depression

WHY DO MEN LOVE SAD GIRLS?

I wrote this for Harper’s Bazaar. Image courtesy of Paramount. 

“You were so frail that you looked like you would just float away.”

My ex-boyfriend says he fell in love with me that day, as I sat saturated in sadness reading the Buddhist recovery memoir Dharma Punx, wearing a ripped Diane Von Furstenberg dress and the label of Major Depressive Disorder. The dress had torn during a date rape when I first moved to New York, but I continued to wear it years later because I loved it. And like some perverse attraction to dating a depressed girl, men flocked to me because of it.

It’s a trope that pop culture loves to depict (The Virgin Suicides, Prozac Nation, and Girl: Interrupted, among others). But for me, a bisexual and queer woman who at the time was primarily dating cis-gendered straight men, it meant a stream of partners being attracted to, and enjoying, my inability to stand up for myself: an excuse to sleep with a “beautifully fragile” woman who would not ask for much in return.

The fact that an aura of sadness can attract partners is not uncommon. On average, men find women with some psychological vulnerability more attractive, according to a 2012 University of Texas at Austin study which looked at the connection between sexual exploitability and sexual attraction. This is not necessarily problematic, explained clinical psychologist and relationship expert Barbara Greenberg, but it can become a substantial cause for concern for those experiencing severe suffering who may be less likely to protect themselves. This can often appeal to the wrong type of men.

Most of my lovers during this time didn’t know what to do with me, and I allowed those who loved and made love to me to treat me with limited deference. I later found out this can be a typical occurrence for people who are depressed. “A lack of respect can be tolerated when a person is down,” noted Dr. Greenberg. “They may not be aware of self-protection because they are so hungry for validation wherever they can find it. We are worried about the predators who come at it from a place of bad intention—a person who probably has either a narcissistic or antisocial personality, somebody who lacks empathy.”

Indeed, one of the most twisted guys I dated during my lowest was a man whose label read “Antisocial Personality Disorder.” He wore it loudly through lies, a lack of empathy, and eventually, verbal abuse. Those with mental disorders such as Narcissistic Personality Disorders and Antisocial Personality Disorder are especially eager to take advantage of someone who is depressed because it’s all about their needs. Diagnosis of personality disorders is controversial (it’s a bit twisted to tell someone that their personality is a disorder), but people with limited or nonexistent empathy certainly exist, in my experience.

Essentially, my radar for picking well-meaning partners was broken because my self-esteem had gone dry. Within the span of a few months, I was sexually assaulted (again), my parents divorced, and I left a long-term cohabiting relationship. I moved to Brooklyn and simultaneously gave up alcohol in an attempt to start over. But the combination of leaving a relationship in which we shared many mutual friends, and no longer socializing in bars, dissolved many of my friendships. The isolating side effect of depression didn’t make finding new friends easier. I hadn’t yet learned nourishing coping mechanisms; so rather than focus on healing myself through therapy, creative outlets, and new friendships, I poured myself into sexual and (questionable) romantic relationships with lovers who didn’t treat me with the care that I needed. The effect was cyclical. I would feel worse when a partner put me down or used me for sex, leaving me to seek validation in other men—and during this time, they were always so easy to find.

The other type of problematic partner one encounters while living with depression is the savior. In cinematic portrayals of love and depression, the sad girl’s partner usually has good intentions. They want to rescue her. The trouble is, you can set groundwork for a relationship dynamic that is difficult to unweave later, says New York City-based sex therapist Kelly Wise. When the depressed partner begins to recover and gain autonomy, the “savior” partner may find themselves uncomfortable with the new power balance.

Still, there are partners who genuinely care. However as my friend Ashley, who suffers from Major Depressive Disorder and wished only to use her first name, explained: “After a while, they give up. One of my exes broke up with me because he said I was bringing him down and he couldn’t handle my breakdowns anymore.” It took years before Ashley learned to avoid partners ill-equipped to deal with depression by being honest and upfront about her own situation.

