Ask the Sexuality Expert: The Not So Sexy Parts of Anxiety and Depression

By Angela Gunn

We have so many strategies that allow us to zone out easily during relaxed moments, but when sex or physical affection is presented, our bodies must suddenly engage in the present moment. This presence often brings a flood of thoughts and feelings from the day, or those sparked by sex in general. For someone struggling with anxiety or depression, this flood of negativity prevents us from connecting with our partner and enjoying sex and pleasure in the ways we might like.

Fear not! We have some thoughts and tools to support you in shifting this pattern.

How Mental Health Impacts Sex

Despite our best efforts, sex is highly impacted by mental health and overall well-being. We could talk for days about why, but in simple terms, your whole self is involved in connecting; sex is both a physical, emotional, and psychological process. Your bodies engage, feelings spill over, and thoughts about your past and present sexual experiences can pop in.

When you struggle with anxiety or depression these symptoms commonly escalate when under stress, and prevent you from moving towards sexual situations in general. These patterns play out in all types of relationships and partners, including casual, long term, queer, straight, and non-binary identified individuals and couples. Here’s a few specific ways the symptoms manifest.

Anxiety’s Impact on a Healthy Sex Life

Anxiety commonly involves symptoms like panic, trouble breathing, nausea, over thinking, and avoidance. As you might imagine, panic or nausea during sex is less than sexy. Even worse, it can result in shutting down or disconnecting during sex itself, which prevents enjoyable sensations or feelings.

When that happens sex becomes associated with compliance or lack of pleasure, and perpetuates the cycle of avoidance or reduced desire. Maintaining erections and achieving orgasm becomes difficult and leads to further frustration and disconnection. While there is so much pleasure potential outside of erections and orgasms, being in a head space to be creative and open to other kinds of touch and connection may be inhibited too.

Depression’s Impact on a Healthy Sex Life

Similarly, depression symptoms such as sadness, lethargy, hopelessness, withdrawal, and isolation inhibit our ability to be available to connect and our awareness of sexual desire. As sexuality researcher Emily Nogoski explains, desire is a motivation system, not a drive or biologically determined concept as we commonly believe libido to be. Shifting this understanding of desire can help us manage the ways that depression and anxiety impact desire by impacting motivation. Ask yourself, what might increase my motivation for sex when I’m having a hard time? How might my partner do things to turn me on, that won’t make the symptoms worse?

One exacerbating factor in managing these symptoms is being a person who identifies as gay, queer, gender non-conforming, or non-binary. These identities carry with them stigma, shame, and oppression from others, which is so tough to manage while trying to navigate complex relationship dynamics. If the individual is also receiving hormone therapy and seeking new ways to engage with their genitals and partners, the anxiety and depression symptoms can make this exploration and adaptation much harder.

So what are some strategies?!

Strategies for Enjoying Sex While Dealing With Anxiety and Depression

First, there are some worries at times about using sex as a tool for managing symptoms. Rest assured this is generally not a problem. Sex is a healthy, as well as physically, emotionally, psychologically rewarding experience when done consensually and in ways that maximize sexual health.

Balancing other ways to manage symptoms can be a good strategy if you’re concerned about the frequency of sex seeking behaviors, such as exercise, spending time with friends, writing, or seeing a therapist. Talkspace can be a really great way to check in daily and get long-term tools and interventions for managing symptoms.

If lack of desire or motivation for sex is the biggest challenge, it can be helpful to start integrating mindfulness into your coping strategies. This can include slowing down, breathing deeply, and noticing what is happening in your body in the moment. Taking a minute to calm, sometimes doing a visualization or physical movement such as a walk or a few minutes of movement can shift the cycling of symptoms. Let your partner know what is happening and ask for their support if possible; they want sex, so supporting you in the ways you need will help them get their needs met also.

If you can, identify the stuck thought or feeling that is repetitive, name it, and reframe it. What other story can you tell yourself about what is happening in your brain or body? For example, instead of “I am going to fail so I can’t have sex right now” you can repeat “I’m going to try my best and my partner cares about me either way.”

Lastly, redefining sex can ease some of the pressure that impacts symptoms. If you define sex as connection and pleasure, it opens the door to all types of touch and fun, regardless of the ways your body may be shutting down. For example, your genitals aren’t ready to engage, but a hot makeout and snuggle would feel really good.

Manage Your Symptoms for a Better Sexual Experience

Instead of needing to zone out, you can integrate symptom management into the ways you engage physically and increase your opportunities for pleasure, connection, and feeling better overall. Thank you to those who asked questions about this topic through our Instagram profile, we would love to hear your comments or thoughts!