I’m (30m, bottom) at a difficult point where I feel forced to choose between my mental health and my sex/relationship life.

For context, I’ve dealt with moderate depression and anxiety since my early 20s. Thankfully, I finally sought professional therapy at the start of this year (2014). My psychologist/psychiatrist suggested medication to complement the counseling, and after some adjustments, it made a noticeable difference. The combined therapy helped me get back on my feet.

As I began feeling better, I decided I was ready to enjoy dating and sex again—something I had put on hold for a while. That’s when I noticed the unwanted side effects of the medication.

The desire for sex is definitely there—the drive and “horniness” are alive and well. I get excited during sex, and I genuinely enjoy it. Pleasing my partner turns me on completely, and I’ve been told I’m very good at it. However, I rarely get an erection and almost never reach orgasm, no matter what we try. It’s like my body just won’t cooperate. Some of my FWBs noticed this and eventually started drifting away. I wasn’t too bothered since these connections were all NSA.

Then, this past August, a situationship turned into a beautiful relationship. I was thrilled about where it was heading, and the sex was amazing. My partner noticed the issue right away, so I decided to be honest about my suspicions regarding the medication. He seemed to understand, but I could tell he felt like it was his fault—that he wasn’t doing something right. I reassured him that this wasn’t the case, but I don’t think he ever fully believed me. We ended things not long after, and I suspect this was a big part of the reason.

Throughout all of this, I kept my psychologist updated. They confirmed that these side effects are common with the SSRI I’d been prescribed. We experimented with different medications: some slightly improved my sex drive, others made it worse, and a few didn’t help at all. We even tried weaning me off the meds entirely, which did start to restore my sex drive, but my depression and anxiety slowly crept back. So, I made the choice to resume the medication.

On top of all this, I’ve realized I’m craving a deeper kind of intimacy beyond just the sexual aspect—things like kissing, cuddling, being held, and simply feeling close to someone. It might be a sign that I’m maturing emotionally or moving past my “ho” phase, or maybe it’s a mix of everything I’ve been experiencing lately.

I feel like I’m trapped, forced to choose between having a healthy sex life, stable mental health, or a meaningful romantic connection.

Any advice or insight would be really appreciated 😔