The following is intended for readers 18+

To make life with depression even more depressing, the mental illness can seriously mess with your sex life. Unfortunately, depression can go hand in hand with sexual dysfunction, which can affect everything from your libido to your ability to orgasm. This can be rough on not only the person suffering, but also on the person’s partner, and can put a strain on relationships.

Just as not everyone feels comfortable opening up about their mental illness, not everyone feels comfortable opening up about their sex life. And they’re even less likely to open up about it if they have a problem and feel like they’re broken or not “normal.” Can you blame anyone for not divulging when the word “dysfunction” has such a negative denotation? Sadly, it’s pretty common for people with depression to have their sex life interrupted in one way or another.

The chemicals in our brains that help us feel sexual desire are thrown off when the other chemicals in our brains are wonky from depression. This is the case whether or not you’re on medication. If and when you add medication into the mix, you are hopefully treating the depression itself, but then you also risk the sexual side effects which antidepressants are notorious for. Studies show that 45% of people with untreated depression experience some sort of sexual dysfunction, and 63% of depressed people on medication suffer from it as well. Damned if you do, damned if you don’t, huh?

We all know a trademark characterization of depression is that it can make you lose interest in activities you once loved, even things you never dreamed of not wanting anymore, like sex. When you’re depressed, you might totally avoid these activities, or if you do go through with them, not feel the pleasure you once experienced — and this can go for anything from playing your favorite sport to having sex. A low libido, or, lack of interest or desire for sex, can be the first road block you’ll encounter.

Aside from the initial lack of desire, there can be some factors that can make sex really difficult — the physical signs of arousals. For men, this can mean trouble getting and maintaining an erection. For women, this can mean a lack of vaginal lubrication. This can make the person suffering feel inadequate or embarrassed, and it can make the partner feel confused. They may take it personally and become offended, when in reality, the problem runs way deeper than that.

Then, if you do end up having sex or engaging in some sort of sexual activity, you may find yourself fighting a whole other battle, whether you are a man or a woman: achieving orgasm. Depression and/or antidepressants can be a big culprit of anorgasmia, which can present in a couple of different ways. For example, you may not be able to orgasm at all (and ejaculate, if you’re a man) or you may be able to orgasm under certain specific circumstances. A slew of antidepressants are linked with delayed or absent ejaculation in men and absent orgasms in women. Sad, right?

So, what can you do if your sex life is hurting because of your depression? Are you doomed to sub-par sex…or no sex at all? Thankfully, there is hope — here are a few options.

1. Be Open With Your Partner

Talk to your partner (or partners) about what you’re feeling and what you’re dealing with. Get it all off your chest. Your partner may have no idea what you’re going through or the difficulty you’re experiencing. Communication is key when it comes to sex, whether or not a partner is depressed. If your partner isn’t open to hearing you out and working with you to try to overcome your problems, maybe it’s time for a new, more compassionate partner.

2. Delve Deeper Into Therapy

If you’re currently in therapy, whether in person or online, don’t be embarrassed to bring up your sex life. Trust me, your therapist has probably already heard it all from other clients! When you talk about your problems surrounding sex, you and your therapist may uncover some things from the past that you’ve been subconsciously holding onto that are affecting you.

You could also see a sex therapist who specializes in clients who struggle with sexual dysfunction. With them, you can learn more about your mind, body, and ways that you can take control of your sex life. You can even bring your partner with you, too.

3. Change the Way You Take Your Current Medication

There are a couple ways you can go about doing this. Studies show that side effects are dose dependent, meaning the higher your dose, the more likely you are to experience sexual side effects. With permission from your doctor, you can experiment with a lower dose to see if it makes a difference in your side effects. While doing this, you’ll also want to carefully monitor your mental wellbeing.

Another thing you can do is change the time you take your medication. If you know you’re going to be having sex, take your dose afterwards instead. You can also try adding on an antidote, or another drug onto what you’re already taking. There are some drugs that are commonly added on to combat sexual side effects. One of these is buspirone, an anti-anxiety medication, which has been shown to reverse side effects when taken with antidepressants. Other examples of add-on medications are nefazodone, mianserin, and amantadine.

4. Switch Medications All Together

While drug classes like SSRIs, SNRIs, and MAOIs often do list sexual dysfunction as a side effect, there are some less common, newer antidepressants which are less likely to cause sexual side effects. If your sex life is really important to you and your side effects are really getting you down, you can talk to your doctor about making a switch. Some examples of drugs that are less likely to cause sexual dysfunction are Wellbutrin, Remeron, and Viibryd. Remember that you will need to slowly wean off your prior medication rather than stop cold turkey in order to minimize withdrawal symptoms. Meet with an in-person or online psychiatrist to discuss your treatment options. .

While sexual side effects can be extremely upsetting and leave you feeling frustrated in more ways than one, you can turn things around. Follow these tips and work with your therapist, psychiatrist, and partner — and you’ll be having better sex in no time.