by Aina Cagigos Martin | May 8, 2026 | Anxiety, Depression, Health, Mental Health, Relationships, Therapy |
Depression and anxiety can change how you experience sexual intimacy. The low mood, loss of pleasure, and fatigue that come with depression in your daily life can also affect your sex drive, and end up bleeding into the bedroom. This is not uncommon among people with depression or anxiety: a 2022 systematic review and meta-analysis of people with Major Depressive Disorder not on medication found sexual dysfunction in 83% of women and 63% of men.
Sexual difficulties don’t mean you’re broken; it just means that your body and your mind are at capacity, and that is something your therapist can help you with.
How do depression and anxiety affect sexual drive?
Depression and anxiety can both get in the way of intimacy, but they do it differently.
In depression, you might feel like things you used to enjoy don’t feel as good anymore. This is a core symptom of depression that can extend to your sexual life. That’s because depression also comes with changes to your brain and the way it’s connected. The signals between the parts of your brain that handle desire, pleasure, and arousal can get disrupted. What’s more, depression can involve fatigue, changes in your sleep and appetite and sometimes a negative view of yourself, which can also affect intimacy.
Anxiety on the other hand activates your nervous system, your fight or flight mode, and gets your adrenaline pumping to face threats. A little activation can be neutral or even helpful during sex (Bradford & Meston, 2006), but elevated or chronic anxiety keeps your body locked in that state, which is the opposite of the relaxed state needed for arousal.
You might also feel like you can’t focus during sex, like your brain is everywhere. That’s because anxiety comes with worries, and a worried mind can’t stay present with sensations. Your attention might be pulled in many directions, such as self-monitoring, performance, thoughts about body image, or even finances and health. Your brain is too busy to stop and focus on intimacy, and everyday anxiety often morphs into anxiety about how things are going during sex itself.
Finally, antidepressant medication such as SSRIs (Selective Serotonin Reuptake Inhibitors) and SNRIs (Selective Norepinephrine Reuptake Inhibitors) can cause sexual side effects in 58-73% of people taking them. This further complicates the situation: is it the depression, anxiety, the medication or all of it? That would be the kind of question to bring up with your prescriber or therapist.
Should sexual health be part of my therapy?
Mental health difficulties and sexual difficulties affect each other. If you’re depressed, you may be more likely to develop sexual difficulties. And if you have sexual difficulties, you may be more likely to develop depression.
Even so, not all therapists routinely ask about sexual functioning. Many wait to be sure the client wants to talk about it, while clients often wait for the therapist to bring it up, creating an accidental mutual avoidance. But sexual well-being genuinely matters. The research shows that sexual quality of life is linked to overall quality of life and relationship satisfaction. And when it isn’t addressed, it can worsen the very thing you came to therapy for.
How do I bring it up in therapy?
Bringing this up can be hard, especially if it isn’t something you’ve talked about before. But a few things can make it easier:
- Naming the awkwardness is allowed. You can name how you feel about bringing up a topic, be it awkwardness, stress, shame, or guilt. Something as simple as “I’m not sure how to talk about this” is a good way in.
- Naming it once is the hard part. Once you’ve said it out loud once, the topic is in the room, and it gets easier from there.
- Being specific helps. Telling your therapist that something’s off with your sex drive is a good start but they may need more information. The better your therapist knows your problem, the better they can help. That might mean naming what’s changed, when it started, or whether it lined up with starting medication.
- Referral isn’t a rejection. If your therapist thinks this topic would be better handled by someone with specific training in sexual health, that’s not a rejection but a commitment to getting you the right care.
Therapy is your space to bring up anything you feel you need to work on. Talking about sexual difficulties may not be common in your day-to-day life, but it is an important part of your life and is completely normal to bring up in a therapeutic setting.
Not sure where to start? Connect with us today, we’re here for you.
by Fiona Scott | Sep 12, 2023 | ADHD, Anxiety, burnout, Chronic Illness, Chronic Pain, Depression
We’ve all seen articles telling us how to ‘indulge’ in self-care in a curated, Instagrammable, Pinterest-worthy way. You know, bubble baths and pedicures, mojitos with your friends and charcuterie boards. And that’s… nice for those who can manage it. But if you read those articles, and the very thought of all that is exhausting and makes you want to cry, read on… we’ve got you covered.
What is Self-Care?
Here’s the thing: Self-care means anything that you do for your own good. And, just like Maslow’s hierarchy of needs, we can classify self-care in a pyramid.The bottom of the pyramid? Things like: taking your meds, brushing your teeth, getting out of bed (with or without getting dressed), making yourself eat. And if those are too much, try and think of the smallest thing that you could manage to do in your day, and prioritize. It’s probably more important that you eat something and take your meds than get dressed or brush your teeth. Of course, those things are important, too, but when you’re in crisis, you need to choose the absolute essentials.
