Depression and Sex - Joellen Notte

Depression Kills Sexual Pleasure and Destroys Relationships, Right? Not so fast…

Depression means the end of sex and, consequently the destruction of relationships. It’s one of those things that feel like common knowledge. It feels like something everyone just knows and doesn’t even really need to be said because we are all aware of it already. It’s devastating but there’s nothing to be done because that’s just the way it is, right? But what if I told you that that’s not necessarily the case? That, while depression’s impact on our sex lives and relationships can be devastating, there are things we can do about it.

When Allies Become Adversaries (aka “Resentment Sucks”)

I truly believe that depression does not inherently do harm to our relationships. While it (and the treatments we receive for it) may affect our sexual function and add challenges to our relationships, I believe that it is resentment that does the relationship-ending damage we associate with depression. So, where does all of this resentment come from?

We live in a world that treats both mental health and sex as taboo topics, leaving most of us without the ability to discuss them openly. This leaves folks who are experience depression without a way to communicate what they need, it leaves their partners with no understanding of what’s going on, and it leaves everyone with no way to address any sexual issues the depression might be causing. Consequently, we end up resenting each other. This isn’t inevitable, though.

Here are some things we can do to keep our sex lives and relationships not just alive, but thriving in the face of depression. 

Get on Their Team

Your partner doesn’t want their depression to be there any more than you do (in fact they probably want it there even less than you) so get on their team.  What does that mean? It means following their lead. It means listening more than you talk. It means trusting your partner. It means believing them when they describe their symptoms. It means learning what depression is. It means not trying to fix them. It means meeting them where they are. It means recognizing that they aren’t their diagnosis. It means being willing to communicate differently. Clearly, it means a lot of things.

Getting on your partner’s team is making the mental leap from being frustrated, thinking of your partner as someone who “has depression,” to recognizing the symptoms of depression that show up in your partner and being able to ask the right questions when they do. This is the first step towards fortifying your relationship and avoiding resentment.

Make Conscious Sexual Decisions

When it comes to depression, a popular piece of sex-related advice is “Just do it!” Often well-meaning folks put this out there on the grounds that sex is nice and once we do it, we’ll remember that we wanted to do it- huzzah! The problem here is, what if you make yourself “Just do it,” and realize you didn’t want to? Folks who are dealing with depression often face a degree of disempowerment and forcing oneself to do something you don’t want to do is only going to make that worse and lead to more what? You guessed it, resentment!

So what do you do? Make conscious decisions about sex. Think about it a bit every day. There’s a kernel of truth in the “just do it because you might figure out you wanted to after all” advice and here’s that kernel: If, upon examining your feelings you find that it’s not that you don’t want sex, it’s that you want it but you are struggling with acting on the impulse (because depression can do that- stuff suddenly seems super onerous) this might be a time you consider “Just doing it”. If however, you sit with it and the idea of having sex “seems totally foreign”, or “actively turn(s) your stomach” (both actual ways folks with depression have described feeling about sex to me) and you’re just not there at all, this might be a time to step away for a bit. These are things you can communicate with your partner about so that you stay on the same page, which is always good!

Be Sexually Flexible

In researching my book. The Monster Under the Bed: Sex, Depression, and the Conversations We Aren’t Having I found one issue came up over and over again in reference to maintaining a healthy sex life while coping with depression: the need for flexibility. I often say that folks get tripped up by wanting the path to sex to be short, straight, and completely familiar. The truth is, it is not.

What About Sexual Side Effects?

Folks seem pretty clear on the fact that antidepressant medications can come with “sexual side effects”, the term frequently goes undefined. So what are they and what drugs cause them (spoiler alert, it’s not just antidepressants)? Here are some answers:

What do we mean by “sexual side effects”?

Usually when we talk about sexual side effects we are talking about these things:
• Loss of libido
• Erectile Dysfunction
• Vaginal Dryness
• Genital Numbness
• Delayed Orgasm
• Anorgasmia (Inability to orgasm)

What drugs can cause them?

