Markham Heid

Any number of psychological, social, cognitive or physiological issues could be to blame, says Robert Hedaya, MD, a clinical professor of psychiatry at Georgetown University School of Medicine and founder of the . (Yes, even things that seem unrelated to your mental health are related to your mental health.) There's also a very real possibly something's gone awry with your antidepressants.

Think that's what might be going on with you? Read on to find out what might be causing your meds to come up short, and then be sure to meet with your doctor so she can adjust your treatment plan.

<h1> 1. Your medication was altered on the DL. </h1>

Prescription form with pills and pen with on blue. Top view. Medical concept.

Sometimes pharmacies change a medication because of insurance factors, says Dr. Michelle Riba, a clinical professor of psychiatry at the University of Michigan Comprehensive Depression Center. A higher dose may be cheaper, or they may change from a pill to a capsule or something like that.

In these cases, its possible youre taking more or less of your medication without realizing it, which could explain why your symptoms are different or worse than before, Dr. Riba says.

<h1> 2. Something else is up health-wise. </h1>

Global Healthcare Medicine Insurance Doctor Concept

A number of medical issues-from infections to inflammatory conditions-can affect how you feel and how well your antidepressants work, Dr. Hedaya says. Ask your doctor to evaluate you for these and other issues to see if they might be to blame.

<h1> 3. You started taking other meds or supplements. </h1>

Multi-colored pills scattered on a bright background, a place for text.

Prescription drugs and OTC supplements can interfere with the way your antidepressants work, Dr. Riba says. Another medication or substance may take over the receptor or decrease the concentration of medication youre taking for depression, she explains.

When you see your MD, see if he thinks anything you've started taking could be interfering with your meds.

<h1> 4. Your sleep schedule is messing with your pills. </h1>

Poor sleep can interfere with your antidepressants, Dr. Riba says. If youve had problems sleeping lately-maybe you just cant seem to fall asleep, or youre sleeping more than you used to-that could mess with your antidepressants effectiveness. So could taking something like melatonin or another supplement to address any sleep issues.

<h1> 5. Your substance use has changed. </h1>

bottle of sparkling wine with cork on a colored background

Someone may go back to smoking or may be smoking more, which has an impact on how antidepressants work, Dr. Riba says. Alcohol or other substance use-including marijuana-could also induce depression in some people.

If youve recently started drinking, smoking, or using other substances-or you changed your patterns of use-this could explain why your antidepressants dont seem to be working.

<h1> 6. Your depression has become more severe. </h1>

As time goes on, depression symptoms can become worse. As a result, the same dosage or type of medication that worked for you in the past <a href="https://www.mayoclinic.org/diseases-conditions/depression/expert-answers/antidepressants/faq-20057938" id="6f124133-1b79-3536-a1b9-16c50d0f95bc"> might not cut it anymore </a> .

Ask your doctor if trying a new medication or dose might help to ease your symptoms.

<h1> 7. You might be dealing with tachyphylaxis. </h1>

Yes, Your Antidepressants Can Just Stop Working.

Tachyphylaxis might sound like a horribly scary disease, but it's actually the medical term for a medication that has simply lost its effectiveness. Believe it or not, this happens pretty regularly with antidepressants.

If your doctor thinks this is what's going on, there are a number of <a href="https://www.womenshealthmag.com/health/a27306104/antidepressant-stops-working-solutions/" id="74c377a8-8499-3d7c-a6c6-af2ee821591d"> alternative treatments he or she might suggest </a> . Def make an appointment to chat through what options are best for you.

Depression is a complex mood disorder-one that stems from countless different factors. That said, there are a million reasons your symptoms might seem like they've come back or gotten worse, even if you're meds had been keeping your mood pretty stable. It's more common than you'd think: Up to 57 percent of patients on antidepressants have their symptoms reemerge, according to  .

Feel Like Your Antidepressants Stopped Working? Here’s What Could Be Happening.

In fact, up to 57 percent of patients on antidepressant drugs may have their symptoms re-emerge, according to . And in some cases, antidepressant medication may stop working entirely.

If you feel like your depression medication isnt working the way it should, the first thing you should do is tell your doctor. The source or sources of the problem need to be identified and corrected, says Robert Hedaya, MD, a clinical professor of psychiatry at Georgetown University School of Medicine and founder of the .

