Depression, Libido and You

I am a young wife and mother who struggles with Dysthymia – or chronic low grade depression.  I’m currently taking Zoloft, which strongly inhibits my ability to orgasm and causes low libido.  I was raised in a Christian household, waited until I was married to have sex, and now that I am free to enjoy sex, my medication makes it near impossible.  Have any of you ever dealt with something like this?  Is there something I could use that would help me combat the effects of the medicine?

Please keep in mind that I am not a physician, but I am going to talk on my own personal experience on this subject.  I am also referencing information on mayoclinic.com to help with this article as well.

Depression is real.  I would not have believed 5 years ago that I would be taking antidepressant medication, but here I am.   It all started in me with tiredness all the time.  I could sleep for extremely long periods of time during the day if I had the time.  At night, I never feel like 8 hours is enough sleep.  I always wake up still exhausted.  I get home, and my kids want my time and attention…. I just don’t care to do it.  My husband sends me texts during the day making me feel loved and desired . I know I should feel something back, and sometimes I do, but sometimes I don’t…it’s nothing he’s done or not done, but like I said earlier, I feel like I have lost my sense of feeling…  I start trying to cut back on caffeine…that is so hard on me.  This Southern Belle loves her sweet tea, and lots of it, so when I am at home, I make decaf sweet tea to meet my need for tea.   I boosted my vitamin C, my B complex vitamins, my calcium (well, I am premenopausal, so I need more calcium anyway) and I increased my iron, too.   I have been anemic in the past.  Still, no remedy for it, so I visited with my doctor about the tiredness.   She tells me that I sound depressed.  No, no, no, I can’t be depressed.  But you know what…. I am.   I am at a point in my life where some days I could care less about what is going on.   If I could stay in bed in my PJ’s all day, I would, but I MAKE myself get up for the sake of my family.   I MAKE myself not take naps sometimes so my kids won’t think that their mom is narcoleptic.  (Yes, they have used that word…)  I feel panicky at times, and I have never felt that way before.   The news…gosh, I just don’t listen to it or read it or watch it on tv….it depresses me and makes me anxious.   I read emails for people the wrong way and I get highly apprehensive and irritable and anxious.  Conflict … ha ha…it sends me off the edge.  I hate conflict.  My doctor knows all about the libido problems I have, so to help with the depression, she prescribes me Wellbutrin.

There are different classifications of antidepressants.   There are selective serotonin reuptake inhibitors (SSRI’s)tricyclic antidepressants, monoamine oxidase inhibitor (MAOI) and norepinephrine and dopamine reuptake inhibitors.

SSRI’s are medications like Lexapro, Celexa, Paxil, Zoloft and Prozac.   These medications are designed to allow the neurotransmitter serotonin to be utilized more effectively.  Serotonin is used to help metabolize stress hormones.  If you click on the link for the SSRI’s, you can read more information about the medications and side effects.  Tricyclic antidepressants are medications like Adapin,  Sinequin, & Norpramin.  They were originally used to combat depression but have been replaced in recent times with SSRI’s.   Other antidepressants have fewer side effects than the tricyclic drugs.  TCA’s inhibit the reabsorption of serotonin and norepinephrine by brain cells.  You can find out more about TCA’s by clicking the link.  Monoamine oxidase inhibitors (Nardil, Parnate, Marplan, Emsam) relieve depression by preventing the enzyme monoamine oxidase from metabolizing the neurotransmitters norepinephrine , serotonin and dopamine  in the brain.  You can learn more about MOIA’s by clicking the link.  Norepinephrine and dopamine reuptake inhibitors (Bupropion/Wellbutrin) increase the levels of both norepinephrine and dopamine by inhibiting their reabsorption (reuptake) into cells.  It’s thought that these increased levels help enhance neurotransmission — the sending of nerve impulses — and thereby improve and elevate mood.  More info on NDRI’s are at the link provided.

The side effects of these different types of drugs are somewhat overwhelming.   In the case of the reader above’s question, what can she do to combat the effects of the medication?   The best thing I can do is recommend that you take your problems with your symptoms back to your doctor and ask what your options are.  Can your dosage be changed?   Would Wellbutrin (or another type of antidepressant) work as well as Zoloft for you?  Can I occasionally take a “one day” holiday from my medication?   Is there another medication or herb I can take safely with my antidepressant that will help boost my libido?    The only person who can truly help is your physician.  Make an appointment to talk to him/her about it.

