If you are stressed or depressed and have erectile dysfunction, you are not alone. Erectile dysfunction is commonly associated with these mental health problems. Erectile dysfunction (ED) is a condition where a man cannot get or maintain an erection firm enough for sexual intercourse. 

As you age, the risk of ED increases. However, a man can get ED at any point in time, regardless of his age. The good news is that an underlying cause can be determined in most ED cases, and treating them can help reverse ED.

While many ED cases are secondary to a physical disorder, mental or emotional factors can also be responsible for it. About 10%-20% of the ED cases are psychological, which are usually curable. In some cases, the mental factors may stem from sexual trauma or childhood abuse. But, the most common causes of psychological ED are stress and depression.

Stress and depression may also cause other conditions that are responsible for ED, such as:

• High blood pressure
• Obesity
• Excessive alcohol consumption
• Heart disease and high cholesterol levels

Read on to know how stress and depression cause erectile dysfunction (ED) and how to manage them.

Definition – Stress & Depression

Before we move ahead, let us quickly understand the meaning of stress and depression.

Stress

Stress is your body’s response to specific events in life. Some common factors that may make you feel stressed are experiencing something that threatens you, something unexpected, or feeling you do not have control over a situation.

What contributes to stress may vary from person to person and depends on the genetic makeup and social and economic circumstances. Overall, stress can be defined as a degree to which you cannot cope or feel overwhelmed as a result of unmanageable pressures.

Depression

Depression is a common condition that negatively affects how you think, how you feel, and how you act. It causes feelings of loss of interest in activities you enjoyed or sadness. Depression may also lead to various physical and emotional problems and decrease your ability to function at home and work.

Symptoms

Some common symptoms of stress and depression are:

Stress

• General pains or aches
• Dizziness
• Clenched jaw
• Grinding teeth
• Acid reflux symptoms or indigestion
• Headaches
• Muscle tension in face, neck, or shoulders
• Increase or decrease in appetite
• Racing heart
• Problems sleeping
• Fatigues
• Sweaty and cold palms
• Shaking/trembling
• Sexual difficulties
• Diarrhea
• Upset stomach

Depression

• Having a depressed mood or feeling sad
• Changes in appetite
• Weight gain or loss unrelated to dieting
• Fatigue
• Loss of pleasure in activities once enjoyed
• Sleeping too much or trouble sleeping
• Feeling guilty or worthless
• Suicidal thoughts
• Difficulty concentrating, thinking, or making decisions
• Increase in pointless physical activity, such as pacing, inability to sit still, handwringing
• Slowed speech or movements
• Loss of interest in sexual activities

Causes

A man can usually get three types of erections:

• Psychogenic (due to mental or visual associations)
• Reflexive (as a result of physical stimulation)
• Nocturnal (occurring during sleep)

All these types of erection involve various bodily processes and systems, and disruptions in any of them may cause erectile dysfunction.

These include:

• Blood vessels
• Hormones
• Nervous system
• Muscles
• Emotions

Mental health issues, such as anxiety, depression, and stress, may also affect how your brain regulates your body’s physical response. In the case of an erection, depression and stress may interrupt how your brain regulates messages to the penis to facilitate extra blood flow.

You can think of the brain as a highly sensitive sexual organ. Sexual desire is cultivated in the brain and works its way down. The penis depends on the chemicals produced by the brain to change blood flow required for sexual activity and to promote libido.

These chemicals boost communication between brain cells and enhance blood flow to your sex organs. The problem with a mood disorder is that the brain circuits communicating using these chemicals cannot function properly.

Imbalance in these brain chemicals makes sex more difficult. This is especially true in older men who have occasional troubles with sexual dysfunction.

Thus, many men with stress and depression have reduced or no sexual desire, causing a tremendous strain on intimate relationships.

How Stress and Depression Result in ED

There are two major types of stress, good stress and bad stress, when it comes to sexual performance. Stress and depression come under the second category of stress. 

When your body experiences healthy stress, such as a new relationship, exercise, or a promotion at work, it releases testosterone. This extra testosterone aids in relaxing the blood vessels of the penis when you are sexually active, resulting in an erection.

On the other hand, when your body goes through unhealthy stress, such as relationship problems, traumatic events, or work stress, it releases cortisol. Cortisol is a stress hormone that narrows blood vessels in your body, including the penis. When blood cannot flow properly, you may face difficulty in getting an erection.

Over time, long-term stress reduces the amount of testosterone in your body. Low testosterone levels are common in men with mental health issues such as stress and depression, which may ultimately cause ED.

