Our society already doesn't allow us a whole lot of room (if any room at all, actually) to openly discuss our mental health in a safe, empathetic, and helpful way. Mental illness is "invisible," so it is considered secondary, if not outright imaginary, when compared to physical ailments. We may not often talk about mental health struggles such as anxiety, but pretending the disorders aren't real doesn't prevent them from happening. Combine the silence and stigmatization surrounding mental health with our overwhelmingly sex-negative, shaming culture, and it's no wonder that we never really honestly speak about how anxiety affects sexuality and relationships. And this silence remains despite the extremely large number of people dealing with some form of anxiety, and the fact that anxiety can permeate every aspect of our lives.
According to the National Institute of Mental Health, 18.1 percent of the adult population in this country are diagnosed with an anxiety disorder. That comes out to approximately 40 million adults between the ages of 18 to 54. Anxiety disorders are broken down into several types of disorders, including panic disorder, social anxiety disorder, phobias, and generalized anxiety disorder. As you will read in the accounts shared by numerous people below, Post-Traumatic Stress Disorder (PTSD) is extremely common among survivors of sexual assault and sexual abuse. As a result, sexual activity, even when it is consensual, can trigger flashbacks and panic attacks. In fact, studies show that survivors are "6.2 times more likely to develop PTSD" than women who have not experienced rape.
Anxiety can be treated through counseling, medication, therapy, open communication, a combination of all of the above, and lots of other methods. When we are afraid to discuss our anxiety and the role it plays in our sex lives, it is hard to develop trust and boundaries, so it's hard to achieve the healthy pleasure that we deserve. Let's combat the stigma by talking openly about what it's like to be in sexual relationships while managing anxiety. Here is what eight people had to say:
1. Medication Can Dull Sensation, But It Is Often Worth It
"I am diagnosed with General Anxiety Disorder. Without medication, I suffer from intense bouts of anxiety that can leave me paralyzed. During the periods that I was single, I used to have a lot of anxiety about potential sexual partners. I wasn't too fond of the idea of one-night stands because I couldn't trust that they wouldn't hurt me... A lot of that anxiety stemmed from past sexual abuse, so I was extremely protective of myself. Now I am in a great relationship with someone I can see my future with. We have a great sex life, but when I started taking an anti-depressant for my anxiety, it really affected my capacity to have an orgasm.
For about two months I was almost completely anorgasmic. Penetration felt good, but my clit was numb. This is a common side effect when initially taking anti-depressants. I tried not to let it bum me out too much because I was really grateful for the relief from my anxiety even though I was used to having fantastic orgasms with my partner. After three months, I have regained most of my ability to orgasm, though it is delayed. Hopefully my ability to orgasm will reach it's full potential again, but I will take the compromise for regaining my emotional and mental health." - Theresa, 28
2. Becoming Comfortable With Your Sexuality Is A Gradual Process Helped By Supportive Partners
“Sometimes I still have to make a conscious effort to try to love and appreciate my body and all of its capabilities. I have a partner now who loves everything about my body, but it took a while before I was able to be totally comfortable with him seeing every part of me. Every encounter with my boyfriend has always been consensual, but there have definitely been times where I've felt the need to disassociate because the experience is so overwhelming. This caused some early encounters to be painful and embarrassing. There have definitely been tears — both happy and sad. Like, I cried the first time I had an orgasm. I just have a lot of feelings, and a lot of the time they're unpredictable!
As our relationship has grown (it's been almost five years), my boyfriend and I have learned to be completely open with each other. I'm able to say straight up, 'hey, I just don't know if I can handle this right now. I'm feeling way too anxious' and he'll just get it. He's become more in touch with his own emotions, and can recognize anxiety within himself... We're also both on depression and anxiety medications that have made a world of difference in stabilizing our emotions and allowing communication to flow more freely. Even if there's a chance that these meds lower both of our libidos (I honestly wouldn't know since I've been on meds since I was 14), they've still allowed us to have a completely fulfilling sex life. We don't do it as often as we might like, but when we do, it's almost a spiritual experience where I feel like we're the only two people in the world. It's awesome.” - Violet, 25
3. It Can Feel Like You Don't Deserve Love
"I'm pretty well-regulated now (shout out to DBT therapy and finally figuring out a good medication regimen!) But there have been lots of times where I've been totally overwhelmed by my mental sh*t. This has obviously affected my relationship to my boyfriend. He is the person I'm around the most, so the person my disorders affect the most (apart from me, obviously) is him. And a lot of my anxiety is in relation to my body, which obviously affects my sex life. There have been times when I haven't been able to be touched because I hate how I look or because any physical contact brings up rape-related trauma feelings. And there have been times when I've started crying because I'm not getting enough physical contact and therefore feel like [my boyfriend] doesn't love me at all, that I'm ugly and worthless and unlovable. Depression, anxiety, and bipolar disorder do this thing where they convince you that you have no value, that every aspect of your being is garbage. I've had this thing a lot in my 'sexual history' where I've been so convinced that I'm worthless/ugly/unlovable that I trust people more who seem to hate me, because their hatred confirms my own self-loathing and vice versa.
