0:03

Welcome

0:03

to the Psychology podcast.

0:06

I am your host, Doc Justin Laymiller. I

0:08

am a social psychologist and research fellow

0:10

at McKinsey Institute and author of

0:12

the book. Tell me what you Notte. The science

0:14

of sexual desire. and how it can help you improve

0:16

your sex life.

0:18

It is well known that depression and certain

0:20

drug treatments for depression such as selective

0:23

serotonin reuptake inhibitors or

0:25

SSRIs can lower sexual

0:27

interest, sexual desire, and

0:29

sexual activity levels. However,

0:31

it turns out that the story of how depression

0:33

and sex are connected is more complicated

0:36

than this. Depression is one

0:38

of those things that can affect different people in

0:40

very different ways. Research

0:42

actually finds that depression can potentially

0:44

increase and decrease sexual

0:47

activity. So how do we explain

0:49

this pattern of results? Why does

0:51

depression reduce the veto for some people,

0:53

but increase it for others? That's

0:55

what

0:55

we're going to be talking about today.

0:58

I

0:58

am joined by JoEllen Notte, a writer,

1:00

speaker, and mental health advocate whose

1:02

work explores the impact of depression on

1:05

sex and relationships. Since

1:07

two thousand twelve, she has written about sex,

1:09

mental health, and how none of us are broken

1:11

on her award winning site, the Redhead,

1:13

bedhead. Joellen is the author

1:16

of the monster under the bed. Sex,

1:18

depression, and the conversations we aren't having,

1:21

as well as the upcoming book in it together,

1:23

navigating depression with partners, friends,

1:26

and family. This is going to be

1:28

a fascinating conversation. stick

1:30

around and we're gonna jump in right after the

1:32

break.

1:36

Health care training programs usually include

1:38

some information about gender and sex trueity,

1:40

but few of them give you adequate training if your goal

1:42

is to become a sex therapist or educator.

1:45

This is where the modern sex therapy institutes

1:47

can help. MSTI offers

1:49

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1:51

well as multiple certification programs in

1:53

sex therapy and sex education for mental

1:56

health and medical professionals. All

1:58

trainings can be completed one hundred percent

1:59

online. Whether

2:01

you're looking for certification or simply

2:03

an opportunity to build and expand your knowledge

2:05

base, MSTI can help. For

2:07

more information on their programs and offerings,

2:09

find the link in the show notes or visit modern

2:11

sex therapy institutes dot com.

2:19

If you love the science of sex as much as I do,

2:21

consider becoming a friend of the Kinsey Institute

2:23

at Indiana University. The Kinsey

2:25

Institute is the world's premier research organization

2:28

on sex and relationships, and you can help them

2:30

continue the legacy of doctor Alfred Kinsey.

2:32

whose pioneering research changed everything

2:34

we think we know about sex. Visit

2:36

kenseyinstitute dot org to make an impact.

2:39

Your donations can help support ongoing research

2:41

projects on critical topics. You can

2:43

also show your support by following Kensey Institute

2:45

on Facebook Twitter, and Instagram. Thank

2:48

you for supporting sex science.

2:53

Hi, Joellen, and welcome to the Sex and Psychology

2:55

Podcast.

2:56

JoEllen, and thank you so much for having

2:58

me. Thank

2:59

you so much for joining me. It is a pleasure

3:01

to finally meet you. So

3:04

I'd like to begin our conversation by having

3:06

you tell us a little bit about yourself and

3:08

your professional journey. It looks

3:10

like we both became professional sex

3:12

writers around the same time. about twenty

3:14

twelve or so. So what is it that

3:16

led you to start writing about sex in the first

3:18

place? Okay.

3:19

So I'm a failed theater kid.

3:22

Right? So I basically spent

3:24

my twenties bouncing around kinda not knowing

3:26

what I was doing. I I got out of

3:28

theater because it was nothing like the puppets and

3:30

I started teaching yoga because

3:32

that's what basic girls did in the early two

3:34

thousands. And then I had this big

3:37

life implosion in two thousand eleven.

