It’s the one no-one talks about. But for those whose relationship carries issues of mental health, it is a common experience that anxiety, depression and medication can have a big impact on a couple’s sex life.
I have spoken to so many women who have expressed concerns about their sex lives due to their own or their partner’s mental ill health. But trying to talk about sex and mental health can be a very uncomfortable experience because neither topic are easy to be honest and open about. In this area, there is perhaps the greatest risk for silence to fall and loneliness to set in.
For some, the impact of medication most severely affects their sex life. Their ability to function in the bedroom, a loss of libido, the side effects of different medications which affect weight, menstruation, and tiredness. This can make not only having sex, but enjoying sex, difficult for couples. And of course this can have serious ramifications on the intimacy and enjoyment of the relationship, but also family planning.
For some, the sheer drain of their mental health struggles mean that exhaustion and low mood move sex much farther down on the agenda. The sheer thought of the intimacy and involvement required is just too much; for those who find just making it through the day a struggle, any more demands on their bodies, minds and emotions is out of the question.
It is no secret that sex is the meeting of two souls as much as it is the meeting of two bodies. When one of those souls is fighting an endless battle for wellness, there can be a long-term emotional distance. Mental unwellness is an experience that is hard to share, and hard to understand. When the relationship takes on a dynamic whereby one spouse must care for the other in a significant, imbalanced, long term way, this impacts the desire for sex and the ability to experience genuine intimacy and union.
Whilst there is unknowing and mystery in all of our relationships, the battle for understanding a loved one with mental health issues, and the battle for that loved one to find expression for themselves through the fog of unwellness, can create a distance that feels wearying and creates aloneness as opposed to the mystery of the ‘other’ that is part of the joy of union.
Sex can be a way of maintaining intimacy when words and talking and the other parts of married life are difficult. It can also become the last thing that either partner wants to do because the rest of life feels so tough. It is another area of marriage that needs constant communication, and endless commitment, especially when the relationship is under strain. And it is hard to know how to move forward when sex isn’t happening, isn’t working or isn’t the place of intimacy it was meant to be.
We have learnt to be most careful with our words and communication to each other when it comes to sex. Vulnerability levels are high, and therefore respect needs to be also. We have also found that sex can be a place where the usual dynamics of mental health can be put to one side. And we have found that conversations around sex can reveal and expose other relational issues that need to be addressed for our intimacy in general to grow.
We have also found that appropriately honest conversation with another trusted friend/ counsellor/ spiritual director has been helpful in reflecting on and receiving wisdom about what is the most private and personal aspect of married life. It is this issue, as much as any other aspect of married life involving mental health issues, where it can be helpful just to know that other people out there are experiencing similar challenges, and learning how to face them too.