Sex after baby. We all know the cliche about its nonexistance – after all, the sleepless nights, the leaky breasts, and the lack of personal space that accompany a newborn aren’t exactly aphrodisiacs.

But sex after postpartum depression? Is a uniquely difficult experience for many mothers.

With my husband’s permission, I wanted to take the time this week to share my own experiences with sex, depression, anxiety, and medications. I know I’m not alone – and I want you to know you’re not alone either.

At first, relations with my husband were slowed only by the physical limitations that follow a vaginal birth: pain, scar tissue, and sleep deprivation. You see, I started my first weeks as a mother with postpartum anxiety and it wasn’t until months later that the depression took hold. But as it slowly invaded my brain, my interest in sex waned. This is a common symptom of depression and, for me, the numbness I felt toward my child and my life spread into my marriage.

It took months for me to accept that I was suffering from postpartum OCD and postpartum depression and to seek help. When my doctors put into place both talk therapy and medication plans, I finally began to feel just the smallest bit like myself again. But as my happiness returned, my libido only diminished. And though I knew that couples typically experience a temporary drop in marital satisfaction after the birth of a baby, I couldn’t help but feel concerned. It was more than just a decrease in desire.  I found the thought of having sex completely repulsive.

After some research, I learned that the antidepressant I was using (an SSRI) is linked to sexual dysfunction in a high percentage of patients. I nodded my head as I read about the symptoms, including loss of desire and inability to climax. It felt like I was being punished for treating my depression, and I wondered how a marriage is supposed to survive both mental illness and celibacy.

So as hard as it was, I brought up my concerns with my psychiatrist. Over the two years that followed, we worked through a series of medication trials, finally settling on a mood stabilizer that seemed to alleviate the depression without such a severe impact on my sex life. When I became pregnant with my second child, however, I chose to return to my SSRI, knowing there was more research to support its safe use during pregnancy. I made that decision knowing I would be sacrificing my libido, but fully aware of the risks untreated depression carry for both baby and mother during pregnancy.

I wish I could tell you that the sexual side effects were limited to my first postpartum period. But, sure enough, they returned as the medication took hold and I felt the depression and anxiety lift. I also wish I could tell you that this is a story written entirely in the past tense, but almost 3 years postpartum, I still take the SSRI daily, and it continues to impact my desire and performance.

At times, it feels as if I have to choose between sanity and marriage. I hate that the medication that works so well — that allows me to feel like a calmer, more rational version of myself — takes something so important away from both me and my husband. But I am also grateful for the life it allows me to lead. My doctors and I speak about the sexual side effects of my medications at each appointment and are constantly balancing them with the therapeutic benefits – and we have tweaked dosages and timings to help as much as possible. (I won’t get into the details – that is something for you and your doctors to discuss.) For now, we’ve found a plan that, while far from ideal, allows me to continue treatment for my medical condition.

I hope that if nothing else, these last 6 years negotiating the world of antidepressants, mental illness, and sex allow me to help someone who may be suffering in the same way:

I want you to know that if you are experiencing sexual side effects from your anxiety, depression, or medications that you are not alone.

It’s important to be honest and open with your doctors about all side effects and symptoms you are experiencing, including loss of libido and lack of performance.

Finding the right medication and other treatments for postpartum depression (and other mood and anxiety disorders) can be a complicated process, but there are many options out there and probably one that will fit your needs.  Don’t give up.

photo credit: fotolia.com