3:39

I got divorced, my father died, like

3:41

everything hit the fan all at

3:43

once. And I started

3:45

thinking I have to figure out what I'm gonna do with

3:48

my life. And then one night, I'm sitting at the bar with

3:50

friend and we're talking about these guys we're seeing

3:52

and I turned to her and I said, I'd

3:54

love to be able to just sit and talk about sex

3:57

all the time, but I have to go figure out what I'm Notte do

3:59

with my life. And it took me about

4:01

twelve hours till, like, my workday

4:03

the next morning. for

4:04

it to hit me that what I wanted to do was

4:06

talk about sex. And because

4:08

it was a topic I always felt

4:10

out of the loop on and and, like, I didn't

4:12

know enough and whatever, I thought

4:15

other

4:15

people probably felt that way too. And

4:17

if I could make this website where I

4:19

learned things, and as I learned them, I could say,

4:21

hey, I learned this. You should know it too.

4:24

that would be cool and

4:25

fun for everybody.

4:26

And that's kinda how I got started

4:28

as the red had been hit. Well,

4:30

I love that because everybody

4:33

Notte everybody. But most people like to talk

4:35

about sex, and they like to learn about

4:37

it. But there aren't a lot of great resources

4:39

out there. And so it's great to have people who are

4:41

sharing helpful educational tools

4:44

and resources for helping people to better

4:46

navigate their intimate lives. Now,

4:48

as I mentioned at the top of the show, we're going to talk

4:50

about depression and sex today.

4:53

So you've written extensively about

4:55

sex and mental health. And the

4:57

basis for a lot of your writings has been this

4:59

set of surveys and interviews that you conducted.

5:02

So can you start by telling us a little bit about

5:04

how many people you've talked to over the years

5:06

and the kinds of questions that you ask them?

5:09

Sure. So it started in twenty

5:11

fourteen when I did the first survey, and

5:13

that was like a typical, like, multiple

5:15

choice questions

5:16

type of survey. And

5:18

I asked people about their

5:21

depression history, the ways

5:23

it showed

5:23

up in their sex life, the things their

5:25

doctors told them about in advance, the things

5:28

their doctors didn't tell them about in advance. And there was

5:30

even a really elaborate section on,

5:32

like, sexual activities you usually

5:34

like and what that looked when you were depressed

5:36

that I ended up not using because the whole project

5:39

changed. But I did that under

5:41

the supervision of a psychotherapist

5:42

named Steven Biggs, and

5:44

he worked

5:45

with me, I would go to him and I'd say, can I

5:47

ask people this? Is this ethical? Is this cool?

5:49

Whatever. And I put it

5:51

out and I thought, okay, it'd be great if I could

5:53

get a hundred responses. And I

5:55

got eleven hundred

5:56

responses, which was amazing.

5:59

So at the end of

5:59

that survey, there was a little

6:02

thing

6:02

you could fill in if you were willing to

6:04

be interviewed by me. and

6:06

five hundred people said they wanted

6:09

to be interviewed. So made a hundred

6:11

interview slots available, and then

6:13

because we're dealing with people coping with depression

6:15

who are not super great at keeping appointments.

6:18

Twenty of those people showed up.

6:20

So after that, for my

6:23

subsequent interviews, I made

6:25

kind of like an essay question survey.

6:27

Right? An interview that people could answer

6:30

on their own time from their computer. They didn't

6:32

have to make an appointment. They didn't have to show up.

6:34

And that resulted in another

6:37

two hundred people. So altogether, it's

6:39

been over ten hundred people.

6:41

So

6:41

it sounds like a lot of people want to talk

6:43

about their experiences with

6:45

depression and other mental health issues and

6:48

how that intersects with their sex lives. And

6:50

I'm not surprised by that because both depression

6:52

and sex are taboo topics.

