Pick One: Happiness or Sex Drive
I knew I had to make a choice when my depression and anxiety started affecting every dimension of my life. Lack of interest in my favorite pastimes. Lack of enjoyment in eating foods I used to love. (And I loved a lot of foods.) Disinterest in doing much of anything… besides sleeping. My love of snoozing never diminished. But the time came where I was tired of being tired. I was sick of feeling listless and hopeless. I had to decide.
Do I want to be happy or do I want to orgasm?
Before Wellbutrin, an NDRI (norepinephrine-dopamine reuptake inhibitor) became an ultra-popular alternative to SSRIs (selective serotonin reuptake inhibitor) the typical prescription drugs to treat clinical depression were medications like Prozac, Paxil, Zoloft, Lexapro, and Celexa. (How antidepressants work and their varieties.)
It wasn’t until being treated with Zoloft first, then Lexapro for nearly 10 years that a new doctor recommended trying Wellbutrin XL for my depression, either in addition to the SSRI or as an alternative.
Wellbutrin, she told me, wouldn’t have the sexual side effects as SSRIs did. (Still, I wasn’t aware that any side effects could turn into permanent afflictions.)
After so many years with a disappearing libido, I thought I’d found the best doctor in the world! Maybe the third try was a charm! Why hadn’t I been told about such a miracle drug previously? It definitely would have helped my self-confidence earlier in the years if I could have had some semblance of a normal sex-drive in my 20s.
So… why was I kept on the SSRIs so long despite complaints of a slim to none libido if an NDRI, the antidepressants that shouldn’t affect sex drive, may have worked just as well? Especially considering it’s a crap-shoot on which drug will work better for one person vs another.
I have no idea.
I was prescribed an antidepressant (and all subsequent antidepressants) by a family doctor — a general practitioner. None of the doctors recommended me to see a psychiatrist or therapist. My original GP, over 15 years ago, told me my symptoms sounded like depression and generalized anxiety and prescribed SSRIs. No further questions asked and no discussion of side effects. I found those lovely side effects later from personal experience and Google.
If I’d have known going down the SSRI rabbit-hole might cause ongoing sexual dysfunction long after cessation of the drug I don’t think I would have jumped so quickly onto the “miracle drug” bandwagon.
Side note. A tip from a long time depression sufferer: Your family doctor or GP is not the best person equipped to deal with issues of mental health. They don’t have the specialized training into psychotherapy as a psychologist or psychiatrist would have. All too often they prescribe an antidepressant automatically instead of considering a referral to a good therapist which may be all you need to start with.
But, visiting a family doctor instead of a trained psychiatrist or therapist may be your only option — as it was for me. My U.S. medical insurance did not cover mental health, therefore, visiting a psychiatrist or therapist would not have been a covered service. Being in my early and mid-20s, paying out-of-pocket hundreds of dollars for a specialist wasn’t in the cards.
Wellbutrin: Higher Doses Aren’t Always Better
I was prescribed 150mg of Wellbutrin XL once daily. I was on it for months, alone, with no other antidepressants. Upon a checkup visit, I told my doctor that the dark feelings didn’t cease and sometimes caught me off guard. I still felt sad and listless. But, on a positive note — a glimmer of my libido returned. Finally, I could orgasm, it just took much longer than before taking any medication.
The darkness had to go. The doctor increased my Wellbutrin dose to the maximum — 300mg of Wellbutrin XL daily.
And it worked. I started to feel better — at first. A few months of happiness and enjoying my past activities. Loving food again (which felt great, but my waistline didn’t like it). I felt good and my libido was still creeping back up. All was well — until I watched an episode or two of Law and Order: Special Victims Unit.
Everything went to shit.
Seeing the horrors on that TV show spiraled my fragile mind into a paranoia I’d never experienced in my life. Suddenly I was terrified of my children being irreversibly hurt or killed — children I didn’t have! I made a vow to never have kids— without discussion with my spouse — because of what could happen to them. I saw dangerous people in anyone and everyone. My family. My friends. My own spouse. I cried a lot. I was afraid to leave the house because something could happen. I didn’t want my spouse — though at the time I felt he could be a psycho with no evidence whatsoever — to leave either for fear of something bad happening.
Talk about your whole life coming down on you at once. Everything stopped and everyone became a danger to my safety and wellbeing — and a danger to my non-existent children.
Back to the doctor, I went. This time, to another doctor since I’d moved to a different city.
Another change in medication…
This time I was given, once again, 150mg of Wellbutrin XL but in combination with the SSRI Celexa at 20mg daily. My new doctor informed me that the maximum dose of Wellbutrin was absolutely too much for my body and symptoms and the extreme dose was causing the severe paranoia.
This new combo of NDRI and SSRI would set everything right. This should be the winning combo. “But if this doesn’t work, we’ll just try something else,” The doctor assured me.
Thank God. Because I wasn’t about to live with being terrified of my own shadow and everyone else's for the rest of my life!
However, at this point, I was feeling like a science experiment of sorts.
Celexa: The Drug That Took My Libido and Kept It
Ah… Celexa. How I loved how you made me feel — happy, full of life, ready for anything that came my way — and you even made me want kids again.
