I’ve always been very open about my depression and mental health. I don’t let it define me, but it is so much a part of who I am that I can’t really not acknowledge the fact that it is a very big part of what goes together to make me the person I am.
As a general rule, apart from when I am at my very worst, depression hasn’t had too much of an adverse effect on my libido. When circumstances, and the availability of a willing partner, allow, I probably enjoy sex every bit as much as anybody else. Actually, this is a bit of an interesting point as, given that I have suffered from depression on and off since my teens (before I became sexually active), it’s actually difficult to say how depression has affected my libido. I’ve been on anti-depressants now constantly since 2004. Before that, from about 1995 onwards, I had occasional episodes where I would be prescribed a 6 month course. The only comparison I can make is that between my current libido and that of those periods pre-2004 where I wasn’t on medication. As much as I can tell, any reduction in libido is more down to me now being a world-weary late 40 something and not a constantly randy 20 something, than it is down to my illness.
My orgasm can, on occasion, be somewhat hit or miss. This depends more on the particular medication that I am on as much as anything else. Amitriptyline tended to slow me down where I could fuck for over half an hour before I came. Duloxetine, on the other hand, tended to make me trigger happy. Citalopram, as it did with almost every aspect of my life, tended to just “smooth” things out. I might come, I might not; my orgasm was never a foregone conclusion and it wasn’t uncommon for either me or my partner, or quite often both of us, to decide to just give it a miss. I’m currently on Fluoxetine. The only “adverse” effect it has is that I have little or no plateau phase. It doesn’t affect my “staying power” one way or the other, but I often get very little warning that orgasm is about to occur. There are worse effects it could have, I guess, but being taken by surprise by your orgasm when you are just nicely settled into your stride can be somewhat disconcerting. The only thing that has really suffered is masturbation. I find it almost impossible to reach orgasm on my own. For me, masturbation tends to exacerbate rather than relieve any particular sexual tension/frustration that I may be experiencing. So much so, that I have all but given up indulging myself. I genuinely can’t remember the last time I tried.
Yes, there are times when I’m at my worst, where sex has no interest to me. Having said that, when I’m in those particular phases, life itself holds no interest, so when I’m barely eating or sleeping, and existing day-to-day if not hour-by hour, then it’s hardly surprising that sex simply isn’t on my radar.
And that’s the thing; when I am at my absolute worst, I genuinely am merely existing from one moment to the next. I have never attempted to end my life, but in those darkest places, I am indifferent to whether or not I go on living. I have written before about the longing for the oblivion of experienced non-existence. On twitter, there have been countless occasions when I have expressed the desire to simply no longer be.
So how do take care of myself?
Generally I just try to distract myself by keeping busy. If I keep my mind occupied, I don’t have time to allow thoughts to be drawn toward, or linger on the things that bring me down. It is, however, a bit of an all or nothing strategy. I either have to be constantly “doing something” to distract myself or else actively keeping my mind away from its dark corners. Evenings, before I fall asleep can be difficult times. Weekends can leave me worn out from the effort of just enduring them.
When I am at my very worst, the only option is to retreat, to hide myself away from the world. I actually find myself embracing, and being embraced by the darkness. I use it as a kind of camouflage, a protective shield from the world around me. I know that this “protection” is an illusion. I know that this is how it feeds. Sometimes, however, I have to allow myself a strategic defeat to allow myself to regroup and rebuild and rejoin the struggle.
Is it sustainable? The honest answer is that I genuinely don’t know. I can never know for certain if, having survived it for 30 years so far means that I’ve worked out how to live with it and survive all that it can throw at me, or if the constant attrition means that one day I may not make it through the next onslaught.
I have tried counselling, I have tried CBT, I have even tried hypnotherapy; nothing has really had that much of a positive effect. I practice mindfulness and meditation; the first so that I am aware of my mood and how it fluctuates, the latter as a way of bolstering my defences.
As for sex; the feel-good aftermath of orgasm is always a welcome addition to my well-being arsenal.