6:55

And we often don't have a lot of

6:57

outlets or safe spaces where we can

6:59

talk about these things. And sometimes, it

7:01

feels easier to talk about these things online

7:04

to a stranger over the Internet. You know, I think

7:07

that's part of the reason why I get so many

7:09

people who sign up to be in my sexual fantasy

7:11

studies because a lot of people

7:13

just don't have anyone that they feel like

7:15

they can share their fantasies with. And so having

7:17

that opportunity for catharsis or

7:20

just the ability to talk about some of these

7:22

complex issues that they don't otherwise get to

7:24

talk about can be therapeutic in

7:27

some ways. So as I mentioned

7:29

at the top of the show, depression is one of those

7:31

things that can have different sexual effects

7:33

on different people. However, most

7:35

people think about depression as something that

7:37

lowers interest and sex, and

7:39

it often does. So let's talk

7:41

about that first. Can you give us a sense

7:44

of how common this is? And

7:46

also, what are some of the reasons why

7:48

depression might lower interest in

7:50

sex? and let's not get into the medication

7:52

stuff yet because I wanna dive into that in a few

7:54

Notte, but just depression in general

7:56

and why it might lower libido.

7:59

This

7:59

is an interesting

7:59

thing and it tells a lot about how we

8:02

as a society kind of view

8:04

sex and our libidos and Notte. Because

8:06

we really had to separate

8:07

out the feelings about

8:09

sex that happened when you're not medicated versus

8:12

the feelings about sex that happened due

8:14

to medication. and they all

8:16

get lumped together and called lowered libido,

8:19

but a lot of times with

8:21

depression, the less

8:23

interest in sex can have to do with

8:25

lower self esteem, it can have to do

8:27

with the fact that depression just makes everything

8:30

seem hard. Right? So you can think, Notte, I'd

8:32

love

8:32

to have sex, but I'd have

8:34

to get up and take off my pants and it

8:36

just all sounds overwhelming. So, no.

8:39

And depression can also take

8:41

away the flavor of everything. Right?

8:43

Everything seems kind of mass. So

8:46

what's the difference? Based basically,

8:48

it's a different experience

8:49

than that thing where sex

8:52

just feels foreign and you don't even think

8:54

about it. And those can both happen in the course

8:56

of depression and its treatment. But it's important

8:58

to be able to separate them if you

9:00

want to kind of navigate your sex life

9:02

while coping with depression.

9:04

Yeah. And so there are a lot of different

9:06

reasons why depression might

9:08

have that libido lowering effect

9:10

for some people. And some of the other

9:13

work that I've seen suggests that part

9:15

of it might have to do with people's coping

9:17

strategy for depression. And

9:19

so some people are what we call internalizers

9:22

where they kind of turn inward. And

9:25

that seems to be related to

9:27

lower levels of sexual interest in

9:29

behavior, whereas other people

9:31

are externalizers. They look outward.

9:33

And so that's where we might

9:35

see people engaging in very

9:38

different levels of sexual activities. So

9:40

coping strategies might also be part of story

9:42

here as well. Yes.

9:43

And this was a big thing that I

9:46

didn't know Doing all the research

9:48

for the first book was a huge learning

9:50

experience for me because I went in

9:52

saying what a lot of people say. We know

9:54

how depression and fact sex it makes you want

9:56

it less. And it wasn't until that

9:58

first round of interviews when

9:59

a quarter of the participants talked about

10:02

wanting sex or having sex more when they

10:04

were depressed, but it even occurred to me to

10:06

ask about that. Howard Bauchner: Yeah,

10:07

and I think that's such an important

10:10

point that when it comes to conducting

10:12

surveys, the quality of the

10:14

data, the risk responses that you get is gonna

10:16

depend on the questions that you're asking.

10:18

And if you don't ask the right questions

10:20

or have the right response options, you might

10:22

be missing very important pieces of information.

10:26

And I found that in lot of my research,

10:28

by having some open ended questions in

10:30

there, where you say, for example, is there

10:32

anything else you would like to tell me about this particular

10:34

topic and how this intersects with your life?

