Question: I can’t remember the last time I had a full erection, and my orgasms are mostly “blah.” I’ve always been single, and I’ve avoided having sex with a partner due to the risk of AIDS. Also, I’ve been pretty depressed for years. Could my possible depression be an influence on my sexual situation or are my erectile problems purely a physical issue?
Yes, the mind-body connection is absolutely important when it comes to men’s and women’s experience of sexuality. That’s not to say that physical problems in and of themselves don’t get in the way of sex or cause sexual problems. It is certainly possible that your blood pressure problems are contributing to your erectile problems.
Depression Can Affect Desire
However, the mind is important too. Time and again, researchers have found that even mild depression can interfere with men’s and women’s sexual experiences. Depression can contribute to problems with desire, erections and ease of orgasm.
When people feel depressed, they may more easily allow distracting thoughts to get in the way of their arousal, which can contribute to erectile problems. If you find yourself saying negative things to yourself about your body, your sexuality, your fantasies or yourself more generally, these may be important to pay attention to.
You also made a point to mention that your concern or anxiety about HIV/AIDS has gotten in the way of your being able to pursue a sexual relationship with another person. If you want to be intimate with another person, then it may be important for you to find a way to overcome this anxiety – to realize that through careful decision making one can greatly reduce their risk of HIV or sexually transmissible infections (STI).
For example, you and a partner could use condoms for oral, vaginal or anal sex. You and a partner could also agree to get tested together for HIV and other STIs prior to being sexual together. In addition, you could be careful to only engage in low risk sexual activities together until you feel more comfortable and confident with each other’s HIV status and testing.
In short, you may be able to find ways of managing your anxiety around HIV transmission so that you can pursue a satisfying, healthy relationship with another adult. Yes, there is risk involved in sex – but it is also risky to remain isolated and alone if what you want is to connect with another human being.
You may find it helpful to meet with a therapist who can help you to manage issues related to depression or anxiety as well as your sexual concerns. You can find a trained sex therapist through the American Association of Sex Educators, Counselors and Therapists at www.aasect.org.