Illustration by Meghan Sim

This piece contains a content warning for suicidal ideation, depression, self-harm, and eating disorders. 

My sex life before being prescribed SSRIs was amazing.

I was a horny teenager. I masturbated daily — often two or three times a day — and I could make myself orgasm in minutes. Hard. I remember my orgasms as strong and long-lasting. 

I had so much fun with my solo-sex. Teenage me dreamed of the heightened pleasure I’d experience once I became sexually active with a partner. Great sex was all I wanted.

It still is…

…  

SSRIs (Selective serotonin reuptake inhibitors) are a type of drug commonly used to treat anxiety, depression, and mood disorders. The three most common SSRIs are Zoloft, Lexapro, and Prozac .… and in 2022, approximately 83.4 million people were prescribed one of these medications. 

 SSRIs work by increasing serotonin levels in the brain.

“Serotonin is a neurotransmitter (a messenger chemical that carries signals between nerve cells in the brain). It’s thought to have a good influence on mood, emotion and sleep. After carrying a message, serotonin is usually reabsorbed by the nerve cells (known as “reuptake”). SSRIs work by blocking (“inhibiting”) reuptake, meaning more serotonin is available to pass further messages between nearby nerve cells,” writes the National Health Society. (NHS) 

The leading theory states that mood disorders like depression and anxiety are likely caused by a deficiency of serotonin in the brain. Therefore, by increasing the amount of serotonin in the brain, the symptoms of these mood disorders can be decreased. 

But you know what else uses neurotransmitters in the neurological process? 

Sex. 

“It is known that an increase in serotonin affects other hormones and neurotransmitters such as testosterone and dopamine. This may lead to side effects of sexual dysfunction, as testosterone may affect sexual arousal, and dopamine plays a role in achieving orgasm,” writes Pharmacists Kristyn Straw-Wilson and Elizabeth Jing.  

This is why SRRIs are infamous for producing reduced sexual desire, reduced sexual satisfaction, impotence, and anorgasmia (the inability to have an orgasm). 

…

The first time I seriously considered killing myself was in 2015 as a sophomore in high school. The timeline to get to that point wasn’t simple. I started thinking about all the ways a person could die as early as the 5th grade, but it wasn’t until the 9th grade I developed severe symptoms of depression and anxiety.

It was sometime after October 2013 when something in me dwindled and dimmed. I was 14 at the time, and suddenly, I was not smiling the same as before. By May 2014, my favorite history teacher at school had asked me if something was wrong (my shift in mood was that visible to outsiders), and by August 2014, I was in therapy. 

Fast forward a few months past August, and I fell in love with a boy. I adored him with the fervor that only a 15-year-old can feel, and when he broke up with me — because I was depressed and unable to maintain a relationship — my world crumbled. I stopped eating;  I began cutting; I hoarded and hid in my room approximately 70 pills (that my pediatrician had prescribed me for a different ailment) with the intention of eventually ending my life. 

Things didn’t get better after that. 

I continued to suffer throughout high school, two gap years, and two years of college with feelings of despair, debilitating hopelessness, depression, and anxiety. Four therapists came and went. I actively planned my death a number of other times and somehow managed to keep my eating disorder and self-harm a secret (not really). 

I wanted to try medication from a young age — foolishly thinking it would magically cure me — but because of the stigma around antidepressants, I never asked any of those four doctors about it. 

…

I was 21 in 2021, and with my newfound adulthood came a newfound strength to advocate for myself in ways I had previously been too shy for. I finally had the courage to ask Therapist #5 about the possibility of medication. 

This older woman on Zoom had only known me for 50 minutes, but she agreed that with my debilitating depression and anxiety, I would likely benefit from antidepressants. Therapist #5 put me in touch with Therapist #6, and Therapist #6 immediately prescribed me Zoloft. 

I was so ecstatic at the prospect of finally being cured that I kept a journal titled ‘The Zoloft Diaries.’ In it, I tracked my mood changes over the course of two weeks. I transcribed ‘The Zoloft Diaries’ into an essay, comparing my text to Paul Preciado’s “Testo Junkie,” and handed in that as my final paper for a philosophy class. 

I was on Zoloft, and I wanted everyone to know. 

…

It was also around this time that I met a man with whom I’d — unsurprisingly — fall in love again. He was the first person I took to bed. 

Most people don’t achieve an orgasm the first time they have sex, but even under those awkward first-time circumstances, I could tell something was off. My body wasn’t responding the way I was used to: I wasn’t aroused, and his fingering felt okay rather than good, or ideally, great. 

It only took my SSRIs five days to ruin my sex drive. 

…

A few months later, when I mentioned this unnerving sexual numbness to Therapist #6, and suggested switching from Zoloft to another medication, their response was, effectively, to suck it up. 

I was told in broad terms that it was “more important to stay alive than to cum.” Their priority as a doctor was to keep me from killing myself … and besides, the sexual side effects would likely diminish with time. I just had to hold out. 

…

A year passed and nothing changed. 

I engaged in unfulfilling sex, going through the motions because I loved my now-boyfriend (the guy I had fallen in love with), but not because it brought me any physical pleasure. 

I grew increasingly ashamed of the failures of my body. 

I routinely dismissed any attempts he made at pleasuring me because I couldn’t find anything that made me feel more than just neutral. 

