Mental Illness

Caregiving: Sex And Intimacy

Rather by accident, this is going up the day after Valentine’s. Perhaps my subconscious was trying to tell me something. Somewhat less subtle than my subconscious were the chocolates and roses from Mr. Juniper. I did ask him if they were to sweeten me up over this article and he burst out laughing.

Right, there is something I want to point out before I go any further and it relates to Mr. Juniper’s “history.” This isn’t usually something I’d discuss, but given what’s going to follow, I feel it’s important. Mr. Juniper has, to put it simply, gone through a lot and has a difficult history. One thing he has not gone through, however, is sexual abuse. Why is this important to point out? Because all abuse has an impact, and it’s not a wild guess that sexual abuse can affect consensual sex, and intimacy, among other areas of life. Though I’d also make the point that abuse which isn’t sexual abuse can also have an impact on consensual sex, and intimacy, too. And just as I’m aware that other parts of our life would be different if Mr. Juniper’s history was different, I suspect this would be a different article if that history had included sexual abuse.

This is feeling hard already. I know, hard. I’d try and avoid a word synonymous with erections if it weren’t for the fact that it’s pretty much all my brain can come up with right now, and my thesaurus happens to be being held hostage underneath The Long Halloween, The Philosopher’s Stone, The Fault In Our Stars, Twilight and the ballet version of A Midsummer Night’s Dream. It’s one thing for a thesaurus to be stuck under books, it’s quite another to be stuck under a ballet company and orchestra. I could say difficult, instead of hard, but I don’t think that would be quite right. Difficult seems to imply more complexity to the situation than there is (as I see it, at least), but hard seems just right somehow.

Before going terribly much further, there’s a myth going around that if a person has a sex life, they can’t be mentally ill. Or at the very least, that their illness can’t be that bad. Bullshit. Fucking bullshit. Usually, the only indicator of a person’s mental health that involves a bed is sleep. Forgive me another moment of frustration, but seriously? Seriously? The idea that having a sex life negates mental health struggles is hideous. Where does this idea come from? That a person’s well-being is entirely dictated by their sexual activity? To give an example of where I’m coming from on this: many moons ago, Mr. Juniper and I had gotten to know each other in the biblical sense (strange for a Humanist, but such is life), and later that day, I had to pick him up from Accident & Emergency. It was a day of surprises, that’s for sure. There are people with a whole range of illnesses who have sex. Sometimes it’s a short-lived illness, sometimes a long-term illness, sometimes a life-threatening illness. Sometimes it’s a physical illness and sometimes it’s a mental illness. And yet, they may still have sex! And even then, sex isn’t solely about Tab A In Slot B. So, to those who persist in thinking that a sex life negates mental health struggles: kindly fuck off and stop making assumptions about my husband’s mental illness based on what happens when the urge takes him to suggest a little wham-bam-thank-you-ma’am.

Anecdote time: I was in Glasgow recently, having lunch with a friend, and discussion of sex and intimacy almost resulted in me throwing spoonfuls of desert at him. (I resisted the urge, in case you were interested.) It wasn’t his fault, he just happened to be making points that I didn’t particularly want to hear. That’s one of the things that makes discussion of sex and intimacy hard, having to hear the things you don’t necessarily want to hear.

It is worth pointing out, before I go any further, that sex and intimacy are not one and the same. At all. Sex is the whole “pencil full of lead“ part. Intimacy is “the bird and the bee hugging it out after lying back and thinking of Scotland” part. (The thesaurus may be stuck, the dictionary of idioms is not.)

Some more elaboration, perhaps? A quote even? This isn’t, strictly speaking, the best quote to illustrate the difference between sex and intimacy, but Will Grayson, Will Grayson is spectacularly wonderful in its awesomeness and also happened to be the book I read while on the train to Glasgow.

“I realize this is not, like, boyish. I realize that properly speaking guys should only think about sex and the acquisition of it, and that they should run crotch-first toward every girl who likes them and etc. But: The part I enjoy most is not the doing, but the noticing. Noticing the way she smells like oversugared coffee, and the difference between her smile and her photographed smile, and the way she bites her lower lip, and the pale skin of her back.” ““ Will Grayson, Will Grayson by David Levithan and John Green

See a difference? Intimacy doesn’t even have to be about the physical, it’s primarily the emotional.

It is by no means true of all people with a mental illness, but for Mr. Juniper, sex and intimacy are something that he’s struggled to define and see as separate things. That’s not to say that sex and intimacy can’t go at it like rabbits, they are amazing together but that they can also exist independent of each other. The reason this matters is that when We Need To Talk, it’s important to know if we’re talking about sex, intimacy or both.

