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1. In what ways can depression affect a person’s sex life?
Loss of libido (sex drive) is one symptom of depression. Other symptoms may include changes in appetite and sleep patterns, moodiness, decreased energy and social withdrawal. Depression is a serious illness and loss of sex drive may be the least consequential symptom. Unfortunately, many antidepressant medications also decrease the libido. Other medication sexual side effects may include temporary impotence in men and delayed orgasm in both men and women. These side effects can vary from one person to another and sometimes go away after taking the medication for a few weeks.
2. How can a person emerge from self-esteem-damaging habits that are the result of depression (such as overeating, letting oneself become physically unattractive, etc) and find their way back to feeling sexy and confident?
Some symptoms of depression (such as decreased energy, apathy, and increased appetite and sleep) bring on self-esteem damaging habits like lethargy and overeating. Your self-worth is further diminished because you have gained weight and you don’t feel as attractive. Severe depression usually requires medication and psychotherapy to improve energy and motivation. From there, the patient can resume healthy lifestyle behaviors.
Exercise is a natural treatment for mild to moderate depression because it increases endorphins which are chemicals in the brain that cause us to feel happy. Regular exercise also tends to increase testosterone levels which improve the sex drive. Patients with chronic depression need to establish a disease management plan with their therapist to keep them focused on maintaining healthy behaviors.
3. If a couple is experiencing sexual difficulties but they believe only one of the partners is the primary reason for this, should they still attend counseling together, or is individual counseling a better option?
I recommend that both partners participate in counseling. During counseling, the partner who is not the identified patient can learn techniques to help the patient resolve his or her sexual difficulties. The supportive partner can also learn to avoid behaviors that may be reinforcing the problem. At each session, both parties can report what they experienced and observed in their sexual relationship since their last appointment. The supportive partner’s participation can actually improve their communication and intimacy causing the relationship to become more complete and fulfilling for both individuals.
4. How might the sex life of a person with ADHD be different than a non-sufferer?
Persons with Attention Deficit Hyperactivity Disorder (ADHD) are easily distractible. She might go to the bathroom to brush her teeth and then decide to clean the shower while she is there. They can be hypersensitive to sensory stimulation. A television playing in the same room might interfere with his ability to focus and attend to his partner. Repetition of activities or a partner’s desire to make the sexual experience last as long as possible could be perceived as boring and cause a person with ADHD to lose interest. Individuals with ADHD may be slow to initiate sex if other activities or stimuli interfere with their attention to the relationship. With that said, rating the quality of sex always depends on the subjective assessment of the individuals involved. Not everyone with a diagnosis of ADHD has symptoms that interfere with their sex life. Individuals with ADHD can improve the quality of their sexual relationships by complying with medication regimens and practicing behavior modification techniques to help them maintain focus.
5. How might a person with ADHD share their condition with someone they are dating?
Living with a person with Attention Deficit Hyperactivity Disorder (ADHD) can be very annoying and requires a lot of patience. Their sexual responsiveness is often the least of the partner’s concerns. Individuals with ADHD often have trouble managing time and money. They are often perceived to be unreliable and incompetent even when they may have above average intelligence.
It is important to disclose this or any other mental health issue to anyone with whom you are contemplating a lasting, intimate relationship. Potential partners need to be informed about the illness and support your ongoing plan for treatment. Persons with ADHD have a responsibility to themselves and those around them to comply with treatment regimens (medication and behavior modification) that minimize their symptoms. The diagnosis should never be presented as an excuse for disappointing others. A supportive partner can help the ADHD patient monitor the symptoms and adjust disease management strategies as necessary.
6. Are people with ADHD, OCD, etcetera more likely to experience sexual difficulties in their lifetime than others? Why or why not?
Mental illnesses like Attention Deficit Hyperactivity Disorder (ADHD) and Obsessive Compulsive Disorder (OCD) can influence almost every aspect of an individual’s life if they are not properly managing the illness with medication and psychotherapy. Some psychotropic medications have sexual side effects that can cause temporary impotence in men and delayed orgasm in both men and women. Many of these medications also decrease the libido (sex drive). However, some people with these or other mental illnesses may experience no sexual difficulty at all.
Sexual fulfillment is dependent on the needs and practices of all parties involved in the sexual experience. It is important to sexually engage with others who have a similar sexual appetite and who enjoy the same kinds of sexual activities. One can have ADHD, OCD, or another mental illness and have a very satisfying sex life. The illness does not always impair one’s ability to be a skilled and attentive sexual partner.
About Steven Davidson, MBA, LCSW, CST – NashvillePsychotherapy.com, Follow him on Twitter @SexTherapistTN
Steven Davidson is a licensed clinical social worker and certified sex therapist in private practice in Nashville, TN. He has a master’s degree in social work and a master’s degree in business administration with a specialization in health care management. He has over 25 years experience in behavioral health in both inpatient and outpatient mental health and addiction treatment settings.
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