The Facts About Depression

Depression can make managing every part of your life an uphill battle, and that definitely includes your intimate life.

According to the National Institute of Mental Health (NIMH), about 21 million adults in the United States had at least one episode of major depression in 2020, which represents about 8.4 percent of people 18 and older. Roughly 10.5 percent of women and 6.2 percent of men reported a major depressive episode.

Indeed, it's likely that most people experience some periods of depression in their lives. For those who suffer from chronic depression, the illness can be especially debilitating.

Depression can affect much more than a person's mental health, leading to physical symptoms and sexual health issues, among others. Find out what depression is and what you can do about it.

Contrary to common misconceptions, depression is not a simple feeling or something you can easily "snap out of." Officially, depression is considered a mood disorder characterized by episodes of persistent sadness and a lack of interest in activities you normally enjoy.

Many people who suffer from clinical depression, sometimes referred to as major depressive disorder, frequently experience the following:

• Changes in sleep habits
• Decreased pleasure or interest in hobbies
• Feelings of self-loathing or guilt
• Long periods of sadness
• Hopelessness and emptiness
• Suicidal or self-harm thoughts
• Trouble concentrating

Someone is considered clinically depressed when they experience multiple depressive symptoms throughout most of the day for a period of at least two weeks, but it may sometimes last weeks, months or years.

A multitude of causes, from hormonal changes to hereditary influences, can lead to long-term depression.

One leading theory regarding the onset of depression involves brain chemistry, particularly neurotransmitters in the brain that are responsible for communicating with parts of the brain. Many experts believe abnormally functioning neurotransmitters may be a trigger for inducing depression.

Of course, conditions such as gender dysphoria, anxiety, bipolar disorder and obsessive-compulsive disorder (OCD) can also lead to depression.

Many people who have a significant family history of personality disorder also experience depression, though researchers have yet to reach any conclusions as to which genes, in particular, may be responsible.

Certain health conditions or hormonal influences, including thyroid issues, nutritional deficiencies or hormonal changes—such as those related to pregnancy and menopause—can also play a role in the onset of depression.

Depression typically occurs in episodes, though how long an episode lasts varies depending on the severity and the individual affected. These episodes are characterized by intense feelings of worthlessness, sadness, suicidal ideation and/or lethargy.

People with depression often lose interest in activities that once brought them joy, including spending time with family and friends, having sex, exercising and partaking in hobbies.

Depressive disorder can also lead to the following:

• Irritability
• Difficulty with focus and memory
• Emotional outbursts
• A "foggy" sensation that makes it difficult to think properly

In addition to the mental and emotional impacts of depression, a host of physical effects can occur as a result of depression.

Depression can cause unexplained or unidentifiable physical aches and pains as well as hormonal changes that can lead to further complications. For example, many people with depression often have higher cortisol levels and increased resistance to insulin. These factors affect blood pressure and cholesterol and potentially contribute to developing diabetes.

Additionally, depression can alter your sex drive, and many medications used in the treatment of depression can cause issues with reaching orgasm, premature ejaculation or erectile dysfunction (ED).

Depression and other mood disorders, such as bipolar disorder and anxiety disorder, have also been linked to an increased likelihood of establishing unhealthy habits. These habits may include drug and alcohol use, eating disorders and risky sexual behaviors, all of which can negatively impact your overall health.

Given depression's effects on mood and energy, people who have it are more likely to struggle to keep up with healthy habits. In other words, they are more likely to "let themselves go" during periods of depression. This effect can mean eating an unhealthy diet, oversleeping or not sleeping enough, and neglecting to clean up after themselves or take care of basic personal care.

Furthermore, intense depression can cause many people to experience feelings of self-loathing and potentially suicidal thoughts or tendencies, meaning people with depression are more at risk to commit suicide and self-harm.

Depression often co-occurs with other disorders, such as anxiety, which can contribute to a litany of sexual side effects and a tendency to turn to self-medicating practices such as excessive drinking or drug use.

At its core, depression is a mental health disorder, so diagnosis doesn't involve X-rays or similar techniques. Instead, it is typically diagnosed by a mental health professional who asks a series of questions relating to mood, energy and any thoughts of self-harm or suicide. Your doctor may also order additional tests to rule out other organic causes of depression.