10:36

You often find, oh, there are

10:39

things that I didn't realize because,

10:41

you know, we all carry our own world views

10:43

or biases into the way that we construct. questions,

10:46

we do the best that we can in terms of trying

10:48

to capture diversity and experience

10:51

and so forth. But sometimes, you just don't

10:53

know because you've never thought about something for?

10:55

So is it through qualitative questions

10:57

that you kind of learned that there is this

11:00

depression horniness effect?

11:02

Yes.

11:02

So one thing I noticed in the

11:04

actual initial survey is that anywhere

11:06

where there was a box where you could tell me

11:08

more or like anything didn't cover

11:10

people jumped on that, and that's

11:12

how I knew people were so excited to talk about

11:15

this. And it gave me a little

11:17

inkling that I had missed the thing about

11:19

increased libido or, you know, having

11:21

more sex. But it was

11:24

really it was those interviews, the

11:26

stories people told. And, you know,

11:28

the ways people analyze their own feelings

11:30

and said, like, when I get

11:32

depressed, I really want to, like,

11:34

that comfort that I feel from Saxons.

11:36

And that made me learn that Notte

11:38

only did some people have more sex, but there

11:40

was a whole range of reasons why

11:42

that happened. Yeah.

11:44

And so I'd like to talk a little bit more about

11:46

some of those specific reasons. So you said

11:48

about a quarter of your participants said

11:50

that they get corny or they're more interested

11:53

in sex. when they're depressed. And

11:55

as I mentioned, part of this might be due

11:57

to their coping strategy. Maybe some of these folks

11:59

are externalizers where they're looking

12:01

outward for ways of coping and

12:04

dealing with their depression. But

12:06

as you mentioned, it could also be just wanting

12:08

to seek comfort So what are some other reasons

12:11

why people who might be depressed

12:14

might be even more interested in sex or

12:16

engage in higher levels of sexual behavior?

12:18

what

12:18

I noticed was that some people,

12:21

they

12:21

found good things and sex for them.

12:23

Right? They felt like there was a good payoff.

12:26

A couple other people reported almost,

12:29

sex is like a self harm, thing

12:31

like they went out and they pursued dangerous

12:33

sex or they put themselves in situations they wouldn't

12:35

normally because, like,

12:37

fuck it all. I'm so depressed. So

12:40

that was really eye opening too. That,

12:42

like, There's not a universal because

12:44

the world tells us so often, have sex. Sex

12:46

is good.

12:47

You like sex. Sex is good for

12:49

us. And there can be situations where

12:51

great sex is amazing for us, and there can be

12:53

situations where sex is

12:55

not such a great thing at that moment.

12:57

Yeah.

12:58

It is so true. And this has

13:00

me thinking about some other research that I've

13:02

read. And what we

13:04

see in the literature on depression

13:07

Notte is that, yes, some people do

13:10

go out and seek sexual behavior because they're looking

13:12

for that comfort or because we know that

13:14

sex can have a mood boosting

13:16

effect on people. People tend to experience

13:19

a sexual afterglow that can last twenty

13:21

four to forty eight hours where there's this sort of

13:23

mood elevating effect of sexual behavior.

13:26

So for some people, it might be about that.

13:28

But there are also, as you mentioned, some people

13:31

who kind of seek out more dangerous and

13:33

risky sexual activities. So there is that

13:35

link too for some people where depression

13:37

can lead to engagement in risky sexual

13:40

behavior such as having more unprotected

13:42

sex or in some cases putting themselves

13:44

in dangerous situations. There

13:47

is a paper I read last year on

13:50

sex as self injury published

13:52

in the Journal of Sex Research, and it was

13:54

about these folks who go

13:56

out and intentionally put themselves in

13:58

very dangerous sexual situations

14:01

where abuse and violence and other things

14:03

like this can happen. And

14:05

it's not the same as seeking out BDSM

14:07

because BDSM is consensual king.

14:09

things are negotiated in advance. These

14:12

people will go into these situations. They don't

14:14

have safe words. They don't have that discussion beforehand.

14:16

So this is something different. And

14:18

oftentimes, it is about wanting to punish

14:21

the self because they don't feel worthy.

