I don’t know exactly when it shifted, and I definitely don’t know why. I tend to put a definite cut off around 2008, since the 2008-09 episode was so profound, lasted so long, and smothered me; like sleep, under morphine.
At first I blamed the drugs. That was comforting and easy, because after all a side effect of SSRIs is loss of libido. It also held out the promise that once I was off the drugs, I’d be up and running again. I was willing to put up with a flatlining sex drive for a while, for the relief the antidepressants gave me. They were only temporary, after all.
And then I came off the drugs, and I looked forward to the promise of torrential lust. Being young and gay in London with no strong desire for sex is… frustrating. I wanted that part of my life back. So I waited, and I waited, and it never came.
Oh sure, I could get drunk and horny. But that’s missing the point, isn’t it? Drunken lust is clumsy, grasping and loose. Temporary, and soon forgotten. Being young and gay in London with no strong desire for sex is more than a little alienating.
I still blamed the drugs, or maybe I blamed the depression, or both. Blamed some kind of permanent rewiring of the circuits of sexual desire. Maybe they’d burned out? Maybe they’d atrophied? We live in a culture saturated by sex – gay subcultures especially are sodden with it. But for all that, we seem to have little real regard for it. For most of us, sex is important, beyond hedonism and lust and beyond even passion. It’s important for contact, for happiness. For relationships and belonging and feeling a broad and deep range of emotion, sensation.
And I wasn’t getting any.
“Loss of libido” is thrown away in the patient information sheet which details side effects of SSRIs, alongside “failure to reach / maintain an erection (in men)”* and “Anorgasmia (failure to reach orgasm)”. I guess in the grand scheme of things, these aren’t profoundly worrying side effects – the other drug I’m on, lamotrigine, lists Stevens-Johnson syndrome (a potentially fatal loss of skin) and disseminated intravascular coagulation (DIC, AKA Death Is Coming) as it’s potential side effects. Yes, I’d rather have no sex drive and shit orgasms than die horribly from my skin sloughing from my body. Still. Hardly a fair comparison.
Sex is important. And when you’re prone to depression, not having a full – or any – sex life, and thus no romantic life, is dangerous. It denies you a source of pleasure, emotional soil in which to grip your roots to the world. “Protective factors”, in the dry but honest language of a psychiatric consultation. The fewer roots you have the more likely you are to wither. The easier it becomes to simply take the hand you’ve been dealt, and fold.
Sex is important. I really, really don’t think the wider psychiatric community appreciate just how important it is, largely oblivious to how antidepressants can deeply wound a life.
Of course, I’m human, and humans excel at making simple things complicated. Maybe the depression led to a plummeting libido. Maybe SSRIs turned down too many switches inside my head. But people are more complicated than just brains. After so long without a shag, the whole issue takes a life of it’s own, entwining with sexual confidence and body confidence, until it becomes impossible to know if you’re not having sex because you don’t want to, or because you’re afraid to.
I hope this problem is nice and simple and neurological. I hope my bottomed out libido can be blamed on a zapped out reward pathway, or a scrambled endocrine system, or anything other than high level psychology. Because if it’s up to psychology, I really can’t see it being resolved any time soon. Sex is important. Without it I don’t meet guys, I don’t date. I must be the only gay man in London who has never met anyone off Grindr. Seriously. My last online hookup was in 2008. This. Is getting. Tiring.
“Would you be open to a mood stabiliser?” The psychiatrist asks.
I’ve been rumbled. They want to take the hypomania from me.
“Which one?” I ask. They know I study neuroscience. It’s in the file. An awful lot is in the file.
I’ve heard of it, but beyond it being a mood stabiliser I know nothing. I don’t want the sluggishness that can come with some psychiatric meds (paroxetine destroyed me with sleep; and I’ve seen the effects of olanzapine – an antipsychotic – second hand). Will it place a final nail in the coffin of my libido? I’m wary. I want to know it’s mode of action, I want to know if…
“Like I say; I think the SSRIs work because they make me slightly hypomanic. If you take that away… What’s left?”
He reassures me; “just a trial”
It’s ultimately up to me. Naturally I go online and look up the mode of action (voltage gated sodium channel blocker, calcium channel blocker, glutamate modulator). I look up personal experiences.
Rise in libido.
Not everyone, not all the time. And sometimes the reverse – maybe it could be the final nail in the coffin. And sometimes the rise is due to activation of mania, sometimes fades after a few weeks. Still. It hangs there, glowing on my iPad screen. The promise of lust. Rise in libido.
I say yes.
I take the pill.
*Seriously, this is how it’s phrased. I love the fact they felt the need to specify.
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Can’t say I understand it from the gay man’s perspective but I can say I understand it from the mentally-ill, bi-polar, lesbian’s perspective and it sucks. It was 2002 when they first put me on SSRI’s and quite some time before moving me into the bi-polar category with all it’s related drugs. I’very waiting, ever so patiently, for one of the side effects that I do get saddled with to actually do me some good.
LOVE your posts, by the way. Found so much to relate to and empathize with in each one I read.
I’m glad that you like them – I’ve just been over to your blog, and yup – so much I recognise! I’ll naturally keep you updated about the lamotrigine situation; fingers very much crossed!
Just read some of your blog posts regarding ssri and libido and it’s like reading my struggles and thoughts, especially the feeling of alienation, being gay and young the perception is the need to have lots of sex without a second thought, and it is quite lonely when it just doesn’t happen… really wanting to feel how you used to and for things to just be in sync so you can resume living, because it is more than sex it’s like this primal instinct which shapes the choices we make and who we become. I struggle so much with my identity, so your phrase about you being gay but really bad at it made me laugh, yet I can relate. Anyway, just thought i would write that to you. I’m Charlie by the way, I live in Kent. Hopefully someone will figure this out soon so we can all get our sexy on again, sigh.
You’re right – it’s something primal which helps define who we are. Losing that is so frustrating, and I’m really hoping I can regain something. I’m definitely going to bring it up with my psych next time I see him.
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Finally, it’s fantastic – and a rather scary – to state the importance of sex. Depending on definitions (and, of course, the only definitions that matter are the ones we feel ourselves) it’s been two years since I had sex.
An ex of mine once called me a “horny little monkey”, and couldn’t believe that it had really been that long since I had sex. What he didn’t understand was that, in a life of almost totally lacking in sexual confidence, I’d had very little sex. The final nail in that coffee was depression and SSRIs. First, the depression ruining libido, and removing whatever social facility I had meant I hardly ever wanted sex, and when I did I couldn’t get it. Secondly, the SSRI sexual disfunction meant I could barely masturbate, let alone have sex.
Now I’m in my late twenties and I feel lost, and very very sad. I don’t know how to get sex, and as I ‘recover’ and feel my libido rising, it makes me so angry. What am I to do? I might as well never those feelings for all the good they now do me. Sour, sour grapes.