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How to Overcome Depression-Related Erectile Dysfunction

It’s hard to get hard when you lack motivation and don’t feel great about yourself, but for guys with depression-related ED, there are plenty of solutions

Depression sucks, but at least you can still jack off, right? 

Actually, wait — that’s not always true. For many depressed people, sex is largely off the table, solo or otherwise. Either they can’t get hard enough to pursue it, or they’re not interested in it in the first place. But what is it about being depressed that makes us physically incapable of enjoying one of the few carnal pleasures our bodies allow? 

“It’s very common for people with mental-health disorders to have sexual dysfunction, not always due to treatment that they’re on, but as a function of their disorder itself,” says Joshua Gonzalez, a board-certified urologist and sexual health advisor for Astroglide. To wit, an older Stanford study estimated that sexual dysfunction occurs in around 25 percent of people with major depression, though rates may be much higher. 

Sexual dysfunction can also be a side effect of selective serotonin reuptake inhibitors, or SSRIs, the most popular form of antidepressant medication-based treatment. Often after starting an SSRI, people report an inability to orgasm, a lack of desire or erectile dysfunction (ED) that can last even when the depression itself goes away. 

But again, in many cases, these exact symptoms are a facet of depression, even when SSRIs aren’t involved. As one guy on Reddit who’s been unable to get an erection while depressed explained in a recent post, this can be emotionally and romantically devastating in ways that creep into other aspects of life, too. “Most embarrassing thing was when a girl tried to give me a hand job but my penis was unresponsive,” he wrote. “I’m frustrated to the point that my school work is slipping, and my depression is worsening. Love is an important thing in life. How can one be happy when one can’t find love?”

He’s definitely not alone — according to Gonzalez, it’s common for depressed people to report that their low libido has had negative effects on their relationships. “It makes sense, right?” he tells me. “If you’re feeling generally depressed, you might find it hard to even get out of bed. The last thing on a depressed person’s mind may be wanting to be sexual.” This isn’t necessarily due to how depression impacts your sexual organs, per se — rather, it’s more related to your energy levels and state of mind. 

It can be particularly true when it comes to self-image. “Often, people who are depressed don’t feel particularly great about themselves,” Gonzalez continues. “Having healthy self-esteem and self-image is really important in terms of how you feel about yourself sexually.” When these things are functioning in a healthy way, they can encourage people to pursue sexual activity with partners or themselves. When they’re not, it can make people shy away from pleasure or create the kind of anxiety that exacerbates ED. 

In short, it can be totally self-cyclical. You’re depressed, so you’re not interested in sex; then you’re depressed because you’re not interested in sex. Complicating things further are any side effects SSRIs may bring. Fortunately, these don’t have to be permanent, nor are they the only option. “It’s common with all the SSRIs [to produce sexual dysfunction], but there are other depression medications that aren’t SSRIs that are more sex-friendly,” says Gonzalez. One such medication is Wellbutrin, a dopamine and norepinephrine reuptake inhibitor (NDRI) that many say helps with their depression without causing any sexual side effects. In fact, lots of people say it makes them hornier

On Reddit, lots of guys have shared their experiences on how depression has contributed to erectile dysfunction. Three years ago, the topic was covered in a thread on r/AskReddit when u/LBIOB428 asked his fellow redditors what they did when they lost their sex lives due to depression and stress. The thread amassed over 426 comments, most of which centered around a similar theme: The best way to help your sex drive bounce back when you’re depressed is to treat the depression itself. 

“Mine suffered immensely while my depression and anxiety went untreated, even while I was exercising and eating right,” top commenter u/NellieX wrote. “After I got a diagnosis and antidepressants, my sex drive skyrocketed. We went from once or twice a month if we were lucky, to 3-5 times per week, sometimes more.” 

As many others explain, “treatment” can range from actual medications to taking better care of themselves by exercising or finding a hobby — there’s no one-size-fits-all cure for everyone. Some in the thread also reported that traditional talk therapy helped them manage their depression, in turn helping their sexual function. People might also find some success with sex therapy — a 2020 study found cognitive behavioral sex therapy to be effective in treating ED in young men whose symptoms appear to be caused by depression or anxiety.

For guys who are already on SSRIs but experiencing ED still or as a result of the SSRIs, there are some options. If you can get hard, even if only partially, but maybe struggle to maintain the erection, traditional ED treatments like Viagra can help in some cases, as can cock rings. Neither of these can force you to get hard if you’re not in the right headspace for it, but they can give you a boost if your main problem is staying hard once you’ve gotten there. 

Overall, the best thing you can do for yourself if you’re dealing with both depression and ED is to talk to a medical professional, whether that be a urologist, a psychologist or a sex therapist. They can help determine if what you’re dealing with has a physical cause or whether it’s a side effect of depression, and work to solve the problem accordingly. Either way, it’s perfectly normal, and there are plenty of possible solutions. So try your best not to let it add to your despair. 

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