You ’re feeling despairing, you have low tone– regard, and your body just ca n’t sexually engage/ perform. You know in your heart that commodity is wrong, but every time you talk to someone they tell you “ it’s all in your head”. Could it be depression? Erectile dysfunction? Perhaps, like with numerous men, it’s both ….
How are depression and anxiety related to erectile dysfunction?
There’s good stress and bad stress when it comes to sexual performance, and depression and anxiety fall under the latter. When your brain experiences healthy stress — for example, from exercise, a new relationship, or a promotion at work — your body tends to release testosterone. When you’re sexually stimulated, that extra testosterone helps to relax the blood vessels in your penis and cause an erection.
However, when your brain is under unhealthy stress — for example, from traumatic events, relationship problems, or work stress — your body can release a hormone called cortisol instead. Cortisol constricts the blood vessels in your penis. When blood can’t flow properly to your penis, that’s when you may have difficulty achieving an erection.
Over time, chronic stress (chronically high cortisol levels) decreases the amount of testosterone your body makes. Low testosterone, also known as “low T,” is common in men with mental health issues like depression and anxiety who experience erectile dysfunction.
What can I do about it?
While the answer to this question is different for everyone, there are three main steps your doctor will take to help you with your erectile dysfunction if you also experience depression or anxiety.
Determine if your ED is caused by another health problem
Most erectile dysfunction symptoms (including premature and painful ejaculation) are linked to physical (not psychological) conditions, so it’s important to make sure your body is physically healthy. Things like diabetes, smoking, heart disease, and prostate cancer are common causes of ED. If you are otherwise physically fit but are experiencing depression or anxiety, your doctor will move on to step 2.
Treat your depression or anxiety
When erectile dysfunction is caused by depression or anxiety, healthcare providers will focus first and foremost on treating your mental health issues, whether through therapy and/or prescription medications. If you can relieve your mental stressors, your erectile dysfunction symptoms are likely to improve, too.
Talk therapy and cognitive behavioral therapy are useful ways to help treat a variety of mental health issues. These are usually the first-choice options when you have depression or anxiety. If therapy isn’t enough on its own, your doctor may also recommend prescription medications. While some men might see taking medication for mental health as embarrassing, just know that it can make a huge difference in your quality of life. Also, remember that many of the antidepressants and anti-anxiety medications out there take about 4 to 6 weeks to really start working, so don’t get discouraged if you’re not feeling any changes right away.
As with any treatment plan, always keep an open line of communication with your healthcare provider about what you’re feeling, so they can adjust anything, if needed.
Treat the erectile dysfunction directly
Sometimes, even after you’ve figured out how to manage your mental health issues, you may still have symptoms of erectile dysfunction. For example, ED is a possible side effect of many antidepressants and anti-anxiety medications, and changing medications for your mental health issues may not always be the best option. If that’s the case, there are medications available that just treat erectile dysfunction, like sildenafil (Viagra) and tadalafil (Cialis).
Some men also find sexual counseling (sometimes called sex therapy) to be beneficial here. This type of therapy focuses on improving sexual dysfunctions (like ED) and is especially helpful if you have experienced abuse or suffer from post-traumatic stress disorder (PTSD).
In recent years, we’ve been getting more and more questions about pornography-induced erectile dysfunction. While watching these kinds of videos isn’t a mental health disease, it does have to do with the mind having an effect on sexual health.
There hasn’t been a lot of research in this area, but studies so far have shown that the more frequently men watch pornographic videos, the more frequently they experience ED symptoms. The men in these studies were otherwise healthy and under 40 years of age. Many of these men found that over time, they either had to watch more videos or watch more extreme content to achieve an erection. Many also found that they couldn’t enjoy sex with their partners as much. Thankfully, research shows that this phenomenon can be reversed by not watching pornography for a few weeks. So, if this all hits close to home, try unplugging for a bit and see if that helps.