Of course, dating with depression is very different when you’re in a long-term relationship than when you’re single. A reliable, committed partner will educate themselves about their significant other’s sickness (and yes, depression is a sickness, not a moral failing) and learn how to be supportive. Those with depression may experience it again in their lifetime, Dr. Greenberg reminded, which is why she advises being honest about your mental health history with partners.

A supportive community along with self-care during periods of depression can also help you tune into your needs, and as a result, sniff out the bad guys. With the support of friends, family, and sometimes therapy, you’re less likely to rely on unhealthy partners as a means of companionship. “You need to have your radar up, and if your radar is not operating properly then you need to operate on the radar of people who love you. Rely on the radar of your friends and rely on the radar of your therapist because yours is probably not as sharp when you’re depressed,” explained Dr. Greenberg.

Eventually, I got better and gained the self-realization and strength to untangle myself from unhealthy relationship patterns. I was able to heal through therapy, antidepressants, and the self-care of beauty routines. Perhaps most importantly, I built up friendships and community that provided love, support, and companionship without expectations of sex.

I know the demons I saw still exist, I simply now understand how to slay them. Recently, due to personal changes and the political climate, I, like many others, caught another whiff of depression. So I continue to work hard while making time for self-care, which for me, looks like splurging on a good massage followed by a night of reading, or watching Shonda Rhimes. As a single person, since many of my demons did arise from sexual assault and abuse, I now make sure to let lovers know when I need some time and space. And I’ve noticed that people with an honest interest in my well-being are very understanding when I express that need.

I acknowledge the part of myself that was once completely convinced that my existence was meaningless, however I’m also able to decide that even when living seems hard, the moments of joy make the moments of misery worth it. Believing in magic is more fun than believing in nothingness. And when it comes from a healthy place with worthy partners, having good sex and falling in love is one of the most delicious ways to revel in the joy of being.

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HOW VANITY CURED MY DEPRESSION

I wrote this for Harper’s Bazaar

Down the street from my cluttered Brooklyn apartment sits a high-end nail salon that helped to save my life. Filled with aspirational pink cushions and soft notes of jasmine, the salon’s manicurists would paint my short, round nails an O.P.I black onyx—or, if it were a cheerier day, a dark purple.

For two years, during 2013 and most of 2014, I was deeply depressed. After experiencing a sexual assault, a breakup, and my parents’ divorce, the structure of my world slowly began to give way. I was held captive by a distinct powerlessness that sucked me into a vortex of dark disappointment; and eventually, the cruelest depression I had ever experienced.

I sought out a psychiatrist and as expected, my blood was soon filled with sex drive-killing antidepressants. Though they helped, I quickly learned that what I really needed at the time, what I actually wanted, was slightly simpler—I wanted someone to take care of me.

It started with the manicurists at my nail salon. I learned that having appointments to show up to (especially those that included a massage while my nails dried) helped to get me out of bed. I dyed my hair an oxblood red that, coincidentally, needed several visits to the hair salon. Gradually, I began to put more effort into my appearance at home: I tried winged eyeliner and I discovered eye cream. Before I knew it I had found a bonafide beauty routine, which, rather than cover up what I was going through (although a YSL red lipstick is a terrific tool for camouflage), became a daily reminder that I was a living, breathing person who was worthy of being considered—worthy of being paid attention to. And apparently, I was onto something.

“Self-care is enormously helpful during depression,” explained Dr. Marlynn Wei, a New York-based psychiatrist and psychotherapist. “Depression often causes isolation and withdrawal from all the things that you normally do to take care of yourself and feelings of low self-worth, so making sure to focus on being kind to yourself to allow yourself to heal is so important during this time,” she continued. “Beauty routines, if done mindfully from a place of self-compassion, can also enhance your mind-body connection.”

