Psychiatry

Low desire or depression? How to tell the difference

"I just don't feel like it any more" is one of the most common things people say in my clinic. Sometimes low desire is the whole story. Often it is one part of a bigger picture.

How depression affects desire

Depression changes far more than mood. It reduces energy, pleasure and interest across life, and sexual interest is often one of the first things to go. Many people notice the change in their sex life before they recognise that they are depressed.

Signs it may be more than low desire

Consider depression if, for two weeks or more, you have had several of these:

• Low or flat mood most of the day
• Loss of interest in things you used to enjoy, not only sex
• Changes in sleep or appetite
• Tiredness, poor concentration, or feeling slowed down
• Feeling worthless, guilty or hopeless

Other common causes

• Medicines. Some antidepressants and other medicines can reduce desire or make orgasm harder. Do not stop them on your own; there are usually ways to adjust treatment.
• Hormones and health. Thyroid problems, low testosterone, high prolactin, diabetes and chronic illness can all play a part.
• Stress and exhaustion. Long hours, caring responsibilities and poor sleep leave little room for desire.
• The relationship. Unresolved conflict, distance or pain during sex quietly switch desire off.

Why it helps to look at both together

Treating mood without asking about sex can miss side effects that make people stop treatment. Treating desire without asking about mood can miss depression. Assessing mind, body and relationship in the same consultation avoids both mistakes.

This article is general information and does not replace a consultation with a doctor who has assessed you.