How Depression Affects Sex - Woman Depressed in a bed

How Depression Affects Sex and What to do About it 

Estimated reading time: 8 minutes

By Jose Ramirez, LMHC

Depression is one of the top three most common mental health issues in the U.S. Millions of people are affected by depression and it can look and feel different from person to person. The common theme connecting the experience of depression is that the symptoms negatively impact overall functioning, sexual functioning included.

Does depression affect sex? 

For most people, yes depression does impact sex. One of the symptoms of depression is a loss of interest in doing things you would normally enjoy. For most people, sex is up there in the enjoyment category (not everyone, I see you Ace folx). For the majority of people, depression affects all aspects of their lives – work, relationships, leisurely activities, hobbies, etc. 

Depression affects sex and sex affects depression. What does that mean exactly? 

When people are depressed, their sex drive and overall sexual wellness is usually negatively impacted. However, sex can also help people feel good, even people who are depressed. The problem with depression is that it tends to affect sexual drive and wellness to the point that people are not interested in having sex. This can be a vicious cycle and it can have negative impacts on relationships. It’s important to know how depression symptoms affect sex, because the more knowledge one has, the better informed treatment will be. 

Learn more about depression therapy in Fort Lauderdale here.

Here are a few depression symptoms that affect sex:

Anhedonia, or the inability to experience pleasure is one of the hallmark symptoms of depression. In fact, you have to experience anhedonia to some degree to be formally diagnosed with clinical depression. Physical anhedonia is the difficulty or inability to experience pleasure from sensory or physical experiences like eating, touching, sex, or movement.

The inability to experience pleasure will most definitely affect sex. Sex is pleasure’s realm. Sex should be about pleasure and when people are depressed it can be very difficult to experience pleasure. It’s almost like there is a literal block created by the depression that makes it next to impossible to get into the pleasure.

If you’re feeling depressed and not up for sex, that’s perfectly ok, just be sure to communicate this to your partner so there are no miscommunications. Remember, anhedonia is not only an inability to experience sexual pleasure, it’s the inability to experience pleasure across the board. Chances are if you’re not experiencing pleasure day-to-day, you’re not going to have a lot of luck experiencing sexual pleasure either. 

Feelings of guilt. People who experience depression are no strangers to feeling guilty. In fact, people who are depressed tend to blame themselves for the negative things that are happening in their lives. Guilt is a pleasure and eroticism killer. It’s next to impossible to genuinely enjoy sex when you feel guilty. 

Guilt also shows up by making the person believe that they are depriving their partners of sex, and it’s all their fault. When these thoughts are present, it’s difficult to say no. Some people engage in people-pleasing and may only have sex to please their partners without their pleasure being front and center, as it should be. This is why it’s important to communicate these feelings to partners. If your partner(s) knows that you struggle with guilt, they can help reassure you that it’s not your fault and that they don’t expect sex from you when you feel this way.

Feeling of worthlessness. The experience of worthlessness is guilt’s evil sidekick. Usually guilt and worthlessness show up together and torment the person struggling with depression. The main problem with feelings of worthlessness when it comes to sex is that they directly affect self-esteem, body-image, and confidence. 

In order to have good sex there needs to be a level of confidence and feeling decent about one’s body. People who struggle with this often don’t feel attractive or sexy and that really takes its toll on desire. This is one of the symptoms that people can overcorrect and misuse sex as a way to cope. Think about it, if you don’t feel attractive or sexy it wouldn’t be unheard of to use sex for validation. We all do it to a certain extent but to have sex purely for the sake of validation can become a problematic pattern of behavior.

Fatigue. Depression is exhausting. People who struggle with depression often feel very tired and have low energy. Many individuals describe this exhaustion as “not wanting to do anything but lay in bed with the covers over my head.” On a good day when one is tired, sex is the last thing on the mind. Imagine having to deal with the exhaustion caused by being depressed? Sex is a physical act, it takes energy and requires a lot of physical effort. When one can barely get out of bed, sex is not likely possible.

