Writer’s note: This column mentions depression and suicidality.

When me and my BF first got together about a year and a half ago, we were having the best sex of our lives! Then I decided with the help of my therapist that I needed to be medicated due to suicidal thoughts and anxiety/depression.

The medication helped a lot with my mental illness, but unfortunately it made my sex drive plummet. I was still able and happy to get my man off on a regular basis, but didn’t have much interest in sex for myself (including masturbation) for a long time (6-8 months I think). Once in awhile I would get in the mood, but then I was never able to achieve orgasm.

I’ve since come off of the medication and am healthy and my sex drive has gone back to “normal.” The problem is that my BF got in of the habit of not even attempting to pleasure me. I’ve tried to talk to him about it and when we talk he seems enthusiastic about it, but never follows through with trying when we get in the sack! How can I help him understand the importance of this to me?

— Trying to Get Off More  Than Just My Meds

It sounds like you’ve taken a quick and victorious journey with and through your mental illness, which is amazing and wonderful. However, it sounds like your boyfriend may have been left in the dust a little bit on your speedy trek to the top of recovery mountain.

A year and a half is not a very long time in the grand scheme of relationships and I wonder if he’s got a little bit of whiplash from where your realities once collided at the intersection of mental health and sex drive.

It’s intense to be someone suffering from depression and suicidality, that is for certain, and there co-exists another reality which is that it’s also tough to be the romantic and sexual partner of someone going through those experiences. You are feeling like your old self — and that’s so great, but it’s possible that he’s still feeling wary that the other shoe might drop.

The fact that your sex lives have been affected by this path (which, of course, why wouldn’t they be?) further complicates things. Sex can be an intimate and vulnerable place to be, and if you’re simultaneously experiencing fear for your loved one’s mental and physical safety or even the residue of that, it can be tough to be brave about initiating certain sex acts or instances even once the dust has settled. The pressure he may have built up around the correlation between your inability to orgasm and the state of your mental health may also be a big blockade to his comfort in even trying and the inordinate amount of fear that may accompany perceived failure.

Your question is how can you express the importance of his pleasuring you, to him. But I wonder if it’s not the importance that he’s not understanding, but rather if it’s residual fear, responsibility, or hesitance that’s getting in the way. Address the shadow that might still be lurking for him about the connection between your sexual well-being and your mental well-being (a short stint with a couples therapist might be helpful here). And assure him that you’re both in the clear to start enjoying a well-rounded sex life again without fear of the worst.

Clinical Support Options offers local 24/7 mental health crisis support for Hampshire County at (413) 586-5555 and the National Suicide Prevention Lifeline can be reached 24/7 at (800) 273-8255.

Yana Tallon-Hicks is a pleasure-positive sex writer and educator living in the Pioneer Valley. She has a website bursting with sex advice, resources, and workshops at yanatallonhicks.com.