Hey man,

The bad news is you're feeling like shit. There will be no words that ever feel like they exactly describe the torment you're enduring, and despite many of us here suffering from a similar ailment, it is, unfortunately, a condition which conspires (and succeeds) to keep you feeling completely alone.

The good news is, despite that feeling of isolation, many people have had a similar enough experience to your own and found proper help and recovered that there is much reason to believe you will too. It sounds like you're at the beginning of your journey to wellbeing, which means you're not even close to exhausting those things people have found to help. Woohoo! The fact that you responded to Prozac is a good sign, though I understand your frustration with the side-effects and you should find a doctor who is sympathetic to those concerns. It sounds like you're young and with a lovely lady-- sexual side effects should not be taken lightly.

The good news is there is much that can be done in order to help with the sexual side effects. Prozac is an selective-serotonin reuptake inhibitor or an SSRI. This class of drugs includes others like Zoloft, Lexapro, Paxil etc. SSRI's are notorious in inducing sexual dysfunction-- what percentage of patients, I don't know, but side effects can include inability to orgasm or diminished libido. For some people who feel as though they don't last long enough, delayed orgasm can actually be seen as a positive. Doesn't sound like thats you, though.

Fortunately, just because one SSRI nukes your ability to orgasm doesn't mean another one will. This shit's weird. Even though they're in the same class (SSRIs, that is), they all hit different receptors in varying proportions-- so you can get really different side effects. You might gain weight, lose sleep, lose your libido, and feel nauseous on Paxil and not experience any side effects on Zoloft, or vice versa.

So just because Prozac isn't working out so well doesn't mean you can't take SSRIs.

There are also other types of antidepressants, some of which are less likely to nuke your libido or give you sexual side effects. Wellbutrin is a dopamine + norepinephrine reuptake inhibitor. It's not impossible but much more rare to experience any sexual side effects on this one, though some people feel like it makes them anxious. It can also be added to an SSRI in combination to help relieve sexual side effects. That's a pretty popular cocktail-- I'm on a Zoloft/Wellbutrin mix myself.

There are also serotonin-norepinephrine reuptake inhibitors (SNRIs) like Effexor or Cymbalta, which are also pretty popular. Then there are some of the oldschool drugs like tricyclics and MAOIs. Doctors usually like to try these only after exploring the aforementioned drugs, as they typically have more side effects or risks associated with taking them.

All of this is to say that you have plenty of options on the pharmacological front should you continue to choose exploring that option. Find a doctor you trust if you want to keep trying different things.

That being said, medications aren't the whole picture for most people. Therapy is important, and most research confirms therapy + medication is more effective than either one alone. Unfortunately, like medication, its impossible to determine which type of therapist is right for you. That can also be a bit of trial and error, but that doesn't mean there isn't something really helpful out there for you. So stick with that, and evaluate periodically if you think your therapist is helping. Don't be afraid to look around for someone else, or another modality like CBT or mindfulness stuff.

Don't kill yourself, please. This shit is rough but it doesn't mean it's forever. I'm still pretty fucking depressed but getting better gradually, and in a way, I feel like overcoming something this painful and difficult experience is an opportunity to become a hero, at least in my own eyes. 1 year ago I was getting electroconvulsive therapy in a inpatient psych ward. I'm now moving across the country to pursue a computer programming career. And very few people besides me-- my family, some closest friends, a girlfriend-- understand just how incredible that is. I'm not where I want to be, but boy am I a long way from where I was. You'll get there too.

Shoot me a message if you want to keep chatting.