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I often hear from clients struggling with depression and anxiety that sex just isn’t what it used to be. They may be less interested in sex in general (much to the chagrin of partners), or they may have trouble with orgasm and satisfying sexual experience. Being unhappy with your sex life can feel disheartening and frustrating to say the least, especially when grappling with low mood or anxiety on top of it all.

There are many possible contributors to low libido or trouble with orgasm. Both underlying depression and anxiety AND the medications that we sometimes use to treat those can cause these frustrations. Clients will often stop taking their antidepressants suddenly or too soon, hoping that they are to blame for a lackluster sex life. It can also be easy to blame partners, work stressors, family obligations… the list can go on and on. But like all aspects of health, sexual health is complex! There may be one or a dozen reasons why our sex lives have gotten off track. Here are three things that commonly impact our sex lives, and what we can do about it.

Depression and anxiety

Lack of interest in sex can be a primary symptom of depression. With depression, most things you normally enjoy, including sex, just don’t sound fun anymore. Anxiety, especially when chronic, can also cause decreased libido, as anxiety plugs us into the “fight or flight” state, where we cannot relax enough to feel sexual, or be present during sex. Luckily, depression and anxiety are very treatable. There are many things you can do to address these unhappy mood states. Often the best plan is combination of methods- psychotherapy, medication, improving sleep, reducing stressors in your life, acupuncture and massage, exercise and nutrition- all of these are opportunities to improve mental health and get your sex life to where you want it to be.

Relationship dynamics

Trouble in your primary relationship can also be a root cause for a less than stellar sex life. It is very common to blame the sex itself as the reason for unhappiness, as it is much easier to focus on, in comparison to complicated relationship dynamics. More often than not though, it goes the other way- sexual satisfaction follows personal satisfaction in your relationship. An uninspired sex life can be a thermometer for how things may be going between two people, even two people who are fully committed and want to be good partners. Couples therapy can be so helpful in this area, as these root dynamics are often complex and loaded. A therapist can be an unbiased third party to give everyone a voice and get some things on the table that may seem too difficult for a couple to address alone.


Many people are aware that antidepressant and antianxiety medications can cause decreased libido or trouble with orgasm. However, there are many things you can do to address these side effects without stopping a medication that has been helpful to you. You may need to change the dose of your medication, or switch to another similar medication. Or, you may need to add a medication to specifically address sexual side effects. Talk to your clinician before stopping your antidepressant if you are unhappy with it.
Because of the stigma around the topic of sex, we often avoid discussing unhappiness in our sex lives with others. I encourage you to voice your concerns with your clinician or therapist, to get support for what may be going on for you. Taking care of your entire self and your relationships are fundamental to a happy sex life.



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