Mental Health During a Pandemic and Its Impact on Sex

As stay-at-home orders continue in response to the COVID-19 pandemic, I’ve seen many people guess at how isolating with romantic partners may be impacting relationships. Meme after meme suggests a “baby boom” occurring in nine months. The assumption is that couples will increase their sexual activity because they have little to do and nowhere to go. I’ve seen some jokes with a play on corona as suggested baby-names, while others hark fears of a toilet-paperesque condom shortage. Others suggest that the opposite effect will happen, and more relationships will end due to the impact of the pandemic.

While I do not believe there will be a boom in divorces, I do see how isolation and minimal distraction can amplify existing strains on a relationship, and at the same time make it harder for couples to navigate new ones. From what I am seeing in my private practice currently, couples are experiencing high levels of despair about their health, their jobs, their finances, and their futures. The current climate is spreading fears, worries, and concerns instead of sexual desire and intimacy.

Since March 14, 2020, roughly 22 million Americans have applied for unemployment. Many couples with unemployment struggles must grapple with financial burdens on the relationship, which may not have been there before, or may have existed to a lesser extent. They have to figure out how to maintain shelter, access to food, payment of bills, and obtaining access to medical and mental care if they’ve suffered a loss of insurance.

Since March 17, 2020, 88% of organizations are requiring their employees to work from home. That means that if couples were fortunate enough to keep their employment, they are now struggling to learn how to work from home. If both partners are working remotely, this doubles the challenge. Partners who have children are having to learn how to negotiate around who will care for them in the home while the other is working. Couples are having to deal with bandwidth issues, as both may be needed in online meetings which may include video components. I’ve even seen individuals express frustration as they subtly witness their partner act in ways they refuse to within the relationship, like volunteering for additional work, openly expressing needs, and engaging in social communication.

The common trauma responses we are feeling during this unprecedented time will impact our desire to have sex. Stressors and strains challenge individuals’ mental health and well-being. New and compounded stressors from the pandemic only double-down on the pain. When mental health and well-being are out of balance, that state can disrupt someone’s ability to feel close and vulnerable. Partners who cannot feel closeness have difficulty supporting their significant other. When partners don’t feel close, they don’t want to have sex.

Mental Health and Well-Being

Mental health is defined as the emotional, social, and behavioral well-being of people and communities. Well-being is a state of being comfortable, healthy, and content (which may include feelings of happiness, peace, or balance). People often view mental health as the absence of a mental health condition or illness. This is not the case. Mental health exists on a range, and an individual’s mental health moves back and forth along that range throughout their life. An individual's experience of and response to different stressors and strains, contributes to their movement on the continuum.

Stressors are defined as any event that pushes individuals beyond their physical or mental capacity to maintain stability. Strains are defined as the undesirable results of stressful experiences in different areas of individuals’ lives. Healthy functioning on one end of the continuum includes the ability to address, or even the absence of, stressors and strains, while the other end is the severe symptoms that are a result of the impacts of stressors and strains.

There’s a lot to be uncertain about right now. Researchers are studying how the COVID-19 pandemic is affecting us, but most of the research isn’t accessible and can only look at the present (and make an educated hypothesis for the future). We can look at current research around shared community trauma, such as natural disasters, but we must consider that this research is region-based, while the current pandemic is global. We can also look at resilience to create guesses on the necessary change needed for positive effects for the community. But again, these studies will not be able to take into account all the enormous changes that have occurred for people during this pandemic. What is certain is that stress, depression, and anxiety are all common reactions to our changing social climate.

Stress

Taking into consideration stressors and strains, stress is then defined as the adverse symptom that is the result of undesirable outcomes from experiences that are beyond the control and capabilities of individuals. Inhibited sexual desire is a common type of sexual dysfunction that affects both men and women as a result of increased stress. Stressed humans often feel preoccupied, confused, worried, and exhausted. Research has shown that stress lowers the creation of sex hormones, like testosterone or estrogen, due to the flooding of cortisol (the stress hormone), which itself lowers arousal. Individuals with vaginas will experience a disruption in the natural creation of lubrication. Research also implies that stress can increase the chances of erectile dysfunction because it interrupts how the brain sends messages to the penis to allow for extra blood flow. Stress, therefore, has a neutralizing effect on our physical ability to engage in sex, and our psychological sexual desire. 