14:24

And they do this. They engage

14:26

in these very intense and risk key behaviors

14:29

and that in the

14:31

moments might, you know, sort of, provide

14:33

that sensation that they're looking for. But

14:35

in the end, it actually makes them feel worse.

14:37

because then they regret the behavior that

14:39

they did. So it can become this

14:41

thing where, you know, people might seek

14:43

out sex to deal with their

14:45

depression, but then they end up feeling

14:47

more depressed than they had because they regret the

14:49

behaviors that they engaged in. So it can

14:51

be very complex. when we're

14:53

talking about this. Howard Bauchner: And

14:55

I think this is the importance of

14:57

community and the importance of

14:58

good BDSM education and

15:01

and stuff be because there were the

15:03

people who talked about how, you know,

15:05

they were members of like dungeons or

15:07

they had their kink community. and

15:10

in that quest to feel something.

15:12

They got more into impact play,

15:15

electro stimulation, whatever. And

15:17

in the container

15:18

of a trusted community where

15:21

they felt safe. It was

15:23

a good outlet, but

15:25

I can Totally see that going

15:27

the wrong way. If you don't have that

15:29

space and you don't have the education on

15:31

that going in.

15:33

Yes, absolutely. So it is one

15:35

of those things where people might be

15:37

seeking out that sensation, wanting to

15:39

feel something. And there can

15:41

be different ways to go

15:43

about this. And, you know,

15:45

I think going that consensual kink root is

15:47

one thing. But for the people who are really using

15:50

sexist self injury. That is the

15:52

whole other issue that's

15:54

I think can be further damaging to their

15:56

mental health. Now depression

15:58

in and of itself, as we've discussed, can

16:01

affect sexual desire and sexual activity

16:03

levels, but some depression treatments

16:06

specifically the usage of antidepressants can

16:08

be another factor that affects someone's sexuality.

16:11

Now, there are a few different kinds of antidepressants.

16:14

Perhaps the most common are the SSRIs,

16:17

which target the neurotransmitter serotonin

16:19

in the brain, which is important for regulating

16:22

mood. However, there are some antidepressants

16:24

that target a different neurotransmitter entirely,

16:27

specifically dopamine. So

16:29

what can you tell us about the sexual side

16:31

effects of these different kinds of antidepressants?

16:34

So

16:35

I'll be honest, because

16:37

I'm not a doctor. I

16:39

didn't feel super comfortable getting into

16:41

the, like, the intricacies of the different medications.

16:44

So what I

16:45

did learn was that there was

16:47

one medication that the people

16:49

from the I had more sex while I was depressed

16:52

camp, reported using. And

16:54

then there was a lot of talk about, but

16:56

I considered the three different categories

16:59

of side effects that came from SSRIs. Is

17:01

that at all helpful? I feel like I didn't

17:03

really answer that question. yeah,

17:05

so it is the dopamine targeting

17:09

antidepressants that tend to be related

17:11

to those increases in sexual

17:14

interest in in sexual behavior. But

17:16

the ones that target serotonin tend to have

17:19

this very different set of sexual

17:21

effects. And as you mentioned, there are three of them. You know, it

17:23

can impact your level of sexual

17:25

desire, you know, just your overall interest and

17:27

sex, but it can also have the

17:29

effect of making it difficult

17:31

to become aroused or stay aroused and

17:33

also to have an orgasm. And

17:36

for some people, that orgasm delaying

17:38

effect of SSRIs is actually a desirable

17:41

side effect. So there are some men who

17:43

will take SSRI's as a treatment

17:45

for premature ejaculation even though

17:47

they're not depressed because they want that

17:49

orgasmic delayed effect.

