere Else,” and eighth in “Sitting Alone in the Dark While Thinking of the Worst Things.” Arguably, her strongest event.

Commentator 1: Let’s hope she’s up to the challenge when we return after these messages.

[commercials for six hours]

Commentator 1: And we’re back. This is it. Amanda Rosenberg for Team Great Britain.

Commentator 2: She’s starting with the classic Head Under the Covers. There’s a little bit of movement, so there’ll be a deduction for that. Really breaks the illusion of death, and that’s what the judges are going for.

Commentator 1: Here’s the first peep… looks around… and a smooth transition back under the covers. Nicely done.

Commentator 2: And now for the “No’s!”  The trick is to start by saying them quietly then build to a crescendo. Here’s the first “No!” soft…distressed…nice…a little harsher…good…and now we’re getting to the last “No!”  loud and with a cry at the end. So pained. Magnificent. This is text. book. crying.

Commentator 1: And she goes straight into Stare at the Ceiling and Contemplate Death. This move requires maximum concentration and sadness…and…and it looks like…..yes! She’s clearly numb and wants to die! A real pro.

Commentator 2: It’s like watching her back in 2008 where she stormed it at the Beijing Bipolars.

Commentator 1: Next up, the Stay Here for Three More Hours. It’s important that we see some self-loathing here.

Commentator 2: It ain’t great if you don’t hate, ain’t that right?

Commentator 1: Yes it ain’t.

[three hours pass]

Commentator 1: OK. Preparing for her final dismount…a triple twist and turn in the sheets, she launches herself. 

Commentator 2: And yes! Rolled onto the floor face first… absolutely stuck that landing. She has got the be happy with that. And by happy, I mean distraught.

Commentator 1: Watch out, South Korea! Rosenberg is back and more depressed than ever.

Commentator 2: She got an impressive amount of  air in that dismount despite gaining 30 pounds from Abilify.

Commentator 1: There is very little to critique in this routine. It had everything you could want — darkness, misery, with just a touch of existential dread. Flawless, absolutely flawless.

Commentator 2: And I think the judges agree with you there…9000 points! That puts her at the top!

Commentator 3: Amanda. A stunning routine and 9000 points. How do you feel?

Amanda Rosenberg: I’m fine.

Commentator 3: What a pro!

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