Now there are some alternatives to antidepressant drugs.   Ask your doctor if it is safe to take you off your antidepressant and try St. John’s Wort (an herb) to see if that would help you.  Do your research on herbs and make sure the ones you buy are good quality herbal supplements, not just the cheapest one at the counter.   I ask questions at our local Whole Foods markets about herbs and get their herbal specialists to point out ones that would be best for me to use.

I also found a few articles of interest for you from Mayo Clinic:

Depression in Women

Selecting the Right Antidepressant

Tips to Cope with Side Effects

I want to add one more thing to this.  My husband has been so very supportive of me in all of this. I was reminded tonight of the song he and I danced to at our wedding reception “I Will Be Here” by Steven Curtis Chapman.  Through all we’ve been through in our 15 years of marriage, he is still here, he still will be here no matter what.  He’s my biggest hero and my staunchest supporter.  Don’t count your spouse out to help and encourage you if hard times.  Remember your vows said in for better or worse, sickness and in health, for richer or for poorer until death do us part.   Your husband will be there for you, too.

I hope this helps.  Please feel free to post your experiences with antidepressants and libido.  Anything that you have done to overcome the side effects of your antidepressants will help other women out there with the same problems.    As for me, I think it is time to get my Wellbutrin evaluated.  It was working for me for awhile, but lately I have been more stressed at work and with things happening in life in general, so it may be time to up my dose if my doctor deems it necessary.  I will keep you posted!

14 Comments

  1. Thank you so much for this. I struggle with depression and I started to take medication for it finally at the beginning of this year. It’s comforting to know that there are other Christian women out there who go through the same thing. I am taking Wellbutrin and haven’t noticed it affecting my libido.

  2. wow, excellent article! you just described me perfectly. i’ve had all of these exact symptoms for several years and wondered if it was depression. i even purchased some st. john’s wart tea to see if that would help. i don’t take any other meds, and my husband and i use natural family planning – i know that st. john’s wart can interfere with other meds. i haven’t started it yet so i don’t even know if it would really help. i know that i do a lot better when i eat a very clean, healthy diet (no sugar or simple carbs) and excersise for at least 30 minutes 5 times a week. it doesn’t really affect my libido though unless i’m under stress, any stress at all will send my libido packing. i don’t really have the ability to go to a doctor right now, but i’m very interested to read everyone else’s experiences and how they cope.

  3. Hi, all!

    Well, I was in the same boat as many of you…depressed even though I never thought it possible for me (I distinctly remember being critical of people with depression – thinking they were just being lazy or lacking in faith or self-discipline, until I had the humbling experience of crying throughout the day and barely being able to get myself out of the house).

    I finally chose to take medication, which was very hard for me, as I avoid drugs like the plague. I think I was on Prozac…but I can’t remember for sure. I was not married at the time and not participating in premarital sex, so I can’t speak to its libido-affecting attributes.

    I chose to see a good Christian therapist at the time, as I didn’t want to be sucked into meds for the rest of my life and I knew that most of my depression problems were history based (I was raped as a 7 year old and had never dealt with it). Check out Theophostics – it seems very different on the surface, but this kind of therapy did free me completely from my sexual abuse and I am now able to enjoy life without depression and have a great sex life.

    That said, the meds were instrumental in helping me do the things I needed to do to get through life until I completed my therapy. It also re-set my chemical imbalance. My body was so used to running on low seratonin levels, that I’m not sure it would have rebounded on its own – although God is capable of anything. :) After one year, I weaned myself off of the medication (generally not advised) – never to look back. I have now been drug and depression free for over 5 years. There is hope! Speak with your doctor or counselor – maybe your drug use, and therefore side-effects, can be eliminated after a time too – it doesn’t have to be a permanent fix. I think sometimes people just get on meds and then the doctors leave them there without ever re-evaluating the need. Maybe your body just needed a reminder on how to run properly again or maybe you could use some counseling for some issues you have (if you have any)…just some food for thought! Hope that helps! Good luck!

