ED, no desire, pleasure - can this be depression?

[bart9]

I wanted a 2nd opinion about whether sexual problems could be caused by depression -- or something else. A psychiatrist diagnosed depression, but I'm still not convinced as most of my symptoms are physical and I haven't experienced a major mood change.  I've had thorough blood work done but my doctors didn't find anything they thought significant (a brain MRI showed vascular lesions, but they said they couldn't diagnose anything based on this and ruled out MS).  

My symptoms began 4 years ago without any triggering incident: Fatigue, weakness, mental fog, light headedness, loss of libido, erection difficulties (no full erections), including loss of involuntary erections while asleep, and loss of pleasure from sex.  Otherwise my life feels quite normal.  I don't take any medications.

As far as I know, loss of libido is normal with depression or chronic fatigue syndrome but not the loss of erections.  Any ideas about whether depression could cause this?  Or anything else?  If it is depression, is the best way to get relieve these physical symptoms by taking anti-depressants (even though they can cause these symptoms)?  I've been pretty thoroughly tested but is there anything else I could investigate?  

[bart9]

Thanks for your responses.  I have already been to two urologists and none could find a medical condition.  They did standard tests, hormonal levels, diabetes, but didn't find anything.  Also, standard ED drugs do very little for me.
Also Dr. Epp said that loss of involuntary erections is NOT a problem in depression, but indicates a medical condition.  Is there any other kind of tests that could be done or any unusual medical conditions they might have forgotten to test for?  
Metropolis, also did I understand correctly that you are saying that depression can cause loss of involuntary erections?
Thanks again.    

[Janice M Epp, PhD]

Hello.

The dead give-away is your reporting that you no longer have erections upon awakening. This indicates a medical condition. Depression can indeed affect desire and subsequently, erection; however, when sleeping and upon awakening, erection isn't under conscious control, so if everything is working, you would experience erections.

If you DO decide to take anti-depressants, ask your psychiatrist for alternatives to some of the SSRI's that interfere with erection/orgasm. Wellbutrin is one that is associated with the least side effects.

Schedule an appointment with a urologist for an exam to determine what's interfering with erections. Best of luck to you. Dr. J

[metropolis]

Depression is indeed a major cause of erectile dysfunction. Erections start in the brain and if the brain isn't working properly, sexual problems - incl. ED - may occur. Moreover, most antidepressants (e.g. SSRIs) can worsen the problem. The good news: psychogenic ED is easily treatable. I suggest you consult a doctor (urologist) before you decide to try anything, self medication is always a risk.