Sex Can Disappear In Couples With Depression — But This Habit Can Help
When one or both partners in a relationship has depression, it can affect many parts of their shared life together—and sex is definitely one of them.
Depression can reduce libido1, both as an effect of the condition and as an effect of antidepressants if taking them. But beyond that, couples dealing with depression also have specific relationship challenges that can lead to tension and, therefore, avoiding sex.
How depression affects sex in relationships.
Past research3 has shown that depression tends to be linked with lower relationship quality, and two reasons for that are relationship uncertainty and a concept called interference.
Relationship uncertainty refers to not feeling sure or secure about your relationship. Interference refers to the ways in which your partner's behavior interferes with your own daily routines and goals. For example, your partner's tendency to push off doing the dishes might get in the way of your goal of having a clean kitchen. In the case of depression, a depressed person's sometimes unpredictable emotional states may mean the couple can't always stick to their plans.
Both of these things—relationship uncertainty and interference—can affect how connected a couple feels to one another, and a lack of connection can definitely make couples less likely to want to have sex. Both concepts have also specifically been linked to sexual challenges in depression.
The effect of sexual communication.
The new research was conducted by Amy Delaney, Ph.D., a Millikin University communication professor who surveyed both partners in 106 different-sex couples where one or both had been diagnosed with depression.
While relationship uncertainty and interference were both linked to lower sexual satisfaction, she found there was a mediating factor: sexual communication.
She asked the couples a bunch of questions to understand how they felt about talking about sex, how often they did it, and how successful those conversations tended to be. Turns out, relationship uncertainty and interference didn't just automatically make a couple's sex life worse—they did so by way of stamping out conversations about sex.
The more uncertain partners felt about the relationship and the more they perceived interference in their lives because of the relationship, the less likely they were to talk openly about sex—and the less likely it was for any sex talk they did have to go well.
"When individuals in the context of depression grapple with ambiguity about the status of their partnership, they are less likely to engage in conversations about sex," Delaney writes in the paper on her findings. "When facing disruptions to day-to-day routines and goals as a result of interdependence with their partner, people might feel embarrassed, frustrated, or hesitant to engage in a conversation about sex."
That lack of sexual communication (and lack of effective sexual communication) was largely what was associated with a worse sex life.
And understandably so: It's hard to have good sex if you're not feeling comfortable talking about what turns you on and what you want and don't want. Many past studies have shown that not being able to have open conversations about sex is linked with less satisfying sex. It seems simple, but the truth is, talking about sex is something many people struggle with. And when you add depression to the mix, it can only make these conversations feel all the more difficult.
"Some of the sexual intimacy struggles of depression (low libido, decreased self-esteem, troubles with function) might be unavoidable as partners navigate their mental illness," Delaney tells mbg. "But if couples can effectively engage in conversations, they might mitigate some of those negative relational effects."
Delaney's research suggests all the relationship challenges that come with depression can significantly affect libido—but talking about it openly might help offset some of those effects. In general, having candid conversations about your relationship can often help couples feel closer, which itself might make them be more interested in sex.
"It isn't enough to have conversations about sex," Delaney adds. "We also have to feel like those conversations are effective. Maybe that means you've collaborated with your partner to make a plan for improving your sexual connection. Or maybe effective looks like feeling heard and understood by your partner, or that they now better understand your perspective/wants/needs."
In her paper, she also suggests couples who are dealing with depression, particularly those who are dealing with sexual challenges because of it, try to address concerns about the relationship feeling shaky or areas where partners may be negatively affecting each other's goals and routines. Dating with depression comes with unique challenges, and talking about them can only help.
"Perhaps effective conversations are those that feel like a step forward, even if things don't substantively change in the couple's physical relationship," she says.
Kelly Gonsalves is a multi-certified sex educator and relationship coach helping people figure out how to create dating and sex lives that actually feel good — more open, more optimistic, and more pleasurable. In addition to working with individuals in her private practice, Kelly serves as the Sex & Relationships Editor at mindbodygreen. She has a degree in journalism from Northwestern University, and she’s been trained and certified by leading sex and relationship institutions such as The Gottman Institute and Everyone Deserves Sex Ed, among others. Her work has been featured at The Cut, Vice, Teen Vogue, Cosmopolitan, and elsewhere.
With her warm, playful approach to coaching and facilitation, Kelly creates refreshingly candid spaces for processing and healing challenges around dating, sexuality, identity, body image, and relationships. She’s particularly enthusiastic about helping softhearted women get re-energized around the dating experience and find joy in the process of connecting with others. She believes relationships should be easy—and that, with room for self-reflection and the right toolkit, they can be.
You can stay in the loop about her latest programs, gatherings, and other projects through her newsletter: kellygonsalves.com/newsletter