  4. Oh Ladies, I’m right here with you….. Just started the meds about a month ago, and SO SO SO glad I did. Overall, I feel so much better, I’m still tired and a bit cranky but it’s easier to be happy and interactive and I don’t hit the rock bottom so bad when things don’t go my way. That said, my O has been missing. It still feels good, and overall I do feel so much better that I still enjoy sex, but no pop. I didn’t have a whole lot of choice on drugs, I had to get approval from 2 specialist doctors on drug selection before my PCP would write the prescription. I’m on Prozac too. I’m hoping to wean off in 6 months or so, and that was the intention when I asked for the prescription, because there has just been lots of stuff going on, and I have a very strong family history of depression, so I wanted to see if this would help me over the hill before I got too stuck on it.
    If you need the medicine, take it. You and your doctor can decide. I would have preferred Wellbutrin (because of the lower incidence of sexual side effects) but it wasn’t even one of my choices after all the doctors were consulted.
    Hoping I’ll be like Paprika above and be able to come out on the other side.
    Thanks for the honest and even-handed article, SpicyNutmeg!!

  5. First of all thank you so much for this wonderful website!
    I am not depressed (yet!) but for 8 months I have been suffering severe nerve pain from two slipped discs in my neck. I have been taking a whole host of drugs but the most significant are dihydrocodeine and gabapentin (a drug usually prescribed for epilepsy but which also works for severe nerve pain), and the doses have been escalating and escalating so that now I am having hallucinations. Both drugs are notorious for decreasing libido.
    We got married 4 months ago, and I lost my virginity on my wedding night (it was wonderful and worth the wait!). This was the only day since my pain started that I’d managed to reduce my painkiller dose (I was very high on natural endorphins!).
    Now though, the pain gets worse every week, I have even more neurological complications, and wear a neck brace 24/7 as I am at high risk of spinal cord compression. We had to shelve honeymoon plans because of my condition and our lives are now entirely dominated by my pain.
    We desperately want to make rampant love with the careless abandon you’d expect from newlyweds! We do have what I can only describe as “careful” sex, occasionally, but now the problem is even more frustrating because my husband has developed ED… probably in sympathy. It must be scary for him and we’re both worried about hurting my neck if we get too enthusiastic. Then he gives up and tries to give me oral instead, but I can’t orgasm if I think he’s not enjoying himself, and don’t even get halfway most times thanks to my meds. I can’t give him oral in return (or even a hand-job) because it hurts me and could damage my spine even more.
    I am scheduled for spinal surgery next month (hooray), but because my nerves have been compressed for so long, it could be another 6 months or year before they recover fully and the pain goes. I am physically dependent on (but not psychologically addicted to) codeine, and so I will have to go through withdrawal as well.
    I just want to love my husband in every way possible and it is so heartbreaking to see both of us struggle like this after waiting so long. I guess the best we can do for now is be patient again, keep communicating, and keep praying.

  6. Just wanted to say that I struggled with depression the first 5 years of my marriage, even though there was nothing terribly circumstantially wrong in my life. I took Wellbutrin, and while it was better than other options, I also lost my O. My libido wasn’t very good, but it hadn’t been from the beginning anyway. I struggled to go to work every day and felt like crying most of the time. Like others, conflict really put me over the edge.

    We decided to try to have children, so I got off bc pills and the anti-depressant. At that point I was feeling better, but it wasn’t until I started working out and eating a low-carb diet that I started really “living”. It changed my life. I only pursued it with alternative doctors because we were infertile. Changing my diet and exercising were the best things that ever happened to me.

    We have since adopted a child and I have never felt better. I still have minor relapses now and then (having a baby is wonderful but stressful), but it’s nothing like it used to be. I praise God for helping me through it. If you need medication, don’t feel bad using it. It really helped me through a tough time. Through counseling, diet changes, exercise, lots of prayer, and the support of my husband, I have changed radically from those early years. I hope this encourages someone.

  7. I just wanted to chime in here real quick…I’m a young married woman, and I saved myself for marriage. I was shocked to discover on my honeymoon that I was unable to have sex! I went through a lot of emotions and became very depressed, but my husband was so good to me through it all. February of 2010 I had a hymenectomy, which was successful but did not solve our problem. I have too much exposed nerve pain. So, (very) long story short, I am on Zoloft…and praise God!…we can have sex! I just wanted to throw this out there because once I stopped keeping my problem to myself, I found a few others who had the same issues and also thought it was just their lack of “experience” or “tolerance”. It has affected my ability to orgasm, as well as my libido, but I’ve pushed through and hope that someday I will be able to get off Zoloft and lead a relatively “normal” sex life!

