July 23, 2025 • 21 mins
Six months into the "When Depression Is In Your Bed" podcast, I realized I'd barely touched on one of the most significant aspects of depression in relationships—the impact on sexual intimacy and physical connection. The bed isn't just where we sleep; it's where we dream, where we struggle with insomnia or can't find the energy to rise, and where we reach for connection with our partners.
Physical intimacy becomes particularly fascinating when viewed through the lens of nervous system regulation. Our nervous system can be in one of three states: ventral (safe and connected), sympathetic (fight or flight), or dorsal (shutdown and depression). When depression takes hold, that dorsal state dominates, leaving us feeling disconnected and alone, even beside someone we love. Sex and touch can serve as powerful tools for co-regulation—the way two nervous systems help each other feel safe and connected.
Drawing from my 21-year relationship journey, I share how physical intimacy functions differently throughout a partnership affected by depression. In our early years, my husband and I were both "dorsal dwellers," finding safety in withdrawal but using physical connection to temporarily emerge. Sex was mutually beneficial co-regulation, creating bridges of connection between our often shutdown states. As time passed, patterns shifted—my husband began frequently reaching for intimacy when depressed as a means of feeling better, creating an imbalance where I felt more like a regulating tool than a partner. Resentment grew, leading to my own disconnection during intimate moments, creating a destructive cycle we've spent years untangling.
After years of working through this together, we made significant progress once we began to understand the language of our nervous systems. Without judgment, I could see his reaching for connection was his system seeking safety, rather than believing negative misinterpretations about his behavior. He could understand my withdrawal wasn't rejection but self-protection. This compassionate framework has transformed how we approach intimacy, allowing us to distinguish between different needs and experiences—sometimes one partner needs support, other times both are regulated enough to enjoy fully mutual connection.
This summer, I'll be sharing mini-episodes about my lived experiences navigating depression in relationships. Follow me @trish.sanders.lcsw on social media and check out my upcoming Getting the Love You Want workshops and retreats.
- If you and your partner are ready to co-create the roadmap to the relationship of your dreams, join us for the next in-person "Getting the Love You Want" Weekend Couples Retreat!
For support in how to have deeper connections and better communication in the relationships that matter most in your life, follow the host, Trish Sanders on Instagram , Bluesky or LinkedIn.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
Hello and welcome to the when Depression is in your
Bed podcast.
Would you like to explore theconnection between depression,
sex and your nervous system?
Are you interested in learninghow they can work together and
also sometimes work against eachother, especially when we're
talking about long-term intimatepartners?
If you're curious, please joinme today as I explore this
complex and deep topic.
(00:22):
I'm your host, trish Sanders,and I am delighted that you are
here.
Let's get started.
Today is an exciting episode,not just because of the topic,
which is, in fact, exciting inmy opinion, but also because
it's my 26th episode.
So that means that I have beenrecording weekly podcasts for
six months, and when I beganthis project, or when I started
(00:43):
to think about beginning thisproject, thinking about
podcasting for six months seemedjust about impossible, but not
completely impossible, because Itook on the challenge.
And here I am today and I'mreally excited to be here and
the experience so far has beenso amazing and I can't wait to
see how my journey unfolds inthis whole podcasting world.
(01:06):
I will say that part of menoticing that I was coming upon
this milestone really made mewonder about what I wanted
today's episode to be about, andas I started thinking.
I started realizing that I havea podcast called when
Depression Is In your Bed, andsomehow I have gone six months
hardly mentioning sex at all.
And so when you think aboutrelationships and beds, sex is
(01:26):
something that often comes upand I think it's really
important to talk about, and Icertainly haven't been avoiding
the topic and it also wasn't myintention for that to be the
primary focus of this podcast,but it's a really important
topic for relationships and Ithought that now was the time to
talk about it.
I do want to just say a littlenote that when I thought about
what to name the podcast, thename when Depression Is In your
(01:49):
Bed was the very first name thatreally came to me and it just
fit, and not just because of howdepression affects a
relationship's sex life, whichit often does, but also because
there's so many pieces aboutwhen depression is in your bed,
in your life as an individualand in your relationship.
It affects how you sleep.
It affects how you literallydream at night, but also how you
(02:13):
dream and hope when you'reawake.
It affects if you go to bed atnight or if it's hard for you to
go to bed at night, right Likeif you suffer from insomnia and
you can't get to sleep or youactually can't even get out of
bed because you're soimmobilized, and it affects how
you feel when you wake up in themorning and, of course, when
you're in relationship.
Depression affects many aspectswhen it's in your bed in this
(02:34):
literal way, when your nervoussystem and body is experiencing
depression and it is physicallyin your bed, how that affects
your ability to connect againwith yourself, of course, but
also with your partner, and thatincludes every yourself, of
course, but also with yourpartner, and that includes every
possible type of connection,whether it's emotional or
spiritual, or psychological or,of course, physical.
You know how you cuddle up atnight, if you kiss each other
(02:56):
goodnight, or kiss each other orcuddle in the morning.
All of that is affected whendepression is in your bed, and
so that's how I came to thetopic, and those were all the
things that I was thinking about.
But, like I said, sex isdefinitely a part of that, and
today I'm going to just beginthis conversation, because it is
so vast and there are so manydifferent experiences that
(03:18):
people may have with sex orphysical intimacy and depression
.
Today I will just be startingto create this frame of
understanding so we can start tosee how sex and physical
intimacy can be used in intimatepartner relationship.
It doesn't have to be anintimate partner relationship,
but I am going to be talkingabout long-term committed
(03:39):
partners and how we can use itto regulate our nervous system
and how that could be a reallypositive experience, and also
just a little tiny bit, fortoday at least, about how that
can really become problematic inrelationship.
I'm going to talk about someoverarching ideas about
co-regulation and how sex isused, specifically as it
pertains to depression.
But you don't have to bediagnosed with depression to use
(04:01):
sex in this way, because evenif you're not clinically
depressed, all of us have anervous system that only has
three states that it can access,and it's a ventral state of
safety.
It is a mobilized response tothreat, which is our sympathetic
fight or flight responseSomething's happening to me, I
have to do something about it.
And then there's dorsal, whichis the immobilized response to
threat.
Things are so overwhelming Ineed to collapse or withdraw or
(04:24):
hide, or I don't have theresources to fight, so I have to
replenish and renew, and that'sthe dorsal state, which is
associated with depression.
And so, even if you're notstuck in depression or
clinically depressed, yournervous system also goes to the
dorsal state, and this coulddefinitely apply in any and
every relationship, even when adiagnosis is not present.
So, to begin, what isco-regulation?
(04:45):
It is in nervous system terms,and I work from a polyvagal,
informed perspective, so this isin line with polyvagal theory,
which is all about how ournervous system is at the heart
of everything we do and how weexperience ourselves and others
and the world, and soco-regulation is the idea that
two nervous systems or twopeople in any kind of
(05:05):
relationship Again, I'm talkingabout long term intimate partner
relationships but any twopeople in any kind of
relationship it could be yourcoworker, it could be a friend,
it could be the person standingnext to you online at the
grocery store, but our nervoussystems are always interacting
with the other nervous systemsaround us, and you can imagine
that when you're in an intimatepartner relationship, it's
called intimate.
(05:26):
I'm referring to it as anintimate relationship.
Right, there's an intimacy,there's a closeness, and
depression certainly affectsthat experience of closeness.
When we're in our dorsal state,that's a state of disconnection
, and so we often feeldisconnected, even from the
people that we love the most.
And so the idea of co-regulationis how two nervous systems can
really work together andcommunicate together, as a
(05:49):
matter of fact, in their ownnervous system language, not in
words.
And of course, this is wheresex and physical intimacy can be
really powerful, because youdon't need words, right, it's a
very physical, body, sensoryexperience.
And so when two nervous systemsfor my purposes I'm going to
talk about intimate partnerswhen two partners can feel safe
(06:11):
together and they are attuned totheir own needs and each
other's needs and they can havea meaningful social engagement
with each other, that feelsreally positive and can feel
really delightful and wonderful.
And if you think about a reallygreat sexual experience or
intimate physical experienceyou've had, if you think about
one of the best when you felt soconnected, so loved, so safe,
(06:35):
so seen, so powerful even thenthat's really what we're talking
about when our nervous systemis in our safe ventral state.
And so that's one experience ofregulation and one way to
co-regulate, when two partnersare both in that ventral safe
state and they can come togetherand enjoy a really satisfying,
meaningful, fun, sexy,physically intimate experience,
(06:58):
right?
So that's one way to use sex.
Is you're feeling good alreadyand you're just feeling even
more good with your partner.
There's self-regulation, whichis how we make ourselves either
stay in a ventral state or howwe help our nervous systems move
from a protected state, thatsympathetic or dorsal, and move
into ventral.
And then there's co-regulation,which is how we do that with a
(07:18):
partner right, and so that'swhat we're talking about today.
The first way we canco-regulate with sex is sort of
like hey, I'm already feelinggood, you're feeling good, let's
enjoy this experience together,and so that's wonderful.
That is generally not theexperience you're going to be
having when depression is inyour bed, certainly if there's
active depression.
So, moving on to anotherfunction of sex, when it comes
(07:39):
to the nervous system anddepression, there is that aspect
of co-regulation versusself-regulation that I just
mentioned.
And when you're in dorsal, whenyou're stuck again, this is an
immobilized state, this is not.
Oh, I don't feel like doingsomething.
This is I am physically unableto take action.
Now that's a deep, deepdepression.
There's a lot of flavors ordegrees.
(08:00):
I call them the steps ofdepression.
A lot of the time that you knowif you're in a deep, deep
depression you're not gettingout of bed, but you can be on
one of the higher steps as Ienvision it, where you are kind
of going through the motions,you're feeling numb but you're
still like going through the dayto day and there's a little bit
more energy.
But self-regulation can be hardto grasp when you're in that
dorsal state.
So reaching out to your partnercan be a really lovely
(08:24):
experience of like, hey, can youoffer me a hand Right?
And there's a lot of differentways that this could be done.
Today we're talking about sex,so I'm going to stick to talking
about that.
But it can be at times and Iwill explore this in much
greater detail in later episodesso I know that there's a lot
that's not being said here ornot being said in a
comprehensive way, but that canactually be a very positive and
(08:47):
healthy experience if bothpartners are aligned and attuned
to one another and they bothfeel safe that the depressed
partner or the partner whosenervous system is stuck in
dorsal can reach out to theirother partner whose nervous
system is not stuck in dorsaland say, hey, can I use some of
your energy to kind of help liftme out of here?
(09:07):
Or physical intimacy doesn'thave to be sexual intercourse
sex I'm using is a very broadword for touch, for caressing,
for cuddling, for eye gazing,for massage, so a very wide
array of what that can mean.
And so that's one way that adepressed person can reach out
and benefit from the energy oftheir partner's nervous system
that can help them to move intoa more regulated state.
Also, sex is something that ifyou're able to engage in when
(09:31):
you're feeling depressed, it canreally help you feel alive,
because when you're in dorsal Imean most people, certainly my
experience it's very empty, it'sdark, it's dreary, it's
definitely alone, it's a verydead feeling space, and so the
experience of sex can be amazingand alive, and it might just
last for the duration of thesexual experience, or it might
(09:51):
help lift somebody out of thatdorsal experience and they might
be able to be a little bit moreregulated in a little bit more
of a lasting way.
Nothing is an immediate andforever lasting fix, and what I
mean by that is that our nervoussystems are constantly in flux,
we're constantly going throughdifferent states throughout the
day, and we need to be able todo that.
That's vitally important forour survival and for our
(10:11):
thriving, but it is about notgetting stuck in a state and
being able to regulate andmanage.
So, again, I can talk a lotmore about that, and I I have in
previous episodes and I willagain.
But moving back into how sexcan be used as a co-regulation
tool is also in that idea thatbeing able to engage again with
that eye contact, with that softand gentle touch, with even the
(10:33):
rocking, the motion, could bewords, but without even using
words.
If you think about the soundsof sex, that can be sort of
rhythmic or it can be massaging.
If you think about the soundsof sex, that can be sort of
rhythmic or it can be massaging.
If you think about moaning, orif you think about humming and
sighing, there's a lot ofsimilarities that could be the
sounds that are helpful for ournervous system and they can
really help us reach for ventral.
So there's all of these reallypositive ways that sex can be
(10:57):
used to help a depressed partnerbe able to regulate.
However, there's a lot ofcaution in this because it's not
always a good experience and itcan't always be the go-to each
and every time.
And I will talk a little bitabout the evolution of my
husband and our experience ofsex and regulation in our
relationship over 21 years,which I will talk about in a
(11:19):
moment.
I just want to say that thereare a lot of ways you can have
dysregulated sex.
You're still very shut down orit could be very disconnecting.
Either you yourself aredisconnected because you're
depressed or your partner maybeis not depressed, but they
become disconnected becausethey're really not feeling safe
themselves in that experience.
(11:40):
So they're not having aconnected experience of sex or
physical intimacy with you,which can be very problematic.
Again, I'm not really going togo deep into that today, but I
will absolutely talk a lot moreabout that in the future.
So just know that I'm notsending a message of sex is the
way to help your depressedpartner get out of their
depression.
Please know that that's notwhat I'm saying, but that it is
(12:02):
one of the options that can beon the menu, so to speak, of
what partners can do together tohelp one partner or both
partners to reconnect with thatventral safe nervous system
state.
So just to kind of give you anidea of my own personal
experience and how this haslooked in my own life, I'm going
to tell you again kind of likethe sex, depression and nervous
(12:24):
system story of Trish and Benover our 21 year relationship
and it's going to sound verylinear the way I'll tell it.
Over time, as I dive more intothis, I will definitely tell you
more details and you'll seethat it is not in any way a
linear journey, but itdefinitely has evolved over time
.
And so, going back to our veryearly days, this is before we
(12:45):
had kids, before we were married, before we were
well-established in our careers,and at that time we were both
dorsal dwellers, which is a DebDana term, and Deb Dana I've
referenced before, she is theclinical application person of
all things, polyvagal and she'samazing.
And so being a dorsal dwellermeans that your nervous system
has a tendency to get stuck inthat dorsal experience.
(13:07):
I and my husband both foundsafety and protection in that
shut down, withdrawn, collapsedplace while we were growing up
and we took that safety, thatway of finding safety, into our
adult lives.
And in our early relationship wewere totally functional.
I mean I was in graduate schoolwhen we met and he was going
through a career change and wethen had jobs that we held with
(13:28):
no issue.
We were able to get up in themorning and do what we had to do
and get everything done and wewere pretty good employees, I
would say.
But at night, on the weekends,we were very shut down.
We would sleep all weekend longand we drank a lot of wine at
night, for sure, back then, andwe were very functional dorsal
dwellers, I would say, and atthat time we often use sex as
(13:50):
co-regulation and we would beable to connect with that
physical intimacy.
My husband, if you know thelove languages, one of his love
languages is definitely physicalaffection and just being very
close.
If you know the term kangaroocare, when a baby is born they
recommend skin to skin contact.
And when our son was born, welearned about kangaroo care.
We were like, wow, we dokangaroo care too as adults.
(14:11):
Right, and that's true, we usedto do kangaroo care, we used to
just do skin to skin contact.
And how safe and connected wecould feel, even when one or
both of us were feelingdepressed.
It's maybe even a little bithard to describe, but I can
experience that feeling.
I can experience it in mynervous system right now as I
think about it, because I justfelt like I didn't feel alone
(14:33):
anymore.
I felt like this was my person.
Here we are, us against theworld.
We can both be safe here inthis really beautiful space and
it was incredible and that wasreally our very early beginning
and there was a lot ofco-regulation that was beautiful
and mutually beneficial andcertainly safe for both of us
(14:54):
and then eventually fast forwardlots of time that I won't go
into all the details now,although you've heard me talk
about some and again, you'llabsolutely hear me talk about
them again in the future.
But eventually things became alittle lopsided because I
started feeling like myhusband's go to.
As I mentioned before, if sexis your go to, I feel depressed.
(15:15):
Let me have sex with my partner.
Eventually.
While I totally understand whythat makes sense and why that
works, eventually it doesn'talways feel so good because it's
not, as I started off talkingabout in this episode, that
eventual experience that bothpartners are feeling good and
then it just becomes like thisway to just enjoy feeling good
together.
It's lopsided that I was notnecessarily feeling depressed
(15:37):
and he was, and he was againreaching up a hand saying, hey,
can you pull me up?
But it kind of was like hey, myback's hurting, I'm leaning
over pulling you up a lot, youknow and it stopped being so fun
and enjoyable for me, whetherthat was eye gazing or kangaroo
care or sexual intercourse,sexual activity and all the
things under that umbrella.
I started feeling resentfulabout that experience and I
(16:00):
didn't want to have thatexperience anymore.
And so then I could disconnectand go into my own dorsal
shutdown, and it caused a lot ofproblems over many, many, many
years, and again I'll dive indeeper into the specifics in
later episodes.
Eventually though I don't knowhow many years 15 years, 18
years in some ways we're stillgoing through it after 21 years,
(16:23):
although we've come an awfullong way, I have to say.
But eventually I was like, hey,like this is not the kind of
sex that I want to be having.
And my husband was like, yeah,me, neither, I don't enjoy it
when you're shut down.
I'm like, oh, yeah, well, Idon't enjoy it when you're
depressed and you're reaching upto me as your only lifeline,
right?
And those were theconversations, and there were
many, many conversations we had.
And eventually we're like wehave to do this different, right
(16:44):
, it doesn't feel good foreither of us, so we have to
figure out a new way.
So that and it has been quitethe journey it's been very bumpy
at times, but also reallybeautiful and really connecting
at times because with thenervous system language we are
understanding and I can haveabsolute compassion for why Ben
reaches out for me in that wayand he can understand.
(17:05):
While I welcome supporting him,I don't want sex to only be.
It's really not only only issuch an absolute term, but it's
not the only way that he usessex or that we have sex together
.
It's not that at all, butthat's how it feels for my
nervous system.
That's the nervous system story.
The only time we have sex iswhen you're reaching out to feel
better, when you're depressedor when you've had a bad day at
work, and then that doesn't makeme feel special, I don't feel
(17:28):
important, I don't feel seen, Idon't feel like he's able to
attune to me and, quite honestly, he probably isn't when he's
really dysregulated, which makestotal sense, right.
And so now we've really gottento this place where we have this
beautiful language, where I cansay to him you know what I want
to have, this really enjoyableco-regulation experience of sex
where we're both feeling goodand we're both bringing our
(17:50):
whole selves, our whole body,our whole spirit into our sexual
experience.
And that can be fireworks andreally exciting.
I can feel chills andgoosebumps as I talk about it,
right.
That's like the delicious,juicy, wonderful active sexual
desire and fun and sexy.
Right, that's the sexy,wonderful stuff that people
(18:10):
maybe dream about, or certainlyI dream about and absolutely
experience when my nervoussystem is regulated and when
Ben's nervous system isregulated.
So we've been really figuringthis out, and adding the layer
of the nervous system has beenprofoundly enlightening for me
because it helps me understand,without any judgment and with
real full compassion, my ownexperience and Ben's experience.
(18:33):
And so that's where I'm gonnaend for today, because there's
so much here and I can't wait totalk to you about it.
So stay tuned for futureepisodes.
For the next several episodes,I'm gonna do something a little
bit different.
I think it's gonna be fun,because we're in to summer right
now.
I'm going to be doing what Iimagine will be mini episodes
where I'll talk about my livedexperience, like something that
(18:55):
happened that week, somethingthat went really well or
something that didn't go so well, and how I handled it or didn't
handle it, or how I figured itout after the fact, if I kind of
really was dysregulated andmade a lot of missteps.
And I'm just going to sharesome of those experiences and
I'll take a little break fromsharing these frameworks.
I felt like it was importantfor me to share how I look at my
(19:17):
world and my relationship, andcertainly the relationships that
I work with as a therapist andas a coach, and I wanted you to
have that information to referto to help deepen your
understanding, if that's whatyou're interested in.
And now I'm going to just talkabout my experience for a little
while and see how that goes,and I hope you're enjoying
summer or whatever season it isfor you right now, and I'm going
(19:39):
to go continue enjoying somemore of my summer and play with
these little mini episodes for afew weeks and I'll be back to
full length episodes in the fall.
But I didn't want to stop theflow because I'm really enjoying
this podcast experience and I'mreally enjoying connecting with
you and I look forward toconnecting with you more.
So be sure to follow me onsocial media and definitely
(20:01):
connect with me there and checkout my Getting the Love you Want
workshops and retreats that Ihave coming up.
And that's all for today.
As our time comes to a close, Iask you to keep listening for
just a few more moments becauseI wanna thank you for showing up
today and I want to leave youwith an invitation as you hit,
stop and move back out into theworld on your own unique
(20:22):
wellness journey In order tomove from where you are today to
the place where you want to be.
The path may seem long orunclear or unknown, and I want
you to know that if that seemsscary or daunting or downright
terrifying or anything else,that is totally okay.
Know that you do not have tocreate the whole way all at once
(20:44):
.
We don't travel a whole journeyin one stride, and that is why
my invitation to you today is totake a step, just one, any type
, any size, in any direction.
It can be an external step thatcan be observed or measured, or
it could be a step youvisualize taking in your mind.
It can be a step towards action, or towards rest or connection
(21:07):
or self-care, or whatever stepmakes sense to you.
I invite you to take a steptoday because getting to a place
that feels better, more joyful,more connected than the place
where you are today is possiblefor everyone, including you, and
even when depression is in yourbed.
If today's episode resonatedwith you, please subscribe so
(21:30):
you can be notified when eachweekly episode gets released.
I encourage you to leave areview and reach out to me on
social media at trishsanderslcsw.
Review and reach out to me onsocial media at trishsanderslcsw
.
Your feedback will help guidefuture episodes and I love
hearing from you.
Also, please share this podcastwith anyone who you think may
be interested or who may getsomething from what I have
(21:50):
shared.
Until the next time we connect,take care of yourself and take
a step.
Hello and welcome to the when Depression is in your
Bed podcast.
Would you like to explore theconnection between depression,
sex and your nervous system?
Are you interested in learninghow they can work together and
also sometimes work against eachother, especially when we're
talking about long-term intimatepartners?
If you're curious, please joinme today as I explore this
complex and deep topic.
(00:22):
I'm your host, trish Sanders,and I am delighted that you are
here.
Let's get started.
Today is an exciting episode,not just because of the topic,
which is, in fact, exciting inmy opinion, but also because
it's my 26th episode.
So that means that I have beenrecording weekly podcasts for
six months, and when I beganthis project, or when I started
(00:43):
to think about beginning thisproject, thinking about
podcasting for six months seemedjust about impossible, but not
completely impossible, because Itook on the challenge.
And here I am today and I'mreally excited to be here and
the experience so far has beenso amazing and I can't wait to
see how my journey unfolds inthis whole podcasting world.
(01:06):
I will say that part of menoticing that I was coming upon
this milestone really made mewonder about what I wanted
today's episode to be about, andas I started thinking.
I started realizing that I havea podcast called when
Depression Is In your Bed, andsomehow I have gone six months
hardly mentioning sex at all.
And so when you think aboutrelationships and beds, sex is
(01:26):
something that often comes upand I think it's really
important to talk about, and Icertainly haven't been avoiding
the topic and it also wasn't myintention for that to be the
primary focus of this podcast,but it's a really important
topic for relationships and Ithought that now was the time to
talk about it.
I do want to just say a littlenote that when I thought about
what to name the podcast, thename when Depression Is In your
(01:49):
Bed was the very first name thatreally came to me and it just
fit, and not just because of howdepression affects a
relationship's sex life, whichit often does, but also because
there's so many pieces aboutwhen depression is in your bed,
in your life as an individualand in your relationship.
It affects how you sleep.
It affects how you literallydream at night, but also how you
(02:13):
dream and hope when you'reawake.
It affects if you go to bed atnight or if it's hard for you to
go to bed at night, right Likeif you suffer from insomnia and
you can't get to sleep or youactually can't even get out of
bed because you're soimmobilized, and it affects how
you feel when you wake up in themorning and, of course, when
you're in relationship.
Depression affects many aspectswhen it's in your bed in this
(02:34):
literal way, when your nervoussystem and body is experiencing
depression and it is physicallyin your bed, how that affects
your ability to connect againwith yourself, of course, but
also with your partner, and thatincludes every yourself, of
course, but also with yourpartner, and that includes every
possible type of connection,whether it's emotional or
spiritual, or psychological or,of course, physical.
You know how you cuddle up atnight, if you kiss each other
(02:56):
goodnight, or kiss each other orcuddle in the morning.
All of that is affected whendepression is in your bed, and
so that's how I came to thetopic, and those were all the
things that I was thinking about.
But, like I said, sex isdefinitely a part of that, and
today I'm going to just beginthis conversation, because it is
so vast and there are so manydifferent experiences that
(03:18):
people may have with sex orphysical intimacy and depression
.
Today I will just be startingto create this frame of
understanding so we can start tosee how sex and physical
intimacy can be used in intimatepartner relationship.
It doesn't have to be anintimate partner relationship,
but I am going to be talkingabout long-term committed
(03:39):
partners and how we can use itto regulate our nervous system
and how that could be a reallypositive experience, and also
just a little tiny bit, fortoday at least, about how that
can really become problematic inrelationship.
I'm going to talk about someoverarching ideas about
co-regulation and how sex isused, specifically as it
pertains to depression.
But you don't have to bediagnosed with depression to use
(04:01):
sex in this way, because evenif you're not clinically
depressed, all of us have anervous system that only has
three states that it can access,and it's a ventral state of
safety.
It is a mobilized response tothreat, which is our sympathetic
fight or flight responseSomething's happening to me, I
have to do something about it.
And then there's dorsal, whichis the immobilized response to
threat.
Things are so overwhelming Ineed to collapse or withdraw or
(04:24):
hide, or I don't have theresources to fight, so I have to
replenish and renew, and that'sthe dorsal state, which is
associated with depression.
And so, even if you're notstuck in depression or
clinically depressed, yournervous system also goes to the
dorsal state, and this coulddefinitely apply in any and
every relationship, even when adiagnosis is not present.
So, to begin, what isco-regulation?
(04:45):
It is in nervous system terms,and I work from a polyvagal,
informed perspective, so this isin line with polyvagal theory,
which is all about how ournervous system is at the heart
of everything we do and how weexperience ourselves and others
and the world, and soco-regulation is the idea that
two nervous systems or twopeople in any kind of
(05:05):
relationship Again, I'm talkingabout long term intimate partner
relationships but any twopeople in any kind of
relationship it could be yourcoworker, it could be a friend,
it could be the person standingnext to you online at the
grocery store, but our nervoussystems are always interacting
with the other nervous systemsaround us, and you can imagine
that when you're in an intimatepartner relationship, it's
called intimate.
(05:26):
I'm referring to it as anintimate relationship.
Right, there's an intimacy,there's a closeness, and
depression certainly affectsthat experience of closeness.
When we're in our dorsal state,that's a state of disconnection
, and so we often feeldisconnected, even from the
people that we love the most.
And so the idea of co-regulationis how two nervous systems can
really work together andcommunicate together, as a
(05:49):
matter of fact, in their ownnervous system language, not in
words.
And of course, this is wheresex and physical intimacy can be
really powerful, because youdon't need words, right, it's a
very physical, body, sensoryexperience.
And so when two nervous systemsfor my purposes I'm going to
talk about intimate partnerswhen two partners can feel safe
(06:11):
together and they are attuned totheir own needs and each
other's needs and they can havea meaningful social engagement
with each other, that feelsreally positive and can feel
really delightful and wonderful.
And if you think about a reallygreat sexual experience or
intimate physical experienceyou've had, if you think about
one of the best when you felt soconnected, so loved, so safe,
(06:35):
so seen, so powerful even thenthat's really what we're talking
about when our nervous systemis in our safe ventral state.
And so that's one experience ofregulation and one way to
co-regulate, when two partnersare both in that ventral safe
state and they can come togetherand enjoy a really satisfying,
meaningful, fun, sexy,physically intimate experience,
(06:58):
right?
So that's one way to use sex.
Is you're feeling good alreadyand you're just feeling even
more good with your partner.
There's self-regulation, whichis how we make ourselves either
stay in a ventral state or howwe help our nervous systems move
from a protected state, thatsympathetic or dorsal, and move
into ventral.
And then there's co-regulation,which is how we do that with a
(07:18):
partner right, and so that'swhat we're talking about today.
The first way we canco-regulate with sex is sort of
like hey, I'm already feelinggood, you're feeling good, let's
enjoy this experience together,and so that's wonderful.
That is generally not theexperience you're going to be
having when depression is inyour bed, certainly if there's
active depression.
So, moving on to anotherfunction of sex, when it comes
(07:39):
to the nervous system anddepression, there is that aspect
of co-regulation versusself-regulation that I just
mentioned.
And when you're in dorsal, whenyou're stuck again, this is an
immobilized state, this is not.
Oh, I don't feel like doingsomething.
This is I am physically unableto take action.
Now that's a deep, deepdepression.
There's a lot of flavors ordegrees.
(08:00):
I call them the steps ofdepression.
A lot of the time that you knowif you're in a deep, deep
depression you're not gettingout of bed, but you can be on
one of the higher steps as Ienvision it, where you are kind
of going through the motions,you're feeling numb but you're
still like going through the dayto day and there's a little bit
more energy.
But self-regulation can be hardto grasp when you're in that
dorsal state.
So reaching out to your partnercan be a really lovely
(08:24):
experience of like, hey, can youoffer me a hand Right?
And there's a lot of differentways that this could be done.
Today we're talking about sex,so I'm going to stick to talking
about that.
But it can be at times and Iwill explore this in much
greater detail in later episodesso I know that there's a lot
that's not being said here ornot being said in a
comprehensive way, but that canactually be a very positive and
(08:47):
healthy experience if bothpartners are aligned and attuned
to one another and they bothfeel safe that the depressed
partner or the partner whosenervous system is stuck in
dorsal can reach out to theirother partner whose nervous
system is not stuck in dorsaland say, hey, can I use some of
your energy to kind of help liftme out of here?
(09:07):
Or physical intimacy doesn'thave to be sexual intercourse
sex I'm using is a very broadword for touch, for caressing,
for cuddling, for eye gazing,for massage, so a very wide
array of what that can mean.
And so that's one way that adepressed person can reach out
and benefit from the energy oftheir partner's nervous system
that can help them to move intoa more regulated state.
Also, sex is something that ifyou're able to engage in when
(09:31):
you're feeling depressed, it canreally help you feel alive,
because when you're in dorsal Imean most people, certainly my
experience it's very empty, it'sdark, it's dreary, it's
definitely alone, it's a verydead feeling space, and so the
experience of sex can be amazingand alive, and it might just
last for the duration of thesexual experience, or it might
(09:51):
help lift somebody out of thatdorsal experience and they might
be able to be a little bit moreregulated in a little bit more
of a lasting way.
Nothing is an immediate andforever lasting fix, and what I
mean by that is that our nervoussystems are constantly in flux,
we're constantly going throughdifferent states throughout the
day, and we need to be able todo that.
That's vitally important forour survival and for our
(10:11):
thriving, but it is about notgetting stuck in a state and
being able to regulate andmanage.
So, again, I can talk a lotmore about that, and I I have in
previous episodes and I willagain.
But moving back into how sexcan be used as a co-regulation
tool is also in that idea thatbeing able to engage again with
that eye contact, with that softand gentle touch, with even the
(10:33):
rocking, the motion, could bewords, but without even using
words.
If you think about the soundsof sex, that can be sort of
rhythmic or it can be massaging.
If you think about the soundsof sex, that can be sort of
rhythmic or it can be massaging.
If you think about moaning, orif you think about humming and
sighing, there's a lot ofsimilarities that could be the
sounds that are helpful for ournervous system and they can
really help us reach for ventral.
So there's all of these reallypositive ways that sex can be
(10:57):
used to help a depressed partnerbe able to regulate.
However, there's a lot ofcaution in this because it's not
always a good experience and itcan't always be the go-to each
and every time.
And I will talk a little bitabout the evolution of my
husband and our experience ofsex and regulation in our
relationship over 21 years,which I will talk about in a
(11:19):
moment.
I just want to say that thereare a lot of ways you can have
dysregulated sex.
You're still very shut down orit could be very disconnecting.
Either you yourself aredisconnected because you're
depressed or your partner maybeis not depressed, but they
become disconnected becausethey're really not feeling safe
themselves in that experience.
(11:40):
So they're not having aconnected experience of sex or
physical intimacy with you,which can be very problematic.
Again, I'm not really going togo deep into that today, but I
will absolutely talk a lot moreabout that in the future.
So just know that I'm notsending a message of sex is the
way to help your depressedpartner get out of their
depression.
Please know that that's notwhat I'm saying, but that it is
(12:02):
one of the options that can beon the menu, so to speak, of
what partners can do together tohelp one partner or both
partners to reconnect with thatventral safe nervous system
state.
So just to kind of give you anidea of my own personal
experience and how this haslooked in my own life, I'm going
to tell you again kind of likethe sex, depression and nervous
(12:24):
system story of Trish and Benover our 21 year relationship
and it's going to sound verylinear the way I'll tell it.
Over time, as I dive more intothis, I will definitely tell you
more details and you'll seethat it is not in any way a
linear journey, but itdefinitely has evolved over time
.
And so, going back to our veryearly days, this is before we
(12:45):
had kids, before we were married, before we were
well-established in our careers,and at that time we were both
dorsal dwellers, which is a DebDana term, and Deb Dana I've
referenced before, she is theclinical application person of
all things, polyvagal and she'samazing.
And so being a dorsal dwellermeans that your nervous system
has a tendency to get stuck inthat dorsal experience.
(13:07):
I and my husband both foundsafety and protection in that
shut down, withdrawn, collapsedplace while we were growing up
and we took that safety, thatway of finding safety, into our
adult lives.
And in our early relationship wewere totally functional.
I mean I was in graduate schoolwhen we met and he was going
through a career change and wethen had jobs that we held with
(13:28):
no issue.
We were able to get up in themorning and do what we had to do
and get everything done and wewere pretty good employees, I
would say.
But at night, on the weekends,we were very shut down.
We would sleep all weekend longand we drank a lot of wine at
night, for sure, back then, andwe were very functional dorsal
dwellers, I would say, and atthat time we often use sex as
(13:50):
co-regulation and we would beable to connect with that
physical intimacy.
My husband, if you know thelove languages, one of his love
languages is definitely physicalaffection and just being very
close.
If you know the term kangaroocare, when a baby is born they
recommend skin to skin contact.
And when our son was born, welearned about kangaroo care.
We were like, wow, we dokangaroo care too as adults.
(14:11):
Right, and that's true, we usedto do kangaroo care, we used to
just do skin to skin contact.
And how safe and connected wecould feel, even when one or
both of us were feelingdepressed.
It's maybe even a little bithard to describe, but I can
experience that feeling.
I can experience it in mynervous system right now as I
think about it, because I justfelt like I didn't feel alone
(14:33):
anymore.
I felt like this was my person.
Here we are, us against theworld.
We can both be safe here inthis really beautiful space and
it was incredible and that wasreally our very early beginning
and there was a lot ofco-regulation that was beautiful
and mutually beneficial andcertainly safe for both of us
(14:54):
and then eventually fast forwardlots of time that I won't go
into all the details now,although you've heard me talk
about some and again, you'llabsolutely hear me talk about
them again in the future.
But eventually things became alittle lopsided because I
started feeling like myhusband's go to.
As I mentioned before, if sexis your go to, I feel depressed.
(15:15):
Let me have sex with my partner.
Eventually.
While I totally understand whythat makes sense and why that
works, eventually it doesn'talways feel so good because it's
not, as I started off talkingabout in this episode, that
eventual experience that bothpartners are feeling good and
then it just becomes like thisway to just enjoy feeling good
together.
It's lopsided that I was notnecessarily feeling depressed
(15:37):
and he was, and he was againreaching up a hand saying, hey,
can you pull me up?
But it kind of was like hey, myback's hurting, I'm leaning
over pulling you up a lot, youknow and it stopped being so fun
and enjoyable for me, whetherthat was eye gazing or kangaroo
care or sexual intercourse,sexual activity and all the
things under that umbrella.
I started feeling resentfulabout that experience and I
(16:00):
didn't want to have thatexperience anymore.
And so then I could disconnectand go into my own dorsal
shutdown, and it caused a lot ofproblems over many, many, many
years, and again I'll dive indeeper into the specifics in
later episodes.
Eventually though I don't knowhow many years 15 years, 18
years in some ways we're stillgoing through it after 21 years,
(16:23):
although we've come an awfullong way, I have to say.
But eventually I was like, hey,like this is not the kind of
sex that I want to be having.
And my husband was like, yeah,me, neither, I don't enjoy it
when you're shut down.
I'm like, oh, yeah, well, Idon't enjoy it when you're
depressed and you're reaching upto me as your only lifeline,
right?
And those were theconversations, and there were
many, many conversations we had.
And eventually we're like wehave to do this different, right
(16:44):
, it doesn't feel good foreither of us, so we have to
figure out a new way.
So that and it has been quitethe journey it's been very bumpy
at times, but also reallybeautiful and really connecting
at times because with thenervous system language we are
understanding and I can haveabsolute compassion for why Ben
reaches out for me in that wayand he can understand.
(17:05):
While I welcome supporting him,I don't want sex to only be.
It's really not only only issuch an absolute term, but it's
not the only way that he usessex or that we have sex together
.
It's not that at all, butthat's how it feels for my
nervous system.
That's the nervous system story.
The only time we have sex iswhen you're reaching out to feel
better, when you're depressedor when you've had a bad day at
work, and then that doesn't makeme feel special, I don't feel
(17:28):
important, I don't feel seen, Idon't feel like he's able to
attune to me and, quite honestly, he probably isn't when he's
really dysregulated, which makestotal sense, right.
And so now we've really gottento this place where we have this
beautiful language, where I cansay to him you know what I want
to have, this really enjoyableco-regulation experience of sex
where we're both feeling goodand we're both bringing our
(17:50):
whole selves, our whole body,our whole spirit into our sexual
experience.
And that can be fireworks andreally exciting.
I can feel chills andgoosebumps as I talk about it,
right.
That's like the delicious,juicy, wonderful active sexual
desire and fun and sexy.
Right, that's the sexy,wonderful stuff that people
(18:10):
maybe dream about, or certainlyI dream about and absolutely
experience when my nervoussystem is regulated and when
Ben's nervous system isregulated.
So we've been really figuringthis out, and adding the layer
of the nervous system has beenprofoundly enlightening for me
because it helps me understand,without any judgment and with
real full compassion, my ownexperience and Ben's experience.
(18:33):
And so that's where I'm gonnaend for today, because there's
so much here and I can't wait totalk to you about it.
So stay tuned for futureepisodes.
For the next several episodes,I'm gonna do something a little
bit different.
I think it's gonna be fun,because we're in to summer right
now.
I'm going to be doing what Iimagine will be mini episodes
where I'll talk about my livedexperience, like something that
(18:55):
happened that week, somethingthat went really well or
something that didn't go so well, and how I handled it or didn't
handle it, or how I figured itout after the fact, if I kind of
really was dysregulated andmade a lot of missteps.
And I'm just going to sharesome of those experiences and
I'll take a little break fromsharing these frameworks.
I felt like it was importantfor me to share how I look at my
(19:17):
world and my relationship, andcertainly the relationships that
I work with as a therapist andas a coach, and I wanted you to
have that information to referto to help deepen your
understanding, if that's whatyou're interested in.
And now I'm going to just talkabout my experience for a little
while and see how that goes,and I hope you're enjoying
summer or whatever season it isfor you right now, and I'm going
(19:39):
to go continue enjoying somemore of my summer and play with
these little mini episodes for afew weeks and I'll be back to
full length episodes in the fall.
But I didn't want to stop theflow because I'm really enjoying
this podcast experience and I'mreally enjoying connecting with
you and I look forward toconnecting with you more.
So be sure to follow me onsocial media and definitely
(20:01):
connect with me there and checkout my Getting the Love you Want
workshops and retreats that Ihave coming up.
And that's all for today.
As our time comes to a close, Iask you to keep listening for
just a few more moments becauseI wanna thank you for showing up
today and I want to leave youwith an invitation as you hit,
stop and move back out into theworld on your own unique
(20:22):
wellness journey In order tomove from where you are today to
the place where you want to be.
The path may seem long orunclear or unknown, and I want
you to know that if that seemsscary or daunting or downright
terrifying or anything else,that is totally okay.
Know that you do not have tocreate the whole way all at once
(20:44):
.
We don't travel a whole journeyin one stride, and that is why
my invitation to you today is totake a step, just one, any type
, any size, in any direction.
It can be an external step thatcan be observed or measured, or
it could be a step youvisualize taking in your mind.
It can be a step towards action, or towards rest or connection
(21:07):
or self-care, or whatever stepmakes sense to you.
I invite you to take a steptoday because getting to a place
that feels better, more joyful,more connected than the place
where you are today is possiblefor everyone, including you, and
even when depression is in yourbed.
If today's episode resonatedwith you, please subscribe so
(21:30):
you can be notified when eachweekly episode gets released.
I encourage you to leave areview and reach out to me on
social media at trishsanderslcsw.
Review and reach out to me onsocial media at trishsanderslcsw
.
Your feedback will help guidefuture episodes and I love
hearing from you.
Also, please share this podcastwith anyone who you think may
be interested or who may getsomething from what I have
(21:50):
shared.
Until the next time we connect,take care of yourself and take
a step.
Popular Podcasts
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
New Heights with Jason & Travis Kelce
Football’s funniest family duo — Jason Kelce of the Philadelphia Eagles and Travis Kelce of the Kansas City Chiefs — team up to provide next-level access to life in the league as it unfolds. The two brothers and Super Bowl champions drop weekly insights about the weekly slate of games and share their INSIDE perspectives on trending NFL news and sports headlines. They also endlessly rag on each other as brothers do, chat the latest in pop culture and welcome some very popular and well-known friends to chat with them. Check out new episodes every Wednesday. Follow New Heights on the Wondery App, YouTube or wherever you get your podcasts. You can listen to new episodes early and ad-free, and get exclusive content on Wondery+. Join Wondery+ in the Wondery App, Apple Podcasts or Spotify. And join our new membership for a unique fan experience by going to the New Heights YouTube channel now!
24/7 News: The Latest
The latest news in 4 minutes updated every hour, every day.