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Depression and Intimacy for Men: Guide to Restoring Your Sex Life

It's true what they say: The brain is the body's biggest sex organ. When things aren't right in your head, things often aren't right with your sex drive. In fact, between 35 and 47 percent of moderate depression sufferers also have problems with sex drive, much more for those with severe depression. Given the importance of sex in romantic relationships, the loss of sex drive that so often accompanies depression can have huge effects on both a male sufferer and his partner. In this article, you'll learn how and why depression has an impact on libido, what you can do to improve the situation, how to talk to your partner about your loss of sex drive, and some questions you might want to ask your doctor.

What are the sexual side effects of depression?

Depression is the No. 1 cause of disability for 15- to 44-year-olds in the United States - typically the peak years of sexual activity as well. Therefore, the sexual side effects of depression can be quite a blow to relationships. The most typical sexual side effects of male depression are:

• Loss of desire. Individuals suffering from depression are less likely to want to initiate sex and less likely to respond to their partner's advances. This is because people suffering from depression are unable to anticipate and therefore want to pursue pleasure - they can only see their current pain.
• Sex is less enjoyable. One sign of depression is the sufferers are less able to experience pleasure, so if a man suffering from depression does have sex, he's less likely to enjoy it.
• Erectile dysfunction. The neurotransmitters that are so important to mood also affect blood flow to the penis, so depression can often lead to difficulty achieving or maintaining an erection. This is true of up to 90 percent of men suffering from severe depression, and 54 percent of those suffering from moderate depression.
• Difficulty achieving orgasm. All of the above lead to a less satisfying sexual experience, which in turn makes it more difficult for sufferers of depression to achieve orgasm.

  
  Unfortunately, sometimes the medications used to treat depression can also reduce a man's level of desire. SSRIs, for instance, are known to have sexual side effects.

  In American society, men are viewed as the initiators of sex, so it can feel emasculating to have little desire for sex or ability to perform, and some men feel that their very identity is threatened. Luckily, there are a variety of treatment options available.

The most important thing to remember if you're experiencing loss of sex drive is not to quit your treatment for depression. Whether your antidepressants or the depression itself are causing your loss of sex drive, getting treatment for depression should be your first priority. That said, here are a few options for treatment of depression-related sexual dysfunction:

• Give it time. Some people don't start seeing a return of their libido until they've been on an antidepressant for several months. If your libido does not return right away, be patient. That doesn't mean it's gone for good, and it doesn't necessarily mean you're on the wrong medication.
• Change the dose. Sometimes the sexual side effects of antidepressants have to do with the amount an individual is taking, and many people would be able to effectively treat their depression at a lower dose of the drug. Of course, you should never lower your dose without discussing it with your doctor first.
• Change the drug. Certain antidepressants are more commonly associated with sexual problems than others. If you and your doctor agree that your lowered sex drive is a result of the medication you're on, consider switching to a type that is less likely to interfere with sex drive.
• Change your mind. Whether depression starts as a result of neurochemical or environmental factors, sufferers eventually adopt a self-defeating mindset. When you haven't had a desire for sex for months, it's easy to assume you will continue not to have a desire for sex. This creates a self-fulfilling prophesy, however, so it's important to unlearn the thought patterns that are keeping you where you are, which is why therapy is often so beneficial for those suffering from depression.
• Try couple's therapy or sex therapy. While individual therapy for your depression is an extremely important part of the healing process, if your depression and corresponding lack of sex drive are affecting your partner, you may benefit from going to therapy together. Some therapists deal specifically with issues of sexual dysfunction, and may help you find ways to reconnect with your partner.
• Consider St. John's wort. For mild to moderate depression, the herbal remedy St. John's wort has been shown to reduce depressive symptoms without reducing sex drive. Discuss with your doctor whether this treatment might be right for you, and be sure to let your doctor know if you're taking St. John's wort prior to starting a prescription drug regimen, as drug interactions are common.
• Get some exercise. Exercise is a natural antidepressant, and also naturally increases libido. Even going for a short walk with your partner every day may do you more good than you'd expect.

Communication with your partner

It's easy to see how depression can have a profound impact on a man's intimate relationship with his partner. Not only do partners sometimes assume a man's depression is their own fault, but if the man no longer wants to have sex, this increases a partner's sense that something is wrong in the relationship. Your partner may feel neglected, unsexy, undesirable or even unloved, so it's vital to maintain open and honest communication during this time.

• Tell your partner how you're feeling and what you want. If there is a type of sex play you still enjoy, talk to your partner about your desires. Be honest about feeling frustrated with your lack of desire, if you are. And admit to your partner that you're just not feeling like sex lately, rather than trying to blame each failed attempt on some outside cause, such as work stress or something about the specific situations.
• Connect physically without being sexual. If you just can't bring yourself to be sexual with your partner, spend extra time cuddling, giving backrubs or connecting in some other way on a physical level.
• Reassure your partner that your depression and lack of libido are not her or his fault. Because they aren't, right? If they are, your relationship has bigger problems to deal with than lack of sex.
• Tell your partner how much you appreciate his or her support. It's not easy supporting someone with depression, but many depression sufferers find that having someone there for them is a huge reassurance. Make sure your partner knows this.

Questions to ask your doctor

• Is the antidepressant I'm on known to cause loss of libido?
• Might a lower dose of the drug still be effective for treating my depression, while reducing the chance of sexual side effects?
• Could St. John's wort be an effective alternative treatment to prescription medication?
• What are the odds that my sex drive will return in time without further treatment?
• Is there anything else you'd recommend I try?

Some men are embarrassed to talk to their doctor or their partner about loss of sex drive, but being honest with about what you're experiencing is the first step toward restoring your sex life. Most men are able to recover completely from episodes of depression and their accompanying side effects, so keep up hope that your sex drive will soon return, especially if you take action and do what you can to restore your sexual relationship with your partner.