Dr. Hedaya explains that a range of factors could lead to a reemergence of depression symptoms or a loss of antidepressant effectiveness-everything from a change in your relationship status to an underlying disease could be the cause. No matter what it is, your doctor can help you sort through all the variables and determine the best remedies.

To familiarize yourself with some solutions your MD may recommend, keep reading.

How To Deal If Your Antidepressants Stop Working

If your antidepressant was working but seems to have stopped, its likely that the underlying cause or causes of your depression have not been appropriately addressed, Dr. Hedaya says. Put another way, antidepressants alone are not likely to keep your depression at bay in the long run.

Medications are important, but nearly all <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3918025/" id="9e6e6a99-51bd-369f-a98e-b9db8d034fe7"> studies show </a> that taking medication along with psychotherapy is key, says Michelle Riba, MD, a clinical professor of psychiatry at the University of Michigan Comprehensive Depression Center.

If one-on-one psychotherapy isn't an option for you, joining a depression support group may also be helpful, Dr. Riba says.

<h1> Suggest a different dosage or new Rx. </h1>

Its possible that your doctor may increase or decrease your antidepressant dosage to help restore its effectiveness. But wed first want to evaluate a lot of other things, Dr. Riba says. For example, drinking or smoking more or less than you typically do could affect the way you respond to your antidepressant, she explains. So could taking other non-depression medications or supplements.

But if the problem really is your medication, increasing or decreasing your dosage could be effective, she adds. Of course, this is something your doctor should oversee. Never adjust your dosage unless youve gotten the green light from your provider.

Another option your doc may recommend: Trying a different type of antidepressant, since not all meds work the same way. If, for example, youre taking a selective serotonin reuptake inhibitor (SSRI), trying a different class of drug might be helpful.

<h1> Ween you off your current medication. </h1>

Your doctor may recommend that you stop taking your medications altogether for a period of time. After taking a break, responsiveness [to a medication] sometimes comes back, says Steven Hollon, PhD, a professor of psychology at Vanderbilt University.

This process involves slow and careful weening-not simply going cold turkey-and youll need your doctors guidance to do this safely. (Read: Do not do this alone-seriously, guys!) During this process, its possible your depression symptoms may worsen. You may even become suicidal, Dr. Riba warns.

<h1> Suggest non-drug treatments. </h1>

Theres no question that regular exercise is important for your mental and physical health, but theres also evidence that taking up exercise can help quell depression symptoms if your antidepressant isnt working well.

A Baylor College of Medicine recommends exercise as a helpful non-medication treatment for depression. And on exercise and depression suggests that all types of physical activity-from running to yoga-could help people manage their symptoms.

That doesnt mean you should swap out your medication for exercise, but taking whatever your doctor recommends and also adding exercise could be helpful.

Unless youre a doctor, youve probably never heard the word tachyphylaxis (tak-i-fi-lak-ss). Its the medical term for a medication that has lost effectiveness, and according to <a href="https://www.sciencedirect.com/science/article/pii/S0165032718316859" id="c58184b7-7996-3ed8-ad9f-0c744cd307d5"> new research </a> , this happens on the reg with antidepressants.

Here’s What Your Doctor Might Do If Your Antidepressants Stop Working

The trouble is, e-cigs are far from virtuous. Theyre highly addictive and dangerous in their own right. Theyre probably not as bad as traditional cigarettes, but theyre still pretty bad, says Stanton Glantz, Ph.D., a professor of medicine and distinguished professor of tobacco control at the University of California, San Francisco.

Glantz says the vaporized particles in e-cigarettes can cause heart and lung inflammation thats similar to what happens when you smoke tobacco. E-cigarettes may also elevate levels of some potentially dangerous lung proteins.

And theres the nicotine problem. Some vape liquids-namely Juul pods and their knockoffs- <a href="https://tobaccocontrol.bmj.com/content/early/2019/01/31/tobaccocontrol-2018-054796" id="e1da95bd-4027-3324-ab82-b8f52ddf741c"> contain as much or more nicotine </a> as a full pack of traditional cigarettes. Nicotine isnt just an addiction problem. Glantz says that compound mimics chemicals that nerves in the brain use to communicate with each other. So you start bathing your brain in nicotine, and this can disrupt normal neural pathways and their development, which is why young people who start on e-cigarettes have such a hard time quitting.