In my experience with depression, the enemy is not unwanted thoughts dancing for attention (as with anxiety), or even daggers of self-hatred. What you’re fighting is a nothingness set on sucking your ambition, and in later stages, a will to live. It’s a faceless enemy that fights dirty. For me, the act of self-care was retaliation. It helped me to feel alive. It wasn’t so much about the discovery of night cream—or the lasting power of Kat Von D’s liquid lip liner—it was the “Hey, you! I know you want to die right now, but still you’re beautiful, and worthy of being taken care of.”

Today, in an age where women are shamed for their makeup routines and their want to look beautiful as much as they are for daring to appear disheveled, engaging in vanity was an act of triumph I didn’t know I was capable of. The maintenance required to obtain my red hair and perfectly-manicured hands might not be for everyone (for you it might be long hot showers, a new hairstyle, or wearing high heels again), but somewhere along the way, I began to see glimmers of my old, buried self. What’s more, I wasn’t choosing a beauty routine to please a perspective romantic partner, I was doing it for me.

During this period I moved out of my ex-partner’s apartment and into my own. I dove into writing. And, over manicures, I turned Twitter friendships to new, real-life friendships with fellow writers. Slowly, I got better. Through therapy I dealt with the sexual assault and the pains of the breakup, which faded and eventually morphed into a friendship. Now I live with a new partner who is not scared of my occasional depressive proclivities. And at one point, with the support of my doctor, I simply stopped taking my anti-depressants—and nothing happened. I didn’t need them anymore.

When I look back at the person sitting in that Brooklyn nail salon, I hardly recognize her. But I do thank her for teaching me how to properly apply a red lipstick and the value of a night cream. And while I still haven’t learned to do my own nails (I lack the dexterity), I finally found the important person I needed to take care of me: myself.

 

The Tough Choice Pregnant Women With Depression Have to Make

I wrote a new article for Mic. Image Mic/Getty.

Amy* is a blogger and teacher who lives in Ohio. She was also diagnosed with bipolar disorder in 2003. Since her diagnosis, she has become the mother of three children.

“[During] my second pregnancy I didn’t really have any problems, but when I got pregnant the third time … it wasn’t planned, [and] I was on Lamictal,” she told Mic. Lamictal is an anticonvulsant often used to treat epilepsy which has proven effective in treating bipolar.

During the first trimester of her third pregnancy, Amy was told to go off her medication. “Everyone [was] like, ‘Oh if you stay on it they’ll be hurt for life!'” she told Mic. She looked up Lamictal and found out it was a Category C drug, meaning the FDA determined that animal reproduction studies “have shown an adverse effect on the fetus,” causing potential health risks for pregnant women.

Amy wanted to stop taking the drug, but she wasn’t able to get in touch with her doctors. “My mood pretty much just plummeted,” she told Mic. Three weeks later and still in a state of despair, she finally got in touch with her psychiatrist’s office. “They said, ‘Well, you shouldn’t have gone off of that,'” she recounted, with palpable frustration.

Later in her pregnancy, Amy said she struggled with some of the more severe symptoms of her mental illness. “I was doing a lot of self injury, cutting,” she told Mic. After being turned away from one mental health facility, she ended up in the medical side of a psychiatric ward. “I still wasn’t good, but I was more stable,” she said.

Pregnant women living with mental illness face monumental struggles. According to the World Health Organization, approximately 10% of pregnant women experience a mental disorder during pregnancy, primarily depression. (In developing countries, that number is higher: about 15.6%.) For Amy and other mothers who fall in this category, pregnancy isn’t a picture-perfect experience of satiating ice cream cravings and emitting a radiant glow.

Although the symptoms of postpartum depression are well-understood, as the New York Times reported in May, “far less recognized is an equally troubling condition: antenatal depression, or depression suffered during pregnancy.” In addition to depression, researchers have found that 5 to 16% of women struggle with an anxiety disorder during their pregnancy.

Traditionally, many doctors have warned against patients taking antidepressants while pregnant. But the truth about whether it’s OK to take such medication during pregnancy is more complicated than we think. Pregnant women with mental illnesses must make critical decisions about treatment — not just for their own health but for their baby’s.

