Anxiety and sex are not happy bedfellows. Living with anxiety often means it’s present wherever you go ― including between the sheets. Whether it’s anxiety/stress itself or the medication you use to treat it, the issue can have wide-ranging effects on a person’s sex life. While no two people will experience mental health conditions in exactly the same way, you should be aware of some general truths about anxiety and sex.
How anxiety might impact your sex drive
One effect of anxiety on your sex life is a lowered libido, or desire to have sex. Higher levels of cortisol are associated with anxiety and stress emotions, and high cortisol can suppress sex hormones that impact desire.
Having sex when you’re feeling anxious is like asking your mind to multitask. It is almost as if you have two competing interests for the same neurological system. Anxiety in itself can be a function of a breakdown in the ability to manage competing and mutually contradictory thoughts/experiences. The brain becomes locked in a seemingly impossible position, and unable to reconcile conflict, the psychological dissonance; the person unable to feel s/he is in control.
It is worth noting that not everyone who experiences anxiety (or anxiety/depression) will experience a decreased libido. There are some who may use sex as an anxiety reliever, or who will masturbate compulsively, for instance.
How anxiety might alter sex and intimacy
Anxiety can affect the sex you do have. For one, anxiety can delay or impede your ability to orgasm, and make it harder to maintain an erection.
Additionally, some of the physical symptoms of anxiety can throw a wrench in your plans. Those symptoms include tensed or clenched muscles, rapid breathing and light-headedness — all of which can be pretty distracting if they’re coming from a feeling of panic and dread, and not an orgasm.
The distraction that anxiety can bring into the bedroom certainly doesn’t help you stay connected to your partner in the moment. There can be a quite debilitating impact on our ability to reach out to and connect with other people. (Often, we just want to pull the bedsheets over our eyes and hope it all goes away.) This can be yet more pronounced in intimate relationships.
Sex and anxiety/depression medication
Anxiety/depression medication can lead to shifts, and a dampening, of affect and sexual responsiveness. The medication can be something of a ‘crutch’ to help people cope with psychological pain. There can be something of a neutering effect – both of the very bad and the very good. A kind of mild serenity – which doesn’t really want sex and the intensity of mental/emotional engagement sex can entail. (Cf. ‘Brain Sex’.)
If it’s anxiety (or anxiety/depression) medication that’s causing you concern, try talking to your doctor. Your dose could be adjusted or you could switch to a different medication, although it’s worth noting a different drug might bring about other equally undesirable side effects. Medications can need careful and professional management to do the most good and avoid harm.
Your doctor might try adding an atypical antidepressant medication such as Wellbutrin (Bupropion) to your existing regimen. Wellbutrin has been shown to mitigate some of the negative sexual side effects of other medications. If your anxiety is severe enough to be impacting your daily life, it’s understandable that doctors will prioritize that and the medicine that helps you instead of sex. That being said, don’t let it deter you from advocating for yourself. A satisfying sex life is also important for your mental health.
Anxiety and sex therapy
If your anxiety is unrelated to medication, you also have strategies to get more out of your intimate life. Talking to a sex therapist could be a great place to start, especially if you think that past trauma could be at play.
One of the things that’s beneficial about having a sex therapist is that they are trained to gently help people develop more comfort talking about sex.
A sex therapist can help you work through concerns and facilitate communication with your partner if anxiety has caused a breakdown in your intimacy. However, therapy is often expensive and inaccessible. You could try a more affordable option, like text therapy, group therapy or finding someone who can provide sliding scale session rates based on your income.
Additionally, try stress-relieving techniques like meditation or mindfulness exercises. Given the many physical ways in which anxiety manifests, it can be useful to really focus on where you feel that anxiety in your body. Does it make you take shallow breaths? Tense up your muscles? If you can better understand the ways you experience anxiety, you can work on developing specific coping skills for your particular body. If you’re new to meditation, you might start with one of these apps.
Even a little self-exploration on your own might also help. While it might be difficult at first to manage your anxiety with a partner, figuring out what turns you on (and finishing in the process) can help ease your stress and know what to communicate to someone else when the time comes.
While it’s true anxiety and sex might not be happy bedfellows, exploring your options for treatment can make your bed cozier for you and whoever else you’re bringing along for the ride.