I've got a sad problem. My sex life with my husband of 12 years, total of 15 together, was hot for a few years, but dropped off when I started antidepressants ten years ago—can't orgasm, very low libido, but the meds changed my life for the better.

We have four young children and for the past year, one of them has been very sick—a life-long, serious illness—and dealing with our sick child is physically and emotionally exhausting. Though my spouse is a WONDERFUL teammate AND I love him AND he is physically attractive, I just don't have it in me to have sex of any kind with anyone. Not even myself.

At work I'm energized because my job has been a respite from the staggering, miserable situation at home. But I'm otherwise so depressed—at times suicidal—I don't know if I could even give a hand job without weeping. On top of that, I have really let myself go—caring for myself is at the bottom of the 'to do' list these days—so I also feel unattractive.

I feel so bad for my husband having to put up with me, I told him it's totally fine if he goes elsewhere to fulfill his (rather strong) sexual desires, but he says he doesn't want to do that. Any suggestions?

Dead Down There

My response after the jump...

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I'm so sorry to hear that you have a sick child—that's a tremendous burden.

You know, DDT, yours is the kind of letter that an advice columnist—myself included—usually skips over. Because there are no easy answers, no two-or-three paragraph fix. I'm sure you have already asked your doctor to adjust your meds; I'm sure you've already reached out to family and friends for help and support; I'm sure that, if you have the resources to bring in paid help (to make time and space for you and husband to take care of yourselves and each other), it has already occurred to you to do that.

Here's all I got: sometimes people make huge sacrifices for love, DDT. Look at the sacrifices you're making for your children—all of your children—and your family. If your husband loves you more than he needs sex, if sex is something he's willing to a sacrifice to be with you and be there for you and be there for his kids, then I would urge you to accept his loving sacrifice and stop feeling bad about your lack of sexual desire.

Sometimes what is, is. And sometimes there isn't anything a person can do—or a person can advise a person to do—to change anything. Having a sick child, needing your meds, the crushing burdens of family life: those aren't circumstances that are likely to change in the foreseeable future. Focus on what works in your marriage—your partnership, your teamwork—and not on what doesn't, or doesn't for now, and let it go.

And if you haven't talked to your doc about your meds, please do—if you're feeling suicidal, DDT, then it's definitely time to tweak those meds and seek some additional treatment or support. And talk to your husband, again, about his unmet sexual needs. Give him the okay to masturbate to whatever porn he enjoys, whenever he needs to, and let him know that you meant it when you said you were fine with him finding sex elsewhere.

And, again, I'm sorry. Hang in there.