“I took fluoxetine for the whole pregnancy,” Jess*, a mom blogger living in New Zealand who has been diagnosed with panic disorder, told Mic. “I was very concerned about it and was willing to stop taking [the meds], but at the same time, the risks of me becoming extremely unwell were far too high. You need to weigh the risks and benefits.” Jess’ daughter was born healthy in 2013.

rappling with stigma: Women struggling with mental illness often experience extreme guilt and fear if they choose to take a medication during their pregnancy. And unfortunately, there aren’t many reproductive psychiatrists to help them make decisions about their treatment.

“It’s challenging because there are a lot of psychiatrists who are very uncomfortable treating pregnant patients, just because there isn’t a lot of training on that. And then there’s a lot of [obstetricians] who aren’t as comfortable treating mental health issues,” Dr. Anna Glezer, a psychiatrist in San Francisco who specializes in reproductive psychiatry, told Mic.

Glazer told Mic that the answer to whether a woman should take medication during pregnancy largely depends on the medication and the woman taking it. “I think it will be really hard for anyone to say that a particular medication, treatment, supplement, anything, is ‘absolutely safe’ in pregnancy. But there are definitely some that are safer than others,” she said.

Some medications, such as the selective serotonin reuptake inhibitor (SSRI) antidepressant Paxil, are shown to cause harm to a fetus. (That said, other SSRIs, such as Prozac and Celexa, are generally considered to be OK to take during pregnancy.) Other types of antidepressants, such as tricyclic antidepressants like Tofranil and serotonin-norepinephrine reuptake inhibitors like Cymbalta, have been determined to not have any serious effects on a fetus and can be safely used during pregnancy.

Yet, as Glezer explained, deciding which meds to take during pregnancy isn’t as simple as finding out what’s OK and what isn’t via a Google search. “I would say that apart from a couple of select medications, I don’t say that you absolutely can’t be on something. Otherwise, it’s absolutely a risk-benefit [analysis],” Glezer said.

This decision-making process is more complicated than people might think. In some instances, the mental illness itself poses more risks to a fetus’s health than the medication the mother might be taking.

“Depression in and of itself has consequences during pregnancy,” Glezer told Mic, citing increased risk of self-harm, as well as less serious conditions like sleep loss, as examples. “Furthermore, if you’re depressed and unmotivated while pregnant, you might not have the energy to do some of the things your doctors are recommending. Then there’s the illness of depression itself, and studies have found that[‘s] associated with things like smaller babies [low birth weight] or preterm deliveries.”

These days Amy is doing well, as is her daughter, who was born healthy in 2011. But the lack of information on psychiatric disorders and pregnancy is prompting professionals like Glezer and women like Amy and Jess to work to spread awareness.

“That was a big factor in me starting my blog,” Jess said. “I was so sick of having to act like nothing was wrong. I really hope that by sharing my experiences, maybe one person will benefit. Then it would all be worth it.”

Ultimately, some women with mental illness are going to want to live as pharma-free as possible during their pregnancies. But others are going to find that they benefit from medication, even in small doses. “I’ve actually found that pregnancy-related depression responds really well to even really low doses of medication,” Glezer said.

If taking even small doses seems too risky, Glezer recommends purely non-pharmaceutical approaches are available, such as psychotherapy, massage, light therapy, acupuncture and exercise. Prenatal yoga has been shown to help with anxiety and depression.

“Women who do yoga during pregnancy and postpartum are better able to fight anxiety and depression because yoga lowers the stress hormone cortisol and helps develops a stronger relaxation response,” Dr. Marlynn Wei — author of The Harvard Medical School Guide to Yogapsychiatrist and certified yoga teacher — told Mic.

Why Do So Many Women Feel Sad After Sex?

Repost of an article I originally wrote for Mic Connections. Photo courtesy of Mic/Getty Images.

The last time I cried after sex was during a summer fling I wasn’t totally into, about a year and a half ago. The sex was consensual, but all of a sudden, while he was on top of me, my flight-or-flight instinct kicked in. I had to ask him to stop before tears came.

