In sickness and in health, for richer for poorer, we vow to love a partner eternally. In reality this is a big ask. How many of us can honestly say what this really means? That standing under a spiritual altar, surrounded by solemnity and community, we understand what we are pledging to do? Until one day you begin to feel the mood around your partner change, imperceptibly you notice sadness lingering and it is more than just feeling "blue" and "down." You begin to feel a slow withdrawal from you, no more affection, conversation is limited, and you feel a disconnect no matter how much you reach out. You are met with a wall, a barrier, that leaves you feeling confused, alone and lonely in your relationship. Sexuality stops. He/she says "I'm depressed", you go into sexual bereavement.
You begin a silent mourning for the loss of your sexuality and intimacy that results from your partner's depression. It feels kind of weird and sexually selfish to tell your friends and family, or even your partner, that you long for an orgasm or sweet kisses. Depression is an illness characterised by persistent sadness and a loss of interest in activities that you normally enjoy, accompanied by an inability to carry out daily activities, for at least two weeks. In addition, people with depression normally have several of the following symptoms: a loss of energy, a change in appetite, sleeping more or less, anxiety, reduced concentration, indecisiveness, restlessness, feelings of worthlessness, guilt, or hopelessness, and thoughts of self-harm or suicide.
There simply is no place in the brain for pleasure. In fact, all energy and resources are needed for survival so intimacy is a luxury which the brain cannot afford. It is difficult to hold onto those vows when you are thrust into a new unexpected role of caretaker for a depressed partner. Roles are reversed as you may need to ensure this person eats, gets out of bed, goes to work, grooms, and does no self harm as you cautiously dole out medication for fear of an overdose. You need a strong and open heart as you feel unloved, neglected, in the way, unwanted, the recipient of unwarranted anger outbursts, and sexually undesired. It can be easy to misinterpret the low moods as hostility, or as evidence that the depressed person has lost interest in the relationship.
This person no longer wants to socialise so you are cut off from your social world, even your family and perhaps your business world will lead to financial strain. And yet, it is at this very time that you are called upon to carry out partner duties. Your depressed partner needs your love and support. The Office for National Statistics (ONS) Measuring National Well-being program found that 20 percent of adults reported suffering from either anxiety or depression. The study found that being in a cohabiting or marital relationship was a protective factor against depression (with the rate of depression being higher amongst single and separated people than those in personal relationships).
Another study found efforts from a partner to help alleviate stress may prevent the development or worsening of mental health problems and, in fact, could help keep the relationship healthy. In an attempt to dislodge from this disconnected dark place, your partner may agree to consult a health care provider after much pushing from your desperate side. Oftentimes the stigma attached to depression causes people to avoid going for treatment or gets them to stop medication. Which proves really problematic as depression will not go away, it simply causes havoc and unhappiness if left untreated.
And here is where I, as a sex therapist come into the picture. One of the first signs of depression is loss of sexual interest, and low arousal. This means erectile changes and lack of vaginal swelling. Many people erroneously think taking a PDE5I, like Viagra, Levitra, Cialis will do the trick - restore the erection and all will be well. Unfortunately one needs to be motivated to take the drug, and depressed people lack motivation. The solution is oftentimes medication, antidepressants. They are marvellously effective in managing depression and bring horribly noxious sexual side effects. They inhibit the sex hormones necessary to feel sexual desire and arousal leaving women dry and men non erect, and they inhibit orgasms. What to do?
Partners Guide To Managing Depression:
1. Get a professional diagnosis to ensure it is depression. Too many people are immediately placed on medication when in fact they need therapy first.
2. Mindfulness is a well researched intervention that manages depression, either alone or when needed, with medication. Find a professional to guide you into this daily practice.
3. Encourage your partner to do yoga as this settles the brain beautifully.
4. Create good boundaries for yourself - maintain your own routine and bring in extra support to ensure you can do this.
5. Acknowledge and accept that finding empathy and compassion for a depressed partner is difficult.
6. Accept that your partner struggles to emotionally and sexually connect with you.
7. Find emotional support elsewhere - no infidelity please!
8. Masturbate, continue to be sexual alone, letting your partner know this is happening.
9. Discuss different medication and dosage with psychiatrists so that sexual side effects are least noxious.
10. Discuss the use of PDE5I so erections are assured.
11. Do not allow your partner to stop medication due to loss of sexual functioning. Be creative and adaptive.
12. Use lubricants to avoid sexual discomfort if you find antidepressants cause vaginal dryness.
13. Definitely invest in vibrators to use together - they remind you of what it feels like to be sexual and alive.