Illustration: Jennifer Vo.
Reading Time: 3 minutes

Dr. Peggy Kleinplatz talks about how mental illness could be killing your sex drive

Mental illness can affect many different areas of one’s everyday life. But one aspect that is often ignored in this struggle for emotional stability is what happens between the sheets. With one in five Canadians personally experiencing mental illness at some point in their lives, these kinds of  health problems can quickly lead to a lot of expired condoms.

Dr. Peggy Kleinplatz, a University of Ottawa professor in the Faculty of Medicine and director of the school’s Sex and Couples Therapy Training, explains that sexual dysfunction related to mental illness can be attributed to more than just mood.

While it might seem obvious that a condition like depression—which causes individuals to lose interest in things they used to enjoy—can negatively affect their sex life, the reason behind this phenomenon is a lot less obvious. Sometimes, the treatment is the biggest culprit.

In fact, the use of pharmaceuticals to remedy these issues can cause the most dramatic effect on one’s sex drive, especially when compared to the direct symptoms of psychological problems.

“By the time individuals with a history of anxiety and depression come to my office, they are generally on pharmacologic treatments, typically, without having been warned of the sexual side effects of their drugs,” explains Kleinplatz.

Antidepressants in general—including Celexa, Cymbalta, Lexapro, Paxil, Prozac, and Zoloft—are correlated with a number of sexual side-effects like erectile dysfunction in men and a decreased desire for sex in women.

For individuals struggling with these kinds of issues, learning that their medication could bring on even more serious side-effects can be quite upsetting. Kleinplatz says that, in her experience, when patients become aware that their medication could be negatively affecting their sex life, “they now feel even more depressed because their sex life has taken a disastrous turn.”

This can lead individuals to abruptly stop taking their medication. Of course, this kind of action is not recommended and Kleinplatz warns that “the withdrawal effects can be severe and cause agitated depression, thereby increasing the risk of suicide.”

Luckily, sex by itself can serve as an effective medication for some individuals. Naturally, “sexual fulfilment tends to make people feel good about themselves and about each other,” said Kleinplatz. She adds that, when it comes to people who have trouble sleeping, “sex to the point of orgasm before bed often helps with sleep.”

However, not all orgasms are created equal. According to Kleinplatz, quality, not just quantity, is important when it comes to therapeutic love making.

“When sex goes down the tubes, people experience anxiety, that is, they become self-conscious when they are having sex,” she said.

This means that it may become harder and harder for your body to respond during sex. She elaborates that “the founders of sex therapy, Masters and Johnson described this as ‘spectatoring.’ Instead of being embodied during sex and feeling alive, it feels as though you are watching yourself from the bleachers.” In turn this can trigger more anxiety and depression, and you might find yourself  in a vicious cycle.

This can even contribute to the development of a sexual dysfunction such as erectile dysfunction or female orgasmic disorder, which are also influenced by psychological factors.

As always, it never hurts talk to your doctor if you feel like your mood-managing meds are negatively impacting your sex life.

In the meantime, Kleinplatz is adamant that sex can be a positive force in people’s lives. 

“Being part of a fulfilling sexual relationship can improve feelings of connection and self-esteem,” she said. “As ways of coping go, in the face of the stressors of life, being in loving, mutual, consensual, fulfilling relationships is a much better choice than drugs or alcohol.”