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7 Ways Your Mental Health Can Mess With Your Sex Life

That mind-body connection is real. ByAnna Borges

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When you’re having problems in the bedroom, your mental health probably isn’t the first thing you think to blame. But maybe it should be! Everything from the stress of daily life to seemingly unrelated conditions can have a sneaky way of screwing with your sex life or leading to sexual dysfunction—even if it’s not always immediately obvious that that’s what’s going on. “There are so many things that go into the mix of our sexual functioning and mental health that it’s difficult to pin down the exact relationship between the two," says psychiatrist Gail Saltz, MD, associate professor of psychiatry at the NY Presbyterian Hospital Weill-Cornell School of Medicine. 

Because of that, it can take some exploration and even professional support to get to the root of any issues you might be dealing with—in part because our sexual histories and relationship to sex matter too. “The experiences that we have throughout our lives shape our sense of self and our emotional well-being, and that impacts who we are as sexual beings,” says Taylor Kravitz, LMFT, a therapist who specializes in sex therapy. 

So, keep in mind, this list is not meant to be exhaustive. But if you’re dealing with any of the following struggles, it’s worth exploring the connection between your sex life and mental health in more detail. 

1. You suddenly couldn’t care less about having sex. 

While there’s nothing wrong with a low libido if it doesn’t bother you, if your typical desire for sex has vanished into thin air, your mental health is a potential suspect. Depression is a common culprit behind libido loss—and get used to hearing that in this article, because Dr. Saltz says our buddy depression can interfere with pretty much every stage of the sexual response cycle, from getting turned on to getting off. Even if you’re dealing with “high-functioning depression” (or what psychiatrists call “subclinical”—as in, you don’t meet the diagnosis for major depressive disorder), you probably know that feeling depressed isn’t exactly an aphrodisiac. 

Feeling too stressed or anxious for sex is definitely a thing too, says Dr. Saltz. For one, anxiety can trigger your fight-or-flight response, which can push thoughts of intimacy from your mind completely. “It’s really an evolutionary mechanism—if a bear is chasing you, you don't want to be thinking about sex,” Dr. Saltz says. 

And, of course, the cruel irony: Some treatments for both anxiety and depression can also interfere with your ability to get aroused. I know, I know. Two common ones are selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). But keep in mind that not everyone experiences the same side effects—treating your depression or anxiety with medications could very well be what helps your libido return from the depression caves. Everybody (and every body) is different. 

2. Or your libido is unexpectedly through the roof. 

Hypersexuality can also sometimes happen with certain mental health conditions, says Dr. Saltz. For example, some people experience it during periods of mania or hypomania associated with bipolar disorder. Post-traumatic stress disorder or substance use disorders may also contribute to certain trauma responses or riskier behaviors related to sex, says Dr. Saltz. If your sex drive suddenly feels out of control or excessive, a doctor can help you make the distinction between high libido and something more. “There’s nothing wrong with having plenty of sex,” Dr. Saltz. “It becomes another issue when it becomes indiscriminate sex, unsafe sex, or out of control sex.” 

Less commonly, some antidepressants like bupropion might actually increase your libido (way to go against the sex-life-crushing stereotype!), as can stimulants commonly prescribed to treat ADHD, says Dr. Saltz. Obviously, this can be a welcome thing for some people, especially if your sex drive was dragging thanks to depression in the first place, but talk to your doc about any noticeable changes just to be safe. 

3. You’re just too pooped for it. 

Whether you’re sleeping way more than usual thanks to depression, feeling too drained by physical side effects of anxiety, or living with insomnia, depleting mental health problems can leave you with little energy to enjoy much of anything—and that includes sex. 

“When so much of your emotional, physical, and mental capacity is being taken up with depression or overwhelm or anxiety or burnout, it’s tough to have the bandwidth for pleasure, even when you desire it,” Kravitz says. She adds that the same can be true for living with ADHD, noting that navigating the world while neurodivergent can compound these feelings. 

Obviously there are lots of reasons why you might not have the energy for sex (like that you’re an exhausted parent or caregiver or you’re dealing with chronic health issues). But if you’re not sure why you’re suddenly more interested in sleep than sex, you might want to consider your mental health. 