I’ve mentioned sex and sex drives a few times in the Caregiving series, but the one that comes to mind (oh my, comes ““ to be fair, I have sex on the brain just now) was a fleeting mention in the Medication article: “There are then also the more day-to-day (though still significant) side-effects that come with medication. These can be everything from a hangover effect that medication can cause, to things like sickness and change in sex drive.” A change? A change? Medication can obliterate a sex drive, and it’s what has happened with Mr. Juniper. If my math is right, one medication reduced Mr. Juniper’s sex drive to 5% of what it had been. Seriously. If I can carry on with the maths here for a moment: equal sex drives to begin with, then Mr. Juniper’s sex drive dropped to 5% of what it had been, and mine stayed at 100%. Hands up if you can see where that might make life hard at times. Hands up if you can see where that makes life hard when the figure drops below 5%. With medication being the cause, the change in sex drive was also nigh on immediate.

One of the most basic struggles that the change in our sex life has presented me with is that I have every urge to be compassionate to my darling husband while still very much having an urge to pounce on him and grab some time between the sheets. Anecdote time again (perhaps this is less Caregiving: Sex And Intimacy than it is Caregiving: Story Corner): Mr. Juniper and I were walking hand in hand across the hospital grounds after an appointment with his psychiatrist in which we had discussed sex. This followed (to paraphrase quite minimally):

Mr. Juniper: Would you rather my condition was stabilised or that my sex drive was back?

Me: You don’t want to know how often I’ve asked myself that.

Mr. Juniper started laughing and gave me a hug.

The appointment we had just come from had been entertaining, it has to be said. Mr. Juniper’s psychiatrist really is a super guy, and welcomes discussion of all sorts. Medication was brought up and from there, the point was made that Mr. Juniper’s sex drive had taken a dive. Like, right off the face of the planet. Mr. Psychiatrist said, rather apologetically, that the medication in question was one that didn’t usually affect sex drives. The reason this news was even harder to stomach, was that previous medications which had affected Mr. Juniper’s sex drive were well known to do so. To say I was unamused on hearing this doesn’t even begin to cover how I felt, especially as none of us could doubt the rather important benefits the current medication was having. Why, oh dear goodness, why did Mr. Juniper have to be in the small percentage that was affected? Mr. Psychiatrist was, however, able to make a couple of suggestions. One was sex therapy, but Mr. Psychiatrist ruled it out as he said it, because he knew the problem wasn’t in Mr. Juniper’s head or between us. The other suggestion, which had Mr. Juniper and his psychiatrist grinning like the Cheshire Cat, while I admittedly couldn’t stop myself smirking, was to, uh, “persevere.” Oh, we would persevere, Mr. Psychiatrist. We would persevere.

Things to be learnt from this? A good psychiatrist is interested in their patient’s well-being as a whole, though when they ask how things are in bed, they are generally interested in sleep, as opposed to naughty times.

The end result of all this is finding myself pretty stressed at times. Mr. Juniper’s medication is of amazing benefit to him, we are able to talk about the issue, I can rationalise the priorities. But it doesn’t stop my brain thinking about sex in a way that I suspect sixteen-year-old boys are quite familiar with. Which is to say: sexsexsexsexsexsexsexsexsexsex. I’m suddenly realising that I maybe need to add a little more definition to this sex malarkey. It’s not about craving the, uh, “end results” that can be attained with sex, it’s about craving one of the most simple of physical connections with my other half. That craving of physical connection also has us knocking on the door of intimacy territory.

Hello intimacy. Long time no see. Okay, that’s not strictly true. But intimacy presents its own challenges. I might as well say it: I’m not going to say a lot on this. Why? By definition, intimacy is something deeply personal. Mr. Juniper has always known what intimacy was, but the change that has come through our relationship is realising that sex and intimacy aren’t the same, that they can actually be separated. That intimacy in our relationship doesn’t have to be about sex, in the slightest. I have to remember this, too. Because when sex is lacking, it’s important to remember that doesn’t mean intimacy is, unless we allow it to be.

