Sex Not Stigma: Using My Sexuality to Manage My Mental Health

Content note: this post discusses mental health struggles in detail and includes slurs and a brief reference to suicide.

Today is #WorldMentalHealthDay. Thousands of brave people have spoken out about their struggles with various mental health conditions. I shared a little bit of my story on Twitter too, if you’re interested. Short version: I live with depression and anxiety.

I use a whole litany of tools to manage my mental health. I take medication, I’m working with The Best Therapist Ever, and I’ve learned to effectively regulate my physical and mental energy levels. I’ve also consistently found sex, masturbation and kink to be really useful and positive items in this toolbox.

A black and white picture of a heterosexual-read couple, sitting together with the woman's head resting on the man's shoulder in an affectionate fashion. They both have dark hair and the man has a beard and tattoos. Pixture by Hot Octopuss and given for a sponsored post about Mental Health Week.

#SexNotStigma

It is ridiculous to me that today, in twenty-freaking-seventeen, that there is STILL such stigma around both mental illness and sex. They are two of the great taboos that plague our society.

As a woman, admitting that you like to have sex can be a radical – and dangerous – act.  Speaking up about a mental health struggles is risky and brave for anybody to do. Words like “crazy” and “psycho” are thrown around with abandon. People with mental health issues are routinely portrayed as dangerous. Services that actually help us are thin on the ground and getting cut left, right and centre. Being a woman who talks about sex and is also open about her mental health. Ohhh, boy…

I’ve had my promiscuity chalked up to my mental health conditions more times than I can count. (“Poor girl, she’s acting out sexually because she’s depressed” at best, or “crazy whore!” at worst.) Interestingly, the same has also been true in reverse (“you wouldn’t be so depressed if you’d stop sleeping around!”) But that’s not how this works! I’m a proud slut[1] AND I have a mental health condition. One did not cause the other and ceasing one[2] will not “cure” the other.

The #SexNotStigma campaign aims to break taboos when it comes to talking about sex, including that surrounding sex and mental health. This post is my attempt to add my voice to that vital conversation.

I wrote recently about how I don’t think “don’t play when you’re depressed” is useful or realistic advice, and today I want to expand on that and talk about why, far from being off-limits when I’m low, sexuality has probably helped save my life more than once.

Sex: intimacy, connection, love.

Some people want to be left alone and can’t bear to be touched when they’re depressed. My experience is usually the opposite. I want to be around the people I love and trust, to connect with them in deep and profound ways. Sex is one of the ways in which I connect with some of the important people in my life. Therefore, honestly, fucking my brains out (or at least fucking my sadness out for a while) is one of the best ways a partner can help me when I’m struggling.

Sex reminds me, viscerally and in the moment, that I am loved. For me, mental health wise, a really good fuck with someone I love is basically a cuddle on speed. Throw in a few dozen orgasms (yes, your girl over here is SUPER multi orgasmic) and you will see a marked improvement in the happiness of your Amy.

Sex helps me to focus on all the joyful things – pleasure, love, connection, vulnerability, sensation – in a world that’s fucked.

Sex literally reminds me that there’s so much to live for.

Masturbation: the ultimate self-love.

Self-loathing is a feature of my depression and an unwelcome visitor that likes to pop in from time to time. I’ve learned that the best way to combat it is to be excessively kind to myself – the way you’d be kind to a partner, friend or child who was in pain. Sometimes I take myself out for coffee and cake. Sometimes I give myself permission to stay in bed, read and nap – take a “mental health day,” if you will. And sometimes, I masturbate!

Aside from the obvious benefits of all the happy chemicals that are released at the point of orgasm, masturbation is a means of reminding myself that I am worthy and deserving of pleasure. And on the occasions when romantic rejection or the ending of a relationship triggers my depression, masturbation reminds me that my sexual (and loving!) relationship with myself is the first, last and most important one of my life.

Who needs that git who dumped me when you have cutting edge sex toys, am I right?