Isolation. Isolation is a very common symptom of depression. When people are depressed, the last thing they feel like doing is socializing or being around people. This will directly impact sex because the urge to isolate even from one’s partner(s) will be present. There may be zero desire to be around people, let alone have sex with them. Isolation can be really hard because it can feel like the one thing that brings peace, but really, it just makes everything worse and maintains the depression cycle. 

Depressed people are at increased risk for experiencing sexual dysfunctions and problems with desire. The symptoms that are associated with depression affect general functioning and therefore, it’s not shocking that these symptoms would affect sexual functioning as well. 

Are you not sure if you have symptoms of depression?

Take this quick quiz to see if therapy for depression could be right for you.

Sex to cope with depression

Sex can be a wonderful coping skill to have in your arsenal. When used correctly, sex can be a means to combat loneliness by connecting with another person. It can be a source of pleasure on a day that you just feel blah. It can help distract from that annoying little thing you have going on at work. However, when misused or abused as a coping skill, sex can be a form of avoidance or a problematic manner of seeking validation.

What should you do if your sex life is impacted by depression? 

Treat the depression itself. 

  • Go to therapy, talk about it, learn some skills to help you manage the symptoms of depression. 
  • Medication is also an option, just be aware of the potential side-effects. 
  • Know that it’s the combination of medication and therapy that are often the best treatment plan for clinical depression. 

Medication is an extremely common treatment for depression. It’s widely available, accessible, and can be very effective. The problem with antidepressants, especially SSRIs, is that the most common side-effects are sexual in nature. 

Problems with libido, erectile problems, and orgasm problems are the most common side-effects of antidepressants. Sadly, most people are not warned against the side-effects that these medications can have, especially if the patient doesn’t ask. This is by no means a PSA against medication. On the contrary, medication can be an invaluable resource, but people should be informed how medication can affect functioning. Open communication with your prescriber is important as there are changes that can be made if sexual functioning is impacted by medication. 

Work with a sex therapist
Finding a sex therapist that also works with depression is a good option because they can help with both the depression and the sexual issues caused or exacerbated by the depression itself.

Sex Therapy is a form of talk therapy which helps individuals and couples address medical, psychological, or relational factors affecting sexual satisfaction. Clients are educated about the issues they are facing so they have a better personal understanding. They are taught how to communicate these issues to partners/spouses. They learn evidence-based skills and techniques to address the issues they are facing. 

Sex therapy can be delivered as an individual or couple’s format. Many people are not familiar with sex therapy and so just to be clear, there is no actual sex involved in the therapy room or with the therapist. 

Talk to your partner
It’s also important that you talk to your partner(s) about what’s going on so they are in-the-know. This way you avoid miscommunications or the possibility of them blaming themselves.

Discussing how depression has affected you sexually, enables your partner(s)  to be there in a supportive role to help navigate the issue effectively. While the issues may only be happening to one partner, it will affect the other(s). It’s important to not bottle it up or engage in heavy avoidance. Remember, acknowledging it will help reduce the shame associated with the challenges you face. 

ICYMI: Check out my post about how to talk about sex with your partner

If you struggle with depression it’s important that you learn how your symptoms affect your sexuality so that you can communicate this to partner(s) and providers alike. This helps maintain healthy relationships, better inform treatment, and it may help you not blame yourself. While it is normal for sex to be impacted by depression a lot of people struggle with this idea. Knowledge and education around this is helpful to stave off self-blame. This also helps normalize the experience and reminds one that the symptoms are normally time limited and a return to baseline is possible.

Depression can have a direct affect on sex from lack of desire to sexual dysfunction. Read to learn more about the depression symptoms that affect sex and what can be done about it. 

Learn more about couples counseling in Fort Lauderdale here.

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Fort Lauderdale Therapist Jose Ramirez, LMHC
License: MH17881

José Ramirez is a licensed mental health counselor and is an expert in depression therapyanxiety therapy, PTSD and trauma-related issues, mood disorders, and LGBTQ+ specific issues. Call 954-488-2933 or email today to discuss how our services can help you.

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