Once you have the basics covered, the next most important thing is to add in some joyful things which will fill your cup. Are you rewatching all of Star Trek in order? (That’s mine!) Do you like to knit, crochet, paint or draw? Do you have ‘$20 in your pocket’ and enough energy to make it to the thrift store? Can you make it out for a Starbucks with a friend?
Self-Care is Necessary
If you find yourself struggling with self-care, try gently asking yourself why. Are you exhausted and in chronic pain and it’s just physically difficult to do tasks? Are you in the bottom of a depression and shame spiral and you don’t feel like you’re worthy of love and care? Do you feel like any time, effort or money spent on yourself is ‘bad’? Maybe some of these things are issues to take up with your doctor and/or counsellor. If you are struggling with everything, including eating and taking meds consistently, it may be time to make a decision to ask for help.
Make Self-Care a Judgement Free Zone
Things that tend not to be helpful: Beating yourself up about what you ‘should’ be able to do, or listening to helpful relatives suggest that ‘if you just got to bed at a decent time’ you’d be able to do everything with ease. In order to work on making changes in our lives, we first need to accept where we are – without judgement, shame, blame or self-hatred.
It can help to find someone whom you admire who has also struggled with similar issues. For example, one of my favourite authors, John Green, struggles with intrusive thought spirals due to OCD, like I do – and it makes me feel just a little bit better.
Creative Coping
If you struggle with certain self-care tasks, look for alternatives. Please know that many, many people have specific struggles with tasks like showering, brushing their teeth, visiting the dentist or doctor, taking their medications, etc. Instead of looking at those Instagram-perfect lives, use social media to your advantage, and find YouTubers and TikTokkers who understand what you’re going through and can give you some ideas:
Showering: https://www.youtube.com/watch?v=43AH2Toi4Ho
Alternatives to tooth brushing: https://www.youtube.com/watch?v=AJ0YaA9nKGc
Dental care: www.youtube.com/watch?v=atM2PbF4SIs&ab_channel=HowtoADHD
Self-Care with ADHD: https://www.youtube.com/watch?v=w_kOPlMttl4
Neurodivergent self-care: https://www.youtube.com/watch?v=pPrF73fN_oU&ab_channel=fosteronthespectrum
If you struggle to take your meds, think about whether it’s a problem remembering (and put them somewhere you will be sure to see them every day), or a mental struggle (you may have to bribe yourself with a treat, or get a loved one to check in with you to help you to be consistent).
Dentists and doctors: if you have fears or specific issues, it can seem overwhelming to tackle medical appointments. Here’s the time to take your loved ones up on their offer to advocate for you, and let them take care of scheduling, transport, being with you and checking in on you during the appointment if they recognize that you are overwhelmed.
It can be hard to work on decorating your space when you don’t have a lot of energy or motivation, but if you spend a lot of time in your room, it’s important. There are resources which can help you. Try this YouTube video for some good ideas: https://www.youtube.com/watch?v=ABof7aqVSoQ
The Best and Bravest Decision
Deciding to work on self-care is a very brave decision. And one of the best ways to do that is to ask for help. This is often really hard! But you probably know some people who would be happy to help if they just knew what you needed. This might involve swallowing your pride a little bit. It takes courage to let even a trusted person into your space when it’s messy or dirty. I 100% promise you that they are not judging you like you are judging yourself. I also promise you that if they were living your life right now, they’d be struggling, too. This isn’t about your sickness, disability or lack of motivation. It’s about figuring out what you need to in order to create a life worth living.
So, self-care can be hard. And yes, that sucks. But it’s the foundation which will allow you to build towards all the good things that are waiting for you. Remember that every tiny act of self-care you can manage will build up into a forward momentum towards feeling better.
by Nik Stimpson | May 10, 2023 | Anxiety, Connection, Counselling, Depression, Dialectical Behaviour Therapy, Education, Encouragement, Health, hope, Mental Health, Motivation, Positive, Reflection
Finding Hope in a World Full of Challenges
Reflecting on the past year, it’s easy to feel discouraged. We are facing multiple ongoing crises in mental and physical health, the environment, economic inflation, political divisiveness, civil unrest, and war. Social injustice remains rampant. These concerns should not be dismissed, and I want to start by emphasizing that optimism in no way neglects their importance. Nor do encouraging statistics take away from the fact that every needless death is a tragedy.