This wasn’t a first-time experience. I live with post-traumatic stress disorder brought on by sexual assault, which means I sometimes have panic attacks during sex, which can sometimes end in tears. But according to a paper recently published in the journal Sexual Medicine, I’m not alone.

According to the study, nearly 46% of the more than 230 women polled have felt depressed after sex at some point during their lives. These women reported feeling symptoms of PCD, or postcoital dysphoria, which is marked by “tearfulness, anxiety, agitation, a sense of melancholy or depression or aggression,” according to the Independent. Of those women, 2% said they felt that way after every time they had sex. And although 20% of the women polled said they had experienced sexual abuse in the past, which led to them developing mental health issues down the road, many of those surveyed didn’t report having a preexisting condition like PTSD to explain their symptoms. 

Why the hell are so many women feeling sad after sex? The PCD study had some obvious flaws. For instance, the results were collected through an online survey, and the sample size included predominantly heterosexual women. But this is not the first time researchers have tried to link sex to sadness in women. A 2011 study published in the International Journal of Sexual Health found one-third of women said they felt depressed even after satisfactory sex.

Jerilyn, 27, is one of them. “Even when I was single, the post-sex depression morphed into a different shade of empty. I always attributed it to the fear of being abandoned,” she told Mic. “I started to wonder if something was being taken from me every time I had sex, even though I enjoyed the act itself.”

Researchers theorized this post-sex dysphoria was caused by hormonal shifts after orgasm. But according to sex and relationship expert Logan Levkoff, the reason might have less to do with biology and more to do with how women’s sexuality is viewed in modern society.

“I think it’s important to remember that if you grow up not feeling empowered by your body, if you feel guilt and shame about sex, if you’ve been taught that your needs are less important than a man’s needs … [it’s not a] surprise that some people wouldn’t feel great after sex,” Levkoff told Mic.

According to Levkoff, part of why women might feel down after getting laid is that their needs weren’t met in bed, a phenomenon linked to how our culture teaches women about their sexual desires. While many men believe that women can achieve orgasm via penetration alone, according to one study, about 75% of women need some form of clitoral stimulation to achieve orgasm.

If their partners aren’t interested in paying attention to their desires, it’s no surprise that women would feel frustrated or emotionally drained after sex. “I think that the take-home message has a lot to do with how we learned about sex [and] how we feel about our bodies,” Levkoff said.

Playing into stereotypes: Possible causes of PCD aside, it’s worth noting that the study could be interpreted as perpetuating the idea that women are more biologically predisposed than men to becoming emotionally attachedto their partners after sex. (That notion was quickly debunked by a study from Concordia University, which found men and women process both love and sexual attraction in pretty much the same way.)

The idea that women are more likely than men to become sad or depressed after sex also inherently endorses the stereotype that women just aren’t really into sex at all. While numerous publications have said otherwise — in fact, a fertility app survey from earlier this year determined that many women would prefer to be having more sex than they’re currently having — the stereotype of the sexless housewife in a frumpy nightgown snapping, “Not tonight, honey,” at her poor, neglected husband still persists.

For this reason, many women don’t buy into the PCD study, insisting that they feel just fine after sex. “The only time I ever feel negative emotions after sex is if it was a one-night stand and I didn’t practice safe sex,” Meredith*, 24, explained. “Maybe guilt the next day, but no, I’m never sad. I love sex.”

Ehris, 22, is also skeptical that women have a biological predisposition toward post-sex depression. “I’ve experienced [sadness after sex] before. But I don’t think that it needs to be pathologized as a problem experienced predominantly by women,” she explained. “I’ve had and heard of partners of both sexes and a variety of genders who have felt melancholic after sex.”