4. You can’t stay present. 

Getting stuck in your head is a hallmark symptom of anxiety, and I’m sure you know it can really kill the vibe during sex. When you get anxious, your body sometimes kicks into a state of hypervigilance, where you’re on high alert for any potential issues or threats, explains Kravitz.  This is clearly not conducive to relaxing and enjoying yourself. Instead, your mind might be racing with sex-related concerns or even totally random worries. Think: What face am I making? Does this feel OK? Am I doing this right? Did I leave the stove on? 

Then there’s ADHD. Yep—unsurprisingly, the condition best known for screwing with your ability to concentrate can also screw with your ability to concentrate on pleasure. Because the ADHD brain loves stimulation, you might get bored more easily and find your mind wandering, says Kravitz. This might be especially true if your sex life feels routine, she adds. While there’s nothing wrong with sticking with what works, if you have ADHD and find yourself mentally checking out during sex it’s possible you’re craving a little more variety in your mental or physical stimulation. 

Don’t forget all the indirect ways your mental health can steal your attention too. Conditions tangled up with body image issues, insecurity, and self-harm might also make you hyper-aware of how you look and act during intimacy. 

5. You get sensory overload. 

Sex is such a sensory experience that can be pretty damn overwhelming for some, especially those with sensory sensitivity—a symptom you might experience if you have ADHD, OCD, or anxiety, among other conditions, says Kravitz. Just think of how many different textures, tastes, sights, smells, and sounds come up during the act. According to Kravitz, it’s not uncommon for people with some mental health concerns to avoid sex and worry they can’t enjoy it at all. 

Kravitz says a lot of people don’t recognize sensory sensitivities when they’re happening, often experiencing it more as anxiety or general overwhelm. She recommends taking inventory of what feels/tastes/sounds/smells/looks pleasurable, grounding, or otherwise positive to you during sex—and what usually takes you out of the experience and into your head—to get a better idea.  

6. You’re having sexual performance issues or pain.  

When things don’t quite work the way you want them to, you might assume that there’s a physical issue at play—and it’s possible—but thanks to the all-powerful mind-body connection, the answer could be surprisingly psychological. For instance, stress and anxiety can lead to muscle tension and tightness, which can lead to painful penetration, Kravitz says. Erectile dysfunction and vaginal dryness are common mental health side effects too, notes Dr. Saltz. 

Similarly, remember how Dr. Saltz said anxiety and depression can muddy up the sexual response cycle? That’s because your body takes physical and mental cues into account when getting aroused. In other words, your brain plays a big part in getting the lubrication and blood flow where they need to go. 

This isn’t to say that all sexual dysfunction or discomfort is psychological, or that this means it’s “all in your head.” But it’s worth knowing that both physical and mental factors can impact your ability to have sex (let alone sex that feels good). So, in addition to looking into what might be going on physically, it’s smart to think about how your mental health could be playing a role too. 

7. Orgasms just aren’t happening. 

Once again, depression and mental health medications can often be to blame here, says Dr. Saltz. Stress and anxiety can also interfere with the brain-body connection, something we previously reported was extremely important when it comes to orgasms. Not to mention, it’s pretty difficult to get off when you’re dealing with any number of things on this list, like dealing with pain during sex or getting stuck in your head. 

Here’s where plenty of sex therapists will encourage you to take orgasms off the pedestal and just focus on pleasure. And that’s fair! But it’s normal to feel crappy when your body doesn’t respond how you expect or want it to. So, if you think your mental health might be behind your inability to orgasm, try talking to a trusted health care or mental health provider about it—whether that’s a therapist, your primary care doc, or the nurse practitioner you have a great rapport with. They can likely answer your questions or direct you to someone who can. 

The bottom line: It’s worth seeking answers if your sex life leaves a lot to be desired—and you don’t have to do it alone. For many, “sexual functioning is hugely important to our self-esteem, relationships, and satisfaction,” Dr. Saltz says. “There are ways of dealing with these issues, therapeutically and sometimes medically, to improve your sex life and life overall.”