How to Have a Healthy Sex Life if Depression Is Getting in the Way

If you have depression and feel that your symptoms are hindering your sex life, these 7 expert tips could help.

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couple's therapy
Here’s why couples therapy could help if you’re worried that depression is negatively affecting intimacy between you and your partner.Getty Images

Having a fulfilling sex life can be challenging for some people with depression.

Research shows that nearly 83 percent of women and 63 percent of men with depression experience sexual dysfunction of some kind, ranging from reduced desire or decreased sexual satisfaction to trouble reaching orgasm.

There are several reasons this could happen, which may vary from person to person, says Christina Lee, MD, the regional director of psychiatry for Kaiser Permanente’s Mid-Atlantic region. “Depression can cause symptoms like a loss of interest or pleasure in activities you previously enjoyed, as well as low energy and fatigue, which can make sex feel exhausting rather than exhilarating,” Dr. Lee explains.

Another common depressive symptom is low self-esteem, which could lead some to feel they’re not attractive or desirable, says Elspeth Ritchie, MD, the chair of the department of psychiatry at MedStar Washington Hospital Center in Washington, DC. “Perhaps you won’t want to have sex, or think someone won’t want to have sex with you,” says Dr. Ritchie. “It can be a downward spiral.”

Depression could also cause you to get too little sleep, too much sleep, or too little or too much of an appetite, resulting in weight gain or loss that may affect the way you see your body, says Stephen Peterson, MD, a staff psychiatrist at the MedStar Washington Hospital Center in Washington, DC. All of these factors can lessen your odds of wanting to be intimate, he adds.

Another potential barrier to sex when you have depression is sexual side effects of certain antidepressants. Some drugs used to treat depression can blunt sex drive, make it difficult to reach orgasm, or cause erectile dysfunction, according to Mayo Clinic.

What Happens When Depression Affects Your Sex Life?

Whatever the exact cause may be, it can feel distressing if you feel your depression is negatively affecting your sex drive or performance. For starters, it could further worsen self-esteem or depressive symptoms for some people, says Ritchie.

It could also affect one's relationship with their significant other. If one partner is consistently more interested in sex or intimacy than the other, it can sometimes lead to hurt feelings. This, in turn, could intensify depression, says Ritchie.

“I’ve seen relationships impacted by just these sorts of issues, and what seemed to start as a sexual issue can impact other aspects of the relationship such as romance, friendship, and fun,” Ritchie explains.

“Not being able to have that relationship can make especially someone with depression feel they are not living up to their part of the relationship and change how they interact with someone they care about,” adds Dr. Peterson.

7 Ways to Cope if Your Depression Is Hindering Your Sex Life

If you feel your depression is negatively affecting your sex drive or performance, these seven expert tips could help.

1. Tell Your Provider About What You’re Experiencing

Talk to your provider or therapist if you feel like depression is hampering your sex drive or performance, suggests Lee. “They may not ask about it and you may be reluctant to discuss it, but if it is impacting your sex life, then you should be honest with your doctor so that you can get assistance and make improvements,” says Lee.

2. Be Open With Your Partner, Too

It can also help to talk to your partner about what you’re going through and help them understand how your depression has affected your sex drive, says Ritchie. This can help clear up any misunderstandings about why your sex drive or performance has changed.

3. Stick to Your Depression Treatment

If you feel your depression is hindering your sex drive or performance, one of the first steps to feeling like yourself again is to make sure the root of the issue — your depression — is properly treated, says Lee.

“Treating just the sexual issues, such as with medication to improve libido, won’t get you far because if the depression isn’t treated, it’s unlikely that the sexual relations will be very satisfying for either person,” Lee explains.

The most common and effective treatments for depression are psychotherapy (aka “talk therapy”) and antidepressant medication, according to Mayo Clinic. It’s important to be consistent with your treatment and don’t skip therapy sessions or medication doses, even if you start to feel better. Doing so can cause your symptoms to come back, per Mayo Clinic.

4. If Sexual Side Effects Don’t Go Away, Ask Your Doctor to Switch Your Antidepressant

Antidepressant medications can have sexual side effects, which can make it difficult for some people with depression to have satisfying sex. For some, these side effects go away a few weeks after starting an antidepressant after their bodies adjust to the medication, according to Mayo Clinic.

But if those side effects stick around and become too much for you to deal with, ask your doctor about making changes to your treatment plan. Your doctor may opt to change your dose or switch you to another antidepressant that causes fewer sexual side effects.

Your doctor could also prescribe you medication to take alongside your depression treatment that helps improve sexual function, says Ritchie.

5. Try Couples Therapy

Couples therapy can be a helpful tool if you feel your depression is negatively affecting your sex life in the long term, says Peterson.

“Couples therapy gives each person in the relationship the opportunity to say how they feel about themselves and the other person and search for options to improve the sexual relationship,” he explains. “It’s critical though to be honest if one or both members of the couple have depression and tell the therapist, so that they can understand the relationship dynamics and make helpful suggestions.”

A couples therapist can help you figure out what’s causing the issue, whether it’s your antidepressant medication or something else. “You may feel overwhelmed by the depression, which makes it hard to focus on joy and pleasure for yourself,” adds Peterson. “Talking that through can be very helpful.”

6. Don’t Force Yourself to Have Sex if You’re Just Not Up for It

If you’re just not up for sex right now, don't pressure yourself into doing it, says Ritchie. There will be days when depression will make you not feel like having sex — and that’s totally okay, she adds.

7. But When You Are Ready, Start Small

If and when you do feel ready for sex, try starting small and slow. There’s a range of things you could try that can help intimacy, says Peterson.

For instance, you and your partner could start by simply hugging and cuddling, maybe in front of a romantic movie, says Ritchie. Or you could ease yourself into sex again with foreplay or other things that could help make sex more enjoyable for you, like lubricant or a vibrator, adds Ritchie.