A little over a month ago, my boyfriend returned from work early in tears. He sat me down in our living room to tell me something I already knew – he had depression. For the first time since his mood had swooped to a dark place mid-lockdown, he was using the big, bad D-word and admitting that he needed some help.
Within days he had joined the ever-growing population of UK adults needing antidepressants. NHS data shows us that 70.9 million antidepressant prescriptions were vended in 2018, and while the data for antidepressant prescriptions in 2020 won’t be available for some time, we know that the pandemic and subsequent lockdown has considerably affected the mental health of UK residents with almost one in five adults admitting to experiencing some form of depression in June 2020.
Naturally, I supported his need for medical support. In the two years we’ve lived together he’s seen me pop my much-needed 40mg of Fluoxetine on a nightly basis, regularly reminding me to take my pills and berating me when I’d forget to order a repeat prescription. I was proud of him for taking the steps he needed to help manage the mental health issues he was having. However, one thing did flash up in my mind – if we were both taking antidepressants, what on earth was going to happen to our sex life?
For people living with depression, the sexual side effects of their medication are an unavoidable reality. I’ve been on antidepressants for over five years, and know that a decrease in my libido and inability to orgasm through sex with another person has caused me no end of stress over the years. As proud as I was of both of us for getting the help we needed, I did wonder how our relationship would fare when both parties were experiencing lack of arousal or difficulty reaching orgasm.
Like me, 27-year-old Ava* was taking antidepressants when her partner was also prescribed an SSRI two years into their relationship. She’d never experienced sexual side effects from her medication, Sertraline, but her boyfriend soon became completely disinterested in sex. Neither of them knew this was a side effect of antidepressants and, over time, she says their relationship became more like that of flatmates.
For Ava and her partner, it wasn’t just the sex that took a hit, but intimacy in general: “For six months after that he wouldn’t hold my hand, kiss me in public – nothing”, Ava tells me, “there was no intimacy at all.”
Without understanding the reason behind his disinterest, she began to feel inadequate. “I just didn’t feel like he was attracted to me anymore and it made me question everything about myself and my body image – I cut my hair, changed my hair colour, everything I could think of to attract him again and it didn’t work.” Half a year after he began taking the medication, the pair decided to split up.
This experience was similar for 41-year-old Shana*, whose husband of 17 years began taking antidepressants in 2016. Six months after he started taking the medication he lost the ability to orgasm, and in the year that followed the pair only had sex three times. Again, neither of them knew that antidepressants were the reason behind it.
Like Ava, Shana felt the emotional repercussions of this change in the relationship. “My sexual confidence dropped to an all-time low and I then lost my libido. This made things even more frustrating for him and we began to argue about the lack of sex in our life. I couldn’t understand why I wasn’t attractive enough to make my husband orgasm, and in turn he felt abandoned by me.”
Neither Ava’s or Shana’s partners had been informed of these potential side effects by the medical professionals that prescribed them. Shana’s partner mentioned it by chance during a routine doctors appointment and was only then informed it was a side effect of the tablets. “It was a huge relief to know it wasn’t us,” she tells me. “Suddenly we were able to talk very openly about things and we mentioned it to close friends who told us they’d been through the same thing – we even managed to have a good talk and a joke about it.”
The key element that helped Shana’s marriage survive was the couple being open with each other about how they were feeling. Communication when navigating a situation like this is far and above the most important thing to consider, couples therapist and Counselling Directory member Laura Vowels tells me.
“Talking about things openly is always the best option. Sexuality is such a sensitive topic and often people can make it worse if the conversation isn’t addressed carefully. Start slowly and focus on the feelings, making sure to not blame, criticise or make any assumptions about your partner.” She reminds me that perhaps the partner in this situation might not be ready to talk about it and to respect their wishes, however, carefully bringing up the way you feel (without the use of blame) will no doubt aid this vital discussion.
Alongside healthy communication, Laura encourages partners to, "take sex off the table" and instead focus on physical, non-goal-oriented touch, taking time to explore each other’s bodies without the pressure for arousal or activity at the end of it. She also reminds me that more often than not, not wanting to have sex has more to do with us than it does our partner, and that often it’s not a lack of sex that’s the problem, but a lack of intimacy, closeness and connection.
In male/female relationships especially, toxic masculinity and societal expectations can play a huge part in preventing male partners from feeling comfortable talking about issues they may be experiencing sexually. “Societally, we expect men to always be hungry for sex, be good in bed and last as long as is needed, but none of these myths are real.” She encourages their partners to be sensitive to this and not to push them before they are ready.
As for myself and my partner, as much as we enjoyed a healthy sex life in our past, the mental wellbeing of both parties take paramount importance in order for our relationship to thrive. And sure, things might begin to change over the next few months as we get used to us both being on medication, but as long as we’re both mentally well and are prepared to adhere to the golden rules of talking about it, we’re prepared to overcome these hurdles in the name of happiness and good mental health.
If you are struggling with your mental health, please make an appointment to see your GP or contact Mind on 0300 123 3393 or text 86463.