Kink: freedom in bondage.

Submitting to a safe partner can be really positive for me when I’m feeling low.

Kink, especially pain play, pulls me out of my head and into my body. It’s hard to be sad when all I can think about is the hand spanking my ass! It’s grounding. It makes all the noise in my head go quiet.

Submission makes me feel useful. When I feel worthless, a well-timed “good girl” can do wonders. To know that I am pleasing somebody else, that I am serving them, gives me a purpose. It reminds me that I have value.

Kink gives me permission to be vulnerable. Play gives me chance to cry if I need to, to scream if I want to, to get pent-up emotions out. It releases me from the responsibility of decision making, of caring for myself or anyone else, even if only for a short time. It gives me permission to just be.

Discovering new paths to pleasure

Mental illness can impact sexuality in many ways. In particular, feeling very low can make it difficult to get in the right headspace to enjoy sex or orgasm. Certain types of common antidepressants including Selective Serotonin Reuptake Inhibitors (SSRIs) can also cause erectile dysfunction and anorgasmia. When I first started taking citalopram – a common SSRI – I lost my ability to orgasm for a month.

Was it hell? Yes. Did it also teach me something valuable, namely that I kinda have an orgasm denial kink? Also yes. While this is something I prefer to be voluntary and not drug-induced, going through this experience taught me something really valuable about my fetishes. So there’s value in that.

Problems such as ED and anorgasmia suck (if you’ll pardon the pun) but they also force you to get creative. I finally broke through my month-long dry spell with a high powered vibrator. That’s how I learned that I love really intense vibration! If your cock isn’t getting hard in the way you want it to, you might discover other routes to sexual bliss that you’d never have previously considered or bothered to try.

Integrating the two

I’ve come to terms, over ten years of having a formally diagnosed mental health condition, that it’s not going away. It’s with me for life and I am better off learning how to manage it than hoping it will disappear. Just like a diabetic would take insulin every day, I take my antidepressants to keep me healthy. (Conceptualising my illness as being exactly comparable to a physical health issue – BECAUSE IT IS – has been surprisingly empowering.)

I’ve also grown into my sexuality in the last ten years. From a girl who was terrified to admit, even in a whisper, that she liked girls and might want to be spanked, I’ve grown into a woman who owns her desires and explores them unapologetically.

And, crucially, I’ve learned to integrate these two things. When my bisexual, kinky and non-monogamous identities ceased to be sources of shame, my mental health directly improved as a result. When my condition started to be properly managed, my sex life improved instantly. And when I learned to use my sexuality to enhance my mental health, I gained a tool that has saved my life.

[1] Yay, reclaiming slurs!
[2] Because you can totally choose to stop being mentally ill, right?

This post was kindly sponsored by the lovely folks at Hot Octopuss, a fantastic and innovative sex toy company who are committed to tackling taboos around sex. Check out their brilliant range of products, including the new Queen Bee, and their blog, where they talk sex, health and stigma. They’ve even offered a discount code for Coffee & Kink readers – use CK10 to get 10% off (and send a little bit of support my way.) All opinions are, and will always be, my own.

A banner ad for sex toy company Hot Octopuss, who sponsored a post on sex and mental health

Sex Educator Interview #6: Dr Liz Powell

Today’s interview is with Dr Liz Powell, who co-hosts Life on the Swingset the podcast as well as doing tonnes of other awesome work. Let’s dive in to what she had to say…

Tell us a little bit about you and the work you do?

I’m Dr. Liz from sexpositivepsych.com. I’m a sex educator, speaker, co-host of the Life on the Swingset podcast, and regular guest on several other podcasts as part of my mission to help people have more meaningful, pleasurable relationships in life and work, as well as the bedroom. I’m also a coach and licensed psychologist (CA 27871)  that works with thruples, couples, and singles to help folks be more of who they really are and communicate more effectively with their partners. Because being confident in who you are is the gateway to great relationships and great sex – and great sex can change the world.

