Sex, intimacy and mental illness

The reach and impact of mental illness is far greater than we often realise.

I know this from spending time in the SANE forums where anonymity gives rise to a rare honesty.

Recently, a member wrote about her difficulties with sex. She's in a loving relationship but past trauma affects her feelings and responses during sex. She was trying to navigate a strong sexual drive that often ended in deep distress as her past caught up with her present.

She reached out through the Forums as this was a topic she hadn’t been able to raise anywhere else. Not even with her psychiatrist. So she was feeling very alone with her concerns.

In reality this experience, or some version of it, is very common. Other Forum members suffering from bipolar disorder have written of periods of sexual risk-taking that damaged their relationships and self-worth. Others have revealed that their chronically low self-esteem made them doubt both their attractiveness and their partner’s desire to be with them. This is not fertile ground for sexual intimacy.

One of the biggest challenges people face is that it's both the condition and the treatment that impacts on their sex lives. A relatively common example is depression, which can leave sufferers with little interest or energy for sex. And in seeking treatment, they may find themselves prescribed a medication that further reduces their libido.

Interestingly, Forum members are more likely to write about the impact of sexual problems on their relationships rather than themselves. They worry that they are letting down supportive partners when they find themselves without the energy, drive or confidence for an active sex life.

Of course these concerns are not solely limited to people with a mental illness. Many long-term relationships experience an ebb and flow in sexual intimacy. However, it’s the compounding factors with mental illness, whether from the condition or treatment, that can make negotiating these concerns more difficult.

Here are some suggestions for dealing with the impact of mental illness on your sex life.

Request a medication review by a psychiatrist

A different dosage or new medication may reduce the impact on sexual drive and responsiveness.

Be open with your treating professionals

For anyone in counselling, it’s entirely possible you haven’t been asked about the impact of your condition on your sex life. Find the courage to introduce the topic and be honest about what you are experiencing.

Challenge your ideas about what a ‘normal’ sex life means

Frequent sexual imagery and references can create a false sense of what everyone else is doing behind closed doors. What matters is your own and your partners satisfaction. There is nothing to be gained from competing with myths or statistics. Or even our past selves.

Communicate openly with your partner

You may find any concerns you have are unfounded. If they turn out to be shared, consider inviting your partner into one of your counselling sessions or initiate relationship counselling. This can help ensure that the conversation is safe and productive. It may be that some aspects of your concerns can be addressed while others remain unchanged. Working towards this shared understanding can strengthen a relationship.

Remember what makes a successful relationship

The success of your relationship doesn’t rest solely on an active sex life. Recent research places greater importance to good communication, a shared sense of humour and compatible goals for long-term relationship success.

As a moderator in the SANE Forums I have seen that couples can work through some of the challenges presented by their illness. One member shared that she had developed a strategy to prevent interference from past trauma. Another wrote about a gentle, thoughtful and gradual return to an active sex life with her partner after a long period of abstinence.

What both these members shared in common was a loving willingness to work with their partner towards a more active and satisfying sex life. They understood that it’s an ongoing process rather than a destination and they've inspired us all.

Join a special event on the SANE Forums on Tuesday, July 24 at 7pm, as we talk honestly about mental illness, sexuality, intimacy and the strategies to combat these issues. Topic Tuesday: Sexuality and Intimacy.