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Saving Your Sex Life When You're Depressed

How to keep your sex life -- and relationship -- alive when you're dealing with depression.
By Katrina Woznicki
WebMD Feature

Chronic depression affects every part of daily life, including sex. It curbs sex drive, yet sex can boost your mood and is important for relationships. And some depression medicines can curb your libido.

Breaking this cycle can be hard.

How to get out of this funk? There's no one-size-fits-all approach. But there are some tried-and-true ways to successfully treat depression without ruining your sex life.

What’s most important, experts say, is to never stop depression treatment out of fear that your relationships and sex live will suffer. That’s because depression itself can hurt relationships and may cause loved ones to take these problems personally.

“In depression, the chemical soup often isn’t right,” says Russell Stambaugh, PhD, a sex therapist in Ann Arbor, Mich., and a spokesman for the American Association of Sexuality Educators, Counselors, and Therapists. “The brain is important for sexuality because of the chemistry, but it’s also important for ideas. It helps how you experience pleasure and how you define it.”

Treat the Depression First

Whatever is happening with your sex life, it's important to treat depression first. Address any sexual side effects later.

Depression is the top cause of disability in the U.S. for people aged 15-44. Men and women struggle equally with sexual problems during depression.

People with chronic depression can experience a loss of desire, take longer to orgasm, and simply find sex less enjoyable.

“The whole process of sexual arousal starts with the ability to anticipate pleasure, which is lost with depression,” says Frederick K. Goodwin, MD, who serves on the scientific council for the National Alliance for Research on Schizophrenia and Depression. “People who are depressed are locked in the moment of their suffering.”

Drugs that treat depression, Goodwin says, “can release sexual function from the grips of depression.” Still, many antidepressants can affect sex drive.

“Medications can change sexual function,” says J. Michael Bostwick, MD, a psychiatry professor at the Mayo Clinic in Rochester, Minn. “But it’s a mistake for patients or physicians to immediately assume a difference in sexual function is bad. It’s different, and then you have to figure out if it’s bad or good. In fact, once the depression is treated, they may have a different view about sex altogether.”

Work With Your Doctor

Antidepressant drug side effects can be tied to the dose prescribed. So sometimes simply lowering the dose will treat the depression without blocking sexual desire, says Goodwin.

But don't tweak the dose yourself. Talk with your doctor if you have sexual side effects from antidepressants (or any other drug).

Goodwin says patients often don't start enjoying sex more until after being on an antidepressant for a few months. And there are antidepressants that don't affect sex drive.

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