Can you tell us (in brief) your “sex educator origin story?”

I’ve been out as queer since I was 17, had my first non-monogamous relationship at 17 (dating quad), and have been involved in kink since I was in college. I was always the person my friends came to for questions about sex or to take them shopping at the adult store. Once I was getting ready to leave the Army in 2015, I decided to transition to full time work with my favorite populations – sexual and gender minorities (SGM) – and issues – sexual problems, relationship issues, trauma. I then started presenting at different conferences and from there went into teaching at venues like sex shops and the Armory here in San Francisco. I love the work I do and I feel really lucky that I get to devote my time to topics I’m passionate about!

What came first: sex education or psychotherapy? How do they inform each other?

I’ve wanted to be a therapist since middle school because I loved figuring out how people work and helping people grow and heal and thrive, so I guess in some ways the therapy part came first. However, I did my first informal sex education work in college when I was president of my school Gay Straight Alliance, long before I ever saw any therapy clients, so maybe it’s that therapy was first in my heart, but education was first in practice. Regardless, I love them both and I think they go hand in hand really nicely.

Why do you think it’s so important for psychs and other medical professionals to be sex positive, and how would you like to see the medical community change in this regard?

In graduate school, the entirety of my training in sexuality was a one weekend class. 10 hours. That’s it. When I worked in multidisciplinary teams in the Army as a psychologist, I saw first hand how little education in sexuality and non-mainstream relationship/sexual practices most medical professionals have. In the field of therapy, most therapists never ask their clients about sex, even though most psychiatric conditions impact a person’s sex life. Medical professionals have often balked at the STI testing I request from them, and some of them haven’t had current information about STIs at all. When we, as those holding a position of power in a provider-client relationship, don’t address sex, we reinforce that sex is shameful and not welcome in our room. We prevent our clients and patients from sharing important information with us that is impacting their lives in deep ways.

I think most professionals shy away from sex because they’re worried that a client will view questions about sex as a come on or something inappropriate, but research shows again and again that our clients follow our lead when determining what they can and cannot talk about. If you bring your own shame or judgments about sexuality into your practice, you are harming your clients and patients.

For instance, I recently saw a Facebook post by a psychologist I knew in the Army outright stating that they would never approve someone’s request for gender confirmation surgery because they think trans people are mentally ill. The American Psychological Association has clearly stated that the research indicates that gender dysphoria is a medical concern, not a mental illness, and that the harm is in denying treatment, but this person, because of his own judgments, is comfortable publicly stating his intention to shame and harm any trans clients he works with.

Without sex positivity in our practices, we violate the first principle of almost every code of ethics in our fields – that we do no harm, and maximize benefit. We as providers must unpack our own issues so that we can serve those who entrust us with their well being.

What’s the best thing about being a sex educator, in your opinion? The worst?

I’ll start with the worst because I like to end on high notes. The worst part of being a sex educator, for me, has been how hard you have to hustle to just start getting paid. I did a panel last year with Dirty Lola of sexedagogo.com and Rebecca Hiles, The Frisky Fairy, of friskyfairy.com, called Sex Positive and Poor where we all talked about how broke most sex educators are. Most of my friends who do sex education for their main income are constantly worried about paying their bills. Being a therapist helps with this some, as I can make a decent income from individual client sessions, but building up a private practice is slow and I went into a lot of credit card debt to get my business going. It looks way more glamorous on the outside than it feels on the inside.

The best part of being a sex educator, at least in my experience, is the amazing community of people I get to be a part of. I’ve got people in my life who I can send a message to about the crazy sex I had and they’re there to cheer me on. Or I can message them to talk about the grief I’ve been working through about my lover who died. The folks I’m lucky to call friends are some of the most kind, loving, smart, perverted, funny people I’ve ever met and I am thankful every day to have them in my life.

What’s your favourite project that you’ve done/been involved with?

