What to do when depression & antidepressants kill your libido: real talk & my story

Depression tanks your libido. Then you finally get help with antidepressants—and your sex drive tanks even more. If this is you, you're not broken. You're dealing with a real, common side effect that nobody wants to talk about.

In this episode, I break down the double whammy of depression and SSRIs on your sex life: how depression shuts down motivation (including for sex), why antidepressants compound the problem by affecting serotonin and dopamine, and how orgasm difficulties create a feedback loop that kills desire even further.

I also share my personal story—how I dealt with depression, the mental scripts generating self-hatred that my brain was trying to protect me from, and how I got off meds through coaching and massive self-compassion work. Literally re-writing the thoughts in my head changed everything.

We cover: what you can actually do about it (medication options, body-based approaches, relationship support), why this isn't your fault, and how to stop choosing between mental health and a satisfying sex life.

Quick note: I'm not a medical doctor—this is educational, not medical advice. Always talk to your doctor about medication decisions.

Get my free guide: 5 Steps to Start Solving Desire Differences
(Without Blame or Shame), A Practical Starting Point for Individuals and Couples, at https://laurajurgens.com/libido

Find out more about me at https://laurajurgens.com/

Transcript

0:01  
Welcome to the desire gap podcast. I'm your host, Dr Laura Jurgens, and whether you want more sex than your partner or less, you are not wrong, and your relationship isn't doomed. You just need better tools to solve the struggles of mismatched libidos. That's what we do here. So welcome and let's dive in. Hey everyone. I am really glad you're here today. Welcome today. This is episode 99 which means the next one's 100 so I am going to be celebrating that. And yeah, I'm glad you're here. We are going to talk today about something that affects millions of people, but often we are not getting enough help, and we're really not talking about it, and that is the millions and millions of people dealing with depression and who have maybe finally gotten help with medication, But then are experiencing a big impact on their sex life. So it could be through tanking your libido, it could be through affecting your orgasm, and it could be through both. So right? That sucks. It really sucks to feel like you have a trade off between mental health and connection pleasure, all those things. So quick note, before we dive in, I am not a medical doctor, even though I have a PhD in biology, that doesn't mean that I'm a medical doctor, and this is not medical advice. So I am a relationship coach, and what I'm sharing today is educational information, and you should always talk to your doctor about medication decisions and side effects. And I am going to get into that a little bit more about how to talk to your doctor about this too, and the type of questions that some of the things you might want to ask. But today I'm also going to share some of my own experience with depression, because it matters, and because I think when we don't talk about it, it reinforces this idea that somehow there's shame around having this really common medical condition, and there isn't shame, there's no shame, there should be no shame. And so we need to be able to talk about this and normalize this and its real impact on people's sexuality, rather than pretending that sexuality somehow doesn't matter. So just to dive in today, this is depression is really a double whammy in a lot of ways, because depression itself really shuts down libido a lot, and that's because your brain in depression is already shutting down motivation for action, and that includes the action of sex. So this is not laziness. It is not that you don't love your partner. It is your brain trying to protect you by powering down and a loss of pleasure in generally many things in life is a hallmark of depression, and it affects everything, including your access to sexual pleasure, including your access to pleasure with masturbation or interest, even in pleasuring yourself or motivation and energy to do pretty much anything, even the things that feel good normally. So that is a major issue. And if you are dealing with depression and you haven't gotten any treatment, I want to really invite you to please reach out to your doctor, to a good therapist, to a psychiatrist. 