All compelling reasons to ditch a vaping habit, even though it wont be easy. While the science of e-cigarette cessation is young, Glantz says many of the same methods people use to quit traditional cigs should also help those who vape. Here, five study-backed methods to help you snuff out your habit:

Theres <a href="https://www.ncbi.nlm.nih.gov/pubmed/22861822" id="b2f63784-bf81-3b81-abb8-d300450ac402"> ample evidence </a> showing that people who exercise experience lower levels of nicotine cravings. Even short bouts of moderate-intensity physical activity-like a 10-minute jog or a quick stop in the weight room-can squelch these cravings.

If you want to activity up a notch, <a href="https://bpspubs.onlinelibrary.wiley.com/doi/full/10.1111/bph.14068" id="eb7b3567-b93d-3cd5-a925-2bf7293b9556"> a 2017 study </a> found that running can alter the neurochemical activity in your brain in ways that knock down nicotine withdrawal symptoms. Exercise also helps you take down stress, a known smoking trigger.

Confident, smiling man with gym bag in parking lot post workout

Habits, whether theyre good or bad, develop when you do the same activity in the same context, says Benjamin Gardner, Ph.D., a senior lecturer in psychology at Kings College London. If you can avoid the cue-whether its walking to get coffee in the morning or visiting a certain bar-that should help you avoid the behavior, he says.

Of course, if youre used to vaping in your car or house, youre going to struggle to avoid those contextual cues. There, try replacing your vaping habit with something like chewing gum, so youre actively doing something, not just trying to stop doing something else. Give yourself a small reward when you opt out of vaping, like five minutes of a podcast or a few post-game highlights videos.

The app called <a href="http://www.thisisquitting.com/" id="a4e7984f-76c6-3fe0-a740-98873bf0aad9"> This Is Quitting </a> was created by the non-profit <a href="https://truthinitiative.org/" id="ad63cfce-f66c-3d62-ac2c-6490b5c68494"> Truth Initiative </a> , which started as a quit-smoking advocacy group but now also helps people avoid the dangers of e-cigs (Glantz has conducted research for the group). The app includes a number of tasks and exercises that are proven to help users quit. An optional free text message service is designed to help you stay on track as you work through this.

Research has found-over and over again-that people who enlist the help of a therapist or counselor are more likely to quit smoking than those who go it alone. Your health insurance may even <a href="https://www.fightcancer.org/policy-resources/tobacco-cessation-insurance-coverage" id="c1712a47-7bf2-3f58-a561-bce9bbf8d8cb"> cover it </a> . You can also call 800-QUIT-NOW for free phone counseling.

If your game plan involves little more than picking a quit date, youre setting yourself up for failure, according to <a href="https://teen.smokefree.gov/become-smokefree/get-ready-to-quit" id="fe1e71ea-ec55-30a7-ab77-ce408098db11"> the governments smoking cessation resources </a> . Winging it wont end well.

Instead, start by writing down all the reasons you want to quit. (Its bad for your body, its expensive, etc.) Next, come up with tactics to help you avoid your usual vaping places or habits and to manage cravings. Being prepared for the tough moments helps you get through them.

Finally, tell your friends and family about your plan to quit. But only do it once youve actually managed to stop vaping for a day or two. While sharing your goals can help you stick with your plans, doing so before you start can kneecap your motivation.

E-cigarettes debuted as a tool to help traditional cigarette smokers kick the habit. Thats not entirely off base: <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa1808779" id="ed324f8e-7d61-3427-aabc-188b2f1fa127"> theres evidence </a> that e-cigarettes really do outperform some older smoking cessation aids, such as nicotine gum and patches.

Your Juul is Wrecking You. Here's How to Kick the Habit

People who are employed full-time outside the home spend approximately 33 percent of their waking hours at their workplace, writes Jennifer Veitch, Ph.D., in <a href="https://www.longwoods.com/content/22409" id="b3c480b3-ba8b-3b87-a08e-22d79f6b3ac4"> a 2011 report </a> on workplace design and mental health. Thats a lot of time to be cooped up in a less-than-optimal space. Exposures to physical conditions at work that can affect one's physical or mental health are both lengthy and frequent, Veitch adds.