However, it’s also important – for our own sanity – to consider the good news. I often describe to my clients how our brains are hard-wired to pay more attention to negative events or feelings than positive ones. This is a well-studied psychological phenomenon known as negativity bias. It can lead to rumination and even depression. We recall criticism better than praise. We remember negative events more strongly than positive ones, and think about bad things more frequently than good things. Counterintuitively, our brains do this for our own benefit. It is far more important for survival to know where the dangers are than to take time to appreciate the wonders of life!
We see this reflected in our news and social media: negative and alarming news grips our attention, and so it gets more airtime. We click more frequently on alarming headlines, so they get published more often. This amplifies the illusion that the world is threatening by default.
We cannot make effective change when trapped in a state of despair. To avoid such a toll, it is important to balance our negativity bias with mindful awareness of what’s going well. And it turns out there are many, many good things happening!
Discovering Optimism
One antidote to the prevailing doom-and-gloom narrative of our time can be found in Matt Ridley’s Book The Rational Optimist. He uses hard data and historical analysis to show that we have made incredible progress in recent centuries, and this trend of increased prosperity is likely to continue as we innovate and adapt to ever-changing circumstances.
Another important book is the late brilliant physician Hans Rosling’s Factfulness: Ten Reasons We’re Wrong About the World–and Why Things Are Better Than You Think. He writes:
“Every group of people I ask thinks the world is more frightening, more violent, and more hopeless—in short, more dramatic—than it really is.
Uncontrolled, our appetite for the dramatic goes too far, prevents us from seeing the world as it is, and leads us terribly astray.
Step-by-step, year-by-year, the world is improving. Not on every single measure every single year, but as a rule. Though the world faces huge challenges, we have made tremendous progress. This is the fact-based worldview.”
Such thinking is not new, either. Even back in 1830, British historian Thomas Macaulay posited:
“Hence it is that, though in every age everybody knows that up to his own time progressive improvement has been taking place, nobody seems to reckon on any improvement during the next generation. … On what principle is it that, when we see nothing but improvement behind us, we are to expect nothing but deterioration before us?”
So, what exactly is all this progress that thinkers like Ridley, Rosling, and Macauley are talking about? Here are some examples.
Good News for a Change
Poverty is declining.
Globally, the number of people living below the poverty line (defined as living on less than $2.15 USD a day, in 2017 dollars) fell from 2.01 billion people (37.8% of the population) in 1991 to 648 million people (8.44% of the population) in 2019. It is still too early to calculate precisely how the covid-19 pandemic affected this trend; preliminary estimates indicate it may have pushed 70 million people or about 9% of the population back into extreme poverty in 2020. Yet the overall trend continues as it has for past decades. In 2017 renowned economist Max Roser commented that “Newspapers could have had the headline ‘Number of people in extreme poverty fell by 137,000 since yesterday’ every day in the last 25 years.” For more insights, see his excellent research website Our World in Data.
Population growth is stabilizing.
Although the global population is still growing, the rate of growth has been slowing down since 1968 in an accurately predicted manner. The population is expected to peak somewhere around 10.4 billion people in the year 2100, and then decline. With reduced poverty comes gains in education and health, and declines in child mortality, all of which are associated with lower birth rates.
The rapid decline in child mortality deserves its own emphasis: Hans Rosling once stated that “child survival is the new green.” According to his educational website Gapminder.org, “saving poor children is an important factor in ending both poverty and population growth. The death of children is not holding back population growth. It is one of the reasons poor people still have many children.” People have less children when they do not need to worry about whether or not those children will survive to adulthood.
Medical advancement continues at an astonishing pace.
Life expectancy is rising everywhere. People around the world are living longer and healthier lives, thanks in part to advances in medicine as well as increased access to nutrition and education. From vaccines that have eradicated deadly diseases like smallpox and polio to new treatments for chronic conditions, the progress in medicine is astounding.
For example, new medical technology allows us to identify cancer and other diseases earlier, leading to better treatment outcomes. Targeted therapies are becoming more widely available, less invasive, and more effective than traditional treatments like chemotherapy. Midstage trials are providing renewed hope for the development of vaccines against various cancers.
Genetics represent another marvel of medical advancement. Knowledge about the genetic basis of diseases helps improve diagnoses and treatments. Researchers are making significant progress in developing gene therapies that can cure sickle cell disease, HIV/AIDS, and other debilitating diseases. Genetic testing is now available for certain inherited conditions, like Huntington’s disease, which can help people make more informed decisions about their health and their future.