17:52

but by taking antidepressants then

17:54

that can also create those issues with sexual

17:57

desire and sexual arousal. So,

17:59

you know, in terms of getting that

18:01

desire delay in orgasm, you might

18:03

have this trade off with some other sexual side

18:05

effects. So when we're talking about

18:07

the link between depression and

18:10

sex, you know, part of it is depression itself,

18:12

part of it is the treatment that you might be seeking

18:14

for depression as well. Yeah,

18:16

and I always say, I break

18:18

them up into categories. Right? So there's the side

18:21

effects that are the feelings about sex. So

18:23

you're feeling differently about sex than you usually

18:25

do. there's the set of orgasm side

18:27

effects. Right? So the an orgasm yet,

18:29

the delayed orgasm, and my personal

18:31

favorite that I learned about doing this research

18:34

strange orgasm or abnormal at

18:36

orgasm, weird orgasm. I always

18:39

say it like their orgasm's gym, but not as we

18:41

know them. People gave these great descriptions

18:43

that were really visceral of, like, I

18:45

knew it was an orgasm but it wasn't satisfying

18:48

or it didn't actually feel

18:49

good or it just felt different.

18:51

And then the third thing I always say is

18:53

the, like, things that change how your

18:55

body functions. So the erectile dysfunction,

18:58

the the loss of lubrication. general

19:01

numbness, which isn't numbness like

19:03

traditional, like, pins and needles, but it's more

19:05

like, you know, that vibrator you usually use,

19:07

you just suddenly can't feel it doesn't do

19:09

anything. So there's like a

19:12

whole host of ways SSRIs

19:14

can mess up your sex life.

19:16

Yeah. It's so interesting. I

19:19

have read a lot about the impact

19:21

of SSRIs on delayed orgasm,

19:23

but not so much about how changes the actual

19:25

sensation of orgasm, which is

19:28

super fascinating, and I think could actually

19:30

be really distressing to some people if, you

19:32

know, orgasms are, for

19:34

many people, one of the most intensely pleasurable

19:36

things you can experience in life. And then

19:39

if you're taking this medication treatment and then

19:41

you're losing that pleasure source. You

19:43

know, you can see how that could be distressing,

19:45

but it could also lead to less interest

19:47

in sexual behavior because it's not as rewarding,

19:50

you know, part of the reason why lot of us seek

19:52

out sex is because we want that orgasm.

19:54

We want that intense feeling that we get

19:56

from it. So

19:58

let's talk about healthy ways of navigating

20:00

sex and depression. Whether

20:03

you're depressed and horny or depressed

20:05

and lacking the beetle, both of them can

20:07

potentially be distressing. And

20:09

I know some people might be thinking that, well,

20:11

being corny doesn't sound like a problem,

20:14

but it can be. Right? So for

20:16

some people, who might

20:18

have this depression hoardingness effect, as

20:20

we've mentioned, they might go out and engage

20:22

in behaviors that they later regret. And

20:25

sometimes these people will label themselves

20:28

as sex addicts. And

20:30

sex isn't really the problem for them. It's

20:32

that they have this underlying mood issue.

20:34

And if that mood issue isn't treated, they

20:36

mistakenly label the sex as the problem.

20:39

Right? And so we see in lot of

20:41

clinical settings that sometimes people

20:43

are just looking at sex and saying

20:45

here, sex is the problem or high levels

20:47

of sexual interest and behavior, but it's really the

20:50

underlying mood issue that needs to

20:52

be addressed. So at any

20:54

rate, let me ask you this question. What do you want

20:56

people to know when it comes to taking

20:58

control of or reclaiming their

21:00

sexuality when they're depressed?

21:02

Okay. So this is important folks.

21:05

A lot of people will tell you, you know, there's lots

21:07

of articles out there that say, if you're depressed

21:09

and you're you've lost interest and sex, just

21:11

do it. just do it because sex is good

21:13

and you'll remember you like it and whatever. And

21:16

that's dangerous on a couple of levels. One,

21:19

It tells the extra horny people that might

21:21

be engaging in unsafe behavior.

21:23

You're fine. You're doing well because sex

21:25

is the thing you're supposed to be doing.

