How can I both cure my depression and get my sex drive back?
July 29, 2014 10:54 PM   Subscribe

I used to like all kinds of funky sex. Since depression came into my life a few years ago, I've been far, far less sexual. In the last few months, I can't even find the will to masturbate let alone allow my beloved to penetrate me or otherwise enjoy sexual activity with me. I don't want to be depressed anymore, and I also want to get back to embodying the sexual being I used to be. How?

I'm 29 and healthy. Depression began at about age 26. I've been in therapy for two years now. I spent two years on Zoloft and a year on Wellbutrin with no positive results. I use Nuvaring as a last resort, as my depressive symptoms align with my menstrual cycle (PMDD). I smoke a single toke of marijuana in the evenings and I don't drink. I eat better than the average American and work a sedentary job. I try to exercise at least once a week but it's an unbelievable struggle to stick to a routine. I have always been overweight, lost a hundred pounds a few years ago and have put about thirty back on thanks to the Zoloft. My sex drive is below zero; my husband isn't highly sexual either, but would love it even if we could go once a week. Right now, I can only muster the troops to have sex less than onceĀ a month, but I don't orgasm despite lots of effort and would be off organizing my bookshelf if I didn't feel so guilty about being a frigid wife.

Therapist advised that my husband and I should find ways to compromise, which to me sounds a lot like "accept that this is how you are now". Therapist says that "some women are just less sexual", that I should realize how culture causes some women to feel like there's something wrong with them for not having a sex drive. True, but still bullshit; I know I liked sex. I was a happy, sex-positive feminist fully aware of rape culture and all that stuff my therapist is trying to relate to me without using those terms. But it used to be that not a day would go by that I didn't make up some fantasy about a guy on the bus or spend too long looking at a nice pair of hairy man forearms. We used to bring in other partners, play with BDSM, buy sex toys and watch porn together. We are (were?) periodically non-monogamous. These days, the thought of sex grosses me out -- not just with him, but with anyone. I don't feel good when I have sex. It makes my genitals hurt a little, even with lube, maybe out of lack of use? I don't have fantasies; I don't masturbate. I don't seek out movies with particular actors to look at anymore. The sex toys I didn't throw out in disgust have grown dusty. My sexual inner life is completely gone.

He and I love each other a lot, tell each other that frequently, and have great communication, but talking about about this sex stuff makes me feel so sad when I know the only action I can take is go back to the doctor, try a new drug, hope for the best and tell him to hang in there for just a little while longer. He's worried about me, but has also told me that he's stopped initiating sex because it's too frustrating to be turned down. Can't blame him. I'd stop trying too if my spouse expressed the thoughts I have. Haha, I have bought him solo sex toys and encourage all the porn in the world if it keeps him happy. But what about me? I want to have sex again. If this is supposed to be my sexual peak, I'll be surprised if my husband sticks around for the long run. This is ruining my life and my marriage. Please help me figure out what I have to do next in order to help myself, because I'm lost. Can I safely call this a medical issue? I'm a huge cynic, but... can a naturopath help? If not, how many more doctors do I have to tell my life story to until I find one that happens to know some magical prescription combo or vitamin supplement that fixes me? What would be a feasible timeline to use when figuring this all out?

Or is this my lot now and am I doomed to having a spreadsheet made in my honor?
posted by anonymous to Human Relations (10 answers total) 7 users marked this as a favorite

If you're not having sex anyway, have you thought about going off birth control all together just to see what happens? Decreased sex drive is a known side effect of birth control.
posted by bleep at 11:12 PM on July 29, 2014 [1 favorite]

I'm not clear on whether you're still on antidepressants and whether you're still using NuvaRing. Both can interfere with libido, as, of course, can depression. From what you said about PMDD, I'm assuming you want a hormonal form of contraception explicitly to suppress ovulatory cycling?

The sexual peak thing comes from research that found women had the most orgasms when they were in their 30s than at any other age, but the culture and women's lives have changed a helluva lot since the 1950s. Statistically speaking, women do slow down, especially after menopause, but it's by no means universal - some couples have fulfilling sexual lives into their 70s.

Can you work with the notion that over a woman's lifetime, she can have more and less sexual desire at different times? Your grief is real but may be premature. There's no medical fix for low libido in women (although Big Pharma's working on it, because such a drug would make big bucks.) But chronic depression is a relapsing/remitting illness, and it's more than plausible that your sex drive will change throughout your lifetime as your mental and physical health, and your circumstances, change.

