Sex, stress, and depression …
How to stay connected when desire fades
Recently someone contacted me with a question and after some talks with colleagues I formulated a response that ended up being much longer than I intended. Since this is not the first time I got this kind of question from a friend, I thought I’d share both the question and my answer with you in the hope that it might be helpful for more people. The question came from a woman in a heterosexual relationship, and therefore my answer is written with that woman’s perspective in mind. However, much of what I talk about transcends gender and sexual orientation. So, I would recommend to read it and take from it what helps you. If you have questions about how this could apply to you, you can always reach out to me.
Her question:
“Since my depression, my libido has been basically zero. We still have sex occasionally, but more for him than for me. So far it hasn’t really returned. It’s also causing some tension in the relationship. Any tips?”
My answer:
“First of all, and you probably know this, but loss of libido is a very common consequence both of depression and of anti-depressants. Just to stress that it is very normal (but shitty) and an experience shared by many.[1]
Sometimes it can help to recognise that having less sex is a contextual factor linked to the depression and not necessarily a result of the relationship not being good. We often automatically assume that less sex means something is wrong with the relationship and more sex means the relationship is fine. The two don’t necessarily have anything to do with each other. This assumption often creates a lot of pressure around having sex, which then further reduces pleasure and lust. Pressure, for most people, is the ultimate libido killer – especially for women.
Overall, the topic is super complex and can have a lot of hidden layers, all of which can be difficult to deal with. Here are some impulse questions that might help you understand what this topic means for you:
1. “Is the sex worth wanting?”
One common dynamic is that there was already dissatisfaction with the sex before the depression started. Depression can then be a convenient excuse to retreat even more from it. This is usually not conscious. So, an interesting question would be: is this frustration linked to the depression, or is it pre-existing? To put it roughly, is the sex you have with your partner “sex worth wanting”? Very often, especially in long-term relationships, women’s answer to this question is "no". This might sound harsh, but it is a wonderful opportunity to take a closer look and see what “sex worth wanting”looks like for you. The exercise "brakes and accelerators" from the book Come As You Are is one useful way to figure out what great sex means to you.
2. “Is it depression… or the way your environment responds to it?”
Another common dynamic is that when people suffer from depression, their environment starts treating them differently. Loved ones often try to shield the depressed person and treat them with much more care, as if they could break at any moment. Even when this is done with good intentions, it usually does not make a woman feel strong, confident, sexual, or desirable. So, this might be something to watch out for. Is the libido going down simply due to biochemical changes, or is it also a result of changes in dynamics at home, work, etc.? Why is she not feeling like sex—because she is feeling what/like what…? One of the most important female “sex organs” is their mind after all…
3. “It’s not always about sex — it’s about what sex means”
Another interesting question, maybe linked to question 1, is why do you have sex? The answer may be different for you and your partner. Is it for connection, to feel close, for physical release, to feel empowered…? Here is a short list of 237 reasons why people have sex - for some inspiration. When you know why you have sex, it can take the pressure out of the situation to see if you can meet that need in a different way. Let’s say it is for connection. Then you can look for other ways of feeling connected in a period when you’re having less sex. This makes the lack of sex less threatening and lessens the pressure around it. Then you can focus on the problems at hand both for you and for your partner: what needs are not being met by both parties due to the lack of sex, and how does each party interpret there being less sex?
4. Sex for him or for me? And what the vagina has to say about it.
Why are you still having sex with him, for him? Maybe this is completely fine for you. Some women feel at peace having sex with their partner and seeing that it makes them happy. But many women do it out of a sense of obligation, as if it is a woman’s duty, and the relationship is not safe or secure if she does not provide sex. Men often (but not always) do not share this viewpoint, but we women have deeply internalised it. An open conversation about this can help! The core question is, does it feel okay for you to continue having sex, or does it feel like you is neglecting your own boundaries? If the latter is true, I would take a closer look as to why you are still doing it. And I would be careful, because the body can start setting boundaries when the mind is too stubborn to listen. This can then translate to vaginismus, or tension in the pelvic floor and pain during sex. Don’t panic—this can be treated but it would be nice not to stretch our boundaries to the extent that our vaginas are literally locking the gates.
5. Practical steps to make a stressed nervous system feel safe
Now to get to some practical things. There is a lot out there… I already mentioned above to really explore what gives pleasure and how you can create a setting that is likely to invite lust in (e.g. using Come As You Are). You cannot force lust, only make it more likely to arise.
Another thing people try is taking sex completely off the table for a while. To takethe pressure out of the situation… for example, by agreeing to have no penetrative sex for a period of months. The clear agreement and mutual decision-making, rather than aa relationship in crisis, can really relax the situation for some (some people also get turned on by the idea of the forbidden sex ☺).
Another thing is to take a closer look at what the sex really looks like. For example, how does it build up? Is there foreplay? Does penetration come too quickly? Someone struggling with depression is usually not in a pleasurable, relaxed state of mind. So, we can in most cases assume that there will be responsive rather than spontaneousdesire. That is, desire that arises as a response to touch instead of desire that’s already there before you get it on. A depressed nervous system might need a LOT of warming up to feel relaxed enough to even consider getting aroused. So slow it down!!! Tantric sex practices could be a great way to start. They are all about slowing down. Massaging, warm showers before, breathing, non-sexual touch, super slow sex… Do everything you can think of to calm the body and the mind. Get naked together and start by slowly touching each other’s bodies (no genitals) and breathing together. I know this might sound strange, but an activated nervous system needs time to arrive in the body. Extensive foreplay and relaxation is often a must to get out of your head. Good sex needs time and space, and in this day and age we often do not create that.
A key element in finding pleasure again is often finding pleasure outside of the bedroom first. Many people don’t rediscover it in the bedroom, with all the expectations and emotions that linger there. So what small things give you pleasure, make you feel sensual? Start there.
6. What if we expand our definition of sex?
The last point, that should maybe have been the first, would be my question about what sex even means. Sex can mean so many things, and many of us define it strictly as penetration. But what if sex is already a gentle touch between lovers, a kiss hello, a gentle touch here and there? A narrow definition of sex can create a lot of pressure – but what if you expand your definition? What if you focus more on emotional and physical intimacy than penetrative sex? What would change?
Overall, we have a tendency to problematise our sex lives by comparing them to unrealistic norms. This is a great opportunity to question these norms. Who says that you need to have sex once a week, once a month, or on any set schedule to have a good relationship? Maybe it is also okay to write sex off for a while and enjoy other elements of the relationship, to focus on solo sex (masturbation) instead? This doesn’t mean it will always be this way, but maybe for now it is? Of course only if this feels okay for both you and your partner.
And of course it is also okay if all of this is too much for you to manage alone. You can always see a couples counsellor or sex coach a few times to help you have this conversation. You can join workshops or events that facilitate your journey if you are comfortable with it. This is not a sales pitch, but of course I do what I do because I know people struggle to have these conversations alone. The great thing is, you don’t have to do it alone.”
