Depression And Sex: How Mental Health Can Affect Your Sex Life

Sex can be an intimate and vulnerable act. Due to the nature of sexuality and libido, various factors can affect whether sex is pleasurable or even possible for a person. One of these factors is mental health. Due to stigma, some people may not be aware of how mental health challenges and mental illness can impact sex life and pleasure. Understanding these connections may be valuable in helping you remain healthy and happy in your sexual relationships.

Can depression impact sexual function?

Depression affects many facets of daily life. Work, school, friendships, family relationships, and self-care can be adversely affected. However, for some, its impact is felt most significantly in sexuality and intimate relationships. Its effects can be felt twofold, as the symptoms of depression often decrease libido and sex drive. At the same time, sexual dysfunction is counted among the many side effects of common depression medications.

For some relationships, sexual intimacy may not be the primary factor in establishing and maintaining connections. However, for others, a healthy sexual connection is critical. Although depression often affects sexual relationships, it may also result in a loss of interest in any sexual activity, including masturbation and sexual fantasies. 

Regardless of how low your libido affects you, it may create a negative cycle of guilt and frustration that can contribute to depression. However, there are steps you can take to recover your sexual desire and build healthy sexual relationships despite depression symptoms. 

Depression symptoms and risk factors

Understanding the relationship between sex and depression can begin with recognizing common symptoms. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), major depressive disorder (MDD) involves five or more of the symptoms below that last for at least two weeks and have a marked impact on daily functioning. Symptoms can range from mild to severe and may include:

• Intense sadness and a low mood

• Excessive guilt or shame without cause

• Thoughts of hopelessness and worthlessness

• Loss of pleasure or interest in formerly enjoyed activities

• Fatigue or a loss of energy

• Changes in appetite

• Sleep disruptions

• Difficulty concentrating

• Persistent thoughts of death or suicidal ideation

Risk factors for depression 

Often, signs of depression appear in the late teens to throughout the 20s. While there are many risk factors for depression, it is considered highly inherited from first-degree relatives like parents and siblings. In addition, women are more likely to experience depression. However, this may be because men are less likely to seek support due to stigmas. 

Other risk factors for depression include the following: 

• Past trauma

• Compulsive substance use

• Devastating loss or tragedy

• Chronic stress

• Chronic physical health conditions

Depression and sex: Translating symptoms of depression to loss of libido

Every symptom of depression may affect sexual health in some way, with some having more impact than others. Below are a few of these impacts and how they can change sexual desire and intimacy. 

Low self-esteem during depression and sex

From thoughts of hopelessness to body image challenges, many symptoms of depression can negatively affect self-esteem, which directly impacts libido. Low self-esteem can cause you to avoid sex or experience reluctance in initiating sex. 

When one chooses to have sex, they may not enjoy it or achieve satisfaction. Part of the reason for this effect is chronic rumination during sex. Instead of being “in the moment,” the mind focuses on worries about sexual proficiency and physical appearance due to low self-esteem. 

Sexual and emotional distance during depression 

Depression can cause emotional disconnection, which can often lead to sexual disconnection. The cause of this disconnect may be seeded in the symptoms of affect but also due to the loss of concentration often associated with depression. If your mind is elsewhere during sex, your partner might perceive it as detachment, potentially causing you both difficulties in achieving sexual satisfaction. 

Guilt and shame during depression

Societal and familial stigma about sex may be difficult to cope with. However, when guilt and shame are added to the equation, it can interfere with the way you think about your sex life in general. When you feel guilty about having sex, it may feed the guilt associated with depression, causing a negative cycle. In addition, a hallmark of depression can be reliving past perceived “transgressions” and the negative feelings associated with them, causing problems for people who believe they’ve done something “wrong” in past sexual relationships. 

Trauma and sexual desire

When an individual has developed depression because of a traumatic experience or alongside it, particularly related to physical or sexual abuse, it can have a negative impact on sexual desire and the ability to sense sexual pleasure. A 2018 study from the University of Texas, Austin, identified comorbid post-traumatic stress disorder (PTSD) and depression as correlates of sexual dysfunction.

Communication can be essential in any relationship, including communication about sex. Depression can result in a fear of communicating with your partner, leading to avoidance. Depression can also cause individuals to believe that no one will understand their experiences and difficulties. For this reason, they may avoid discussing how depression has impacted their sexual desire with their partner. 

Some people with depression experience physical symptoms like the following: 

• High blood pressure

• Fluctuating hormone levels

• Physical discomfort

• Headaches and migraines

• Gastrointestinal distress

• Sleep disruptions

Depression, anxiety, and other mental health conditions may also be causes of erectile dysfunction (ED). Some antidepressants and other prescription medications can contribute to erectile dysfunction in men and decrease sexual desire in women, as well. 

How to manage depression and sexual desire issues

Although symptoms of depression may cause one to believe that change is hopeless, it may be possible to recover your libido and heal your relationship with sex. Below are a few steps to take. 

Visit your doctor for diagnosis and treatment

While depression is a common cause of sexual dysfunction, visit your primary care physician to address or eliminate physical causes. Consider getting a complete physical examination, including lab work and an evaluation of your family medical history. Communicate with your doctor about your symptoms and depression, and partner with them on the course of treatment. 

Some individuals may find it difficult to talk openly about sex, particularly on topics of sexual dysfunction. However, your doctor is there to help. Whether they find a physical condition causing your lack of sex drive or eliminate physiological reasons, they may recommend open communication with your therapist. 

Talk to a mental health professional or therapist

After addressing potential physical causes, speak candidly with your therapist about your libido. It may be challenging to open up at first, but treatment cannot be applied without a therapist understanding your needs. In addition, therapists are trained to be nonjudgmental and unbiased and deal with sexual topics often. If you’re not currently seeing a therapist, it may be beneficial to sign up for therapy. 

Your therapist may address your decrease in sexual desire using psychotherapy practices like cognitive behavioral therapy (CBT) to change how you think about sex and your relationship with your sexuality or help you work through experiences that may have changed your views of sex. If applicable, your mental health professional may partner with your primary care provider or psychiatrist to provide information to help your doctors manage your medication. 

Consider online mental health treatment 

If you have symptoms of depression, including a waning sex drive, you’re not alone — research indicates that one in six people experience depression at some point in their lives. Of these individuals, 34% of adults seek treatment for depression. However, some may avoid seeking help due to social stigma, inaccessibility, difficulty scheduling and keeping appointments, and finances. In the case of couples therapy, coordinating busy schedules around sessions, discomfort about talking to a therapist in person, and worries over the treatment affordability provide unique boundaries. 

One study measuring the self-reported experiences of 318 individuals with depression found that users of an online platform experienced significantly reduced depression symptom severity after engaging with the platform. Online couples therapy is also as effective as traditional therapy for helping partners resolve challenges like sexual libido changes.