What Sex Is Like When You Suffer From Depression

by Rachel Sanoff

It's a struggle that we are often pressured to keep secret in a society that stigmatizes and delegitimizes mental health issues, but depression needs to be openly, safely, and empathetically discussed because it touches so many people, and when untreated, leads to devastating chaos, such as suicide. Depression is all-consuming, affecting our ability to laugh, work, take care of ourselves or our partners, and it even hinders our ability to taste food. It is a sadness and a disorder that permeates existence entirely. For many people, important facets of existence are sexual and romantic relationships. Intimacy is already overwhelming on its own, what is sex like when you're depressed?

Depression is downplayed even though it is a struggle that most of us will have to live with at some point in our lives, if not throughout our entire lives. According to the World Health Organization, 350 million people around the world suffer from depression, and it "is the leading cause of disability worldwide." Further, more women suffer from depression than men.Depression can be clinical and result from brain chemistry, or it can be born out of circumstances such as grief and mourning after the death of a loved one. Depression can be a horrible aspect of Post-Traumatic Stress Disorder after surviving a sexual assault (One-third of all rape survivors develop PTSD.) I spoke with numerous people whose experiences with depression fall into one or more of these categories, and they shared what sex is like for them and how they have learned to cope with depressive episodes and flashbacks triggered by sexual encounters.We do not talk enough about our mental health. We do not spend enough time listening to people who struggle with mental health and depression. Let's listen:

1. Depression Can Lower Your Sex Drive, But It Doesn't Have To Weaken Your Partnership

"My fiancee and I both suffer from depression and decreased libido when we're anxious/depressed, which is basically always. We have sex about once a month, sometimes less. I like sex, and my fiancee is the best partner I've ever had. But when you're feeling lonely and hopeless, it's hard to initiate sex. And when your partner is feeling the same, it's hard for them to take the initiative. When you're depressed, your head is lying to you. It's telling you you're unf*ckable, unworthy of love, only truly seen by others in their moments of disgust. It has all kinds of other physical ramifications that make sex harder, too. I lose energy in a major way when I'm depressed; my days go upside down, and I spend the night having panic attacks and spend the day in bed. I also have a manic streak that means I fill my life with work or get trapped in trying to be 'the best' at sex — trying to 'master it' like I'm in competition against my fiancee's sadness. I haven't fixed it yet (whatever 'fixing it' looks like), but looking sexy and hoping for the best, confronting my partner and demanding he find me sexy, or scheduling sex doesn't work. But being very honest about what we want sexually and really working to overcome each others sexual ennui has helped, as has cutting down on drinking.

<img alt="" src="" class="article-body-image"/>Previously, I've had partners very earnestly and patiently try to 'fix' me — both sexually and emotionally. It didn't work, obv. I've had other partners ignore it and try to wait it out, and others try to confront me about it and start a vicious cycle. One guy yelled at me for not f*cking him anymore because I was too sad and tired all the time, which did GREAT THINGS for me wanting to have sex with him. (Assh*le.)" - Lily, 30

2. Surviving Sexual Assault Often Leads To PTSD, But Supportive Partners Can Help The Healing Process

"I was first diagnosed with depression at 13, so the entirety of my sex life has operated under the cloud of anxiety and depression... And then I was raped. I was consequently diagnosed with PTSD. I’ve since put in a lot of time, energy, money (god dammit), and heart into recovering. I’ll always identify as someone with Post Traumatic Stress Disorder, and I don’t know if I’ll ever be able to be off medication for depression and anxiety. But I am happy and healthy. I’ve been with my boyfriend for over three years. The sex was always amazing, but at the beginning it was also always inebriated (a coping mechanism I’ve employed with great frequency if not great efficacy). But as we got closer, I realized that I was actually enjoying sex with him. With him, I didn’t have to tune out or mentally go elsewhere (or at least not always, and not nearly as frequently as I did with other guys). He kept his eyes open and constantly checked in. So even if I was tuned out, it gave me incentive to tune back in. For the first time since I was attacked, and probably since I started having sex, I felt present. And it was AWESOME. Like mindblowingly awesome.