Here are some of the ways the design of your office may be impacting your mental health-and how to cope.

People who work in windowless or dark offices experience impaired sleep and lower wellbeing than those who have exposure to natural light. Thats according to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4031400/" id="180b9794-46f1-33cc-a465-cac7d19f8130"> a 2014 study </a> from Northwestern University.

Natural light, especially first thing in the morning, helps regulate your bodys circadian clocks in ways that promote healthy sleep, says Ivy Cheung, Ph.D., coauthor of the NU study. Spend the whole day in a dark or artificially lighted space, and these clocks can be thrown off-which may increase your risks for wonky sleep patterns, which in turn raises your risk for depression and other mental health disorders, her study suggests.

If you cant move your desk near a window, spending 15 to 20 minutes outdoors in the morning can help regulate your sleep-wake cycles, Cheung says.

The popularity of open-plan workspaces means most of us are forced to listen to our colleagues conversations, paper shuffling, and obnoxiously loud typing. According to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5086693/" id="8a57c94d-3cfe-3349-a40b-deed3fb5f4f7"> a 2016 study </a> from Germany, exposure to distracting ambient noise is associated with a drop in mental health-probably because noise increases stress.

The more annoyed you are by background clatter, the more your mental health will suffer, that study suggests. Noise-cancelling headphones can help, <a href="https://www.mq.edu.au/newsroom/2017/08/21/a-noisy-work-life-could-put-your-wellbeing-in-strife-expert-calls-attention-to-the-impact-of-workplace-noise/" id="3e5c9c40-4173-3a59-aba9-af917abc9e53"> experts say </a> .

<a href="https://royalsocietypublishing.org/doi/10.1098/rstb.2017.0239#d3e1388" id="a8def4eb-3db3-3331-ada7-4b714889d0cb"> Research </a> from Harvard Business School has found that, ironically, open office plans actually discourage face-to-face interaction. Open architecture appeared to trigger a natural human response to socially withdraw from officemates and interact instead over email and IM, the Harvard researchers write. Employee face-to-face interactions dropped by 70% in open office spaces, their study found.

Relying on digital forms of communication may lead to worsening mental health. A lot of research, including <a href="https://www.sciencedirect.com/science/article/pii/S0165032718310516" id="712a0db2-a8a7-3913-a911-b90dfdcb2d65"> a just-published study </a> on military veterans, has shown in-person, face-to-face interactions are associated with lower rates of major depression and other mental health disorders, while digital communication does not have the same effect.

Going out to lunch with your colleagues may be one effective antidote. Getting out of the office and away from your computer should facilitate real face-to-face conversations. And even a few of these each week seems to benefit mental health, that veterans study found.

Researchers <a href="https://www.sciencedirect.com/science/article/abs/pii/S135382921730223X" id="17294dfa-58f3-30a8-a1c1-3c2eea84abb2"> have found </a> that exposure to natural environments-including green spaces like parks or forests, and blue spaces like rivers and coastlines-can improve wellbeing.

And <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0155614" id="a6c5b732-0085-37bf-ad78-70f894257077"> a 2016 study </a> in PLOS ONE linked natural elements in the office-stuff like plants of fountains-with lower levels of depression. If your office is a gray warren of plastic and metal, thats bad.

Spruce up your space with plants, the PLOS ONE study advises. Decorating your office or cubicle with photographs of forests or other outdoor scenes may also help combat stress, finds <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4690962/" id="72d8d056-d6fb-3c82-a702-372d95f05e2a"> a 2015 study </a> from the Netherlands.

The lack of privacy in open-plan offices can make you feel like your boss or coworkers are always looking over your shoulder. This can lead to emotional exhaustion-also known as burnout. Thats according to <a href="https://www.sciencedirect.com/science/article/abs/pii/S0272494413000534" id="f791bb46-8399-33d3-add8-27c17fbd3c85"> a 2013 study </a> in the Journal of Environmental Psychology.

But that study found personalizing your office space with your own stuff-pictures, memorabilia, tchotchkes, etc.-can make your desk or office feel more like your own personal space, which helps counteract the negative effects.

