As a clinician who specializes in sexual wellness, most people who contact me for help reach out specifically to me because of a sexual problem. In the evaluation process, my job is to look for the underlying issues affecting a patient’s sexuality. I have found that often, the sexual issue is a symptom of something else. This is why exploring a person’s general mental health is so crucial. As you can imagine, both sexual health and mental health are complex issues, both affecting our overall well-being.
Generally speaking, there are many factors that can impact our mental well-being, and in turn will impact our sexual lives. When the client is in a relationship, the first thing I assess is the quality of that relationship. Does the person feel connected emotionally to their partner? Are they feeling resentful for anything? Are there serious communication issues? These types of issues can have a direct impact on one’s sexual desire and one’s sexual satisfaction. In turn, being sexually frustrated can have a direct impact on our mental health.
With the busyness of life these days, I see more and more people who are overwhelmed with life in general. More and more people seem to be suffering from anxiety and depression. Both of these mental health issues can have a huge impact on sexual functioning. For example, two symptoms of depression are low libido and difficulty with arousal. Unfortunately, the medicines prescribed to treat anxiety also may have the side effect of low desire. On the flip side, having sexual problems due to some other issue can contribute to feelings of depression. Therefore, it is essential to address depression with the proper treatment, whether it’s medication, therapy, lifestyle changes, or any combination of these that will lead to improvements in mood, quality of life and sexual well-being.
Although I am not a medical doctor, I also ask clients about their general health, as certain medical conditions can impact not only mental health but also sexual health. For example, any condition that affects the balance of hormones can impact both sexual and mental well-being. It’s also important to examine the medications a person is taking as many have a direct impact on sexual functioning. A thorough evaluation thus requires a medical assessment as well.
One of the biggest issues that has a direct impact on sexual wellness is a history of sexual trauma. Not only does it affect one’s relationship to sex, but it also has an impact on a person’s emotional, psychological and physical well-being. People who have experienced such trauma often experience fear and anxiety, avoidance issues, sexual aversion, flashbacks during sexual activity, concerns with body image, difficulty with intimacy, and dissociation during sex, just to name a few. Finding out about a person’s sexual history is very important, as treatment needs to be approached with a great deal of sensitivity if a person has a post-traumatic stress disorder.
Another area where mental health and sexual wellness is often linked is in the neuro-diverse population. For years, I have worked with couples where one of the partners is diagnosed with Attention Deficit Disorder (ADD or ADHD), or an Autism Spectrum Disorder. These are neurological differences/conditions that can directly impact mental and sexual health. These are complex issues that we now know so much more about. Briefly, a few issues I have seen is distractibility during sex, sensory issues, anxiety, communication issues, to name only a few. These can lead to difficulties with arousal, libido, feelings of insecurity, etc., which can then make one feel inadequate, anxious, depressed, etc. A great book on ADHD and sexuality is Ari Tuckman’s work ADHD After Dark.
In summary, having a sexual problem can lead to mental health issues, and conversely, a sexual problem can be a symptom of a mental health issue. Clearly, they are interconnected in such a way that they influence the other. Trying to find a balance between the two is essential for overall well-being. If you are experiencing a mental health issue or a sexual problem, please seek out professional help. A therapist can provide guidance and support and will work with you to figure out the best treatment approach—and refer you to any other health care professionals if needed.