But sometimes it wasn’t. Occasionally I couldn’t tune back in, I’d slip into a flashback and panic. And yet somehow, that was OK too. Sometimes he’d notice and stop, other times I’d say something and he’d stop. But he ALWAYS stopped. And suddenly, magically, I had boundaries. I’ve healed a huge amount in the past three years and very rarely have PTSD flashbacks. When I do though, I can always count on him to stop. There’s power in that, and for me, there’s safety in power (my power). But depression comes and goes, as does anxiety. So I tell him if I’m upset, if I don’t want to have sex. And if I don’t say it's off the table, then it's on the table. We both initiate, but him more frequently (I still have some stigmas to overcome regarding my sexuality but I’m working on it). If I say I’m not interested, he doesn’t push it. He knows that I love him and find him sexually attractive. 'Not tonight' doesn’t mean anything beyond that. And in turn, I understand that he has needs. I totally support him masturbating, and I know that sometimes he’s not in the mood either. Because he tells me. And I trust him." - Tatiana, 26

3. It Changes How You Understand Love And Your Relationships

"My previous (and first) relationship started before my dad died and ended a month after he passed. Scott's dad passed away about a year before mine did, so he had been through a similar grief and depression. He would ask me, 'Are you sure you can handle a relationship right now?' I assured him yes, but I wasn't ready for everything that it entailed. With Scott, the loss of my dad could be delayed, or at least mediated by this newfound love. We broke up after he cheated on me. No matter how much I want to forget Scott, I haven't been able to, because the pain of the breakup has merged with the pain of my dad dying. While the two are in no way comparable, both were losses - my first experience with loss. The grief from each experience joins together when I attempt to face either. A bad dream about my dad means rethinking all the ways Scott lied when I trusted him. Reliving the ways Scott made me feel like a lesser version of myself calls up the haunting moments in the hospital. I have to traverse the depression of grief to feel anything on the other side. When I feel excited and hopeful about a prospective date, I feel a lull in my emotions and a grip on my excitement. I am not yet convinced that I will find a love as strong as my first, and I do not know without a doubt that I will be as carefree as I was before encountering death. It can be said that loss makes you appreciate what you have, but in an unexpected way, loss can devalue everything. There is no permanence, no reason why anything has to stay; however, change can yield the potential for hope. I know to question my emotions and experience, to talk and think it all out, but I'm learning the answers aren't all there, and sometimes there are no answers at all. Love is the goal of my life, death and loss are inevitable; I live each day learning how they all fit together in unity." - Joseph, 24

<img alt="" src="" class="article-body-image"/>4. Honest And Open Communication About Mental Health Is Extremely Important

"I've asked my partner to let me know if he's going to be unavailable for emotional support. I know he can't be there for me all the time, but just knowing that he's busy instead of trying to reach him and being unsuccessful is incredibly helpful. Depression can totally kill your libido. I have lost a relationship over that before, though that may also have had something to do with a lack of physical attraction. I can't say for sure. But I do know that the intensive daily group therapy, multiple hospitalizations, long list of med changes, and regular extreme meltdowns involved in my previous depressive episode were a huge strain on the relationship. This time around [in my current relationship], I've managed to avoid the hospitalizations and am just in regular therapy once a week, but the meltdowns and need for additional emotional support are definitely hard on my partner. The constant neediness or being in a caretaker role can make sexytime hard. I'm very up-front about my mental illness. You would be surprised how many people are supportive! I've received some derision for same-sex dating, but never for my depression... Every partner I've had has always been supportive, because I've been honest from the very first date. So the ones who won't be get weeded out pretty quickly. Depression is even on my OkC profile!" - Elizabeth, 26

5. Sometimes You Need To Be Alone For A While

"I've had two long-term relationships in my life: the first lasted for two years during undergrad, and the second has been on and off (currently on) since I started law school. During the first relationship, I began struggling with depression and it made things difficult. I started talking to a counselor and taking anti-depressants, and things really improved. We broke up because I moved away, not because of the depression. The second relationship started during a really difficult transition into law school, and the depression began affecting me again. He was extremely understanding but also struggled with his own issues, and ultimately we couldn't help ourselves and each other. During the summer we were apart, I spent a lot of time growing and learning about myself. I spent a lot of time on my own, got a dog, and learned how to love myself, my life, and others again. Now that we are back together, I use that growth and knowledge to be more understanding and tolerant." - Jessica, 23

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