Some people do just fine in cluttered environments. In fact, a messy desk <a href="https://journals.sagepub.com/doi/abs/10.1177/0956797613480186" id="3b1df67a-df3e-336b-ae55-510ed136090e"> can stoke creativity </a> . But <a href="http://images.transcontinentalmedia.com/LAF/lacom/disorganized_environment.pdf" id="0e431242-2c20-31b9-a54a-3d44d0ae93e2"> research </a> has also shown that, for many of us, a sloppy or disorganized space leads to a loss of emotional control. This means you may struggle to maintain your attention-or to keep your stress or anxiety levels in check-if your workplace is a pit.

If you feel like your messy office is doing you more harm than good, cleaning up is an obvious remedy. If you cant control the disorganization around you, try to arrange your desk so that the mess is outside of your field of vision. <a href="https://www.ncbi.nlm.nih.gov/pubmed/21228167" id="ddb1a973-32ef-3ddf-a2e1-08093d73474e"> Research </a> from Princeton University suggests this can help reduce the clutters impact on your attention.

How Your Office Design Affects Your Mental Health

Most offices are engineered with two objectives in mind: productivity and collaboration. Theres nothing wrong with those two design goals. But more and more research is showing that modern work environments can have a negative impact on your mental wellbeing.

How Your Office Affects Your Mental Health

But if those plans include the <a href="https://www.isagenix.com/" id="4717d09e-c11f-3e80-a102-4243c814ca46"> Isagenix diet </a> , experts say you may want to reconsider.

In a nutshell, the Isagenix diet incorporates aspects of fasting and meal-replacement plans. Followers are asked to mostly eschew real and whole foods in favor of packaged shakes, bars, supplements, and other Isagenix-branded products.

There are several different Isagenix systems to pick from, depending on whether your goal is to improve your energy and performance or start your weight loss journey. (The Isagenix site is careful to frame all its products as weight management aids-as opposed to weight-loss products.) The companys basic pitch is that by ditching most real foods in favor of Isagenixs assorted shakes and shots, youll lose unhealthy weight, feel more energetic, and detoxify your body.

You accomplish this by combining shake days and cleanse days, says Mike Roussell, PhD, a nutrition scientist and co-founder of <a href="https://neutein.com/" id="a999d83d-95e2-38f3-a7af-fabec6baeccd"> Neutein </a> , a company that makes brain health supplements. On shake days, youd replace breakfast and lunch with Isagenix shakes, Isagenix snacks, and a variety of supplements, he explains. Then youd prepare your own dinner featuring lean proteins, fruits and vegetables, and a very small amount of fat from healthy oils.

On cleanse days, youd swig several shots of an antioxidant-rich Isagenix concoction, chew some Isagenix tablets, and eat little to no food, he says.

Whats the problem with all this? Aside from the usual fatigue, nausea, and potential constipation seen with most calorie-restricted, shake-based dietary approaches, the biggest risk is loss of lean body mass, Roussell says. He explains that the Isagenix diets protein intakes are likely insufficient to support muscle growth and maintenance.

Furthermore, there is no scientific data to suggest that consuming concentrated antioxidants improves the detoxification capacity of your body, he says. Thus the supplementation protocol likely has no impact on weight loss or your bodys detoxification pathways.

Hands of a climber holding energy bar as snack

In fact, overdoing it on antioxidants could be harmful. Back in the 1990s, some promising research linking the antioxidant beta-carotene to lower rates of lung cancer led to a large-scale study in which smokers at risk for lung cancer took large quantities of beta-carotene supplements. The result? <a href="https://www.ncbi.nlm.nih.gov/pubmed/10359235" id="8b248726-0feb-3612-ac63-f013a860ea63"> Lung cancer rates skyrocketed </a> -prompting the researchers to cut the study short. Turns out, antioxidants <a href="https://www.menshealth.com/nutrition/a19546391/what-are-antioxidants/" id="b19e6aed-40d1-38f4-afac-a3df5421119e"> can in some cases turn into pro-oxidants </a> if the body has too much of them. And this can fire up some of the bodys cancer pathways.

Its exactly this kind of finding that has led most nutrition experts to push people away from ingredient-overloaded shakes and supplements and toward whole-food diets. Also, the various Isagenix plans all feature or promote low-fat eating, <a href="http://science.sciencemag.org/content/362/6416/764" id="fb72cd5c-1154-3801-a11b-887c14bc7774"> which many experts now say </a> is unhelpful for sustained energy and weight loss.

