Mental Health, Sex, & Intimacy
Steph Auteri is a journalist in the sexuality space whose chronic depression and anxiety (among other things) have definitely put a damper on her libido. Renée Burwell is a psychotherapist and educator with a specialization in sex therapy and trauma who has professional knowledge of how even the treatments for various mental health issues can impact desire. Together, they decided to shine a spotlight on how mental health intersects with sexual health, and how—in the face of that—we can all optimize our overall health.
It’s no secret that there’s a strong correlation between mental health and libido. Back in May, Steph wrote about the connection between mental health and libido within the context of the COVID-19 pandemic, a time during which we’ve all been grappling with higher-than-usual levels of fear, anxiety, and grief.
But some of us have been struggling with chronic mental health issues for years. So, what do we need to know about managing mental health and its sexual symptoms over time?
How Mental Health Impacts Libido
Research shows mental health issues such as depression, anxiety, and other psychiatric illnesses have sexual side effects. Depression, for one, is often associated with lower levels of desire, while bipolar disorder and mania are linked to hypersexuality. Anxiety, meanwhile, has been linked to anorgasmia (inability to orgasm), premature ejaculation, and even sexual pain. And these physical symptoms aren’t the end of it. Certain mental health issues can also lead to intimacy avoidance, whether because of fear of abandonment, self-consciousness, low self-esteem, or even exhaustion.
While you might think that tackling the root cause—your mental health—would eradicate the sexual symptoms, the treatments for depression, anxiety, and other psychiatric illnesses can also have a significant impact on our sex lives. For example, while we’ve mentioned that depression has been shown to have an adverse impact on desire, many antidepressants and anxiety medications have been linked to inhibited arousal and desire. Other medications can cause vaginal dryness, weight gain, or impotence, all of which can impact a person’s sexual self-confidence, leading them to withdraw from sexual activity.
So, how can you take care of your mental health without giving up on your sexual health?
Communicate with Your Medical Provider
Let’s be real here—there are not nearly enough medical practitioners checking in with their patients about their sexual health. Sexual health is one of the most neglected areas of focus in healthcare.
This stems from the fact that most medical and mental health educational programs provide very limited, if any, knowledge regarding sex and sexuality and, if it is offered, it’s typically considered optional.
So it’s no surprise that, according to one survey, fewer than two-thirds of doctors routinely ask their patients about sexual activity, only 40% ask about sexual problems, and just 29% ask their patients about sexual satisfaction.
Patients, by extension, often feel weird about bringing it up.
But, if we want our medical providers to treat every part of us, we need to speak up about what we’re experiencing in the bedroom as a result of either our mental health or our medications. Our doctors and mental health providers, in turn, will be better able to prescribe the medications that are right for us, tweak dosages accordingly, or even recommend more holistic treatments in support of both our mental and sexual well-being.
Don’t be afraid to seek out a second opinion. It’s important that when seeking care, one looks for providers with knowledge and comfort around sexual health. Make sure you’re seeing providers who are sex-positive and knowledgeable about the complexities of sexual health. AASECT is a great resource for finding a provider who has a strong foundation in sexual health. Remember to be your number one advocate for your sexual self and health.
Communicate with Your Partner
When we struggle silently with our sexual issues, treating them as a problem we need to fix ourselves, our partners are left to make all sorts of faulty assumptions. They may feel rejected or unattractive. They may wonder why we no longer seem to be invested in that intimate relationship.
Instead, we should be honest with our partners about why things have shifted in the bedroom. With understanding, there can be acceptance. Then, both of you can move forward to pinpoint solutions that leave you happier and more sexually satisfied.
And you don’t have to tackle issues with libido alone. Seek out a qualified sex therapist who can help both you and your partner feel connected to your sexual selves and to each other. Most couples wait five years before seeking a professional, which can end up exacerbating these issues. Don’t be afraid to communicate and ask for help at the first signs of stress.
When it comes to sex advice, the top two tips often boil down to communication and an openness to approaching sexual activity in new ways. That’s because, when we move past a rigid, goal-oriented definition of sex, we open ourselves up to so many new sources of pleasure and intimate connection.
The way we experience pleasure shifts so many times over the course of our lives, for so many reasons. These include aging, relationship status, illness, environment, stress… our mental health is just one more thing among many that can impact our sexuality. So, if we’re not willing to play with different forms of pleasure—if we’re not willing to expand our definition of what sex is—we may end up having a lot less of it.
Everyone has a right to experience pleasure. What pleasure looks like for someone else or even your past self may not be what works for you today. Be open to exploring and to connecting to sex in new ways. Mental health issues do not have to define your pleasure.
Finally, it’s important that we prioritize sex as a natural and beneficial practice in our lives. Many of us have things we may not enjoy doing to take care of ourselves, such as getting up early, exercising, practicing healthy eating habits, and doing our hair, but we do them because we know they’re good for us long-term. Sex and sexual health should be incorporated in our self-care in much the same way we incorporate combing our hair or brushing our teeth.
And remember: It’s okay to have “good enough sex” versus infrequent activity that only increases anxiety, pressure, and discomfort in future sexual encounters. A dip in desire, a lessening of spontaneous desire, or a struggle with erectile dysfunction are not in any way an indication that our sexual health is any less important.
Our struggles with mental health do not have to mean the end of a satisfying sex life. Your pleasure is within reach. It is certainly attainable—it may just require some adjustments and creativity.