My favorite is one I’m currently working on! Cooper Beckett, one of my Life on the Swingset co-hosts, and I are writing a book called Building Open Relationships. It’s a practical, hands on, nuts and bolts guide for how to actually DO non-monogamy. There are so many great theory-based resources out there (More Than Two by Franklin Veaux and Eve Rickert, Opening Up by Tristan Taormino, The Ethical Slut by Dossie Easton and Janet Hardy), but both he and I felt like some of the nitty gritty was missing. We’re creating worksheets, conversation starters, checklists, all kinds of nerdy goodness to help people learn from our mistakes and success.

Tell us about a book that completely changed your life/perspective?

I think this would have to be something by Brené Brown, probably Daring Greatly. Something most folks don’t know about therapists in general, and me in particular, is that we can seem super open and vulnerable, but most of us (or especially me) often suck at being really vulnerable. It’s like I’ve got this great facade of openness that keeps folks outside of the REAL walls. In the last couple of years, I’ve been working really hard on moving past perfectionism and self-judgment and developing my skills at vulnerability and honesty. It’s been a really really REALLY hard journey, but I feel like a much better human, leader, therapist, educator, friend, and partner because of it.

What’s something you used to believe about sex/relationships but don’t believe any more, and what changed your mind?

I used to believe that you could use rules in a relationship in a way that could be healthy. Before I go further, I want to clarify that I’ll be using the terms Boundaries, Agreements, and Rules the way they are defined in More Than Two – boundaries are about myself, agreements are renegotiable by any involved party, rules affect parties that do not have renegotiation power.

Back when I first did some non-monogamy, I almost always had rules with my partners about what I would “allow” them to do with others or what I was “allowed” to do. Many of these rules involved sex acts, time spent together, or levels of emotional involvement. I think that most of the time these rules came from a place of feeling afraid or insecure and wanting to create an external structure to prevent those feelings from happening. What changed this for me was lots of failing in relationships to live up to rules I had agreed to or failing of partners to live up to rules they had agreed to. I also think that reading More Than Two and their clear ethically rooted explanations about rules made it really clear why using rules wasn’t within my values.

What’s the one thing that you wish everyone in the world could understand about sex/relationships?  

There is no “right” way to do anything in the sex or relationship realm, only ways that work better or worse for you and those you’re doing it with. Trying to do things by someone else’s rules or standards will only make you miserable. You have to do things the way that fits for you.

What do you think is the most toxic myth that our society perpetuates about sex/relationships?

There are so many! I think the most toxic myth is that there’s one right way to do things, and you know you’ve found it when your relationship lasts until death. By that standard, I recently had the perfect relationship – we never fought, we were smitten with each other, and after dating for 10 days he died. We lived out ’til death do us part thanks to his sudden, unexpected heart attack. We need to find the success and lessons in relationships that don’t end in death (and those that do) and stop saying a relationship “failed” because it ended or because it was different.

What’s the best sex advice anyone ever gave you?

Never fake it, tell them what to do to help you actually cum.

What’s one question that you wish people would stop asking you?

“Are you analyzing me right now?” As soon as folks find out I’m a therapist, I get this one or its companion “Oh, well I’m not going to talk anymore.” People think they’re being funny, but really, this is just silly. 1) Analyzing folks takes work and you’re not paying me. If you want to shell out some money then I’ll be happy to tell you about yourself, but otherwise, unless it’s flagrant, I’m just trying to be a regular human in the world. 2) Your discomfort around a therapist says WAY MORE than anything else that would’ve come out of your mouth. 3) These are probably the least original things you could say to a therapist. They tell me you’re paranoid, boring, and prone to subtle attempts at manipulation. So if you don’t want me to know things about you, don’t say these things.

And just for fun, because it is “Coffee and Kink”: do you like coffee and how do you take it?

I’m generally more into tea, but I do like coffee on occasion, generally either sweet and light or a nice blended butter coffee (I know, I know, super hipster).

Thanks so much to Dr Liz for her time and expertise. Don’t forget to check out Life on the Swingset podcast and her business, Sex Positive Psych.