You're not alone.
By Zahra Barnes
Depression is typically characterized by sadness, hopelessness, and feeling discouraged, unmotivated, or indifferent about life. This is the depression most people know. But the disorder can manifest itself in some subtle and surprising ways, and some of the symptoms are more easily recognizable than others.
Clinically speaking, if a person has at least five of a certain set of symptoms—like a persistently sad mood, low energy, problems concentrating, insomnia, weight loss, or irritability—for two or more weeks, it's classified as major depression, according to the Anxiety and Depression Association of America.
One of the symptoms you don’t always hear about is a loss of interest or pleasure in sex.
While all the effects of depression can all be tough to deal with, this one can be especially difficult to talk about—and it can sometimes be tricky to treat. But for people with depression, it's a common experience, and one that deserves attention as much as the more “classic” signs of the disorder.
"There's a brain-body connection, so it’s not unusual at all that when people have depression, they can have a lot of physical manifestations," Jamil Abdur-Rahman, M.D., board-certified ob/gyn and chairman of obstetrics and gynecology at Vista East Medical Center in Waukegan, Illinois, tells SELF. That certainly extends to your sex life—in fact, that's often an early sign of depression rearing its head. "Sex drive can be one of the first things to go," Gary Brown, Ph.D, a licensed marriage and family therapist in Los Angeles, tells SELF.
Depression can impact your sex drive in a number of different ways.
First, and most directly, that’s because it involves neurotransmitters like serotonin and dopamine, the latter of which plays a role in both mood regulation and libido, says Abdur-Rahman. When your brain is struggling to properly use these chemicals, it can make you crave and enjoy sex (among other of life’s pleasures) less.
There’s a symptom trickledown effect, too, which can influence the situation. For example, your energy levels might take a dive, and fatigue isn't conducive to wanting to have sex.
In his patients who happen to be depressed, Abdur-Rahman also sometimes sees what he calls "a compromised sense of self," or a feeling of worthlessness that may make them feel less comfortable being intimate with other people.
On top of everything, feeling stressed or ashamed of having depression can exacerbate the situation, says Brown.
There's also a particularly awful link between depression and childhood sexual abuse, Abdur-Rahman says, pointing to research that shows an association between the two. If you've experienced childhood sexual abuse, you may be more likely to deal with depression. And, he adds, "People [who have experienced childhood sexual abuse] can have a subconscious aversion to sex or sexual acts," which can just cause more depressed feelings. The two can basically feed off each other in a vicious cycle.
Even if your libido isn’t affected by the depression itself, it could be dampened by antidepressants.
"There are certain types of depression medications that have demonstrable sexual side effects, including diminished libido," says Brown. Abdur-Rahman notes that serotonin reuptake inhibitors (SSRIs, such as Prozac, Celexa, and Paxil), a popular treatment for depression, are known for influencing people's sex lives, whether by decreasing their sex drives or making it harder (or impossible) to orgasm.
This shouldn’t stop you for getting treatment for your depression. Many people don’t seek help, and it’s a shame, because depression is treatable, and there are options for working around any negative side effects of prescription drugs. Talking through the issue with a mental health professional can help you figure out a treatment plan.
If you're in a relationship, the experts recommend trying to be as honest as possible about your depression and the way it's changed your feelings about sex or your experience during it, even though that's hard sometimes.
"When partners can be involved in that conversation, they can see [sexual issues] as a manifestation of depression instead of a reflection on themselves," says Abdur-Rahman. You can do it one-on-one, or you can see a counselor or therapist together.
"You're entitled to have a healthy, satisfying sex life," says Brown. "If your depression is getting in the way of that, it's worth getting some help."
This article was originally published at Self. Reprinted with permission from the author.