Infirm Consent

Here’s a topic that isn’t discussed very often in reference to recovery and living with mental illness: SEX.

How does a person in recovery deal with the changes in their libido (either up or down) brought on by the physical and mental process that has occurred? How do they develop their own sexual identity and values when they may never have had sex while not under the influence?

How does a person dealing with a mental illness manage relationships, lack thereof, and the adverse effects many medications have on desire, performance or both?

An important part of human experience is often put on hold, swept under the rug, deemed of secondary importance or simply drowned in depression.

That being said, the issues that can interfere with the full enjoyment of our sexuality are quite real.How do we know when we are or are not fully ready or able to consent to sex or commit to a relationship? How can current or prospective partners know?

In the recovery culture, the pursuit of sex and relationships with the newcomer tends to be frowned upon. The reasons for this make a lot of sense–a brain on the rollercoaster of detox and early recovery, desperate for any surge of pleasure chemicals to help replace the lost drugs, is ill equipped to make these kinds of decisions.

In the case of mental illness, there can be phases of altered reality or poor impulse control. With bipolar disorder, for example, sexual behavior can be more impulsive when in a manic state. A date, kiss, or interlude that seemed like a great idea at the time may be regretted in the cold light of a return to a more moderate condition.

These are only examples, but they serve to illustrate that an already complicated part of life gets more complicated in these circumstances.

I’ve had sex while in a hypomanic or manic state, silently changing my mind a hundred times during the process and resenting my partner for not being able to tell. I’ve experienced complete and extended annihilations of my libido due to depression and/or medications. I’ve abused drugs that cause blackouts and lower inhibitions, leading to activities I could not remember the next day. All of these have affected my relationships and my level of comfort with sex.

In this relatively new phase of my life, I have to admit that my biggest feeling about my sexuality is confusion. Maybe that’s the best I can do right now; just admit to myself and my partner that I don’t know what I am doing. He, as well, has to do the best he can in terms of figuring out whether this is a bad time to pursue an apparently willing encounter or not. It’s a mind game he doesn’t deserve, but like much of what we deal with it is what it is.

I’m sure that I am not alone in this. Deciding what kind of sexual life we want–and deciding that we deserve to have it–isn’t easy. Some people need help to protect themselves from exploitation by others, but this doesn’t mean that a healthy experience is impossible. We are human creatures with human longings, not negated by our histories or conditions.

3 responses to “Infirm Consent

  1. What an honest and raw post. So human and authentic on a topic so few are willing to talk about. Well done 🙂

  2. Lori, thank you for bringing up the subject of sex. While I have not had to struggle with the issues of substance abuse recovery, I have bipolar disorder which takes ones libido and sexual responsiveness on a confusing roller coaster ride. On top of the effects of the illness itself, medications interfere with libido and sexual responsiveness. It is very important to discuss medication side effects both with one’s psychiatrist to try to find the best mix, minimizing negative sexual side effects if possible, as well as with one’s sex partner. We are blessed in that we are married to loving, supportive husbands who can and will listen to us. It helps to be in a loving, committed, monogamous relationship where you can safely explore these issues without “doing harm” by sexually acting out.

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