Ehris brings up an important point: PCD isn’t exclusive to women. Men too don’t always feel awesome after sex. “We certainly don’t talk about it as much,” Levkoff said of PCD in men. “And that’s the one thing — this study sort of stereotypes, ‘Yeah, women really aren’t interested in sex.’ I don’t want this to become a self-fulfilling prophecy. I think that’s a bad paradigm to put out there.”

hormonal quirk or a sign that something’s not quite right: An orgasm can be one of nature’s most powerful drugs. When you have sex, the release of hormones in your brain can cause some funny reactions, from making you want to snuggle into your partner’s armpit to making you cry uncontrollably for no apparent reason. The occasional bout of post-sex sadness might be a sign that something isn’t right in the relationship, but it might also just be an odd quirk of nature and nothing more than that.

That said, if you consistently feel sad and depressed after having sex, it’s worth asking yourself why and reevaluating your partner selection. While it might sound obvious, who you’re having sex with plays a major role in how you feel about it afterward. Levkoff said it’s wise to check in with yourself and make sure you are comfortable with your partner and that there are no unaddressed, underlying issues preventing you from enjoying the encounter to the fullest, even if you’re just looking for a one-night stand.

Ultimately, it’s important to have sex with someone with whom you feel safe, “and by safe I mean respected, trusted, cared for,” Levkoff said. “It might not even be a monogamous romantic relationship. If you feel like this is someone you are connected to and who respects you, that certainly impacts [your feelings afterward].”

Jerilyn experienced PCD for years before she started dating her current partner, a longtime friend of hers. They’ve been together five months, and Jerilyn said she is finally enjoying sex in the way she thought she was meant to.

“This is the first time in my life that I have not had some form of postcoital depression. The only reason I get sad is if he falls asleep and I want more,” she explained. “Sex is finally what it should be for me, which is primal and passionate, and no longer something that provokes that overhanging, ambiguous sensation that something isn’t right.”

I’ve dealt with a lot of my PTSD-related issues, and like Jerilyn, I am now with a partner with whom I feel safe. I no longer feel sadness or anxiety after sex. Instead, I feel a lovely, Ativan-esque sense of calmness.

*Some names have been changed and last names have been withheld to allow subjects to speak freely on private matters.

The Post-SSRI Orgasmic High

New for Broadly.

I have been on and off various forms of antidepressants since college. A class of antidepressants (Zoloft, Lexapro, and Prozac) called SSRIs (selective serotonin reuptake inhibitors) is often the first line of pharmaceutical treatment for depression and a safer and less addictive solution than benzodiazepines (Xanax, Ativan, and Klonopin) for anxiety and panic disorders. The problem is, as if trying to date while depressed or anxious isn’t shitty enough, taking SSRIs, which work by blocking serotonin receptors in the brain so that levels of the chemical in the brain stay higher, can basically cause chemical castration.

“The current thinking is that serotonin and dopamine are something like the brakes and the gas when it comes to sex,” explains Dr. Julie Holland, a psychiatrist and the author of Moody Bitches: The Truth About the Drugs You’re Taking. “Too much serotonin seems to make it hard to flip the switch over to orgasm. When women are in a lower serotonergic state, as when they are closer to their periods (PMS) or if they’ve taken MDMA the day before and are temporarily depleted, it’s easier to climax. When women take SSRIs, it’s not only harder to climax, but for many women, it’s harder to feel sexual pleasure or get horny. I have patients tell me they’re less interested in sex, their pelvis feels numb, or it’s nearly impossible to climax.” 

You get off the meds, and then you quite literally get off.

knew that during high school I would masturbate an average of three times a day, and while I had to use my hand to rub my clit sometimes, I also knew I had gotten off during oral, vaginal, and anal sex without using a vibrator. (There’s no shame in using a vibrator during sex; I think more women should. But what if you’re up against the fence at Williamsburg Waterfront and just don’t have it on you?) Yet when I was on Lexapro, a commonly prescribed SSRI, I did not know that girl. Sex became something I did because I knew I was supposed to, rather than because I felt my clit would explode if I didn’t have that hot man in me right this second. “I guess when you’re super depressed your sex life seems not that big of a deal, but when you’re a functioning human being and part of society again you’re like, ‘No, this is actually a pretty key thing that I’m missing out on,'” says Claire, a 29-year-old living in Brooklyn who has also experienced the SSRI chastity belt via Prozac. “I would have sex with the men I was dating because I thought, This is what you should do in a relationship, but it wasn’t really fulfilling. You kind of forget what sex is like. Then you go back [get off the meds] you’re like, ‘I remember!'” 