Depression

There is numerous research that shows a high link between sexual dysfunction and clinical depression. Sexual desire is dependent on chemicals from the brain being released to sexual organs. As depression is a chemical imbalance in the brain, there can be impairments or disruptions which interfere with sexual health. It should be noted that individuals on medication for clinical depression may experience this more, as lowered libido is a common side effect of depression medication. That being said, clinical depression results in symptoms of lowered confidence, questioning feelings of self-worth, dissociation, and lowered self-esteem. When these symptoms disrupt intimacy, other depressive responses such as guilt and shame will occur, or increase, as individuals blame themselves.

During this pandemic, we’ve seen an increase in grief and loss. Individuals are struggling with job loss, loss of stability and structure, financial loss, and loss of expected engagements (canceled graduations, weddings, etc.). The grief and loss also includes bereavement, as more and more people die from complications of, or as a direct result of, COVID-19 (the current total for the U.S. as of April 20, 2020 is 40,000 cases). Depressive symptoms accompany grief and loss, but loss also has its own challenges. People will find themselves questioning their faith, having increased thoughts of death, difficulty with motivation, feeling “foggy” in their thinking, and guilt (especially for survivors of those who have died). It should go without saying, these symptoms severely impact sexual desire and emotional connectivity with loved ones.

Anxiety

Research on clinical anxiety and sexual dysfunction is varied, because anxiety disorders are varied. Literature suggests that anxiety disorders are linked with sexual dysfunction, and that higher severity will result in more severe dysfunction. Those with a panic disorder may respond differently than those with an obsessive-compulsive disorder or generalized anxiety disorder. The common clinical anxiety symptoms include many physical sensations, including: rapid breathing, muscle tension, sleep disturbance, fatigue, headaches, and joint pain. These symptoms interrupt normal sex drive because individuals don’t feel physically-well enough to engage in sexual contact. Some dysfunctions can include premature ejaculation, inhibited sexual enjoyment, and decreased orgasm. Fears around sexual performance increase, which in turn decreases sexual engagement.

Increasing Connection

There are a variety of techniques I am teaching my clients as we continue to examine the effects of the current pandemic on their relationships. The first is continued psychoeducation on stress, depression, and anxiety, and their impacts on sexual desire. I’ve found that this topic of decreased sexual interaction has been so prevalent in the past few weeks that it motivated me to write this article.

Secondly, I encourage partners to engage in emotional attunement. Emotional attunement can be defined as one’s ability to understand, recognize, and properly engage with someone else’s emotional state. When relationships lack emotional attunement, couples feel unhappiness, resentment, distrust, and can even experience a loss of love and desire. Therefore, I encourage my clients to check in with their partners. Especially around sex. Are they truly in tune with their partner's emotional and sexual changes during these times? Are they making assumptions about the reactions they are noticing and the changes they are experiencing? Are they making judgments based on fear?

Thirdly, I continue to connect the established treatment goals for the relationship to the new struggles. I remind my clients of where they want to see their relationship when treatment ends. Creating this consistency and predictability about the relationship minimizes fears. 

There are a variety of more general treatment goals which the current pandemic is only highlighting the need to address and achieve:

• Communication. Partners often seek counseling to increase communication skills. As partners must now learn how to navigate around each other in the microcosm that is a pandemic home, broken communication increases. Learning and implementing communication styles, as well as discovering if new styles must be implemented in this new era, are both essential to relationship growth. This may also mean increasing one’s understanding of the Five Love Languages, and how they may change (love languages change as the needs of a relationship change, and during these times they may differ for individuals whose partners are essential workers).

• Conflict Resolution. Couples often learn in therapy that they don’t know how to fight fair. Conflict resolution is a difficult skill to gain. As relationships struggle with the added stressors and strains from the pandemic, couples may find themselves reverting back to “old battle tactics.” They may use blaming and shaming, avoidance, confusion tactics, or unwavering demands. Learning skill sets essential to conflict resolution will help a relationship become balanced and stable.

• Equality and Freedom. People in couples often struggle with learning the needs of their partner, learning the needs of the relationship, learning their own needs, and learning how to balance and contribute equally to those needs. Couples will see a shift in chores and responsibilities during the pandemic. Those that already struggled with necessary changes around equality of responsibility and freedom will find that these times highlight that imbalance. Though shifting to work at home and lack of childcare may create brand new challenges, I’ve found that these shifts have also further highlighted the same dysfunctional patterns couples already had (such as the partner who already took on the block of duties only increases it more during this time). Therefore, couples must learn to check in with one another in order to learn how the division needs to look for their partner to feel fulfilled.

Though sexual desire in a relationship is determined by a variety of factors, when couples feel safe and secure it’s easier to engage in intimacy. Through actively working on relationship goals, and learning how mental health and well-being contribute to sexuality, couples can find or maintain that security.

Do you think there will be a baby boom in 9 months? Let me know in the comment section below!

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