The highly restrictive nature of some of the Isagenix weight-management plans could also be problematic, says Jeanne Tiberio, MS, a registered dietician and wellness coach with <a href="https://www.varsitytutors.com/" id="c07ba77e-48b6-3e91-ab12-c2ac256e6411"> Varsity Tutors </a> .

Tiberio says she has concerns that the diet could trigger refeeding syndrome, which is a cluster of symptoms caused by metabolic disturbances and malnutrition. She mentions abnormal heart rhythm, confusion, and convulsions as possible side-effects.

On the bright side, she says the meal replacement shakes are a perfectly fine way to get your nutrient needs met while on the go, and could result in weight loss if you simply replace a single meal with one of the shakes." But, she adds, the contents of the Isagenix shakes are similar to Boost and other liquid meal replacement shakes on the market. The big difference: the Isagenix shakes are a lot pricier. Depending on where you buy Isagenix products, a 30-day supply can cost upwards of $400.

There is no reason to buy into the hype, Roussell says of the Isagenix diet. Using meal replacement shakes to cut calories to elicit weight loss is a strategy that has been employed for decades. Furthermore, the Isagenix plan calls for near round-the-clock eating-a grazing style that research says can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4391809/" id="f0a4befe-cb57-3092-afa0-caae1aefc5b9"> stoke your appetite </a> and so may promote weight gain.

Take a step back and squint, and the Isagenix diet looks like a mashup of outdated eating fads and failed nutrition science.

If your current diet is a mixture of fast food and energy drinks, then pretty much any switch-including to an Isagenix plan-could do you some good. But youd be much better off now and in the long run adopting a healthy whole-foods based diet.

So save yourself money and disappointment, and pass on the Isagenix diet. Something <a href="https://www.menshealth.com/nutrition/a19543268/mediterranean-diet-benefits-entire-body/" id="719f09b3-ee67-3943-adf8-17f3ccf7f6dc"> like the Mediterranean diet </a> is the way to go.

Read This Before You Try the Isagenix Diet

If you're gunning to try a new diet, right on.

What Is the Isagenix Diet? Here's What to Know Before You Try It for Weight Loss.

When men are depressed, their self-esteem is down and their motivation is down and their libido may be down, says Ian Kerner, PhD, a licensed psychotherapist and sex counselor. Any or all of these issues could interfere with your interest in sex or your ability to perform.

When you look at sex, its basically about things that excite and arouse you, Kerner says. Depression, meanwhile, is a condition that inhibits excitement and arousal. So its no wonder depression and sex dont mix.

He adds that some popular antidepressant medications-namely, SSRIs- <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4034069/" id="fb19bc2f-99f8-32c0-abee-54748cc1cd30"> can lower libido and interfere with sexual function </a> . So depression may be kneecapping your romantic life in a lot of different ways. Here's a look at a few of them.

<h1> Depression and Relationship Sex </h1>

When people are depressed, sex could very well be the furthest thing from their minds, says <a href="https://communicationstudies.wvu.edu/faculty-and-staff/faculty-directory/liesel-sharabi" id="28fd253e-37ab-364f-a16d-532186bc232f"> Liesel Sharabi </a> , PhD, an assistant professor of communications at West Virginia University.

In one of Sharabis studies, <a href="https://journals.sagepub.com/doi/abs/10.1177/0265407515578820" id="d8cfed43-bd23-3988-ad2c-60a7279f92a5"> published in 2015 </a> , one guy talks about how his depression makes it difficult for him to be around anyone-including his partner. I just want to be left alone so that I dont get in a bad mood, he says. Another man in that study says, Everything feels like an effort. That includes sex.

Interestingly, her research has also shown that couples in which one person, but not the other, is depressed tend to experience more sexual challenges than couples in which both people are depressed. The asymmetry depression creates can make it difficult for the depressed man and his mate to get on the same page sexually, she says.

