How Are Depression and Sex Drive Connected?

Depression affects many people in the United States. It's considered to be one of the most prevalent disorders in America, per the National Institute of Mental Health (NIMH).

Dealing with depression can be tough in so many ways. Not only might you be experiencing mood changes, but you may have issues with weight, memory, and sleep. However, for some individuals dealing with depression, sex in particular can become a challenge to handle.

Here's what you need to know about the connection between depression and sex drive.

How Does Depression Affect a Person's Sex Drive?

Having depression goes beyond just mood changes. "Issues with self-esteem are the hallmark of depression," Christine Manley, PhD, a clinical psychologist based in Nashville, explained to Health.

"The core diagnostic criteria of depression is chronic and pervasive feelings of worthlessness. So if that's the foundation you're coming from with a depressive episode, your self-esteem is going to be in the toilet—and that's going to affect every major area of your life, including your sex life," Manley added.

Depression itself can have ramifications in the bedroom, and it also brings on a number of side effects that also influence libido, said Michael Salas, PsyD, a sex therapist based in Dallas. "Depression can make people lose interest in pleasurable things in their lives; it can increase irritability and pessimism. It's also highly correlated with low energy and fatigue," Salas explained. "All of this can lead to a loss of interest or even avoidance."

Furthermore, the number one symptom that corresponds to almost every single case is fatigue, Manley said. "Depressed people are exhausted all the time; they certainly don't want to have sex at the end of the day."

How Do Antidepressants Play a Role?

People who have been diagnosed with depression are treated with a combination of talk therapy and antidepressants or either of the treatments separately, per MedlinePlus. Those diagnosed with depression who use medication to treat the condition are usually prescribed selective serotonin reuptake inhibitors (SSRIs), which help make serotonin more available in the body, per the National Library of Medicine (NLM).

The NLM also stated that issues with sex are a commonly reported side effect of SSRIs. "[T]he gold standard antidepressants—like Zoloft [sertraline], Prozac [fluoxetine], Paxil [paroxetine], and Celexa [citalopram]—are called selective serotonin reuptake inhibitors, and a ton of research shows that they completely demolish your sex drive," Manley said.

Specifically, SSRIs have been associated with problems such as delays in ejaculation or orgasms and a reduction in sexual desire and satisfaction, per a June 2016 review published in The Mental Health Clinician.

There are other types of antidepressants, like Wellbutrin (bupropion), but those can sometimes increase anxiety or irritability, Manley said. "It's crucial to talk to your doctor about the side effects of these meds: How will it affect your sex drive? Will you experience lubrication or have difficulty with arousal or desire? You may have to try a couple before you find the one that's worth it," Manley added.

Furthermore, the medications that work best may be ones that do have some kind of effect on your sex life, so you and your partner should work with your healthcare provider to determine what's right for you.

How To Work Through the Depression

It's very hard to get over the inertia of depression—not just in the bedroom, but in all aspects of your life. But there are things you can do even without medication that can make a difference when it comes to intimacy.

One thing you can try is doing a workout. "I really encourage people to experiment with new types of exercise," Manley said. "It's so important that they start to feel connected to their bodies again, and that can really get the ball rolling."

If you wince at the idea of hauling yourself to the gym, go with activities that make you work up something of a sweat without any special gear or a gym membership: dancing, walking, or chasing your children around a playground.

Initiating non-sexual contact in and out of the bedroom can also help. "You can re-engage with your partner by touching, kissing, cuddling, fondling, etc.," Salas said.

"This can make people feel less pressured to follow the traditional sexual response cycle and practice enjoying the experience for what it is. When people do this, I encourage them to pay attention to what is most enjoyable and pleasurable and let the body and emotions respond to these sensations." Often, that contact will become sexual, but you've taken away the performance pressure.

Another thing you could do is just talk about your feelings. "A lot of times, the problem isn't sex, it's intimacy. Partners aren't sure how to connect or the connection they had before has been strongly influenced by depression," Manley explained. "Actively attempt reconnection: Remind them how you felt when you first met, talk about a time you felt super connected. If someone has trouble with that level of basic vulnerability in a relationship, of course sexual intimacy is going to suffer."

What If Your Partner Is the One Who Has Depression?

Even if you're not the one with depression, it can still wreak havoc on your sex life—and it can almost feel worse because it's hard to know how to bring the issue up. Whatever you do, tread gently. "People can have a lot of shame around feeling depressed, so if you just show curiosity, it will plant some seeds for the other person to consider depression as a problem," Salas said.

Make sure they know that their quality of life is more important than your sexual gratification. But if you're at your last straw with a partner who won't talk about their depression or how it's left your sex life circling the drain, you may want to find a couples therapist.

"You're going to need to be open that you need things to change to remain in the relationship," Salas explained. Sometimes, people can be too gentle and avoid these topics, Salas added. But it's best to be clear about your needs and how your bond as a couple has taken a hit.