Besides, anxiety, guilt, and low self-esteem are common causes of erectile dysfunction These symptoms are commonly observed in depression. However, such issues may also occur naturally with age and stress.

According to the National Institute of Mental Health men lose interest in sexual activity when they are depressed. Besides, antidepressants are also associated with impotence. Premature ejaculation or delayed orgasm are the common side-effects of antidepressants.

Moreover, having sexual trouble may deteriorate the feeling of worthlessness and other symptoms of depression. This may cause a vicious cycle of both worsening mental health and sexual dysfunction.

Side Effects of ED

Some common complications of ED include:

• Stress, anxiety, or depression
• Relationship problems
• An unsatisfactory sexual life
• Low self-esteem or embarrassment
• The inability to get your spouse pregnant 

Side-effects of ED medicines include:

• Body pains and aches
• Dizziness
• Indigestion
• Changes in vision or vision problems
• Flushes
• Runny nose or congestion
• Headache
• Rash
• Diarrhea
• Sudden changes in hearing
• Loss of vision
• priapism (painful and long-lasting erections)

Treatment

Your doctor may advise you a single or combination of the treatment options mentioned below:

Therapy

The most common treatment of psychological ED involves therapy. It can help you break out of depression or stress and the ED cycle. Common options include:

• Psychodynamic therapy: It involves addressing your subconscious conflict, which finds out the root cause of ED.
• Counseling: A therapist will help you identify and deal with factors causing stress or depression so you can manage them.
• Sexual anxiety therapy: Your physician will discuss and explain ED in detail. This can help reduce the worries and problems caused by a lack of knowledge. They will also help to address your emotional issues and find a solution for the same. Some solutions include reactivating imagination and relaxation.
• Sex therapy: It focuses on sensational pleasure instead of sexual activity or arousal. Sex therapy aims to reduce stress by creating a more reliable and secure sex life.

Alternative Therapies

Alternative therapies may help with stress and depression and include:

• Meditation
• Relaxation techniques
• Yoga
• Acupuncture

Other Treatment Options

Erectile dysfunction is often caused by an underlying condition. In some cases, stress and depression may increase the risk for ED but do not cause it. Consult your doctor if you have additional symptoms with ED. They will help find the cause and ways to treat them. 

Some common treatments for ED include:

• Prescription medicines
• Penis suppository 
• Injections
• Penis pump
• Testosterone replacement
• Penile implant
• Blood vessel surgery

Stress Management

Some ways to manage stress are:

Exercise

Physical activity improves both mental and physical health. To begin with, exercise improves your sleep. And it is known that better sleep means better stress management. Just avoid exercising close to bedtime, which may disturb sleep in some people.

Exercise also improves mood. It boosts the release of endorphins (happy hormones) that enhance sleep, block pain, and sedate you. Studies have shown that active people are less depressed and more positive about themselves. If your body feels good, so does your mind.

Some exercises that may help you manage stress are:

• Running
• Dancing
• Aerobics
• Swimming
• Cycling

Consume Healthy Foods

The benefits of healthy food are far more beyond your waistline and improve your mental health. A healthy and balanced diet builds your immune system, lessens the effects of stress, and lowers your blood pressure.

Healthy food options include lean proteins, complex carbohydrates, and fatty acids present in meat, nuts, fish, and eggs.

Antioxidants also help by protecting the cells from damage caused by long-term stress. They are present in fruits, vegetables, beans, berries, and spices such as ginger.

Researchers have stressed the importance of certain nutrients that help reduce the effect of stress on the mind and body. Try and add the following nutrients to your diet:

• Magnesium
• Vitamin C
• Omega-3 fatty acids

Get Adequate Sleep

Difficulty in getting sleep is a common side effect of stress. If this happens three times a week for at least three months, you may have insomnia, a condition where you may find it difficult to fall and stay asleep.

Besides, lack of sleep may also increase your stress level and cause a cycle of sleeplessness and stress.

Some habits that promote better sleep are:

• Get adequate exposure to sunlight
• Set a sleep schedule
• Exercise regularly
• Avoid caffeine and alcohol close to bedtime
• Try and meditate before going to sleep
• Do not look at your electronics at least 30 minutes before you hit the bed

Final Thoughts

Stress and depression are two common health problems in Canada, and unfortunately, they may worsen or cause erectile dysfunction. Just know that there are various options to help you with ED and your health concerns. The key is to consult your doctor and take help from a mental health provider. Together, they will help you with solutions that are right for you.

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