When a man feels bad about himself, he might not feel confident or worthy of a connection with his romantic partner, adds <a href="https://millikin.edu/people/amy-delaney" id="ab3fc725-21bd-3845-a7f1-ee689ad16cf6"> Amy Delaney </a> , PhD, an assistant professor at Millikin University in Illinois and author of <a href="https://journals.sagepub.com/doi/abs/10.1177/0265407518809488" id="9824e98c-bfb0-3307-a94d-4c7e2e232c55"> a 2018 study </a> on depression and sexual intimacy.

Depression can also leave men feeling alone and isolated, Delaney says, which can interfere with his desire or ability to be intimate with his mate.

The male sex drive is often talked about like its some isolated quality a guy either has or doesnt have-like the ability to throw a football 40 yards, or to handle a few drinks without getting sloppy. The truth is a lot more complicated.

Lots of the literature on depression focuses on decreased desire and [sexual] function, Delaney says. But my research with couples points to multiple layers of sexual intimacy challenges. She says some of these challenges are cognitive while others are interactive.

Cognitive challenges include troubles with self-esteem and feelings of isolation, she explains. Interactive challenges happen when couples struggle to talk about and initiate sex. All of these roadblocks can line up in ways that disrupt the entire system of a romantic and sexual relationship, she says. One example is a concept known as interference.

Interference focuses on the ways partners can disrupt each others day-to-day routines and individual goals, she explains. So interference could be when your partner leaves her towel on the floor, won't join you and your friends for bowling night, or needs a ride to the doctor so you can't make it to the gym.

Normally this sort of interference isnt a big deal. Its just part of being in a relationship. But when a man is depressed, he may feel greater levels of interference from his partner, she says. This can breed resentment, which is poison in the bedroom.

In this and other ways, the sexual challenges that stem from depression are woven into the fabric of the relationship, Delaney says. Fixing these intimacy issues isnt as simple as flipping some libido switch.

<h1> What to Do if Depression Affects Your Sex Life </h1>

For some depressed men, the solution really is as simple as changing medications, Delaney says.

For others, professional counseling is the way to go. But if youre in a relationship, its important to include your partner. Standard treatment protocols really only focus on the individual, she says. But solo therapy often ignores the effects a mans depression is having on his partner and their relationship as a whole, she adds.

I'd advocate for a treatment approach that widens the lens to include [both partners], she says. If couples can work together . . . they may be able to better address the sexual intimacy challenges that accompany one or both partners' depression.

Taking a break from sex may also help, Kerner says. He explains that, if youve been struggling in the bedroom, taking sex off the table can help relieve some of the pressure. Especially if you have a tremendous amount of anxiety around sex-if its something youre feeling very stressed or guilty or ashamed about-taking a sex break can help.

Instead, you and your partner could experiment with other forms of intimacy-stuff like holding hands, kissing, and outercourse, he says. Not feeling that one? Maybe try the exact opposite approach: Just do it, regardless of how you feel. You may quickly come around to sex once youve initiated it, Kerner says.

This wont work for every depressed man, he adds. But just as a morning run can leave you feeling great even if you were dreading the thought of exercise, hopping in the sack even if you dont feel like it can turn out to be as enjoyable as you remembered.

Try to create that sexual spark and nurture it, he adds. Having sex with your partner almost never makes depression worse, but it can boost your self-esteem or have some other palliative effects.

This Is How Depression Affects Your Sex Life

One of the hallmark symptoms of depression is something mental health experts call anhedonia. In a nutshell, anhedonia is a loss of interest or enjoyment in stuff you used to enjoy. And for a lot of depressed men, that includes sex.

There are many factors that can influence sex drive apart from a hormone deficiency, says T. Mike Hsieh, M.D., an associate professor of urology at the University of California, San Diego who specializes in sexual dysfunction. These reasons can range from mental health disorders to medication side effects, he says.

Even if youre completely healthy, its natural for your libido or erectile function to dip now and then, Hsieh says.

Companies that make ED drugs or libido supplements, however, <a href="https://jme.bmj.com/content/41/10/859.short" id="47e804c2-803f-3bb8-a74d-9de29c0e10b5"> like to promote </a> the idea that every guy should be walking around with the sex drive (and pipe-hard boner) of a 16-year-old, but thats unrealistic. In a lot of ways, its helpful to think of your sex drive the same way you think about your mood. Sometimes its up and sometimes its down, and these sorts of fluctuations are normal.

