Depression

Updated 23 June 2014

Depression and sex

It is common for depressed people to suffer a loss of libido. Why does this happen and what can you do?

The symptoms of depression, like insomnia, a change in appetite, a feeling of worthlessness and anhedonia - a loss of interest in things that were normally enjoyed, including sex - can have an immense impact on libido.

Sleep deprivation is an underreported and underrated cause of decreased sex drive, and although researchers have yet to tease apart the sex-sleep connection, it's likely that the hormone vasopressin plays an important role.

The change in appetite common in depression can affect libido, either through weight gain and a combined feeling of helplessness and worthlessness leading to a negative body image, or even through weight loss due to restricted eating. Research shows that the brain chemical neuropeptide Y, which kicks into high gear in response to food deprivation, also undermines sex drive.

Antidepressants
When depression is treated, a normal libido usually returns, although sadly in some cases, some of the antidepressants used in the treatment of depression, can cause sexual dysfunction themselves. Up to fifty percent of people taking SSRI's experience this side effect.

Fortunately, there are ways around this problem. Discussing the problem with your doctor will allow the two of you to decide which alternative is best for you. The alternatives include: decreasing the dosage slightly, waiting six months until your body builds up a tolerance to the drug and the side effects diminish. Another option is taking a drug vacation, where you stop taking the drug on a Thursday and start again on the Sunday, allowing you a weekend with fewer side effects - although this can only be done with certain drugs under specific circumstances. The other option is to change your drug altogether or to start taking another medication in conjunction to counteract the sexual side effects of the first.

Give your libido a boost
A healthy lifestyle is the best way to ensure a healthy libido. Eating correctly, moderate exercise and enough sleep will help you cope with stress, maintain a good body image and keep those hormones in balance. Nevertheless like weight and romance, libido can wax and wane for any number of reasons, but there is no reason to suffer in silence and feign enthusiasm for a spouse's sake, for fear that diminished interest signals a decaying marriage. A decreased libido is something millions of people around the world each year seek treatment for, and like most other medical conditions it can be treated.

(South African Depression and Anxiety Group, updated September 2011)

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Depression expert

Michael Simpson has been a senior psychiatric academic, researcher, and Professor in several countries, having worked at London University in the UK; McMaster University in Canada; Temple University in Philadelphia, USA.; and the University of Natal in South Africa.

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