What if we talked about the impact of depression on our sex life?

If Blue Monday, the third Monday in January which is supposedly the “most depressing day of the year”, is a scientific scam and a marketing invention, the fact remains that for a part of the population, the first month of the year rhymes with “depression”, otherwise with “seasonal depression”. This is an opportunity to talk about the impact of depression, seasonal or not, on sex life. “It is estimated that around 70% of people with depression experience an impact on their intimate lives”indicates the D^r David Masson, psychiatrist at the Nancy-Laxou Psychotherapeutic Center (Meurthe-et-Moselle), head of the psychosocial rehabilitation department. It’s not nothing.

This is easily explained by a certain number of characteristic symptoms of depression: fatigue, general slowing down, devaluation and loss of self-esteem, loss of interest in things that usually bring pleasure… So many points which contribute to reduce sexual desire and limit the desire to be intimate with someone: we lack energy, we have fewer desires – whatever they may be –, we do not feel attractive, etc. . Let us note in passing that the drop in self-esteem can also work in the other direction and lead to consent to sexual relations which would not have been wanted in “normal” times.

In addition, in men particularly, depression can cause significant relationship difficulties, because it is sometimes expressed by irritability, nervousness and/or aggressiveness.

A vicious circle

Beyond the desire itself, depression can also have more mechanical effects, affecting the quality of the erection or lubrication and having consequences on the ability to take pleasure. From then on, sexuality is no longer a source of joy and avoidance mechanisms are put in place. “The feeling of reduced performance associated with low self-esteem will help create a vicious circle of guilt and anticipation. Avoidance phenomena then set in.expose David Masson.

“It’s something we don’t talk about enough.deplores the psychiatrist. Patients do not necessarily dare as much, because they may consider that it is secondary, or that they do not or no longer have the right to sexuality because they are ill. In addition, doctors may also avoid the subject, whether out of embarrassment, lack of knowledge or because they consider it to be a negligible or marginal subject. However, it is indeed a subject that we should not hesitate to put on the table during a consultation.

This is all the more true since this drop in sexual desire can be one of the first “visible” symptoms of depression, which is initially quite silent. However, the earlier this depression is diagnosed and treated quickly, the better it is treated and the more we avoid the vicious circle of avoidance. In addition, the diagnosis allows us to put words into words and thwart guilt. It helps open dialogue within the couple and reduces relational conflicts. As soon as we know that it is depression that is speaking, any fears about love failing or possible reproaches tend to dissipate.

Antidepressants also affect intimate life

Since treatments exist, there is the prospect of recovery. When depression is seasonal, it is often treated quite well with light therapy, lifestyle and dietary adjustments (balanced diet, regular physical activity, etc.) and sometimes psychotherapy (notably behavioral and cognitive therapies). More rarely, treatment with antidepressants may be prescribed. For more “typical” depression – not conditioned by seasonality – we find the combo of antidepressants and behavioral and cognitive therapies.

The problem with antidepressants is that although they are effective, they sometimes have side effects, including reduced sexual desire and impaired pleasure. This is not a surprise, since they “buffer” the emotions and sensations a little. “These side effects may continue after stopping treatmentpoints out David Masson. When it comes to their impact on sex life, not all antidepressants are equal and there are also individual variables.”

This is the reason why, if these effects occur, the Lorraine psychiatrist recommends talking about it with your prescribing doctor, in order to change the molecule. This is all the more true since the sexual disorders caused by antidepressants can in themselves lead patients to spontaneously stop their treatment, with the risk of a relapse.

Autocompassion et explorations

But whether they are induced by depression itself or by drug treatments, sexual difficulties are something to think about alone or within the couple. First there is a first aspect. Let’s call it self-compassion. That is to say, it’s OK not to feel the urge to have sex, it’s OK to have less or no sex, it’s OK not to get hard, it’s OK to only want to masturbate…

Depression is an illness and must be thought of as such, with what this implies in more or less lasting changes, particularly in one’s emotional life. In short, we must move away from a heavy injunction: sex not being a vital need like breathing, drinking or eating, there is no problem in making a break temporary sex, time to get back on your feet. Obviously, when you’re in a relationship, it’s better to talk about it with your partner, because we know that inequalities in desire can be devastating.

All this being said, this decrease or absence of desire linked to depression can lead to developing other forms of intimacy with one’s partner, so as not to completely disconnect from sensual pleasures. Caresses, massages or baths can also be satisfying and help nourish the carnal relationship. Cook a nice meal and eat it together too. Without forgetting everything that nourishes the relationship in its dimension of complicity: watching a good series while glued to each other, playing a video game, etc. The idea is to have fun together, wherever we can find it while waiting for the wave to pass.

Obviously, depression can be a challenge for a couple and the period of remission requires the partner to provide support. It’s not always easy and seeing a couples therapist can sometimes be a good idea.

You will have understood, the most important message around sexual disorders induced by depression and/or its treatments is that you must talk about it both to your doctor, to your psychologist and to your his or her partner. Practitioners must also take it on board, dare to put the subject on the table and ask the right questions, recognizing their patients’ right to sexuality and sensuality.

There is not one sexuality, there are sexualities, an intimate shared by each of us, each in their own way. Find the Intimité·s newsletter every week, a meeting for all ages, all genders, all sexual orientations. A comment, a question? Write to us at [email protected].