Getting rid of Depression = getting rid of Sex

Alas, that is the trade-off many people who take antidepressants have to make, in order to feel happier. No matter which one you choose — you lose.

Cathy certainly felt that way. After an hour of lying in bed, hands between her legs, she realized that her favorite fantasy was not going to bring her over the edge to orgasm.

Aroused and motivated, she switched on her computer and dove enthusiastically into her favorite porn site. Her body was tingling with the desire to release into blissful orgasm. But orgasm was still not happening.

Next, she brought out the trusty vibrator. Still … nothing. Finally after a few more minutes, she pounded her fist against the bed, let out a frustrated howl and gave up. No orgasm was going to happen today.

It was the second time in a week that she has not been able to reach orgasm. Each time it happens Cathy becomes less and less likely to try again. And after so many failed attempts her desire for anything sexual starts to wane.

Cathy’s experience is not unique. Delay, or inability, to reach orgasm is one of the more common issues women (and men) face when they take antidepressants — specifically the SSRI variety. One recent study estimated that up to 80% of people who took SSRI’s such as Prozac or Celexa had this type of frustrating experience.

It had been 6 month since Cathy had started her treatment, and she felt somewhat emotionally better after taking it. She remembered that before starting the pills she had been too sad and listless even to think about sex. “This is an improvement”, she told herself.

But now that she was feeling better, she wondered whether giving up her ability to orgasm and arousal was worth it. She didn’t want to lose her sexuality. And certainly her partner didn’t want her to, either. He hadn’t said anything to her about it lately, but she knew it was beginning to become an issue.

There is no getting away from that double-edged sword that depression causes a lack of desire, but so does the cure for depression — antidepressants.

Does that mean that those who are prone to depression are condemned to a life without sex?

Unhappily, the SSRI variety of antidepressants (or, serotonin-reuptake inhibitors) are the most popular treatment for depression. However, they are also the antidepressant drugs most responsible for killing sexual feelings in women.

Why? Because, the most common SSRI brands — Prozac, Effexor and Celexa — work by making serotonin more available to cells. This now newly free-flowing serotonin (that is being blocked from being taken up into the cells) blocks orgasm.

While delayed orgasm is the primary effect SSRI’s have on sexuality, there is another insidious secondary effect, suppressed sexual arousal.

The frustration of not being able to reach orgasm ‘teaches’ women (and men) to no longer get aroused. The frustration literally inhibits the arousal. So what is a girl to do when choosing between alleviating depression and increasing sexual feeling?

Most people report a low sex drive with depression anyway. If that is the case, then they wouldn’t be giving up much, would they? You might think so, but that is not necessarily the case.

Studies show that sexual activity, such as “orgasm with masturbation”, and “partnered sex” can actually alleviate depression.

The hormones involved are oxytocin and testosterone, as well as the neurotransmitter dopamine. These are both released during arousal and orgasm — either during masturbation or during partnered sex – and give us a boost in mood and a release from stress, and they help to remind of us of the delicious parts of life.

Not having sex can hurt our relationships and our well-being and can therefore contribute to our depression.

Luckily we don’t have to make those kinds of decisions, as there are some simple solutions to treating depression while staying sexual.

  1. 1.      Use non SSRI antidepressants.

a) Some antidepressants do not act on the re-uptake of serotonin, and therefore it is wise to avoid these sexual side-effects. Wellbutrin (Bupropion) is perfect example, because it is not an SSRI and has few sexual side-effects. Doctors have found that adding Bupropion to other antidepressants has been known to counteract the negative effects of other antidepressant.

b) Viibryd is the newer SSRI, which is believed to avoid this inhibition of orgasm and desire. Manufacturers explain how this drug adds another element, which activates a serotonin receptor (5HT1A gene) to limit sexual side-effects — the same as a placebo. We’ll have to wait and see.

2. Reduce your dosage. Studies have shown that there may be a sweet-spot to dosage that will give relief from depression and still allow orgasm and arousal to occur. Work with your doctor to find the right dosage.

3. Other options to SSRI’s. Some researchers have recently found that placebos are as effective as SSRIs. (Kirsch). Talk to your doctor about looking at other options to depression that don’t involve SSRI’s.