How Depression Affects Your Sex Drive — And What to Do About It

“I want to want sex, but I just… don’t.”

“It’s like that part of me is gone.”

“My partner thinks I don’t love them, but I’m just numb.”

“I feel broken.”

These are some client confessions that Los Angeles-based anxiety, trauma, and attachment therapist Cheryl Groskopf, LMFT, LPCC, has heard that illustrate a potential link between depression and sex drive.

“Sex requires presence, energy, connection, and a functioning reward system — all things depression can negatively impact,” she says. “You’re not going to crave intimacy when you’re emotionally frozen or your brain is too foggy to care.”

Below, learn the clinical connection between depression and a lower sex drive, how antidepressants may affect your sex life, and what you can do to feel like yourself again.

Sexual dysfunction, including low sex drive, is one of the most prevalent symptoms of depression. Studies show that an estimated 33 to 45 percent of men with depression have a decreased libido, 29 to 33 percent have erectile issues, and 20 percent have trouble with ejaculation and/or reaching orgasm (anorgasmia).

But why does this happen? One explanation is that depression may cause low sexual desire because of the way it impacts the brain’s reward system.

Studies have shown that patients with major depressive disorder (MDD), or clinical depression, have lower brain levels of the serotonin 4 receptor, a key hub of the reward system. In theory, this disturbed reward processing is said to lower sexual desire and induce anhedonia (inability to feel pleasure) in MDD.

“Depression blunts the brain’s reward circuitry—particularly the mesolimbic dopamine system—making once-pleasurable experiences, including sex, feel flat or uninteresting,” says Ryan Sultan, MD, board-certified psychiatrist and medical director at Integrative Psych. “Low serotonin levels, common in depression, can also impair libido, while elevated cortisol from chronic stress suppresses testosterone and dampens sexual functioning.”

Mood disorders like depression also put you in a “freeze or shutdown state,” says Groskopf. She says this is the exact opposite of the arousal state that sexual desire lives in. “Your brain shifts into energy-conservation mode, which means everything non-essential (like desire, pleasure, and motivation) takes a back seat,” she says.

Depression itself isn’t the only potential culprit behind decreased sexual interest. Sometimes, the medication prescribed to treat depression could be the culprit.

Research shows that between 25 and 73 percent of people who use selective serotonin reuptake inhibitors (SSRIs) experience sexual problems, including loss of libido, delayed ejaculation, and erectile dysfunction (ED). This is thought to occur because antidepressants elevate serotonin levels, which then inhibit the activity in the dopamine and norepinephrine pathways in the brain. Since both of these neurotransmitters play a role in the desire and arousal phases of the sexual response cycle, the result can be reduced sensation in the anatomical structures of the reproductive system, as well as compromised erectile function and ejaculation in men and less vaginal lubrication in women.

SSRIs aren’t the only antidepressants known to cause sexual side effects, either. Serotonin-norepinephrine reuptake inhibitors (SNRIs) and monoamine oxidase inhibitors (MAOIs) have also been shown to affect sexual function.

Common antidepressant medications with sexual side effects include:

• Paroxetine (Paxil^®)

• Fluoxetine (Prozac^®)

• Fluvoxamine (Luvox^®)

• Sertraline (Zoloft^®)

• Citalopram (Celexa^®)

• Escitalopram (Lexapro^®)

• Phenelzine (Nardil^®)

• Venlafaxine (Effexor^®)

• Duloxetine (Cymbalta^®)

While antidepressants play a vital role in treating depression, sexual well-being is also an important part of overall health and quality of life. Concerns about sexual side effects of taking antidepressants may lead some people to consider stopping their medication, but it’s crucial not to make that decision on your own. Stopping antidepressants abruptly can cause depression to return or worsen. Always consult your doctor before making any changes to your treatment plan.

There are ways to reduce or avoid the sexual side effects of antidepressants: Your provider may switch you to another medication, lower your dose, or prescribe an additional medication to your routine. Communication with your healthcare provider is key.

Treating depression and taking strategic steps to support your mental health can increase your sex drive, but noticing this progress may take time.

“It’s not automatic. When mood lifts, libido may follow, especially if a person regains energy and emotional connection,” says Dr. Sultan. “But if antidepressants are part of the picture, psychiatrists often have to balance mood benefits against sexual side effects. Alternatives like bupropion (which enhances dopamine) or psychotherapy (especially behavioral activation and fitness) can help restore desire. Hormonal assessments may also be warranted.”

Bupropion (Wellbutrin^®), a medication that boosts norepinephrine and dopamine in the brain, is often used in combination with SSRIs to reduce sexual side effects. 

Research finds that taking bupropion can increase the desire to engage in sexual activity and also increase sexual frequency.

When Groskopf is treating patients struggling with depression and low libido, her first step is to zoom out. “Low libido isn’t the problem—it’s a symptom,” she says. “The work is about getting your nervous system out of survival mode and reconnecting to safety, pleasure, and choice.”

She recommends the following treatment options:

• Therapy. Specifically, she suggests therapy that targets nervous system regulation, so you’re not stuck in fight, flight, or freeze mode. Working with attachment wounds in therapy can also be helpful if intimacy feels scary, pressure-filled, or emotionally unsafe. Cognitive behavioral therapy (CBT) has also been shown to improve sexual function in men.

• Medication check-ins. If SSRIs are blunting your sexual arousal, Groskopf says that sometimes a dose shift or medication change can make a big difference. That said, you should only ever change your prescription medication regimen under the care and guidance of your provider.. 

• Shifting the pressure. She recommends letting yourself off the hook if you find yourself stressing about trying to feel sexual.

If you believe depression could be causing other sexual side effects, like erectile dysfunction, trying an ED medication like sildenafil (Viagra^®) or tadalafil (Cialis^®) may improve your sexual performance. However, these medications don’t boost libido or induce an erection automatically. You need to be aroused for them to work.

If you’re noticing low libido alongside other depression symptoms, like persistent sadness, loss of interest in usual activities, fatigue, and changes in sleep or appetite, it may be time to reach out to a mental health professional for support.

Here’s what we know about the connection between depression and low sex drive:

• Depression can lower your sex drive by disrupting brain chemistry and emotional regulation. Depression affects the brain’s reward system and makes it difficult to shift to the arousal state of the sexual response cycle.

• Antidepressant medications, especially SSRIs, can also contribute to sexual side effects. These medications are sometimes associated with lower libido, ED, or impaired arousal due to their impact on neurotransmitters like dopamine and norepinephrine.

• Improving mental health and addressing medication side effects can help restore sexual desire over time. Through therapy and adjustments to your medication regimen, you may notice a gradual increase in your libido and quality of life.

Want to learn more about how depression affects your sex life? Explore the connection between depression and ED, get tips on dating with depression, and find more mental-health products and resources here.