Kids. Yeah… that’s where Celexa also stopped me. I did want kids again and we tried for years. “Trying,” being the optimal word. I wasn’t really trying as hard as my brain was attempting to convince me I was — because you have to have sex to have a child. Duh. And that was something I was not doing.
Sex? Yuck. Not interested. Nope — no way no how. If I was really generous one night I would try — but it was nearly numb down below — no “happy” activity from me.
What was left of my sex drive disappeared, along with my ability to orgasm, within two weeks of being on Celexa.
I was at a crossroads. I loved how the drug made me feel. But trying to have a baby and being interested in cleaning the kitchen floor and doing every single chore possible rather than having sex wasn’t going to accomplish my goals. Plus, I’d found out getting pregnant on Celexa was not a good idea anyway considering the possible negative effects on a developing fetus.
I put my pregnancy plans on hold and stayed on Celexa for about six months or so. I figured that after I felt better, I could try to wean off the medication and stick with Wellbutrin only again — at the lower dose — and do some self-help therapy to control my moods and emotions if needed.
Five Years Later: Celexa took my libido and ability to have orgasms during intercourse and kept them. I’ve never regained full sensation or the ability to orgasm with a partner. It’s one of those things where you know it’s supposed to feel good and you try to convince yourself it does but then… nothing. It’s just blah. I’d rather check off my grocery list because sex has become a burden — another chore — and one where I can’t even do a satisfactory job at.
The Future Holds An Unfulfilling Sex Life
I have little hope that my libido will return or the sensation I need to have orgasms with a partner. There isn’t a cure for Post-SSRI Sexual Dysfunction (PSSD). Hell, it isn’t even talked about! It isn’t even warned about!
I never knew this could be my future — my sexless future — my orgasm-less future with my spouse.
Why weren’t we told? Just even the hint of “permanent dysfunction” would have made me pause before swallowing SSRIs for so many years.
Sex is important whether you are male or female. At least males have Viagra and Cialis. What do women have? Not a damn thing! I’ve talked to my doctor and I’ve got nothing but an “I’m sorry. There isn’t anything for women with sexual dysfunction.” Great — just fucking great!
Sometimes I want to stand up and shout, “But YOU did this to me! You put me on medication that could take away something so precious and ruin it permanently and now you have no solutions to fix it?!”
It’s beyond upsetting. I feel mad at myself daily for not knowing something I couldn’t have known. I feel disappointed that I have to deprive my husband of something he desires so much. It’s just — not there. Gone. Forcing myself to do it just makes me feel gross and used. I don’t know how to get around it. I feel like Celexa has robbed me of that part of my brain that regulates sexual desire. What’d it do? Kill it off all those neurons or something? I don’t understand what happened, but it sure feels like shit — maybe akin to chemical castration even.
Moving On Without “Happy Pills”
Now, I’m off all antidepressants. I’m done with them — all of them.
I’m working through my issues — myself — because my insurance still doesn’t cover mental health specialists. Gotta love it right? The U.S. is one of the largest countries and yet its mental health care is one of the worst.
I’m learning to control my anger and emotional roller coaster rides. I’ve found Taoism and herbal supplements like ashwagandha root that is supposed to help with depression and anxiety symptoms. I’ve also tried SAM-e and 5-HTP to help with the negative thought patterns.
Learning and striving to be better without the aid of medications doing the heavy lifting inside your brain is hard. I don’t know if I’ll be able to go for years without returning to an antidepressant but I’m sure going to do my damndest. Maybe someday I can get the bits of my libido back or maybe eventually there will be a drug made for women to help with sexual dysfunction. Whatever it is, I hope I can get some sense of a normal sex life back. I don’t want to let the SSRIs win. I am extremely thankful for getting through such dark times — but at what cost? I can’t help but think maybe… just maybe… there was an alternative I wasn’t aware of that I could have tried first before jumping right into prescription medication. Who knows… maybe spending hundreds of dollars on therapy and/or a psychiatrist would have been better in the long run. I’ll never know. I just have to deal with what I have now and the consequences of PSSD.
Mental Illness Is Not A Flaw
Needing an antidepressant is not a personality flaw or a slight against you as a person. No one would ever look down upon someone needing medication to treat diabetes. Care for mental health is just the same. Never think less of yourself or tolerate others to treat you less-than because you want help for mental illness. Antidepressants have helped many and I am not demonizing them. I just want anyone considering medication to know the risks and go into the treatment with eyes wide open. Though I mourn the loss of my libido, I cannot say for sure I would have gotten through my dark times without antidepressants. If you need medication — take it — and don’t stop cold-turkey when you think you don’t need anymore. Work with your doctor on your treatment plan and never be ashamed or scared to bring up questions or concerns — yes, even the embarrassing sexual ones.
If you are in distress and or feel like you want to harm yourself and need someone to talk to confidentially, please, reach out to the National Suicide Hotline at 1–800–273–8255. They are available 24/7 and it’s not just if you are feeling suicidal. Sometimes you just need to talk to someone who understands the struggle.