Psychiatrists are mostly just going to give you pills these days, so they are not substitute for therapist, but it is often really helpful when you are in a depressive episode to or you have major depression for a long term, like I did, to have medical intervention and medication support. And there is nothing wrong with that. If we get if we have diabetes, we take insulin, right? If we have high blood pressure, you might take medication for that, right? If you are ill in some way, shape or form, you're going to take some sort of medication. And depression is an illness. It is not forever, necessarily. And for most people, it is not forever, but you may need some short term or somewhat medium or long term support from medications. Okay, so the most commonly prescribed SSRIs, which are selective serotonin reuptake inhibitors. They are the you'll hear, you know, Prozac is Zoloft, Paxil, Celexa, those are the sort of common brand names. They are really notorious for sexual side effects and. And we're talking like half of everybody who uses them, like up to 50% of users experience decreased desire, arousal, difficulties, delayed or completely absent orgasm. And the deal is that SSRIs boost serotonin circulating in your brain, which actually side note is made in your gut, and your gut health is really important to producing enough serotonin in your body. So don't forget about what you eat and your gut and your beneficial bacteria, because they are in there helping you produce serotonin. But so SSRIs boost serotonin, and that actually dampens the dopamine, the pleasure chemical, and can lower testosterone also, and some other antidepressants, particularly Bupropion, which the brand name on that is Wellbutrin, that is more that's action is more around dopamine than serotonin. So if that's something that you're on, you might have fewer sexual side effects. And if that works for you, it's not usually the first go to for a lot of psychiatrists or doctors. So you might and it doesn't work for everybody for their depression. So you know, for me, that was actually the choice, because the SSRIs really didn't work for me. I had more of a better response with dopamine support with Bupropion. But so my personal story, here's what happened for me. I had depression for probably most of my childhood, but it was completely undiagnosed, and that was mostly because of trauma. So I had a really bad childhood. If you've been around the podcast for a while, you've probably gotten an inkling of that. I don't talk about it in super detail, but you will have heard me make comments that lead you in that direction. Or if you listen to the podcast I did on my trauma story, that might have given you a little bit more information, but I had a lot of self hatred. I had a lot of bad thoughts in my head about myself, and I really had a lot of fear about people, a lot of lack of safety in the world, and a lot of insecurity in my life, because I was a homeless teenager and I was on my own. I had just learned that people didn't like me, and I was scared of people, and that people were mean and hurtful and abusive, and so I thought I was bad, and I turned a lot of hatred on myself. And eventually my brain shut down my motivation, and I went into major depression, and that was probably protective one. It's our brains. You know, it's like our brains are trying to shut down the motivation. Not everybody's comes from the same background as mine, but when we have overwhelming amounts of stress, for example, our brain can try to start shutting down our motivation system, our emotions or our motivation system, so we start getting kind of numb, and it goes into this. It's really kind of a freeze state of the nervous system, where, in order to not feel so much pain, we start numbing out. And when we shut down motivation, my sexual desire really shut down. Also, even though, you know, I was in my early 20s when I was finally diagnosed and this I like, my whole sexual history was such a mess, and I had had such bad experiences with sex that, like, I didn't really, like, I kind of got horny before that, but I didn't really have a lot of access to my authentic desire. I was socialized, and my experiences were to

8:50  
just try to get approval from men,

8:55  
but essentially I got I went into a major depressive episode where I, like, literally, couldn't function, and I finally got some help with medication. I did not have very much help with psychotherapy, and in fact, I got re traumatized a lot, and was really unhelpful and was actually kind of harmful with the types of psychotherapy that were available at the time. And none of those therapists actually recused themselves and told me that I had trauma. I didn't think I had trauma. I didn't even know that you could have trauma if you weren't a veteran of a war. So and I didn't even know that rape was trauma. So, you know, I was a clueless little baby bird just trying to take in whatever help would be offered to me, and the help that actually did help was the medication, and that was really useful. Now, I was on this medication for like 15 years because I was terrified to be depressed again. It was so horrible being depressed, and I was so afraid that I was. Gonna go back there or that I was gonna go back into suicidal tendencies like I had when I was 16 or so, and I was, you know, homeless and by myself and abandoned by both parents and whatnot. You know, it was more circumstantial than anything else, but I didn't know that. I thought it was me. So essentially, I did eventually pull myself out of this, and I did get off of my medication. Ultimately, through coaching, one of the reasons I became a coach was because it was so powerful for me. I learned how to self coach, and I also learned how to do massive amounts of self compassion practices, and learned not to hate myself. When I stopped directing hate at myself, my brain would actually let me feel other emotions again, and it was wonderful, including pleasure. So I learned how to rewrite my mental scripts and change everything about my own brain chemistry through the magic of neuroplasticity, which is amazing, and I did eventually just actually stop needing to take antidepressants because they were totally irrelevant for me, and I stopped worrying about sliding back into depression. So that's my mini story. But along the way, I also experienced some side effects, even though I was on a what's considered a low side effect version of antidepressants, the Bupropion, I still had decreased interest in sex, and I don't know exactly how much of that was antidepressants, and I think that's one of the things that people don't really talk about that much. We know there's all these side effects, but when you're actually in the inside of the human experience, it's really hard to say. What is a side effect? What is the depression? What is just me not being into this type of sex? What is me just having a lot of stress in my life right now? It's really hard to tease it all apart, and in a lot of ways, you can't. You just have to kind of do what you can with what you have. So we'll talk a little bit more about what you can