This is perhaps a point to quote The Selfish Pig’s Guide To Caring, a book I wrote about in the Support article: Alison Ryan, a carer and former Chief Executive of The Princess Royal Trust For Carers says, “We have needed this book for twenty years.” I’m inclined to go with Alison Ryan. (The book is still endorsed by The Princess Royal Trust for Carers and suggested as “further reading” by MIND.)”:

“I’m sorry, but you won’t find a solution here. Enforced absence from the pleasures of sex is only one of the many problems of being a carer. Some of the others are isolation, burnout, back pain, money. Hardly any of them are addressed openly, but sex is embedded in the deepest silence of the lot. So: if you want it and find a way of getting it, fair enough. No criticism from where I stand, or from where any other carer stands, I suspect. If you want it and don’t get it, well, haven’t you been here before? It didn’t kill you then, and it won’t now. Might give you a headache, though.”  ““ The Selfish Pig’s Guide To Caring by Hugh Marriott

This is pretty much where I am, now. It’s been around three years since I said goodbye to our sex life as it used to be. I try to simply enjoy what we have. Try to enjoy the fact I have been able to laugh my husband into bed by asking, with a sexy purr and a straight face, if he would be interested in an expedition to go spelunking in my cave of treasures.

I suspect this is possibly my finest work in talking a lot without saying a thing. At the very least, I hope I have made the point that sex and intimacy aren’t an easy topic. So, if you don’t mind, I’m going to see if Mr. Juniper heard what exactly it was that the actress said to the bishop.

By Juniper

Rarely to be found without herbal tea nearby. Team Unicorn. Often in pyjamas. Also: TEAM KATNISS!

16 replies on “Caregiving: Sex And Intimacy”

I assume you’ve tried this, but have you asked Mr. Juniper if he will hold you or assist with, um, appliances while you take care of yourself? My husband and I both have health issues, and let’s face it, we masturbate a lot so we don’t bug the other one, but sometimes it’s really nice to have your partner help. It doesn’t require being turned on and you still get that intimacy that is so necessary.

And I have to admit that “assisting” is a good way to sometimes get the actual “-ing”, but that’s not the point.

Apologies for taking so long to reply to you, Kathy. That’s really interesting what you’re suggesting, and thank you for sharing! I’m really glad you and your husband have found something that works for you, I don’t think it’s something that would work for us, though. I think there’s a lot to be said for, uh, “easing” into all the “-ing” as you put it, though. Thanks again!

I never really thought about my sex drive in relation to my meds, but thinking about it, I remember that after I switched meds, there was a period of about a week where I was having, erm,  interludes with myself five, six times a day before going back to normal.

I’ve never heard of the mental illness =/= no sex myth before, although it is sadly true in my case. However, that has more to do with my dearth of time to engage in sex hijinks.

The thing with medication is that it affects the body as a whole, not just the mind, and that’s going to include sex drive, too.

Ah, it’s a while since I’ve heard the “having a sex life means you’re not ill” argument, but it’s very much out there and utterly frustrating.


Oh sweetie, I feel for you. I was there, for the longest time. For months on end he wouldn’t look at me, touch me, talk to me in any meaningful; he’d put up with hugs, cuddles and kisses with the utmost reluctance. I kept telling myself that it wasn’t personal, it was just his illness, and that I would get by with a little help from my hand. And then his sex drive would randomly come back and he’d suddenly want to shag as if the last few months had never happened. More often than not, instead of welcoming it I’d feel really freaked out by the suddenness and the pretence that this was all completely normal. I’m sorry to say that in the end it (and other things) just broke me, and I left him, with deep sorrow and regret last year.

But you and Mr J are doing what he would never do, though I kept begging him to: talking about the situation openly and honestly, and with professionals. Intimacy, I think, is based on both touch and talk. Is it worth setting up some appointments with Relate, either jointly or just for you? (You’re in the UK, right?) They can be fantastic, in my experience, and won’t charge if you’re strapped for cash. But don’t do what I did: let it ride, while becoming increasingly lonely and resentful.

Wishing you strength, courage, and lots of loving support.

Thank you for sharing, Elle. And oh my, I can relate – especially the being freaked out by sex drive coming back. I can certainly appreciate how hard things can be and ending a relationship is rarely an easy decision or experience – it’s where you have to remember to look after yourself.

Oh my, communication is a massive part of intimacy and to a degree, I’d even go so far as to say intimacy is a form of communication. We are in the UK, indeed. Relate is an idea that has been considered very briefly in the past but we’ve found (so far, at least) that the support of Mr. Juniper’s CPNs and psychiatrist have been the best support, and most appropriate, for us. It was definitely a learning curve for me, and for Mr. Juniper, that we had to talk, we had to do something about issues we had, even if we didn’t want to.

