Depressing

Friday, May 28, 2010

Question

I take an SSRI for depression. Do you have any suggestions for dealing with the sexual side effects? I have tried other drugs and they didn't help me at all with the depression. My life is at least manageable with this regimen, so I don't want to change it, even though it now takes me FOREVER to come! I can't seem to cross that line and lose control. It's

Answer

What a fucked-up paradox. If you don't take the medication, your life gets derailed by hopelessness or despair. But if you do take it, it affects your sex life so much that you begin to feel stressed and upset about that. Pharmaceutical companies are aware of this issue and are doing research on better medications, but that doesn't provide much consolation when you have a date right now, this very weekend.

Talk to your psychiatrist or doctor. See if there's anything new—perhaps a combination of drugs—that might be worth trying. Perhaps you could see if a lower dose of your current medication would give you emotional relief and also make it easier to get off. Some doctors prescribe Viagra or similar medications to help with this problem. Because of its intense effect on the circulatory system, including the heart, you should NEVER take erection-inducing medication unless your doctor says you are healthy enough to make it safe. You don't mention any problem getting an erection, however, and I am unsure whether these drugs would make it easier to have an orgasm. But it may be worth experimentation.

Research shows that the most effective treatment for depression is a combination of medication and therapy. Cognitive-behavioral therapy is touted as the quickest and best-documented strategy to create a more positive and stable mood. If you are not currently in therapy, perhaps it would be worth a try, just to see if you could get yourself to a place in your life where you might need less or no medication.

The harsh fact is that we do not have perfect help right now for this serious mental health problem. It seems that some people simply do not secrete enough of the feel-good chemicals (serotonin, dopamine, etc.) to be able to cope with the normal challenges of life. And some people have trauma histories or other life events that are going to predispose them to negative feeling-states. So there is a good chance that you might have to keep on taking anti-depressants for the foreseeable future.

A person with any sort of sexual challenge usually does better with a person they can talk to, somebody who really cares about them, than a random trick. So you might want to cultivate ongoing connections with people who are both fun in bed and wise of heart. Be open with them and share what helps and what doesn't. Some guys with problems reaching orgasm find that they can fuck forever, which their partners love, but in order to come, they need to take matters (and their cock) into their own hands. Masturbating might be easier for you than getting blown or fucking or trying to lose control in somebody else's hand. Have your partner stimulate you until you feel the imperative to come, then give yourself the familiar strokes that have worked well in the past.

Some guys also resort to vibrators. The strong stimulation of one of these little machines can do the trick. But be careful—a vibrator can also create numbness. Monitor your skin condition. If you use a vibrating sex toy that long, you may give yourself a friction burn on your peter.

Warming lubricants are also sometimes helpful.

Be sure to set aside enough time to let yourself relax. You can still enjoy quickies as a form of foreplay and a way to tickle your partner(s). But when you need to receive, do some deep breathing exercises and get a massage. Let your anxieties go. If you notice that your attention is drifting toward problems, bring it back to the present and focus on your body and your partner's body. Trust your partner to tell you if they are getting too tired and need to change what they are doing or take a break. Using verbal fantasy sometimes helps to keep one focused on building arousal. For safer sex purposes, you'll want to use a condom if you might ejaculate in your partner, but to get off, you are probably going to need sex techniques that allow you to shed the condom.

Experiment with whatever seems like it has some potential to help. But the best assistance is probably a circle of fuck buddies or a lover (or all of the above) who like taking their time to give you an orgasm. When you extend compassion toward other people's problems and issues, they are often surprisingly generous in return. (And if they are not, well, there's always another sex ad.)