We are also making progress towards treatments for amyotrophic lateral sclerosis (remember the ice bucket challenge in 2015?) and Alzheimer’s disease. The development of robotics has transformed surgical procedures, resulting in faster recovery times and fewer complications. Telemedicine makes healthcare more accessible and convenient. Wearable tech like smartwatches and fitness trackers can monitor vital signs and alert patients and their physicians to potential health issues.
Mental health care is advancing too!
Technology is helping mental health treatment as well. Our clinic and many others offer secure telehealth appointments, so that remote clients can get the same treatment as everyone else. We utilize cutting-edge measurement-based care platforms such as Greenspace to monitor mental health outcomes and help clients gain insight into treatment progress. Apps like How We Feel and Calm help clients develop emotional intelligence and mindfulness skills in an easy, approachable way. Neurofeedback is another relatively recent technology that provides an excellent alternative (or complement) to traditional talk therapy.
There are many more examples of medical innovation, and it may take time for some of these gains to become sufficiently accessible. But every day we are making great steps towards a healthier world.
There’s still time for the environment.
There’s no denying the reality that ecological sustainability and preservation are serious concerns. It seems likely we will overshoot 2.5°C of global warming, leading to severe weather events, expansion of deserts, food insecurity, animal species extinction, and economic harm. However, we can take solace in the fact that many initiatives are working, and progress is being made.
Many countries have reduced their greenhouse gas emissions while increasing their GDP. The world is making great strides towards clean and sustainable energy. Renewable energy sources like solar, wind, and hydro are becoming more accessible and affordable. Even though nuclear energy has suffered tragic accidents, it remains one of the safest and cleanest forms of energy when compared to death rates from air pollution created by fossil fuels. Fourth-generation nuclear reactors currently being developed will be even smaller, safer, and more efficient with far less nuclear waste produced. Scientists are making important discoveries towards fusion power, which has the potential to radically transform the world’s energy usage.
Another real concern is deforestation, but let us remember the wise words of Mr. Rogers concerning catastrophes: look for the helpers. Organizations like Cool Earth, which I fundraised for in 2019 and continue to support, are doing excellent work in this field. And we have data to support progress: a 2018 study published in Nature (one of the top scientific journals) identified with confidence that global tree cover has increased 7.1% since 1982.
Less harm from natural disasters
Furthermore, improvements in infrastructure and emergency preparedness have significantly reduced annual deaths from natural disasters, which were 3.7 million in 1931 and only 13,008 in 2022. Although we cannot prevent events like earthquakes, we can prevent high losses of life. The numbers prove that our efforts are working.
Admittedly, the tasks ahead will not be easy. But there is strong evidence that human effort and adaptability will allow us to fight current environmental threats and build a more sustainable world.
The world is more peaceful than ever before.
Given the widespread destruction and devastation in the first half of the 20th century, it is notable that the world has not seen a major global conflict in the past 78 years. Even considering the recent Ukraine conflict, warfare today is less frequent, less lethal, and more localized. While nobody knows the future for certain, there are reasons to believe that this calm and stability will persist. The globalization of trade means that the citizens of other countries are worth more to a nation alive than dead. As quality of life improves, we have less reason to engage in the discomforts of violence and vengeance. Institutions such as the United Nations have been developed to foster diplomacy, and cooperation has become more productive than armed invasion.
Violent crime is trending downwards as well. And the number of terrorist attacks and deaths from terrorism around the globe has dropped markedly since the 1970s (contrary to the over-representation of terrorism in the media, it accounted for just 0.05% of global deaths in 2017).
Overall, a person born in the world today is far less likely to be a victim of violence than a person born at any prior time in human history. That’s a remarkable achievement!
Basic needs are becoming more affordable.
It may be hard to believe, but it’s true: basic needs such as food, water, healthcare, housing, and education are becoming more affordable around the world. We owe this development to government and non-profit initiatives to reduce basic costs to individuals and families, as well as advances in technology, transportation, agriculture, and the global economy (lower prices stemming from businesses competing on a global scale).
The International Telecommunications Union, a United Nations agency, reported in 2022 that the price of mobile-broadband services has dropped to just 1.5% of gross national income per capita. Almost two-thirds of the world population has access to the internet. This number continues to rise, along with ownership of mobile phones. With more accessibility and affordability, the world is also becoming increasingly connected. I believe that will be a very important part of furthering communication and cooperation to solve global challenges.
What Now? “Learned Optimism.”
I hope these examples have conveyed that there are many reasons to see hope in all our futures. Our natural negativity bias can lead to a sense of learned helplessness. I firmly believe in countering it by cultivating learned optimism. We are better equipped to take on problems when we have an accurate, factual view of the world. The overwhelming evidence shows that the future is looking positive!
