Let's Talk About Sex and Mental Health

By Dr. Roz, Integrative Healthcare Solutions

Let’s talk about something real for a minute—something many people are thinking but few are saying out loud: “I am having some issues in the bedroom.”

If this sounds familiar, you’re not alone—and you’re definitely not broken. As a psychiatric mental health nurse practitioner, I’ve had this conversation countless times with patients.

The good news? There are real reasons behind what you’re experiencing, and yes—there are also solutions.

How Mental Health Affects Sexual Health

1. Depression

·      ↓ Libido, difficulty achieving orgasm, erectile dysfunction

·      Feelings of worthlessness, guilt, and low energy can reduce interest in sex

·      Antidepressants (especially SSRIs) can worsen sexual dysfunction

2. Anxiety & Panic Disorders

·      Performance anxiety, premature ejaculation, vaginal tighting

·      Excessive worry can interfere with arousal and pleasure

·      Hypervigilance and fear of intimacy may cause avoidance

3. PTSD & Trauma

·      Especially common in those with a history of sexual trauma

·      May lead to dissociation, avoidance of intimacy, fear of touch

·      Flashbacks or emotional numbing can disrupt sexual connection

4. Bipolar Disorder

·      During manic episodes: increased libido, risky sexual behavior

·      During depressive episodes: low interest, withdrawal from intimacy

5. Psychotic Disorders (e.g., schizophrenia)

·      Social withdrawal and disorganized thinking may impact intimacy

·      Antipsychotics can cause prolactin elevation → ↓ libido, ED, amenorrhea

So you started your medications and now your sex drive is gone…

Why Antidepressants Affect Your Sex Life

Most commonly, people experience sexual side effects when they’re on SSRIs (Selective Serotonin Reuptake Inhibitors) or SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors)—medications often prescribed to treat depression and anxiety.

While these medications can be life-changing (and even life-saving), they can also interfere with:

• Sex drive/libido

• Arousal

• Ability to orgasm

• Erectile function (for people with penises)

Why does this happen? Because serotonin, the same brain chemical that helps regulate your mood, also plays a role in your sexual response. When levels are altered, your body may respond differently to sexual stimuli—even if the desire is still there mentally.

But Isn’t Mental Health More Important Than Sex?

Here’s the thing—you shouldn’t have to choose between feeling emotionally stable and feeling sexually fulfilled. Both matter. Sexual health is mental health. Feeling disconnected from intimacy can have a huge emotional impact, especially in relationships.

What You Can Do About It

If you’re experiencing these side effects, please don’t suffer in silence. There are options, and your provider should be someone who’s ready to have this conversation without shame or judgment.

Here’s what we might explore at Integrative Healthcare Solutions:

1. Switching Medications

Not all antidepressants affect sex drive the same way. Some, like bupropion (Wellbutrin), actually have a reputation for being more “libido-friendly.”

2. Adjusting the Dose

Sometimes a lower dose still does the job for your mood—and eases up on the side effects. This should only be done under medical supervision.

3. Adding a Second Medication

In some cases, we can add a second med to help counteract the sexual side effects of your current antidepressant.

4. Therapy & Communication

Sometimes, just talking about what’s going on—in a safe, supportive environment—can bring relief and clarity. We can also work with couples to help rebuild intimacy in new, creative ways.

This Is Treatable. You’re Not Alone.

Antidepressants can be an important tool in your wellness journey, but so is pleasure, connection, and feeling good in your body. If your sex life has shifted and you’re wondering if things can get better—the answer is yes.

At Integrative Healthcare Solutions, we’re here to support the whole you—body, mind, and relationships.