  8. Hey ladies! I am the one who sent in the original email and I thought I’d post an update for you all. Because of a pretty severe chemical imbalance of serotonin, going off the Zoloft is not an option for me, I have tried others (including Wellbutrin) and only the SSRI’s help. I also struggle with GI issues linked to my serotonin deficiency (most of the body’s serotonin is stored in the GI tract). HOWEVER, I have discovered that when I take 10 mg of Buspar (buspirone) about an hour before sex, my libido returns as does my ability to orgasm. I’ve also bulked up on my B complex vitamins which have helped my lack of energy as well. I agree wholeheartedly with Spicy Nutmeg – find a doctor that you trust and listens to you and work on a solution together. I’ve also read that adding Wellbutrin or Ginkgo can help as well, but I haven’t tried either of these. I am lucky to have an understanding husband who is supportive and helpful as well, I couldn’t do it without him.

  9. I think that i may be suffering from depression but i am not sure if it is my birth control pills or depression. i have only been married for over a month and ever since then i have this feeling of hopelessness. I wake up in the morning and i don’t want to get up and face the day. My husband is so supportive and caring but nothing seems to make me feel better i don’t know what to do! i just feel so out of control and feel bad for putting my husband through this.

  10. Pam – It sounds like you need to get to a doctor quickly, maybe the doctor who prescribed your pills. It’s possible that your hormones are messed up, but it’s also possible that you are depressed. The feelings you are having aren’t normal, and need to be addressed. Praying for you.

  11. I struggle with depression/anxiety daily. We currently do not have health insurance and my husband is laid off, so I had to go back to work this summer and leave him home with the kids… all this to say – medication is not an option due to lack of resources available to me (though I used to be on Zoloft after the birth of my first child). I grew up in a very conservative Christian home and all alcohol was seen as very sinful.

    However, I have NO sexual energy or any energy at all for that matter, but if I have a glass or two of wine – my anxeity subsides and I can freely please my husband sexually as I could before having children and facing severe depression. What, if any Biblical guidelines could you provide for using alcohol as a stimilus towards intimacy to relax the depression and anxiety I feel – at least momentarily to please my husband. I feel like without a drink, I am a bore in bed and do not in any way desire sex.

    I have been praying that God would heal this issue, as I truly want to have a fulfilling sex life with and for my hubby and would welcome any advice or encouragement.

  12. Sarah – You are dealing with a lot of things at one time. The best thing would be to get some professional guidance from a doctor, nurse or counselor, especially since you have struggled with depression in the past. Could your church assist you with this, since insurance and money are limited? Your pastor may know of medical or counseling professionals who are willing to help church members. In the short term, I don’t think it’s a problem to relax with a glass of wine. Many devout Christians do not believe that drinking alcohol, in and of itself, is a sin. You have to sort out what you believe about that, but just because you learned that growing up doesn’t necessarily make it correct. If you do decide to relax once in a while with wine, remember that alcohol is a depressant, so don’t overdo it. Also, people can rely too much on alcohol and become dependent on it, so you want to be aware of that too. One thing you could try that costs nothing – some studies have shown that regular exercise is as helpful as medication for mild-moderate depression. If you aren’t exercising regularly, you might try brisk walking, working out with an exercise DVD, etc. Walking is something that you and your husband could do together, which might reduce stress for both of you.

  13. I’ve been on SSRI’s for about 15 years–before I was married, so I never really experienced the O (maybe five times in the 11 years I’ve been married). I take wellbutrin concurrently, but that really hasn’t helped the sexual side effects for me. A decrease in the Effexor, the SSRI I currently take, has actually given me a libido for pretty much the first time ever, but with my depression history, going off the meds altogether is unlikely. I’ve never heard of buspar used in the way you’re describing. Did your PCP or a specialist suggest this? I have the most amazing and supportive husband, and although I throughly enjoy connecting with him intimately, I feel like I’m missing out in part of the whole experience without the O, at least once in awhile!

  14. Ever since my husband and I got married, I’ve had a really low libido. We crossed boundaries before marriage and it took a while to get through bitterness towards him and I think that had something to do with it. A year and a half into our marriage now we’re 6 months pregnant and this whole pregnancy has been awful to our relationship. On the rare occasion that we have sex, it hurts, and in the past 2 months I’ve been horribly depressed. I know it has to do with my hormones, but is there anything I can do? I feel even worse knowing that I’m not giving my husband what he needs. He wants me to be able to enjoy intimacy with him, but it’s not possible when 1. it hurts 2. my libido is so low I don’t have any desire to have sex with him and 3. I have these horrible, hopeless thoughts on top of it all. Please help. I can’t go on much longer like this.


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