You get off the meds, and then you quite literally get off, which is exactly what happened to me when I finally weaned myself off Lexapro over the course of a month. Unfortunately, my sex drive came back just around the time my relationship was ending. My ex had often complained that he didn’t always feel we were on the same page sexually and he hated that he couldn’t get me off, so it was a shame he left just as my orgasms were coming back full force. 

“It would have been different. It definitely would have been different,” says Dr. Helen Fisher, a biological anthropologist from the Kinsey Institute, when I ask about whether going off Lexapro earlier might have changed our sexual chemistry. “Orgasm is really important for a relationship. It makes you like the person! It makes you trust the person; it makes you want to be with the person; it makes you feel warmth towards the person; it evolved for very obvious reasons, which is to make you want to do it again to be close to somebody and hold somebody. When you’re hugging somebody and holding somebody, oxytocin is going up in the brain. Oxytocin is associated with feelings of attachment and calm, and right before orgasms there is a spike of norepinephrine and dopamine that is going to give you feelings of optimism, and energy, and focus, and motivation, and then of course after orgasm there’s a real flood of oxytocin again and that gives you a feeling of deep attachment to a partner. So there’s a reason that men want women to have an orgasm,” explains Dr. Fisher. 

Ross, a 32-year-old New Yorker whose girlfriend took 20mg of Lexapro, agrees. “You can understand it’s science, but it [was] still hard not to take it personally when I couldn’t get her off,” he says. 

Before I regale you with the joy that is the second puberty experienced when flushing all those nasty orgasm police pills out of your system, it’s crucial to note that they do save lives; quitting cold turkey without discussing with your doctor is a no-no. “Some people really need these drugs,” says Dr. Fisher. “They need them to get out of bed in the morning, to make the effort to go find a sweetheart.” 

However, this is not always the case. “Data shows that 70 percent of people who are on these drugs don’t really need them,” Fisher says. “They [get] back on their feet, and they [keep taking them] because they have the feeling of calm and stability, so they stay on them long-term. [But] when you stay on them, you can jeopardize yourability to fall in love and stay in love.”

Yes–there’s more than sex at stake here. SSRIs could be screwing up what humans are already very bad at: finding and maintaining a loving relationship. “If you aren’t interested in having sex, or you’re having less pleasure when you do have sex, it’s going to affect your relationships, obviously. There is even some suggestion that it affects whether women make themselves available for sex when they’re dating, or whether it can affect that angsty/horny feeling when you fall in love with someone,” says Dr. Holland. “Human female subjects on antidepressants spend less time poring over faces of potential male dating partners than the women who are unmedicated.”

SSRIs could be screwing up what humans are already very bad at: finding and maintaining a loving relationship.

Over the course of the month that I quit Lexapro, it felt like a sexual re-awakening. “My patients who have weaned off their SSRIs are happy to report they can climax more easily,” says Dr. Holland. “It’s nice to be able to enjoy sex again, and to connect with your partner on that physical, and often spiritual, level.” Skylar, a 28-year-old from Richmond, knows what the doc is talking about. After giving Zoloft a shot for anxiety attacks, she stopped using it because she decided she’d rather be anxious and having orgasms. “Within a matter of a few weeks I was back to normal in the sex department,” says Skylar. 

Claire, the 29-year-old Brooklynite who was on Prozac, concurs. “I noticed [my sex drive return] more when I was just masturbating by myself, because I [was single] at the time. [I would be] watching porn and using my vibrator and being like, ‘This is amazing!”’ 