My current boyfriend of almost two years genuinely loves, values, and respects me and makes me feel safe... But I still have trouble believing that he really likes me, and that is all so much based in anxiety and depression and my sense of worthlessness and emptiness... Our sex life is really good the majority of the time, like kinda mind-blowing and close and special. But when the tentacles of anxiety wrap around me, it's like I'm not even in my body anymore. I'm way more in control of this than I used to be... I [no longer] seek out degradation from strangers who I hate and who put me in unsafe situations." - Tori, 22
4. You Can Achieve Fulfilling Relationships And Struggle With Mental Health Simultaneously
"I was diagnosed with depression and Generalized Anxiety Disorder in 2009. I [found] myself clinging to people who showed me any type of love, affection, or attention. I began taking anti-depressants and going to therapy. On my road to recovery, I placed my energy in things I loved to do and got rid of the toxic people in my life. I soon realized that the most important type of love is the love that you have for yourself... I am now in a loving, healthy long-term relationship with a wonderful man. I still struggle with anxiety, but I maintain a positive outlook on life and do my best to stay happy and healthy." - Mia, 25
5. Illness-Related PTSD Makes It Hard To Trust Your Body
"A couple years ago, I very suddenly got very sick and nearly died. I was hospitalized for over a month, and though I fully recovered, the mysterious illness, invasive procedures, and traumatic recovery made me feel like I couldn't trust my body, as if it wasn't the body I thought I'd known for my entire life. I was diagnosed with PTSD after leaving the hospital, and I couldn't imagine ever being comfortable enough with this new, strange body to be physically intimate with anyone again. Thankfully, I got over that discomfort after a year and have since had wonderful sexual experiences. However, PTSD and anxiety manifest themselves in a different, really specific way now in regards to sex.
After everything happened, doctors let me know that pregnancy could be extremely dangerous for my health for multiple reasons. Since I don't want to have kids biologically anyway (if ever), that didn't upset me, but it made me terrified of accidentally becoming pregnant. Kind of like, no matter how safe or careful I am about pregnancy prevention, something will go wrong and I'll wind up pregnant because my body can't be trusted. And while I thankfully live in a state where I can easily access abortion should anything ever happen (by the way, my birth control methods have never failed, yet the anxiety remains), it's just a really stressful, expensive thing to think about. While I am happy to say that anxiety over a dangerous unplanned pregnancy does not creep up on me every time that I am sexually active, it still pops up in my brain and takes me out of the moment more often than I'd like it to. But I think I'll feel more secure in my health and my contraception choices as time goes on." - Josie, 26
6. Touch Can Feel Threatening After Trauma
"Back when I was in eleventh grade, our family was undergoing a sustained five-month siege of police violence in our small, corrupt Southern town. Since my mom was darker skinned and an immigrant, we were always looked at as 'outsiders.' This unpredictable violence more-or-less caused a constant anxiety for me as well as my parents and sisters, not only from the fear of what could happen to us from the police, but also due to the fact that the stress of everything was literally tearing our family apart.I started dating a young lady, and when we started our relationship (which coincidentally began during the madness), I didn't mention anything that was going wrong and compartmentalized the relationship part of my life. I think the anxiety and stress from everything around un-did some of our chemistry too. By four months in, my girlfriend and I realized we couldn't express love to each other in the languages that we understood anymore, and we grew more distant until we broke it off. I got more unresponsive to her physical touch, as my mind was associating any foreign touch as something that could be a threat." - Steven, 25
7. Casual Sex Is Difficult And Communication Is Key
"Anxiety makes it hard for me to open up to my partners about my needs and wants in the bedroom. This makes casual sex pretty challenging, since I won't make a peep about how to better please me until I've known someone for at least six months. Sometimes, that never comes at all. In my current relationship, that communication finally came through e-mail. So I e-mailed my partner a list of things I would like and that he could do better for me in the bedroom. It turned into a very long and certainly the strangest e-mail exchange I've ever had. But my partner appreciated it! He says he still goes back to that first e-mail from time to time, to remind himself how to please me." - Elizabeth, 26
8. Intimacy Between Long-Term Partners Can Change Throughout The Years
"My anxiety has pretty much killed my sex drive. It's made me feel more incredibly vulnerable than ever before, despite being in a monogamous relationship for years. Having sex makes me feel more exposed as a result of my PTSD/anxiety diagnosis, and my partner struggles with this shift in our sex life. We're still intimate; it's just the penetrative sex part that's been difficult." - Emma, 24
Want more of Bustle's Sex and Relationships coverage? Check out our new podcast, I Want It That Way, which delves into the difficult and downright dirty parts of a relationship, and find more on our Soundcloud page.