Learning How to Enjoy Sex While Living with Depression and Anxiety

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A therapist once asked me to try and define what my own particular variety of depression felt like. My response felt kind of flippant. But as time’s gone on, I’ve begun to realize that it perfectly encapsulates the condition I still struggle with.

“It’s not,” I replied, “that you feel worthless but that you unequivocally know that you are.”

But mine is only one of the no-doubt thousands of ways depression can manifest.

According to the Mayo Clinic, symptoms can also include feelings of emptiness, a lack of interest in otherwise pleasurable activities, lethargy, physical pain, lack of concentration, and irritability.

And then there’s sex. Already packed with concerns around body-image, performance, emotional vulnerability, rejection, humiliation, physical assault, disease, or unplanned pregnancy, for those trying to cope with depression sex always has the potential to be emotionally devastating.

With that in mind, can depressives ever hope to have an anxiety-free, and even pleasurable, sex life? Or rather, can we learn how to enjoy sex while living with depression and anxiety?

Well, despite that loud and so very assured negative inner voice repeatedly telling me otherwise, I sincerely know that with care, kindness, foresight, and lots and lots of true courage it’s not just possible but a certainty.

You are never alone

Before getting into that, however, I want to step back for just a moment to say that if you or someone you know are struggling with depression then please get help as soon as possible. 

Depression is nothing to be ashamed of: it isn’t because you’ve done anything wrong, are a bad person, weak, or being somehow punished but because you are struggling with a medical or psychological condition. 

And one of the first, and biggest, steps to take in trying to cope with it is to seek assistance. While friends and social networks can sometimes be of assistance, they don’t have the resources or training a doctor or mental health professional has. 

If you don’t know how to contact one, then as soon as possible contact your personal physician, public health services, or call hotlines like the National Suicide Prevention Lifeline in the United States: 1-800-273-8255 (TALK). 

Even if you’re not considering this, still give them a call as they can be invaluable to steer you towards finding the care you deserve. For additional hotlines and other mental health services, PsychCentral has a great resource page.

Another thing I want to say is that, no matter how bleak things may appear, you are never alone in your struggle with depression: the world is filled with people who love and care about you and sincerely want to help. 

Plus, right along with them are others who are also fighting this awful disease, each eager to share their own unique coping mechanisms and even how they’ve managed to conquer it.

Related Read: These DIY Vibrator Workshops Are Helping People Explore Their Sexual Pleasure

Trust and communication

Please remember that as its symptoms, causes, and effective treatments do vary wildly from person to person, anything I’m saying here about depression should always be taken in that context.

In fact, I’d go as far as to say that if anything appears alluring, always discuss the pros and cons of it with your doctor or therapist first, as even though I’ve struggled with these self-destructive feelings for most of my life I’m still only a layperson. 

With that in mind, one of the methods I’ve personally found to try and deal with the sometimes crippling anxiety around sexual activity with a partner is to try to be as open as possible about my depression.

Easier said than done is an understatement—as talking about being a depressive person is rarely considered to be an effective form of foreplay—but years of experience has taught me that it’s far better to simply not play with anyone who isn’t aware, or who won’t be respect and honor my emotional needs. 

BDSM and depression

I’ve even gone so far as to make sharing about my depression an essential part of any initial conversation and, if things go well, the subsequent negotiation. My many years in the BDSM community have been a huge help in this, as these kinds of discussions are a must-do before any kind of play can commence. 

Even so, it’s taken me a long time and a lot of effort to be able to openly discuss what I am or am not emotionally capable of doing, what I need to happen, and what someone might even do if something should go wrong during sexual activity with another person.

Surprisingly, what has helped make this process not so much easy as easier is trying to let go of my former preconceptions of what sex should be and rather make it into an activity that feels emotionally safe. 

Having been born with a penis and testicles, for instance, the inability to achieve or maintain an erection has been a major depressive button. But slowly I’ve begin to be open that because of this anxiety, penetrative sex shouldn’t be expected of me. If it happens then that’s great, but only as an added extra.

Additionally, because of my depression, rejection or criticism hits extremely hard, and while I don’t ever want my partners to lie to me I do ask that they keep this mind before, during, and after play. 

Similarly, I now accept that I prefer to please my partner rather than having them focus on me, finding their enjoyment of my actions much more emotionally positive and therefore sexually exciting.

Factoring in medications 

For many, the use of antidepressants has proven to be very effective though, yet again, how well they work in addition to any side effects that may come along with their relief, is very personal.

One of the most common of these side effects is their effect on a person’s sexuality, which can be everything from a complete lack of interest to the inability to orgasm. 

While these can be annoying, and even on some occasions result in a new issue adding to a person’s depression, I personally say that rather than abandoning their use to first consult your doctor or therapist as often there are other medications available and, second, try to factor in how the medication acts on your sexuality,

It’s very much like being open about your needs as a depressive: if you know how your meds affect your sexuality then discuss that as well, including how it could change how you and your body used to respond.

Again, it’s not an easy thing to do but can be more than worth the effort to minimize giving fuel to your depression through frustration or disappointment.

Loving yourself

If you’ve looked up anything to do with depression, then this should come as no surprise but, even so, it’s always worth repeating: that loving yourself for you who are can frequently be one of the most effective ways to cope with these kinds of negative feelings

Self-love isn’t just a couple of words, though: it can be a tremendous battle, as it goes so much against the lies that depression tries so hard to make you think is real. But depression is exactly that: it’s a biological illness, a mental condition and is never who you are a person, or how people feel about you. 

This is real: You are worthy of joy, you are worthy of happiness, and each and every day you get up, make even the smallest step forward, is a victory in maybe perhaps not completely defeating but at least successfully dealing —one day at a time—with this serious condition.

You will do this. You are brave, strong, wonderful, beautiful and despite what the depression may try to make you believe, you are loved!

Image sources: Sydney Sims,  Steve Snodgrass, De’Andre Bush