While most women return to orgasm-land with a vengeance after being on SSRIs, however, some never come the same again. Post-SSRI sexual dysfunction (PSSD) is a nightmare in reality, in which patients’ sex drives and functioning can take years to return to normal after being on SSRIs. Some patients never feel the same again.

“It’s frustrating that they haven’t found a pharmaceutical cocktail that can be so beneficial for anxiety without those side effects,” Skylar tells me. The good news is there is one antidepressant that can actually promote sexual desire and function: Wellbutrin. “Well, the makers of Wellbutrin don’t really cop to the mechanism of action of their antidepressant, only describing it as ‘non-serotonergic,'” says Dr. Holland, “but it seems as though [it has] an action that increases dopamine levels.

“For many of my patients, they are much happier with the effect of Wellbutrin on their sex lives, over the SSRIs,” Dr. Holland continues. “Wellbutrin can also help to cut appetite and improve focus and concentration. Where it’s weak is in treating anxiety, and especially treating obsessive symptoms. The SSRIs are much better for that.” Not to long after I stopped taking Lexapro, I tried Wellbutrin and had three orgasms during sex on my yoga mat–two clitoral, and one cervical, which until then I didn’t actually believed existed. (Thank you, makers of Wellbutrin.) I stopped Wellbutrin because, as Dr. Holland says, it sucks for anxiety, which is my main enemy at the moment.

After a fuck ton of therapy, quitting drinking, and developing a mindfulness practice (seriously), I’ve earned the bragging rights to say that now, sans SSRI or Wellbutrin, I’m just a little bit nuts. The renewed ability to orgasm is probably helping to keep me so fucking cheery, too. “Orgasms do create a bit of a ruckus with neurotransmitters and hormones,” Dr. Holland says. “In particular oxytocin and endorphins, though the endocannabinoid system may also be involved. They do help to relieve stress, obviously, which is likely therapeutic. And yes, there is a study showing that sperm, when deposited in the vagina, can have antidepressant effects. 

“Much of the brain even shuts down when you’re having an orgasm,” she continues. “It’s a very deep experience.”

A Brief Note on World Mental Health Day

Today is World Mental  Health Day. In case you didn’t read and pick up on this from my last VICE column about death and thinking I had no friends, I had been acting rather depressed, whiney and was feeling quite jaded about humans. OK, I was acting a bit like a spoiled brat. I had hurt people, I had been hurt. Cue Johnny Cash, in the one cover I prefer to the original: “I will let you down, I will make you hurt.” 

A while back I wrote of the time my kitty, Mama Cat, who was once upon a time a homeless teenage mom, had bit me and sent me to the hospital. She didn’t want to intentionally hurt me, she bit me because I had left her alone for Christmas, felt abandoned and was going through her own issues. Her biting response was instinctual. While our bodies, brains, and experiences vary vastly from a house cat, we are still animals. It is a cliché, but there is truth to “It’s not you, it’s me.” Often when we hurt others it is because we are reacting from a place of pain, and when someone else lets you down, you must remember they are dealing with their own struggles. Sometimes the best way to be there for someone you care about is to give them their space and let them heal. Just as I would like to be forgiven for the times I acted like an asshole to others, I forgive those who have hurt me, understanding that their actions may be coming from a place of their own pain, and not to take everything so personal. 

Depression, anxiety, or other forms of mental issues are something that most of us, more people than you think, will likely struggle with to some degree from the rest of our lives. This weekend I’ll have a new column go up, one intentionally more about living than dying. I’ve learned you can’t depend on anyone else to fix you, and you can’t truly be there for anyone else until you have healed yourself. For therapy, some people run, others play guitar, some paint, I write. To write I must experience, because as great as Netflix is, reruns of shows I’ve already seen don’t provide the same creative inspiration of the oddities I encounter when I leave my apartment.

Whatever your therapy is, tonight, and as many nights as you can, get out there and do it. And may we forgive — forgive ourselves for inflecting pain, and forgive those who have hurt us, as we never truly know what someone is going through, and kindness and forgiveness provide more healing and emotional freedom than resentment.

Happy World Mental Health Day.