Best Way to Maintain Intimacy and Sex When You Are Depressed

You always enjoyed my sex life, but recently it hasn’t been very satisfying for me or my partner. I just haven’t felt like making love. I feel so tired all the time that sex is the last thing on my mind. Even when I get aroused enough to want to have an intimate moment with my partner, I find it very difficult to achieve orgasm. I feel like it’s created a lot of tension between us, and, although I know my partner still loves me, our time together just doesn’t seem to be the same.

Depression can create special problems in intimate sexual relationships. Because depression tends to dimin­ish one’s appreciation of pleasurable activities in life, it fre­quently causes frustration and disappointment in sexual encounters, leading to decreasing sexual contact and loss of intimacy. At a time when the depressed person needs increased support and caring, he or she may have difficulty feeling close to the most important person in his/her world.

Maintaining intimacy and sexual contact with your partner

When depression is at its worst, sex can be a very low pri­ority. Depressed individuals sometimes feel as though they’re barely surviving life, and may have difficulty becom­ing sexually aroused or maintaining concentration on sen­sations and experiences that they would usually find stimulating. They may also feel fatigue or a lack of pleasure in general, and may not look forward to sexual encounters even with a loving and gentle partner. Many depressed peo­ple have feelings of worthlessness or lowered self-esteem, or beliefs that their bodies are no longer attractive to their partners. Some will “force” themselves to have sex and then become frustrated over inabilities to physically accommo­date their partners comfortably. Orgasms may be difficult even with careful prolonged stimulation.

The effects of depression on sex are not limited to the depressed individual. Often the partner will have complex feelings about the relationship. These can range from guilt about asking the depressed partner for intimate contact, selfishness for encouraging a fatigued partner to have sex, or frustration and sadness in watching the depressed indi­vidual withdraw from a previously fulfilling aspect of the relationship.

Broadening your sexual pleasure

For humans, sex can be much more than the act of inter­course. People can find enormous pleasure and enjoy­ment from many other intimate activities. Couples who are highly satisfied with their sex lives often view “sex” as a range of behaviors including kissing, caressing, sexual and intimate talk, exploring each others’ bodies, experi­encing the taste and smell of their partners, and sharing sexual fantasies as well as intercourse and orgasms.

Depressed individuals often underestimate the amount of sexual interest that can be evoked by skilled and caring partners. Setting limited goals (e.g., sitting together and holding one another with no expectation that sexual intercourse will result) can often set the stage for increasingly intimate experiences where partners do not feel rushed. Time spent together walking, talking, or doing projects frequently deepens the desire for intimacy, which can often be very fulfilling for both partners. Part­ners can learn to perform sensuous massage and other relaxing experiences that promote closeness. For many people, these intimacy experiences are more important than sexual orgasm. It is important for couples to talk with each other about their expectations. You may find that your partner is less interested in orgasm itself than the process leading up to it.

Medications and sex

While loss of interest in sexual activity and difficulty in achieving orgasm can be part of depression, they can also be the result of medications used to treat depression. As many as 20% of people taking antidepressants report that their ability to enjoy sex or to achieve orgasm is diminished. Usually this is a temporary or slight decrease, but in some cases it can result in a dramatic decline in interest or abili­ty in a person who was previously sexually well-adjusted.

You need not feel discouraged, however, about taking medications for your depression. There are many ways to deal with this medication side effect, and you can talk with your doctor about your options. Some antidepressants have no negative effects on sexual functioning, and your doctor may suggest that you switch to one of these. The most important consideration is to get your depression under control. For the vast majority of people, the interest in sex will return naturally as they recover.

Above all, remember that although depression may temporarily diminish the quantity and/or quality of the sex that you or your partner enjoy, adherence to treatment and exploration of alternative forms of intimacy will gradually restore the satisfying physical and emotional contact you previously enjoyed in your relationship.