Here’s another piece of good news: the myth-driven stigma around accessing mental health care is disappearing rapidly.
In my clinical work, I often draw upon dialectical behaviour therapy (DBT), which teaches skills to strengthen emotional resilience and build a life worth living. These skills include radical acceptance (seeing situations as they are and focussing on what you can control rather than what you cannot) and checking the facts (developing a more accurate and realistic understanding of a situation rather than relying solely on assumptions and emotions).
Therapy can be useful in overcoming negativity and developing a more positive outlook on life. This is not simply turning a blind eye to suffering. Instead, it is about developing the skills to face challenges with a helpful and more effective outlook.
If you’re struggling with negative thoughts or feelings of helplessness, it’s important to remember that you don’t have to face these challenges alone. Consider reaching out to our team of skilled clinicians to explore therapy options and start building a more helpful future.
by Kathryn Priest-Peries | Apr 16, 2020 | Anxiety, Connection, COVID19, Depression, Mental Health, Tips
The COVID-19 pandemic has had many of us in social isolation and practicing social distancing when in public for weeks now. For a fortunate few, this has been a welcome reprieve from an otherwise hectically paced life. For the majority, it has meant being cut off from friends, family, community, and routine supports such as gyms, recreation centres, and social gatherings. We have become a people who are afraid to even greet one another in person. It’s because of these shifts that some of us, particularly those who have struggled with depression before, may be asking the question, “How can I prevent depression during COVID-19?”
How Can I Tell If I’m Depressed During COVID-19?
Anxiety about the risks of catching the Coronavirus are at an all-time high as are concerns about the future of jobs, financial security, and the availability of needed supplies, the education of children, and so on.
When ongoing anxiety is combined with a lack of social and community support, the result can be despair and even full-on depression. Depression is defined by features such as:
- A feeling of purposelessness or hopelessness about life
- Feelings of intense sadness often combined with heightened irritability
- Failing to attend to one’s personal hygiene
- A loss of interest in activities previously enjoyed
- Changes in appetite
- Failure to adhere to previous routines
- Sleep disturbances
- Loss of motivation
Some of the features indicated above are currently forced upon us by the pandemic. For example, simple aspects of hygiene such as going for a haircut are not currently available. And, even if we can find the motivation, many of the activities we would do are structured and rely on facilities such as a gym or a recreation centre which are currently closed.
The Effects of Social Distancing on Depression
Perhaps most alarming out of all of the effects of the pandemic is the imperative that we practice social distancing (or maybe more aptly, physical distancing). While this is entirely necessary at the present time, it can serve to greatly contribute to the development of depression. It is primal in human beings to gather with a friend, a family member, or community supports when experiencing stress. As it happens, we are incurably pack animals – maybe like orcas or wolves. Rare is the person who wants to be alone for extended periods of time while anxious. Rather, we naturally gravitate toward one another and, furthermore, we need social connection to remain emotionally and psychologically healthy. The need for social distancing has forced us to behave in a manner that is counterintuitive to our being healthy in the world.
Ways to Prevent Depression During COVID-19
What all of this means is that we will need to be very deliberate and stubborn in our efforts to fend off depression. I have a few suggestions for us all to consider, as I try to answer the question, “How can I prevent depression during COVID-19?” Here they are:
- Contacting with friends or supports by phone or video. Don’t be shy about admitting that you’re in a funk and just need to talk.
- Go for walks outside alone or with others (6 feet apart of course…)
- Do a bit of what you enjoy – whether it’s a hobby, listening to your favourite music, etc
- Pay close attention to your nutrition and don’t let it slide into bad habits
- Exercise – whether it’s a run outside, a workout following a TV or YouTube instructor, throwing the ball for your dog, riding a bicycle, etc. 20 minutes of exercise daily is ideal to fight depression
- Reach out for professional support if needed. Yes, we’re open for business and can safely meet with you if you feel that a counsellor is needed to support you for a time.
- Stick to as much routine as possible. Get up at a decent hour, get showered and dressed even if you aren’t going out. And then do that 20 minutes of exercise mentioned above
We don’t currently know how long the pandemic will last and that uncertainty can be very upsetting. Preventing the anxiety and the upset from becoming depressed in life is one of the few factors that we can actually control with some decided effort.
If you’re resonating with anything I’ve written, know that I’m rooting for you. We’ve all been there, and we’re all in this together. If you’re asking yourself how you can prevent depression during COVID-19, I’d love to help you out. Give us a shout at the office, and set up an appointment. Don’t go through this alone, we all need some help sometimes and I’d love to be there for you through this.