New research sheds light on the relationship between depressive symptoms and sexual intimacy challenges in couples. The study was recently published in the Journal of Social and Personal Relationships.

“Several years ago, my PhD advisor, Dr. Leanne Knobloch at the University of Illinois, and I worked on a project to understand how depression affects people’s romantic relationships. We didn’t start with any questions about sexual relationships, but I was really struck by the prevalence of how much people talked about depression disrupting their sex lives and their frustration over what that means for their relationships,” remarked study author Amy L. Delaney (@ProfAmyDelaney) of Millikin University.

“I’m interested in depression because the symptoms of the illness are inherently communicative and relational, so as we started to see the toll depression can take on a couple’s sexual connection, I wanted to know more about how people experienced those challenges and how they coped with them.”

The study surveyed 106 couples in which one or both partners were clinically diagnosed with depression.

Depressive symptoms were associated with greater sexual intimacy challenges for both women and men. Some of the intimacy challenges included difficulties with self-esteem related to sex, feeling sexually distant from a partner, trouble communicating about sex, being unsure how to initiate a sexual interaction, and a decreased interest in sex in general.

Delaney also found that perceptions of interference from a partner mediated the relationship between depressive symptoms and intimacy challenges.

“The most substantive finding from this study was that for couples with depression, there are several ways that couples can encounter barriers to a sexual partnership. It isn’t just a loss of libido in one or both partners, individuals can also deal with challenges related to low self-esteem and feelings of isolation interfering with their sex lives, and couples can struggle to initiate sexual activity and to have conversations about sex in the context of one or both partners’ depression,” she explained.

“Additionally, these data suggested that interference from a partner is the one mechanism that links depressive symptoms to these challenges. Interference from a partner happens when people block each other’s goals, struggle to coordinate routines, and disrupt each other’s day-to-day activities. So for an average couple coping with depression and possibly facing some barriers to connecting sexually, they may want to work on ways to better coordinate those day-to-day objectives and routines as one way of coping with depression’s wide-reaching effects on the partnership,” Delaney told PsyPost.

All research includes some limitations, and the current study is no exception.

“One noteworthy caveat is that the couples in this study represent a subset of couples coping with depression. They were recruited through depression support and treatment outlets, so these are all couples who have depression that has been professionally diagnosed and 80% of depressed participants were currently taking an antidepressant medication. These findings, then, do not represent the experiences of couples who are dealing with depressive symptoms that are either undiagnosed or not treated,” Delaney explained.

“Additional questions also remain related to the range of depressive illnesses that exist, for example major depressive disorder, seasonal affective disorder, postpartum depression, bipolar disorder, etc. Although depressive symptoms (feelings of sadness and hopelessness, irritability, disinterest in activities, feelings of isolation, etc.) are considered common across these diagnoses, peoples’ lived experiences of those symptoms could differ based on the type of illness, particularly when we’re thinking about what those symptoms might mean for outcomes in the sexual partnership and in the relationship overall.”

“On top of that, we know that depressive symptoms are often co-morbid with other physical health challenges like heart disease and breast cancer, so I’m interested in asking new questions about how multiple health concerns might interact in ways that affect people’s sexual connection, and what might that mean for the partnership,” Delaney said.

“I think this research is really important because so much existing research on depression has kind of dismissed sex problems as either just a symptom of the depression or a side effect of antidepressant medication. This line of research, however, highlights ways that sex problems are more complex and nuanced than that, and draws our attention to the relational and communicative processes that might matter here,” Delaney added.

“My hope is that a better understanding of the intricate connections between depression, relationship qualities, and the sexual partnership, we can provide couples with useful tools for maintaining their partnership as they cope with depression.”

The study was titled: “Sexual intimacy challenges as markers of relational turbulence in couples with depression“.