If its only been a few days or a week and youre also burned out or stressed, you might want to give it a little more time before seeing someone about your [libido] concerns, says Ian Kerner, PhD, a licensed psychotherapist and author of <a href="https://www.amazon.com/gp/product/0061234621/ref=dbs_a_def_rwt_bibl_vppi_i8" id="813e24d0-65c7-3706-a746-eba1f2bae19d"> Sex Recharge </a> .

So when should you see a doctor about your sex drive concerns? These guidelines could help you decide.

If Youre Experiencing These Symptoms

While many libido issues have nothing to do with a mans testosterone levels, there are clusters of symptoms that doctors look for if they suspect hormone issues or imbalances, Hsieh says. We have a validated questionnaire-the ADAM questionnaire-that we use if we suspect hormone deficiencies, he says.

ADAM stands for androgen deficiency in the aging male. And if you answer yes to two or more of the questionnaires criteria, Hsieh says, that may be an indication that a hormone deficiency is to blame.

<ul><li> Do you have a decrease in libido or sex drive? </li><li> Do you have a lack of energy? </li><li> Do you have a decrease in strength and/or endurance? </li><li> Have you lost height? </li><li> Have you noticed a decreased enjoyment of life? </li><li> Are you sad and/or grumpy? </li><li> Are your erections less strong? </li><li> Have you noticed a recent deterioration in your ability to play sports? </li><li> Are you falling asleep after dinner? </li><li> Has there been a recent deterioration in your work performance? </li></ul>

Its important to note that many of these symptoms are non-specific, meaning theyre caused by a range of health conditions-including mental health disorders like depression, Hsieh says. Some researchers <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2834355/" id="4e178b1e-4da6-37c3-abfa-1adcca7228b2"> have also argued </a> that the yes/no nature of the ADAM questionnaire lacks nuance and precision.

Still, if you answer yes to two or more of these questions, it may be time to talk with a doctor or therapist, Hsieh says.

If Your Sex Drive Drops Suddenly

There is no such thing as a normal sex drive, Hsieh says. Some men seem to need sex or sexual release every day, while others arent bothered by a lot less, he explains. But whatever your baseline, if your libido falls abruptly and doesnt recover within a couple weeks, let your doctor know, Hsieh says. If you have an acute drop-off in how you normally feel, thats not normal, he adds.

If You're Considering Popping Pills

A lot of men are quick to throw OTC pills or supplements at their libido issues. They assume that, because its over-the-counter, these things are safe, Hsieh says. The U.S. consumer supplement market, however, is largely unregulated, he explains. If youre shopping for testosterone supplements online, you could end up in a world of trouble.

We see patients coming into the hospital, including young men, with liver failure as a result of taking these supplements, Hsieh says. A testosterone supplement could also cause your body to stop making that hormone naturally, which can lower your sperm production, Hsieh says. Another common side-effect of OTC hormone supplements is elevated red blood cell counts, which can lead to clots and bleeding problems, he says.

If you dont feel normal, talk to a health care professional rather than turning to Dr. Google or over-the-counter supplements, he adds.

If Your Issue Is Messing with Your Life

In many cases, there are no strict criteria that separate a run-of-the-mill libido lull from a more serious problem. Also, many libido issues are very specific or dependent on context.

I see patients who say they have no problems when they watch porn, but they cant do it with their partner, Hsieh says. I also have guys who say things like, I can only have sex for an hour, but I want to have sex for two hours like I see in porn.

While these concerns can be distressing, they have little to do with your physical health or hormone levels. A safe rule of thumb: If you find yourself becoming preoccupied with your struggles, or if your issue is messing with your relationship or ability to date, its time to see someone, Kerner says.

If it feels like youre in an extended period of low libido or its distressing you, I would recommend seeing a psychotherapist-preferably one who specializes in sexuality, like a sex therapist, he says.

Many M.D.s dont have the specialized training-let alone the time-to talk through all the different psychological and lifestyle variables that may be affecting your sex drive, he says. A therapist may be better equipped to work through all that with you, he adds.

When Should I See a Doctor About Low Libido?

A lot of men assume that low testosterone is to blame for most libido issues, but the truth is often more complicated than that.

When Do I Need to See a Doctor About Low Sex Drive?

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