21:27

So good for you, and that's not

21:29

really helpful for those people. But for the

21:31

people who don't want sex

21:32

and who already have depression, an

21:34

illness that tells you you matter less than

21:36

other people

21:37

your needs aren't important. It

21:39

tells

21:39

them to suck it up and do something

21:41

they don't wanna do that their brain might

21:43

be screaming, know about. because

21:45

maybe it'll work out and feel okay.

21:48

But the thing is maybe it won't. And then

21:50

you're in a worse place than where you started.

21:53

So the important thing is to not

21:55

just do it, but also not do the, like,

21:57

depression means don't wanna have sex. I know

21:59

that. That's

21:59

just how it is thing. So don't

22:01

just do it. Don't just not do it.

22:04

make conscious decisions about sex.

22:07

Check-in with yourself a little

22:09

every day. I know people get a little weird

22:11

about, like, scheduling sex stuff because that's

22:13

not sexy, but check-in a little

22:15

every day. And you can see

22:17

how do I feel today. Does sex feel completely

22:20

foreign? I don't even want to engage in it.

22:22

Okay. I don't push that today. Does

22:24

sex sound like it would be a lot of work,

22:26

but also, Notte, I kinda miss sex?

22:29

Maybe you can work with that. And the

22:31

bonus of all of this is if you have a partner,

22:34

you can bring them in on this conversation and

22:37

it stops that thing where you're just not

22:39

having sex and it becomes a hot

22:41

button issue and it snowballs and

22:43

everybody's upset and resents each other

22:45

and makes it an ongoing conversation so

22:48

they can know that you haven't

22:50

forgotten about them. You're not not attracted to

22:52

them, but this is where your brain is at this

22:54

moment when it comes to sex.

22:56

Let's

22:56

talk a little bit more about how to communicate

22:59

with a partner about sex

23:01

when you're depressed. For a lot

23:03

of people, this is something that they really

23:05

struggle with. you know, how do I even

23:07

vocalize to a partner that I'm

23:10

feeling this way? You know, because

23:12

there's a lot of stigma associated with

23:14

mental illness and mental health issues more

23:16

broadly. So do you have any tips or advice

23:18

you can share on just kind of how to get that

23:21

conversation started in the first place?

23:23

So I think it's important to establish

23:26

the communication around depression kind of over

23:28

the whole relationship, and then you're in

23:30

a great position to apply it to sex.

23:32

So the thing I always say, especially

23:35

for couples, is, you know,

23:37

we tend to fall in this trap of like,

23:39

I see me over here and you and

23:41

your depression over there. and

23:43

we're against each other. But you

23:45

wanna get on the same team. Right?

23:47

So it's the two of you over here and the depression

23:50

over there. And that gives you that ability

23:52

to talk about, okay, this is how

23:54

the depression's showing up right now. And

23:56

then that can easily be applied

23:58

to sex. So

23:59

it doesn't feel like

24:01

Out of the blue, everything's changing and

24:03

nobody understands why and people are mad.

24:07

I know that that's like a tall

24:09

order for lot of people. I'm like, just take these

24:11

two really difficult conversations and just

24:13

have them. But if

24:15

you take the baby steps towards normalizing

24:18

it, eventually it just it does become

24:20

a thing that you know how to talk

24:22

about. You have the vocabulary. I also

24:24

say adopt a new vocabulary. Right?

24:27

So I use a thing called spoon theory.

24:29

which is very popular in the chronic illness community.

24:32

Right? And it basically communicates

24:34

the amount of mental, emotional, physical,

24:36

whatever energy you have in

24:39

spoons. Right? So because

24:41

I have depression, showering in

24:43

morning might take me two spoons where it takes

24:45

my boyfriend half a spoon. So

24:48

I've run out of energy faster. And

24:51

when we got used to that, my boyfriend

24:53

was able to say to me, like, okay, do you have the spoons

24:55

to talk about this? or I could say, you know what?

24:57

I don't have the spoons for sex right now.

25:00

And it would give us a way to communicate

25:02

that we both understood that was really

25:05

like an easy shorthand. Yeah.

