When Jake sits in the therapy room with me it takes a long time before he will make eye contact. In fact, it takes a long time before he raises his eyes and really seems to see the room around him, or me, at all. When I ask him about any experiences of pleasure he had in the past week – a great smell, something beautiful he saw, a delicious treat, physical pleasure – he draws a blank. He looks down and says, "I can’t even imagine what would make me feel good anymore."
Loss of Pleasure: Depression, by clinical definition, causes a person to lose interest or enjoyment in things that once pleased them. It can seem like a gradual disconnection from the world, a drawing away from sensations, people, and activities. Depression impacts every area of a man's life and, of course, his sex drive can be affected profoundly.
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When people are asked why they have sex, the most common answers, for both men and women, are for pleasure and to feel connected to the other person. What happens when a person's sense of pleasure is critically dampened? Not only may motivation and drive for sexual activity go down, but so do fantasies about sex, which can strengthen one's libido. It is no surprise that many people with depression report decreased sex drives. Add to this the general sense of being overwhelmed, exhaustion, and difficulty functioning through daily activities that may be a part of depression and having sex may become another example in their life of "going through the motions". This can be frustrating for partners who ask, "what can we do to make sex fun for you again?”, and find their depressed partner unable to answer because, like Jake, they have lost connection to their own pleasure.
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Self Soothing : We all respond to life stressors, including depression, uniquely. Some men with depression report increased sex drives. They talk about having sex to receive the physical boost and also to feel loved and accepted by another. Indeed, if desired, sex can be a great way to increase feel good chemicals in our bodies such as dopamine, which facilitates pleasure seeking and can aid alertness and energy (Crenshaw, 1996). If it doesn’t feel aversive or overly stressful, having sex or masturbating can be a good choice for enhancing the mood of anyone!
It is a natural impulse to relieve ourselves of negative feelings or uncomfortable situations and we all develop skills for doing this by the time we are young children and add to them over the course of our life. We develop habits that we know make us feel better in the short term. Maybe we learn to distract ourselves with TV, by going for a run, or by eating something sugary. People struggling with depression feel badly most of the time and so their habits for self soothing may become more automatic and entrenched. Some of these habits are genuinely helpful and some end up making things worse. Turning to sex that makes you feel good emotionally and physically is helpful.