8 Ways Sex Is Different For People With Anxiety

For the 40 million Americans with an anxiety disorder, certain parts of daily life can be more challenging — and that includes sex.

Anxiety (and some of the medications used to treat the condition) can lower a person’s sex drive, make it more difficult to orgasm or hinder the ability to maintain an erection. Those who have experienced sexual trauma or were raised to believe sex is shameful may deal with anxiety specifically about physical intimacy.

We asked people living with anxiety to share the ways the mental health condition impacts their sex life. Here’s what they told us.

1. I’m stuck in my head, rather than being in the moment.

“My anxiety makes it almost impossible for me to let go and enjoy the actual act of sex. Even though I love my partner dearly, it can become awkward when my body is tense and I am completely lost in the anxiety attack of worry and overthinking in my head.” — Shelby Goodrich Eckard

2. I have a tough time connecting with my partner.

“I find it difficult to get comfortable with someone and I find it difficult to connect. In order to open myself up to someone on that deep, intimate level that leads to great sex, I really need to connect with that person.” — Erica Gordon

3. I’m hypercritical about how it’s going.

“The last time I had sex with a man I really liked but hadn’t known for too long, it was extremely awkward. In the middle of us making out, I stopped and asked, ‘Are you okay?’ He immediately snapped. ‘What? I’m going too slow for you? You just want to rush into the sex?’ he said. I was instantly flustered and so embarrassed. My anxiety stopped me in the middle of us making out because I was a nervous wreck. I felt like I was moving too slow for him. So I wanted to know if he was good. If only he knew that I love romantic and slow gestures towards making love. I hate rushing into sex. I hate missing out on the foreplay. I hate not getting kissed.” — Charlie G.

When you’re anxious, it can be more difficult to fully enjoy sex. 

4. I find it difficult to get turned on in the first place.

“It’s not easy for a man I’m dating (even if that man is my long-term partner) to get me in the ‘mood’ to have sex. Because I’m so in my head all the time, stressed out, on edge or feeling anxious, my man has to put more effort in to ‘seduce’ me or ‘turn me on’ than he otherwise would have to with a woman who does not struggle with anxious thoughts.” — Gordon

5. I sometimes have a couple of drinks to quiet my mind.

“Although I rarely drink alcohol, I often find myself wanting to drink before sex. It’s so difficult for me, as a person with chronic anxiety, to lower my inhibitions enough to enjoy sex. Alcohol does help with this problem and helps loosen me up, which is why, even though I never crave alcohol in any other setting and I don’t even really enjoy drinking, a sexual setting is the one scenario where I actually would prefer having a couple of drinks first.” — Gordon

6. I fixate on how I look.

“My anxiety and my body image issues seem to be codependent partners in crime. My anxiety goes into hyperfixation on how I’ll look naked, how my body has changed with age, what my partner will view me like, etc. It has at times completely ruined the moment and led to intimacy issues with my partner. It’s hard to explain anxiety when you can’t even understand it yourself, sometimes.” — Goodrich Eckard

7. I ruminate about how sex could affect things with my partner going forward.

“As a person with anxiety, you just never know when the time is right. I’m with a guy I really like and wouldn’t mind having sex with. Everything is going fine. And then boom, just when things start to head that direction, the jilting thoughts race in: Does this guy really like me? Is he just using me for sex? Or does he actually want to get to know me and also just so happens to want to have sex right now? We’re two consenting adults, we don’t need to wait 90 days to have sex, right? But if I have sex with him right now, will he still like me tomorrow or lose interest or will he only call me now only for sex because he’s gotten what he wants from me already? — Charlie G.

8. I get overwhelmed when sex is another thing on my schedule.

“As a busy mom with kids, sex oftentimes has to be planned. If you have anxiety, you know plans can be a minefield. The overthinking, overworrying and constant pressure we put on ourselves completely zap the desire to perform the actual act.” — Goodrich Eckard

Responses have been lightly edited and condensed for clarity.

Sex Ed for Grown-Ups is a series tackling everything you didn’t learn about sex in school — beyond the birds and the bees. Keep checking back for more expert-based articles and personal stories.