25:07

I love that idea and,

25:09

you know, sort of having these handy

25:11

tips or tricks for just kinda getting that

25:13

conversation started or a new language for

25:15

discussing this with a partner can be so important.

25:18

Now one other question about navigating

25:21

sex and oppression. goes

25:23

back to the issue of antidepressants and

25:25

depression treatments. And as

25:27

we mentioned, sometimes people experience sexual

25:30

side effects. So part of the communication

25:32

here also has to be with your healthcare provider

25:35

or whoever you're working with when it comes

25:37

to managing depression or

25:39

other mental health issues. So do you have any

25:41

tips or advice in terms of, you know, how do you

25:44

work with your healthcare provider to

25:46

make sure that you're getting the best possible

25:48

treatment, but you're minimizing any potential

25:50

sexual side effects. Howard Bauchner: So

25:52

I learned something very valuable about

25:54

a year

25:55

before I started doing the research for

25:57

just book. I was a brand new sex writer and

25:59

I got put on a

25:59

new antidepressant and it took away

26:02

my interest in sex, my ability to orgasm,

26:04

all of those things. And as a brand new

26:06

sex writer, I was on a mission to talk about

26:09

sex as openly as possible. So I marched

26:11

into the office of this doctor

26:13

who was a Boston man in his eighties,

26:15

and I said, I can't

26:17

have orgasms and that's unacceptable. And

26:20

he said to me, you know,

26:22

most people don't tell us this

26:24

stuff. And he pulled out this book he had

26:27

that, like, told him the likely side effects.

26:29

And he was like, and the way the information gets in

26:31

this book is we get it from our patients, but nobody

26:33

wants to talk to us about that. So

26:36

my first piece of advice is know

26:38

that your doctor might be really relieved that

26:40

you bring it up. A lot of people think that it's

26:43

gonna be this, like,

26:43

don't go their conversation. But

26:46

before you even have to have that conversation,

26:48

the one big question to ask yourself,

26:50

is how am I feeling on this medication?

26:53

Because you might find that the medication

26:55

is doing wonders

26:57

for you, and

26:58

it has this side effect. And that's something

27:01

you have talked to your doctor about, but you might also

27:03

find that this medication is not doing so

27:05

great for you. And it

27:07

has these side effects, and that's a different

27:09

conversation. The first one is how do

27:11

we make this work? How do we make this tenable? And

27:14

doctors can work with you on

27:16

dosage sizes or the timing of

27:18

when you take the medication because

27:20

those things can all help you kind of sidestep

27:22

some of that stuff. On the other

27:24

hand, they can also work with you to try

27:27

a different medication because don't be discouraged.

27:29

If it takes more than one, it takes a lot

27:31

of people multiple medications to find the one

27:33

that works. And

27:34

it's all part of the process.

27:35

Howard Bauchner: It

27:36

is all part of the process, and I think that's all

27:38

created by us, and these are such important things.

27:41

to keep in mind. Thank

27:43

you so much for this amazing conversation, Joellen.

27:45

It was pleasure to have you here. Can you please tell

27:47

my listeners where they can go to learn more about you and

27:49

your work and get a copy of your books?

27:51

Absolutely. You can find me online

27:54

at redheadbedhead dot com and

27:56

all my information about my books and all that

27:58

stuff is there. I am on

27:59

several social media

28:02

places, Facebook, Instagram,

28:04

Twitter for the time being as just

28:06

my whole name, JoEllen and Notte. Those

28:08

are the places you can find me. Well, thank

28:10

you again for your time. I really appreciate

28:12

having you here and thank you to my listeners

28:14

to keep up with me at to this podcast, visit

28:17

my website, sex and psychology at

28:19

sex and psychology dot com, or subscribe

28:21

on your favorite platform or help take a moment

28:23

to rate and review the show. You can also follow

28:25

me on social media for daily sex research updates.

28:27

I'm on Twitter at justin lamellar and Instagram

28:30

at Justin J. Lay Miller. Also, be sure

28:32

to check out my book. Tell me what you want. Thanks

28:34

again for listening until next time.