Thank you so much for your good wishes, and truly, am wishing you well, too.

I’m really impressed by the way you two are handling everything. And yes, the looking after yourself… That’s why I left, in the end: it was all about him, and I had become a non-person within our relationship. (Trivial example: friends and neighbours would routinely ask, “How is he?” and never, “How are you?”) And I had played my part in enabling that, in being strong, and not complaining and soldiering on….

I spent nearly a year trying to undo the mess, and failed, and eventually quit. It felt like I had killed him, and he is still utterly miserable without me. But he was utterly miserable with me too, and I am (whisper it) liberated. It is such a relief not to be a carer any more, the only functional adult in the relationship.

But my situation is so different from yours, as you and Mr J are pulling in the same direction. That is admirable and precious and essential, however impossibly difficult it may seem from time to time.

That doesn’t seem like a trivial example at all, I think it’s a very, very good example of why carers need support and why a partnership has to be about both people, not just one. It was certainly difficult at times, but asking for help was a big step. Though, even with all the good will in the world, carer or not, it has to be about what’s right for you.

Oh my goodness, I have heard that so often and I so appreciate why. Very glad that it has been a positive move for you, too. Out of interest, I mentioned it in the article, but The Selfish Pig’s Guide To Caring might be a book worth giving a shot as, from what you’ve said, I think much of it would be familiar to you and whilst you’re out of the relationship now, I think there’s a lot to be said for even then, knowing you’re not alone.

I think we’re very fortunate, Mr. Juniper and I. By no means is it always easy, but it’s where support and knowledge have been critical to us and it has also taken both of us to get where we are. I really am glad that you were able to make the right decision for you, though, truly.

This place is amazing, truly! Where is the judginess and the snark?? Rereading your OP earlier today made me realise that yes, the SP G2C is probably exactly what I need to read right now. — the book I needed to read years ago in fact. So if I can’t track one down IRL over the weekend, amazon gets yet another (very reaonable) dollop of my hard-earned cash. Thank you — again!

I’ve heard it the other way- that if you have certain MH issues you will be a ravenous sex fiend, and you’ll pounce on everything. Also, that if you are in an open relationship that that is in and of itself a “symptom”. (Both are absolute BS BTW.)

I’ve found more that my sex drive is more driven by my feelings about my physical health than strictly my mental health. And sometimes I’m just too tired of dealing with people and textures to want to invest my energy there right that moment, which is fine.

Intimacy wise. . . I’m Autistic. The ways that I am intimate as opposed to sexual are different from the general population (Poem example!). I can do and be sexual very well. Sexual you can learn out of a book or magazine or website. Intimacy you can’t.

That’s a very interesting point about intimacy being something that can’t be learnt, because it’s something that, to a degree, Mr. Juniper had to learn about. In that he could ‘do’ intimacy but had to learn what intimacy was. Not sure if that makes sense or not! I think intimacy is also something, as I mentioned, that we have to define for ourselves. Very interesting poem, too – thank you for sharing!

I think there are some instances where sexual behaviour can be relevant to a diagnosis but not in the way that a lot of  people think which you nicely illustrated with the example of open relationships being a ‘symptom’.

I’m pretty lucky in that I don’t have a partner to deal with during all of this, but my god the loss of sex drive is one of the most annoying things about all the crap I’m on. I went from nympho bar slut to nun in the course of a week. A WEEK.

And when I do feel like I’m in the mood, I can’t even make it to the finish line. Lamictal has almost completely taken away my ability to orgasm.

But hey, it’s either that or be completely batshit crazy.

Oh my goodness, what an image! Sound like a very accurate one, though, and very much like what happened to Mr. Juniper – a naturally high sex drive that all but disappeared. That’s something I forgot to mention, but yes, medication doesn’t only affect sex drive but the actual, uh, ‘mechanics’ of sex as a whole.

It’s also a situation where people don’t necessarily realise the balancing act that’s involved with medication, that it isn’t all sunshine and daisies after taking them.

Before going terribly much further, there’s a myth going around that if a person has a sex life, they can’t be mentally ill. Or at the very least, that their illness can’t be that bad. 


I had never heard this before. That’s such a crock of shit. Oh I WISH having an active sex life and having mental illness couldn’t coincide. Cause that would be the best depression cure ever!

I know! But I think it stems from the more general idea that if a person can do X, then they can’t be ill. It’s a bizarre way of thinking but it seems to be everywhere in little ways – ignorance in one of its worst incarnations, perhaps. Love your cure comment!

Leave a Reply