My research is in the area of depression and its treatment but antidepressants are far from the only medications that can alter our sexual function. The list includes (but is not limited to):
• Anticonvulsants
• Antidepressants (SSRIs, MAOIs, Tricyclics)
• Antihistamines
• Anti-hypertensive medications
• Anti-manic medications
• Anti-psychotic medications
• Benzodiazepines
• Beta-blockers
• Birth control
• Opioid pain killers

What Can We Do About Sexual Side Effects?

Sexual side effects are often regarded as an insurmountable necessary evil, as if giving up sexual pleasure is the trade-off one must make for health. This is so not the case. There are things you can do about them – and most of them are fun! You can always talk to your doctor about it and try to find a different medication that works for you. But sometimes we find a medication works for us, we’re happy with its benefits and don’t want to change meds, but it also comes with this huge downside. So, how do we navigate this stuff? I’ve created this list of recommended products for keeping your sex life alive when you’re coping with sexual side effects and some ways we can work around them to keep pleasure coming while staying healthy.

Wand Vibrators

When coping with genital numbness, delayed orgasm, or anorgasmia, a large, strong, wand-style massager can be a powerful tool. As far as I’m concerned, the biggest reason for this is their ability to deliver incredibly strong vibration to large areas. Why is this important? Well, maybe the stimulation you’re used to isn’t working, but maybe stimulating a different area would. Or maybe the whole area needs to be stimulated all at once, by something extremely strong. The upshot is, the internal clitoris is huge, the CUV region is expansive, and the perineal sponge is often completely neglected. A large powerful tool can help you get down to business and find pleasurable sensation anywhere it might be. Additionally the sheer power can be enough to get you past the hurdle of your meds.

Textured Dildos and Plugs

Textured toys can be fantastic because they produce so much sensation! Especially if you’re like me and don’t often use insertable toys, dildos and plugs with a bit of texture can feel like a wake up call to your genitals!

No-Erection-Needed Penis Toys

All too often folks treat erections as the center of sexual activity and pleasure but there can be pleasure without an erection! Wand vibrator attachments for penises can be a powerful way to deliver sensation — a possibly elicit orgasm— even when erections aren’t happening.

LUBE. Lots of lube.

Why? Well, clearly, if you or your partner has a vulva and is experiencing changes in lubrication it’s just a necessity. Seriously, it’s necessary, beyond that, lube just makes everything feel better.

Impact & Sensation

My reasons for suggesting playing with sensation are several-fold: First, let’s take the pressure off “sex is these things we do in the bed” and maybe find some other fun playing. Secondly, several of the meds that can cause sexual side effects can cause an overall dulling of sensation – everything feels kind of “meh,” impact play or something like electrostimulation are great ways to break through that, to feel something when your body seems to not be feeling stuff.

Putting it All Together

While we may hear a lot about how depression will destroy our sex lives and end our relationships, there things we can do about it. By communicating with our partners, getting on the same team, and being willing to explore, we navigate it together.

Sound good? Check out my book The Monster Under the Bed: Sex, Depression, and the Conversations We Aren’t Having, the product of 6 years of research including surveys and interviews with over 1300 people who have lived with depression— to learn more about how you can keep your relationships strong and sex lives healthy in the face of depression.


Joellen Nottte 2020

JoEllen Notte is a writer, speaker, researcher and mental health advocate whose work explores the impact of depression on sex and relationships. Since 2012 she has written about sex, mental health, and how none of us are broken on her award-winning site The Redhead Bedhead as well as for Glamour, The BBC, Bitch, PsychCentral, and more. You can read her blog at and follow her on Twitter at @JoEllen Notte. JoEllen's book, The Monster Under the Bed: Sex, Depression, and the Conversations We Aren't Having was published by Thorntree Press in March 2020.


Twitter @JoEllenNotte

Instagram @JoEllenNotte

Facebook @JoEllenNotte


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