By the way, the dynamic you're in with your husband (where he's stopped initiating and there's a whole big THING about even getting started, with everyone all sad and worried and possibly some hurt and guilt on both sides?) is very common in couples with desire discrepancies, even absent depression. It might be worth talking together with a sex therapist about how to cope with times like these, when the discrepancy is really pronounced. (There is no guarantee that your husband will forever be the one with the higher libido...)
posted by gingerest at 12:18 AM on July 30, 2014 [1 favorite]

Exercise is no fun but that's one thing you have the power to do something about. As someone who battled depression my doctor and therapist kept a steady drum beat going as far as exercise goes. For a while I didn't prioritize it, but once I did, I saw some amazing improvements.

It doesn't even have to be strenuous exercise every day. Getting out and going for a 30 minute walk 3-4 days a week can do wonders for depression, overall health, and by extension, maybe your relationship with your husband. Mix in 1-2 days in the place of those walks where you do 20-25 minutes of strenuous, high intensity exercise, and you'll be even more likely to see a difference. It's even better if you can do it with your husband.

Can you make it more of a priority to see what you can do together? I've noticed just how much of a positive impact it has for me, from helping me sleep better, to shaping my appetite in a healthy direction, to making me feel more energized.

Hope you'll feel more confident and healthy!
posted by Old Man McKay at 12:27 AM on July 30, 2014 [2 favorites]

Seconding trying nonhormonal birth control -- if your doctor thinks it would be ok with your PMDD. I struggled with mood/libido issues for years, trying to treat them with more meds (zoloft, celexa, lexapro, etc). Similar to what you described - sex basically just never crossed my mind as an independent thought. Last year I went off depo provera for the first time in 10 years (was on the pill for 3 before that), and miraculously I am capable of being a happy person with a strong libido! I was trying to cure a medical side effect with more medicine; and I went to SO many therapists, GPs, OBGYNs, psychiatrists, and none of them mentioned that I might be experiencing side effects rather than "true" depression. Not saying this works for everyone, but for me it was like night and day. I get pretty bad PMS (not PMDD), but the 3-4 days of feeling like shit is worth it to me to have the other 23 days be so amazing. Tracking my cycle (which I do for contraceptive purposes) also helps to process the various emotions ("why is this lady standing in my way?! why is that kid screaming?! is everyone an idiot today?!?! Oh, wait, slow your roll, you're just on an 'irritable' day, it's not them, it's you, just chill, be cool...").

From a relationship standpoint, I think this:
I want to have sex again.
is the most important part of your post. As long as the issue is also bothering you and you are continuing to try to improve it, I think this too shall pass. Accepting it or not having an interest in changing it would be dealbreaker territory - but that's not your situation.
posted by melissasaurus at 4:45 AM on July 30, 2014 [1 favorite]

If you want to give your partner enjoyment, there are alternatives to penetrative sex. Also, try reading sexy stories or porn to help get your sexual thoughts get working.

Many anti-depressants, including Zoloft, reduce sexuality. Paradoxically, if you increased the dose and it worked, your sexuality might increase due to reduced depression. Yeah, the weight gain is a major drag. Depression is a terrible beast. Really work on getting exercise; it's genuinely helpful.
posted by theora55 at 7:58 AM on July 30, 2014 [1 favorite]

Try looking up orgasmic meditation.. could tick a few boxes?
posted by tanktop at 10:04 AM on July 30, 2014

I would recommend not smoking marijuana for a while. If you're already taking meds for their mood-altering effects, mixing another mood-altering drug into the mix is making the problem worse. There are a lot of things you can do to fight depression that may assist the prescription medications you take. Exercising, getting sunshine, adjusting your diet, cognitive behavioral therapy, finding new things to do are all helpful tactics. My sister has been fighting depression for many years, and these are all strategies she uses to lift her mood when medication alone isn't doing the trick. The sex drive seems strongly linked to your depression and anxiety, so instead of beating yourself up over that or trying to fix it independently, focus on your mental well-being first.
posted by kfrax at 11:01 AM on July 30, 2014

Have you had your thyroid checked recently?
posted by jockc at 11:13 AM on July 30, 2014

Check into copper IUD's. The current combination of your medication and method of birth control are having a party all about keeping you abstinent right now and you need to drag one of them out so that everyone can try to have a better time.

I'm sorry you're going through this, but know that an Internet stranger believes you can find the answer!
posted by rideunicorns at 2:06 AM on July 31, 2014 [1 favorite]

Nthing what other folks have said: the meds, rather than the depression itself, may be the cause of the nonexistent libido. If it is safe for you to go off of all of them, including the Nuvaring, please give that a try for a few months and see if it helps. If it does, that might help you feel good enough to work on your depression in other ways.

In the meantime, if you want to continue having sex despite not being personally into it, it might help to (a) make a private note on your calendar reminding you to initiate it at regular intervals, and (b) attempt to take pleasure in it from the perspective of enjoying the time with your husband, rather than feeling further demoralized. (Also, use a ton of lube and make that part of the fun.)
posted by metasarah at 12:28 PM on August 4, 2014

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