It’s a topic that I’ve written about before. It’s a topic that I am very well acquainted with. Given that I have suffered from depression off and on since my late teens, the two aspects of this topic are almost inextricably linked. Whilst I wouldn’t go as far as to say I have never had sex when I haven’t been suffering from depression, given that I have been on medication for my condition solidly for the past 14 years, and more often than not in the last 20, it’s fair to say that most of the sex I have had has been had while I have been on anti-depressant medication. A fact that, in itself is more than just a little depressing.
I was first diagnosed when I was 28. With the benefit of hindsight however, it became obvious that I had been suffering for the best (or should that be worst) part of a decade before that. The condition gradually worsening over time, with the episodes becoming harder to fight off, lasting longer, being rougher, and becoming ever more frequent.
So how has it affected me sexually?
Well, for the first few years that I was sexually active, I was undiagnosed. Sex happened the way I understood it was meant to happen. I got aroused when the woman I was with did arousing things with me and, at a certain point and after a certain amount of activity, I would come, having hopefully made her come at least once before I did. Everything seemed to work. Neither I nor my girlfriend of the time had any complaints. We had sex when and where we wanted to have sex, as often as we wanted to have sex (barring of course those spells when we argued, which of course would lead to make-up sex). So all in all, no complaints.
Even when my mood was at it’s lowest and darkest, sex still seemed to happen pretty much on demand. I may not always have been quite as keen, but I never really let it stop me.
But then came the medication.
First there was Paroxetine. It was fairly innocuous and apart from making me feel queasy , both when starting and when coming off, it didn’t really affect me too much either way.
Then there was Amitriptyline. It pretty much spaced me out for months until I got the dosage sorted and my body got used to it. Sexually, it slowed me down. I had the most amazing staying power. I could last, and last, and last. This sadly is not always a good thing; it is actually possible, I learned, to take too long. Things can get a little tender and sometimes a bit boring when there literally no end in sight. On the whole, it was mostly positive, but not entirely without drawbacks.
If Amitriptyline slowed me down, then Lofepramine had the opposite effect. It wasn’t quite premature ejaculation, but it’s as close as I ever want to come (pun semi-intentional). I could come with no warning, generally just as I was settling into my rhythm. It would just happen, between one thrust, one heartbeat and the next. After 18 months of delayed response from Amitriptyline, this was a blow to my system. I had to try to work things so that I maximised my partner’s pleasure without getting over-stimulated myself; resigning myself to the fact that when “my turn” came, it would be over all too soon.
After that came Duloxetine and Venlafaxine. Through them I discovered that the SNRI class of anti-depressants really do not agree with me. I can’t really say what effect they had on me sexually as I wasn’t on either of them long enough to find out. Suffice to say that I felt absolutely wretched the whole time I was on them and the last thing I felt like doing was getting jiggy.
Then came my long association with Citalopram. On the one hand, it kept my mood stable for a long time; approximately 8 years. On the other hand, it made things difficult. While it didn’t slow me down to the extent that Amitriptyline had, orgasm became increasingly hit or miss. Sometimes things would proceed “normally”, albeit orgasm, when they happened, tended to arrive with very little warning; although unlike Lofepramine, I did get some warning, so I was, at least able to arrange things so that I could enjoy it as much as possible. Sometimes however, orgasm became elusive. I could have several bouts of sexual activity without coming. One partner even went as far as to (semi) jokingly describe me as her only blow-job fail in that she couldn’t suck me to completion.
It was during this time that I effectively gave up masturbating. Far more often than not, I was unable to bring myself off and the frustration I was trying to release was, instead, intensified. While I could enjoy sex with a partner, I got little or no enjoyment from it on my own. With a partner, I could take pleasure in their pleasure and that would often help me along. On my own, without the extra stimuli, the ending would so often be so unsatisfactory as to make it not worth the effort.
Today, I am on Fluoxetine. My mood isn’t quite as stable as it was when I was taking Citalopram, but that isn’t necessarily such a bad thing. On Citalopram, I was flat-lining; I was existing, not really living. I tended to have one mood pretty much all the time. In a way, I was numb and this numbness almost certainly contributed to my anorgasmia.
On Fluoxetine, my orgasms are much more dependable (although I still don’t masturbate). My “staying power” and recovery time is probably around average for a man in his late 40s. I still don’t have much of a plateau phase although I have learned to adapt and to make the most of it where I can. How much of this is down to my medication, and how much of it is as a result of me being “of a certain age” I don’t really know. I don’t really have an unmedicated version of me that I can compare with.
The main thing is, I guess, that my mind and my body have had 30+ years to work things out and while it may not be perfect, I am at least capable of both having and enjoying sex, and for that, I really have nothing to complain about.