Erectile dysfunction and depression form a vicious cycle: depression may cause or contribute to a man’s inability to get and maintain an erection, and this difficulty can further exacerbate feelings of depression, which makes the condition worse. A significant number of men who struggle with erectile dysfunction – around 82%, according to one survey – also have symptoms of depression.
Although most causes of erectile dysfunction are physical, there are several emotional or psychological issues that may be responsible as well, or that may act as a secondary cause. Stress, anxiety, and low self esteem are known to affect sexual performance, and these emotions may further feelings of depression, especially if they continue over time. Depression can be an especially frustrating cause of erectile dysfunction, since it can cause it even when a man is in a comfortable sexual situation and is not feeling anxious.
Depression has both physically and psychologically painful symptoms. The chemical imbalance in the brain that causes, or is caused by, clinical depression also affects sexual excitement and the way the brain stimulates blood flow during sexual arousal; this can manifest as a decreased interest in sex overall or as an inability to sustain an erection. Aside from emotional changes that make it harder to care about sex – sadness, hopelessness, apathy – depression’s physical symptoms also contribute to the problem. Fatigue is one of the most common, along with changes in appetite that can lead to extreme weight loss or gain, and some patients begin to abuse alcohol. All of these can affect sexual performance.
Even if depression itself isn’t the primary cause of dysfunction, the medication used to treat it may be contributing: some antidepressants can worsen erectile dysfunction, so it’s important to be open with your doctor about your experience with it. If they’re aware of the condition, they are better able to prescribe a treatment that can help reduce its occurrence.
Whether you believe your depression is the result of erectile dysfunction, or vice versa, seeking appropriate treatment is essential – discuss the problem honestly with your doctor to find the best solution possible.