…

When I brought up my sexual numbness to Therapist #7, she lowered my dosage in an attempt to reduce the negative sexual side effects but refused to take me off the medication entirely. 

“There’s a procedure I have to follow,” she said, “I have to explore every possibility — every dosage — with your current medication before I can switch you to something else.” 

I was once again made to hold out. 

…More months and months of my partner getting off every time we had sex, but not me. I liked the emotional intimacy of sex, but not much else. The way I viewed my body and my relationship to sex was, by now, profoundly tainted by the notion that I was inherently no better than an object. I was there to offer him pleasure, but not deserving of it myself. 

I felt like a tool. Tools are not made to feel pleasure, but rather, offer a service to the user. My body was nothing more than a glorified fleshlight. 

…

Eventually, when the lower dosage proved to be unsuccessful, Therapist #7 switched my medication from Zoloft to Lexapro. Although rare, some people who do not feel sexual arousal on one medication find a way to regain their sexual feelings on another. We had no reason to believe this would be the case for me, but it was my only hope.

I think the truth is we both knew SSRIs did not work for me, but the way medicine is practiced in the United States doesn’t allow for deviation from the checklist of procedure. 

…

According to some studies, 40% of SSRI users will suffer from sexual dysfunction, with that number reaching as high as 73% for users on certain medications. There are so many SSRI users who have endured what is now being called “chemical castration,” but despite the commonness of these side effects, practitioners and drug companies offer few alternatives.  

There are so many of us, The Anonymous Ones, going about our days and living our lives with the heavy secret of antidepressant-induced sexual impotence. 

And it’s a burdensome and isolating secret. 

It often feels like there is no one to turn to — sometimes not even our doctors. 

We might turn to our partners, but while they might be sympathetic toward our conditions, sometimes that gap of experience is stress-inducing and fracturing to a relationship. 

We might turn to our friends, but it’s a hard and embarrassing conversation to have. There is already a stigma around depression and medication. How are we supposed to pile sexual dysfunction onto that negative stereotype? 

Because we often choose to be anonymous (even within the depressed community), we can’t tell who is going through a similar situation. Where are the people who feel broken in the same way I do? — sometimes because of my depression and other times because of my sexual dysfunction.

Who could possibly understand me? 

…

Today, Therapist #8 gave me the green light to stop taking my SSRIs. It sounds cliché, but a weight was lifted from my shoulders when I heard those words. I had been yelling into a void for three years, and only now had someone listened to me. I finally felt seen and validated after feeling invisible for so long. I exhaled in relief and sunk into my seat. 

I immediately researched how long it would take for me to regain my sexual capabilities after tapering my SSRIs to zero. According to the internet, anywhere between a couple of weeks to a couple of months — if ever. 

Some people never bounce back. 

But I’m young and I only took SSRIs for three years. The fatty cells in my body (where the SSRI chemicals are stored) should be able to purge themselves in time. My doctor and I are hopeful.

… 

So, now that I’m off SSRIs, what will I be doing to avoid the deep suicidal depression that I described above?

There’s a big difference in who I was at the age of 15 and who I am now — just a few months shy of my 25th birthday. I have grown in ways I never expected to (not to mention that I did not believe I was going to age this much in the first place). The older I get, the more resources I collect to help me stay safe in times of danger. 

First of all, with therapist #8, I’ve finally found the right doctor. She’s kind and wise and funny, and I adore her very much. There is finally a medical professional I can trust.  

Second, I’ve built the valuable resource of a community in Chicago. I haven’t been here for long, but I already have a long list of dear friends who would act as a support system if things got rough. Together, we operate under the belief that “we’d rather listen to each other speak, than listen to each other’s eulogies.” We’re here to uplift each other, to care for each other, and protect each other when one of us needs to be nursed back into a healthy mental state. 

Lastly, I have developed the language and the skills to recognize when I want to hurt myself. I feel equipped with the strength to ask for help when the time comes to speak up. 

…It might seem silly, but I have a gut feeling that I’ll be alright. 

There’s a little voice in my head that is confident going off SSRIs is the right decision. I’m hopeful because, for some unknown reason, this is the first time in many years that I do not experience seasonal depression. It’s likely because I have all these protective measures set around me. 

…

There is irony in the choice (and sacrifice) of being mentally healthy, but sexually unhealthy, which brings on a depression all of its own.

I’ve been alienated from my body and from my sexual pleasure for so long, I don’t know what the alternative feels like anymore. It’s fucked up and confusing, and I’m angry I spent my formative sexual years suffering under the negative mindset that my body was to be used rather than enjoyed. I’m sad that I never once prioritized myself during sex during that time. I’m troubled that I dehumanized myself daily. As my SSRI side effects lessen, I hope to unlearn these behaviors and learn new ones. 

Part of me feels like I lost three years of my life to SSRIs and the seven doctors who refused to listen to me. 

…

It is not my intention to demonize SSRIs. I simply envy those who can have their cake and fuck it too — the users who can experience the life-saving effects of antidepressants without the demoralizing side effects.

I wish that was me, but it’s not. 

So what can we as a society do to better support the anonymous depressed and anxious folks suffering from SSRI-related sexual side effects? What conversations can we have about sex, depression, medication, and the medical system that will uplift — rather than isolate — The Anonymous Ones? What can we do to improve this pressing but unsaid problem?

Because my bet is that you’ve met an Anonymous One. You just don’t know it.