Dating on Antidepressants
About a month ago, my boyfriend asked me to meet his friends for the first time. Excited to be in the honeymoon phase of a new relationship after almost two years of being single, I painstakingly curated an outfit and set off to his apartment, where a few of us would hang out and drink. Yet within 10 minutes of arriving, I panicked uncontrollably and locked myself in his bathroom to wring sweat out of my long, curly fringe with one of his towels. Needless to say, it wasn't the first impression I hoped to make.
Just a few days beforehand, I had finally spoken to a doctor about my decade-long battle with anxiety and been prescribed 20mg tablets of citalopram, also known as Celexa, a type of antidepressant that falls under the category of SSRIs (selective serotonin reuptake inhibitors). Studies prove the efficacy of this medication: For example, 2016 research published in the International Journal of Neuropsychology found it regulates neurotransmitters released in the brain, helping to "overcome acute stress."
I was warned of potential side effects, such as drowsiness, dry mouth, excessive sweating (such a treat!) and lowered sex drive, the worst of which largely wear off within a month or two and, according to a 2020 summary by the National Center for Biotechnology Information, affect around 10 percent of those who take citalopram. In my mind, these side effects were nothing compared to the gut-wrenching, ever-present knot of anxiety in my stomach, so I shrugged off any worries I had about dealing with them. If these tiny white pills could make the day-to-day drudgery of life feel liveable, I thought, I could manage anything.
'Disclosing my mental health struggles has also brought us closer together, and made communication a priority from day one.'
Yet the more research I did, the more stressed I became, especially when I saw SSRIs are also commonly prescribed for premature ejaculation. As I laid in my boyfriend's bed, a sweaty mess as he gamely soldiered through an hour-long handjob that still didn't end in orgasm, I started to realize that sex and dating on antidepressants might be more of a challenge than I had initially anticipated.
Not all antidepressants will cause sexual problems: There are various types, and side effects vary based on dosage. According to the Mayo Clinic, the likes of Bupropion, Mirtazapine, Vilazodone and Vortioxetine are less likely to cause sexual issues, but SSRIs are commonly prescribed because they come with less risk of serious, long-term side effects, like seizures and mania. To mitigate these risks, doctors will generally start patients on a low dosage, monitor their reactions and only increase if necessary.
For those suffering with severe mental health issues, medication can feel like a catch-22. On the one hand, depression and anxiety can make even the act of leaving the house for a date feel like an insurmountably daunting task—when you're so miserable you can barely get out of bed, the thought of getting dressed up to be judged by a stranger doesn't exactly appeal. Mental illness also exacerbates the emotional peaks and valleys of love, making an ignored flirtatious text message or shitty date feel like the end of the world.
So surely dating is better when you're taking medication to manage your mental health, right? Well, not always. "It would seem that way, but antidepressants can affect feelings of love and cause fluctuations in mood," explained Tess-Leigh Philips, a U.K.-based counselor at mental health service The Mind Map. "[This] can leave some people feeling numb or at the very least apathetic about communicating with their partner."
On balance, though, many people find antidepressants can help pave the path to love. Now 34 years old, U.K.-based writer Francesca Baker has been on a combination of Olanzapine and Sertraline since she began seriously struggling with anorexia, exacerbated by anxiety, at age 19. Baker has been taking this medication regularly ever since, and said it's improved her life exponentially. "I was in a long-term relationship when I first started taking medication, and that relationship lasted until I was maybe 25 or 26," she explained. "I didn't have much of a sex drive, which might have been down to the medication, but the fact that I was very underweight also played a significant role in that."
After that relationship ended, Baker began trawling through dating apps to meet a new partner. Initially, she was reluctant to open up on dates about taking antidepressants. But as time passed and her confidence grew, she developed a policy of mentioning her mental health and history of disordered eating—usually on a first date, but sometimes even earlier during the "getting to know you" conversations on apps. "I would kind of mention my anorexia and then explain how medication helped deal with that," she explained. "It was basically me saying, in quite a holistic way, 'Here is my health situation,' not 'If I don't want to have sex with you, it's because I'm on meds!'"
This might work for some, but not for all—so don't feel rushed to open up to your romantic prospects. "Don't feel like you need to share your medical history on the first, second or even third date," said Philips. "Wait until you feel you've built enough trust, and remember that the hardest conversations are often the most rewarding—your prize may well be increased closeness and security with your partner. If you're met with judgment, it's likely they're not the right person for you anyway."
This statement rings true with my own experiences—no matter how daunting these conversations occasionally are, each of them has built a sense of intimacy in the relationship and established an element of mutual understanding early on.
Now Baker is in a long-term relationship with the "love of [her] life," and she's mastered the art of great sex on antidepressants. "My sex life is fucking amazing," she continued. "The medication definitely reduces my anxiety a lot, but it's also made me feel much more healthy in my own body. I still struggle with anorexia, but I want to recover because I want to do brilliant things with my boyfriend. Despite medication, brilliant sex is one part of that."
There are also ways to get around the lack of orgasm—after all, it doesn't have to be the sole aim of sex—but honesty is the best place to start. Even a statement as simple as, "It takes me a while to come, if I do at all" can alleviate the pressure to climax and allow you both to enjoy each other's bodies without pressure. If you do reach orgasm, it's a bonus.
In my experience, these conversations often make relationships more experimental because we aren't simply going through the motions—kissing, foreplay, intercourse—with the sole aim of orgasm. Since I started taking antidepressants, my boyfriend and I have fucked on a field, experimented with role-play and practiced the art of oral extensively. In some instances, the difficulty in orgasm is actually a huge bonus—when I do come, I come hard. Disclosing my mental health struggles has also brought us closer together, and made communication—which can be tricky to nail even in the most committed long-term relationships—a priority from day one.
Dating on antidepressants poses challenges, but it's definitely doable. "Plenty of people are in happy relationships whilst taking medication–myself included," Philips said. "Personally, I found they soothed my extreme anxiety. That allowed me to open up more easily, which in turn reduced my panic and frustration."
The trick is to stay tuned in to your reactions, keep an eye out for side effects and maintain regular communication with medical professionals. And if SSRIs aren't for you after all, there are alternatives, such as long-term counseling and therapy.
For me, at least, meds seem to work at the moment. After a few weeks of occasionally embarrassing side effects, the dull fog of my mind is beginning to lift. Better still, this increased clarity stops me from tumbling into downward spirals and reminds me that, even if this relationship does end, I'm laying the foundations for a more stable, ultimately more peaceful future. In this context, a few delayed come-shots and a perpetually sweaty fringe feel like a small price to pay.