12:05  
actually do in a minute with both orgasms and libido. But I do want to say on another I want to spend a second at least on the orgasm problem, also, because we know that both depression and antidepressants impact libido. But if you're on antidepressants, you also may struggle to orgasm. And so even if you are interested or having sex, SSRIs, in particular affect orgasms, you can have delayed, diminished or completely absent ability to orgasm, and it creates this unfortunately shitty feedback loop where, if you can't orgasm, sex becomes frustrating. Desire drops further, your enjoyment and your sensation quality can go down too, right? And this is a medication effect. This is not you or your partner failing, but what if your partner interprets it as failing? What if you don't know that it's actually because of your antidepressants? Or what if, even though you do know it's because of your antidepressants, it's still frustrating, because it is still frustrating, probably for you and possibly for your partner, if they just feel like there's nothing they can do anymore, right? Hopefully your partner is not that kind of person who's just gonna like, whoa. Who's just gonna, like, woe is me, like, throw in the towel and, like, you know, kind of make a whole drama scene about it, because, of course, there's nothing you can do about it. Either. Nobody should be exacerbating it by making anybody feel guilty or bad. But it's understandable if you're both a little frustrated around this challenge and this problem, okay, so what can you do? What you can actually do your medical options? You know, talk to your doctor, please. If the only medical advice I'm going to give you today is never to adjust your medication on your own without talking to your doctor. Some antidepressants have fewer sexual side effects. So you can ask about those. Dose adjustment could help. You can ask about that, but please don't just start messing with your dose or going on drug holidays without medical supervision. That can really lead to some major problems with your mental health, and you don't need that. That's not going to help. So talk to your prescribing physician or psychiatrist the other and if you don't like them, if they're not listening to you, and if they don't seem to care about this, get a different one. And I know that's sometimes easier said than done, but like especially when you're depressed and you have very little motivation to do anything. But seriously, like you need someone who's going to be responsive to your actual concerns, it's worth the effort. So some other things that can help extended foreplay and a lot longer warm up time getting to a. Much higher arousal state with extended foreplay, making sure you're getting the kind of foreplay that you need psychologically and physically. That is, I would say, number one, extending your foreplay and making sure it's the right fit foreplay for you. Do not fuck around with quickies when you are in this situation. They can actually exacerbate the problem by making it more disappointing and frustrating, all right. Number two, exercise, it actually helps both your mood and your libido and increases the blood flow to your whole body, including your brain and your genitals. And all of that is really good for depression, and for libido, and for orgasm, anything that increases the blood flow is going to be good for you. And as much as if you're depressed, you may not feel like exercising, like getting into a regular exercise routine is a game changer for depression. So you just kind of have to figure out how to, like, get your ass out there and do it and try to find something that is at least a little bit fun for you. Body another one. Number three, body based practices, somatic practices that help you reconnect with pleasure without orgasm pressure so that could be, you know, one of the things I teach people is erotic breath that can be really wonderful and beautiful, if you want to learn that, come see me, but anything that helps you connect with the pleasure in your body. It could be dance. It could be some sort of movement practice. It could be, you know, contact improv. It could be yoga. It could be windsurfing. It could be anything that helps you get in your body. It could be mindful breathing. It could be petting a cat, right, being in your body and enjoying something pleasurable, Okay, number four is either some sort of therapy, couple therapy, or coaching for the if the mismatch is causing relationship strain. So if you coaching for you, or coaching in your partnership, if you're having relationship strain around this could help you relieve some of the strain, relieve any shame. Just look, we need to get rid of that shit. There's no shame. And if you're feeling shame, it's shutting you down more, and that sucks. And if you're feeling guilty, like, ugh, yeah, that's not helping, right? Let's clear that out. So getting some support from someone who can help you clear out shame, blame guilt and like, miscommunications and help you feel supported, and then really diving into some self compassion around this, and that means learning how to care for yourself and hold your own hand through the challenges of life, including depression, including whatever stresses have led to