Depending on the answers the patient provides, the professional can determine the severity of the condition and work on a treatment plan. Such plans typically consist of a combination of antidepressant medication and talk therapy.

Unfortunately, given its nature, it is difficult to actually prevent depression from developing. But there are several steps you can take to reduce the intensity of symptoms and keep extended periods of depression under control.

Generally, getting enough sleep, exercising regularly, limiting your intake of alcohol, eating a balanced diet and developing stress-management techniques can help ease depressive symptoms and improve your overall health.

Depression treatment regularly involves some combination of medication and cognitive behavioral therapy (CBT).

Working with a therapist can help clients identify triggers and develop coping mechanisms to manage depressive symptoms. In fact, therapy has been shown to boost self-esteem, reduce anxiety and improve social functioning. Therapists can also help patients come to terms with traumatic life events that cause distress or behavioral patterns that may be contributing further to their depression. On its own or in combination with antidepressants, therapy is an invaluable tool for people suffering from depression.

Antidepressant medication includes the category of selective serotonin reuptake inhibitors (SSRIs). Medications such as sertraline (brand name: Zoloft), fluoxetine (Prozac) and escitalopram (Lexapro) fall under this category. Medications such as venlafaxine (Effexor) fall under the category of serotonin-norepinephrine reuptake inhibitors (SNRIs).

Both types of medication, as well as other atypical antidepressants, work by altering hormones and neurotransmitters to combat depression. But these medications can also affect hormones that impact sexual functioning.

By impacting serotonin, also known as "the happy hormone," many medications used to treat depression can also impact hormones such as testosterone and dopamine, which can potentially lead to sexual dysfunction.

Commonly, SSRIs and other antidepressants may lead to erectile dysfunction, lowered libido, difficulty reaching orgasm, delayed ejaculation and vaginal dryness.

Depression can be a hindrance to sexual health in numerous ways:

Depression and libido

On its own, depression can significantly decrease libido as a result of a loss of interest in previously enjoyable activities. Beyond that, depression can affect a person's self-esteem, making it more difficult to feel confident during sex and potentially triggering further anxiety about sexual performance.

Antidepressants, even when they help with self-esteem and other aspects of depression, also affect sexual desire and performance.

Depression and ED

Many common SSRIs have been shown to contribute to the development of erectile dysfunction, and because of how antidepressants affect serotonin and dopamine, they can also impact sexual desire. In fact, research indicates that 40 percent of people on antidepressants experience sexual dysfunction at some point.

Fortunately, symptoms of sexual dysfunction often decrease as the body becomes used to the medication. In other cases, switching to medications such as bupropion (Wellbutrin) or timing the intake of medications can also help to combat sexual issues. For example, have sex before taking an antidepressant.

In any case, it's important to have conversations with your partner if you're experiencing any sexual issues as a result of depression or its treatment. And keep in mind, depression is one of the most common mental disorders people face. And side effects are common, too. It is always a good idea to make your healthcare provider aware of your side effects before attempting to switch or stop medications on your own.

Depression is a difficult condition that can wreak havoc on your personal, social, professional and sexual lives, but thankfully, it may be manageable.

Working with a therapist to develop coping mechanisms and identify the causes and triggers for your depression can help you be aware of when episodes might occur. This can help you avoid situations and scenarios that can worsen depressive symptoms. Additionally, being able to share your thoughts and feelings with a professional who listens and provides support can be beneficial.

Antidepressant medication can also be a major boon despite the sexual side effects. In most cases, the sexual side effects can be treated with other medication or simply with open conversation. When properly prescribed, antidepressants can enable patients to have more confidence in themselves, reduce anxiety and find the willpower to enjoy life.

What are the four causes of depression?

Most often, depression results from a family history of the illness, adverse life events, substance use or prior physical and mental health conditions, including those that cause hormonal changes, such as giving birth or changes to sleep, diet and exercise.

How does depression affect the brain?

Depression can reduce the transfer of important neurotransmitters, such as dopamine and serotonin, that affect mood and energy levels, leading to fatigue, feelings of sadness, lowered self-esteem and suicidal thoughts.

What is the most common treatment for depression?

The most common treatment for depression is a combination of talk therapy and antidepressant medications, often selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs).