The interplay between antidepressant medications like Prozac, sex drives, and depression can be tricky because for many people, both feeling depressed lowers their desire for sex as does taking the antidepressants themselves. Stuck between a rock and a well, sometimes, not-so-hard place, many folks feel forced to choose between healthier mental health and a healthier sexual appetite which, ideally, no one should have to do.

Some ways to manage your sex drive without ditching your medication entirely is to talk honestly with your prescriber about the side effects and see if taking a lower dose or switching to a different antidepressant (Wellbutrin is said to have less of an impact on sex drive) can help you feel more of a skip in your sexual step.

Antidepressants can lower our dopamine levels, the natural chemical in our body that helps fuel our sex drives. Physical activities like hitting the gym, going for a hike, dancing, or however you enjoy getting your blood pumping can help increase dopamine levels and perhaps, your interest in sex. Bonus — do these activities with your partner.

All of this being said, your 7-year relationship with Prozac makes me think that it’s working well and that you’re not looking to break up with it anytime soon. And that’s great! Finding a medication that works well for you can be tricky and maintaining your mental health is a valuable and important part of your sex life and your life in general.

And really, the fact is that you and your boyfriend are right on schedule for a dip in sexual desire: you’ve been together for over a year and you now live together, which can lower the air of mystery and up the air of “What the hell? Why don’t you ever do your dishes and is this your pube on the bathroom sink — gross! — flush the toilet for once!” … or something like that.

Emily Nagoski writes in her book Come As You Are about just how common it is for (primarily, but not always) women to have what she calls “responsive desire” systems. As you’re describing here, responsive desire can manifest as “I’m into sex once we get into it, but it’s hard for me to feel the spontaneous desire to initiate.” Considering how common a responsive desire type can be, combined with how common it can be for couples to feel a dip in drive after a while, and as you’ve said, how distracted and overwhelmed you feel, I’d float the idea that your medication might not be the only factor here.

Rather than position Prozac as the problem without a solution, look towards relational dynamics that can be shifted. Ask for help with the things that distract you, build intimacy between the two of you (date nights, communication, shared interests), and work with the natural flow of your respective sex drives (maybe it’ll just take a little more intention to initiate sex — that’s perfectly normal, and again, right on schedule).

Think about the positive factors that once had you wanting to jump your BF’s bones (what attracts you to him, what makes you feel sexy, the kind of sex you had, or even, other life factors like lower-stress jobs) and evaluate your current relationship to see if/where these components are missing, still present, or can be brought back. Look at the whole picture or it can be hard to find the whole solution.

Yana Tallon-Hicks is a relationship therapist, sex educator, and writer living in the Pioneer Valley. You can find her work and her professional contact information on her website, yanatallonhicks.com.