depression or traumas. And the more self compassion you have, the more you will also have compassion for others. And we need compassion from your partner too, right? They need to understand this is medical and it's not rejection, and you both deserve mental health support, relationship support and a satisfying sex life. You shouldn't have to choose between mental health and satisfying sex life. Sometimes we have to do that a little bit temporarily if there really is strong side effects, and there's absolutely no other way forward than the particular medication we're on, if nothing else works for us at all, but we can make sure it's as short term as possible, and we can add in some of those other options, right? The extended foreplay exercise, pleasure practices and relationship support. Okay? So if you are in this situation, or your partner is in this situation, I just want you both to know that nobody's broken or wrong and you are not alone. There are millions and millions of people dealing with this, and it really sucks that a lot of times when we show up at a doctor or a psychiatrist presenting with depression, we don't get told about the sexual side effects. But even if we do, I mean really, like we're gonna sign up for it, like anything that gets you out of depression. Depression sucks so bad. You're gonna be like, Yeah, even if they're like, Hey, your feet are gonna hurt and you're not gonna be able to walk you still, I would have still been like, give me the depression meds. Like, I don't care. Like, you could have told me that I wasn't gonna be able to see for six months. And I would have been like, Fine, just give it to me, right? But so we often will sign up for things even though they have difficult side effects. If we're told, a lot of times we're not even told, but we're not often told other things that help us manage those side effects, right? When have you ever heard like. Has your doctor ever told you, hey, you're going to need a lot more foreplay, and you should consider talking with your partner if you have one, about how to make sure that you get a lot more foreplay. And that means, including with yourself when you're masturbating, you're going to need a lot more time, potentially, to have an orgasm, and you may have some real challenges with orgasm, and so we need to think about, if you do adjusting your dose, did they talk to you about that they might not have? So I think as consumers, it would be great if we could get a little bit more educated about the kind of questions we need to be pushing our doctors to answer. But unfortunately, when you're in depression and you just want help, like, oftentimes you don't even have the resources to push anybody on anything, right? So this is where, if you do have a partner, they can help you and support you by helping you identify the things that you do want to ask, you know, but I want to do that too, and I want to do that today for you. So asking, Hey, if you you know reporting your side effects, if you are having orgasm or libido side effects, bring them to your prescribing physician or psychiatrist. Ask them about dosage adjustments, ask them about medication adjustments, ask them about what else you can try and tell them that this is bothering you, right? And if you need support for your relationship, or you need to understand your own turn ons better, so that you know what kind of foreplay you need and how to extend it. Or if you need help teaching your partner how to do those things that really turn you on, then reach out for help to me or to somebody else that's a qualified practitioner, but you are not alone, and you don't have to do this by yourself. That's what I really want you to know. So if you're the partner, you know, also make sure you understand and do your research, so that you know that this is not something to take personally. And if you're not seeing changes, and you feel like you really want to see changes, reach out for health, because both you know your mental health and your sex life matters, and you deserve support for both of those things, especially when you're going through a really hard time like depression presents as a very hard time in life. There is a light at the end of the tunnel, which is why I wanted to tell you my story of getting off all the meds and not being afraid of it anymore, and also that I was on meds for 15 years, right? Like, that's okay. There is nothing wrong with it. I'm not ashamed of it at all, and it really helped me get through a time when I needed that support. So if that's where you're at, you're absolutely okay. There are some extra things you can do, and there are some extra questions you can ask. So that's why I wanted to leave you with today, and I hope this has been helpful. I'll see you here next week.

22:53  
Hey. So before you go, I have some more free help for you. If you are okay with sharing your email, I will send you my free guide, five steps to start solving desire differences without blame or shame. This is a practical starting point for individuals and couples. You can opt out of my emails at any time, but I think you'll want to stick around. I am not a spammer. Go get it at www.Laurajurgens.com/libido. Make sure to spell my last name right and the link is in the show notes.