Dear Dr. G,
I have been dealing with depression for quite a few years. I try every day to fight it and to have a desire to stay alive and be with my family. It is the toughest thing I have ever had to do. Although I can see my way through a lot of it, one of the things that frustrates me most is that I have a really low sex drive. My wife has been really good about understanding, but I am starting to get worried that she will leave me soon if things don’t change in that area. I am male, so it is pretty hard to fake an orgasm or even feign sexual excitement. Any ideas you could give me would be appreciated.
Limp Lover
Dear Floppy,
First of all, let me say that I am happy to hear that you are able to push through each day even though the depression makes it difficult. Never downplay the amount of tenacity or effort it takes to do what you do daily. You are a survivor in every sense of the word. You get a gold medal for staying alive! As to your bronze medal or 4th place finish in the sexual arena, I think we can address that as well, and believe me when I say that you are far from the first person to pose this question, but thank you for asking it.
Chronic depression affects every part of daily life including sex. Depression can curb your sex drive in a big way, yet, sex is one of the very things that can boost your mood, and it is very important for relationships. Sadly, some antidepressants can actually curb your libido, which makes the antidote the enemy. One thing to be aware of is that you should never stop any kind of treatment you are getting for depression out of fear that your sex life or relationship will suffer. Please know that the effects of not treating depression will be far worse on your relationship then the impact of a low sex drive.
Your brain is very important when it comes to sexual chemistry because it helps you experience pleasure and it defines what and how you feel. However, when you are in the middle of depression, the chemical mix in your brain can be off a few centimeters to a couple miles. If your brain (the one that is dealing with depression) constantly has negative thoughts and feelings going on, there is a really slim chance that it will want to do something exciting and fun.
If your wife initiates sex or subtly insinuates that she might want to go there in the near future, your brain will pretty much let you know there ain’t no way you’re going there with her. Depression causes your brain and thoughts to basically be locked in the moment of your suffering. This disallows you to positively anticipate much of anything. Yet, the whole process of sex starts with the ability to anticipate pleasure.
Believe it or not, sexual healing (as a couple) isn’t about finding new or exciting ways to please your partner, it is much more about feeling that chemical rush together. It’s about accessing that orgasmic high and accepting it as the healing balm that it can be for the two of you. Your brain once gathered an irresistible amount of testosterone/estrogen, adrenaline, dopamine, serotonin, and oxytocin and a few more to convince you to fall in love in the first place. Somewhere along the line, your chemical levels have fallen. Those same chemicals can once again (if accessed through sex) help you by decreasing your depression, if only for a while.
One of the issues therapists run into with depression is that the patient has been thinking negative or destructive thoughts about himself for such a long time, that it has now become a habit. Quite frankly, it isn’t always possible to correct brain chemistry with just meds. It is also critical to unlearn negative thinking patterns and learn or relearn positive thinking skills through psychotherapy.
The key to improving any sex life is to talk to your partner. Despite what society may tell us, there is no set amount of sex that is to be had on a weekly or monthly basis. There is no standard relative to how, or how often, couples should enjoy sex. The key in that area is to communicate honestly. Those kind of conversations can actually relieve the negative feelings that can become enfolded in the depressed mind, not only because the sexual issue is being addressed, but also because when honesty and understanding is present in conversations, a sense of relief can produce oxytocin which is also known as the Love Hormone. The fact that you said “I am worried that she will leave me if things don’t change” makes me think that you are believing the negative thoughts in your mind rather than checking in with her to see if you are correct.
In all reality, the best thing you can do for both depression and sexual issues is communicate, despite what the thoughts and ideas going through your mind tell you. Really talk. Stevie Nicks said it powerfully when she sang:
Well, there’s no sense in dancing round the subject
A wound gets worse when it’s treated with neglect
Don’t turn around, there’s nothing here to fear
You can talk to me.”
Talk to your doctor.
Talk to your therapist.
Talk to your partner.
You are a survivor.
