We’re parked outside the CVS, my mother and I, and I’m trying to figure out the best way to explain masturbation to her.

I have experienced many things since migrating to Florida almost a decade ago. Student loan debt. Taco Bell’s Frutista Freezes. Chipotle. Who could have predicted this?

My mother and I have long since moved past the fearful and cautious nature of a typical Jamaican mother-daughter relationship. We’ve gone through a lot together; she recovered from a hysterectomy around the same time I started puberty; we’ve crossed borders together. That lady is my best friend.

But we do not talk about sex. 

And especially not in a CVS parking lot.

Like, if you had to definitively rank all the different pharmacies where you might overhear someone describing the concept of masturbation to their elderly mother, that would most definitely happen inside a Walmart somewhere, probably by the home goods section or something.

The only reason I ended up trapped in her Honda Accord that afternoon is because I fell victim to the greatest weapon Jamaican mothers have in their arsenal: deception.

“I’m going to the doctor, come with me?” she said. “My blood pressure high, you know I don’t like driving alone. I’ll buy you Burger King.”

I got dressed.

In the office, the doctor turned to me and asked, “How’ve you been lately?”

“Why are they asking me?” I thought. “My blood pressure is immaculate.”

Confused, I looked at my mother and watched her deflate, weeping.

***

When I was younger, puberty hit hard, and depression followed soon after. Much to our own detriment, Jamaicans don’t “do” mental illness. We do demons and bad mind. And so I dealt with the years of anger and heaviness that weighed on my body any way I could. I wasn’t actively suicidal, but I thought about killing myself casually, the way people talk about going out for dinner. Being alive felt like your friend showing you a video online. You’re sitting there, and they’ve got the video playing, and it’s going on and on, and your friend says, “It gets good; you’re gonna love it.” And you’re like, cool, okay, but then it never really gets good. Nothing happens. And you keep waiting, and the whole time all you want to do is hit that little box in the bottom corner, and close out of the full screen pointlessness of it all.

I had been living at home after graduating from college. Unemployed, and without the structure and distraction of school, I spiraled. My mom noticed.

This appointment was for me.

My mother, still crying, left for the waiting room. The doctor handed me a clipboard with a survey on it. Questions like, “Do you feel bad about yourself, or that you’re a failure to yourself and your family?” (a given) and “Do you have thoughts of hurting yourself or that you would be better off dead?” (a little on the nose, but okay). I got diagnosed with depression by a standardized test. Prescription in hand, I walked out of the doctor’s office and into CVS.

***

The white paper bag sits on the car’s console between us. My mother, timid after her forced intervention, suggests reading through the information leaflet the pharmacist had stapled to the front of the bag. This is, after all, new territory for us both.

Paper says: 20 mg of Citalopram HBr. Possible side effects include: Mild nausea, increased sweating, weight changes, sleep problems, and potential development of anorgasmia.

This is a new word.

I turn to Google and read aloud from Wikipedia: “Anorgasmia: a type of sexual dysfunction in which a person cannot achieve orgasm despite adequate stimulation.”

Let’s pause again for a minute, because What. The fuck.

***

Selective serotonin reuptake inhibitors (SSRIs) (like the citalopram I was prescribed) work by increasing serotonin levels in the brain, blocking it from being reabsorbed. More serotonin results in decreased feelings of anxiety and depression. However, this may also cause sexual side effects like anorgasmia. One theory presented by Medical News Today says that as serotonin increases, dopamine, which is responsible for us feeling stimulated, decreases. The less dopamine you have, the harder it is to be sexually aroused. As a result, anywhere from 25 to 73 percent of patients experience some form of sexual dysfunction from taking an SSRI. 

The introduction of this antidepressant posed a very real threat to a survival routine I had meticulously perfected since the days when my pubescent discovery of my body and depression coincided. At any point during an episode, I could rub one out, make a sandwich, go to bed, and I’d be set for three to five business days. With medication, I would have the energy to participate in Life™ and Be A Person™, but I would also risk never coming again?

These are the options?! Like, are you shitting on my dick, dude?‍

Jamila Dawson, a licensed professional, disagrees with me, a professional fool. Dawson is a Licensed Marriage and Family Therapist, and in speaking with her, she says that self-pleasuring “can be used to modulate anxiety or shift sadness, to sooth agitation, to pass the time” (the ever popular procrasturbate) and “to help with getting to sleep.” Dawson continues, “Consequently, it’s quite normal for people with depression to use masturbation as a support to feel better.” When depression medication interferes with sexuality, this can be an added stressor. “Not being able to experience pleasure is depressing!” Dawson adds.

Thankfully, though, treatment for mental illness is not a one-size-fits-most tie dyed maxi dress from the flea market that shrinks in the wash and now you’re stuck with it forever because you bought it from a white lady with a single dreadlock who doesn’t believe in receipts. As such, Dawson encourages her clients to speak with their doctors about any concerns or noticed changes once starting medication. “Too often people don’t feel comfortable talking about sexuality with their medical care providers, and medical care providers will not always ask or make space for conversations about sexual side effects,” Dawson says. “But I can’t emphasize enough how important it is to be straightforward with medical professionals. You are the expert on your body and experience.”

It had taken me over a decade to truly confront my mental illness, and I only did so because I was forced to reconcile cultural ideas blocking me from seeking help against an irreversible action circling my mind. Now I was supposed to talk about my clit? Out loud? With people? With my mother?

“The introduction of this antidepressant posed a very real threat to a survival routine I had meticulously perfected since the days when my pubescent discovery of my body and depression coincided.”

“You alright?” my mother asks.

I turn, see her looking from me to the meds to the phone screen I was just reading. She looks concerned, and I can understand why. I am now clearly more distressed than I was in the doctor’s office. This is the most I have emoted in weeks. “I mean, that’s kind of weird right?” I say. “All the side effects?”

“Right, like you going sweat more, I suppose?”

“Yeah and the, what was it, the anorgasmia?” I say.

“Hm?”

“The sex one?”

She laughs. “What you worried about that for?” She pauses. And in that pause I know she’s running through what she assumes to be my perpetual singledom. Even still, this woman is a single mother and ran her own business for 30 years; you’d think she’d know that when there’s no one around to lend you a hand, you help yourself. But she doesn’t seem to consider self-service as an option here. Or at least she doesn’t mention it.

And so neither do I. Coming to terms with me being suicidal is enough sharing for one day. She has high blood pressure; she saved my life today; I don’t want to risk it. 

Instead I spend the drive home wondering if masturbating would now become a Tarantino-esque standoff between my brain, clit, and wrist. There were months when, my judgement clouded by self-doubt, achieving orgasm felt like the only good thing I could do. Like, I could come with the best of ‘em. What would masturbating be like on meds? What would I be like? I was afraid.

“What’s most important,” Dawson says, “is to understand that our sexual relationship with our bodies will shift over time and according to what’s happening in our lives, and that’s okay. We need to move beyond binary ideas about sexuality and bodies, and help ourselves and others to reduce stigma around pleasure, masturbation, and mental health.” Like she said earlier, you are the expert on your body. 

Except after beginning medication, I wasn’t the expert anymore, at least not at first. I take the meds. I start to feel different, close to better. But my perspective towards masturbation, and my relationship with my body and mental health, changed. Compared to the overwhelming curiosity of my youth, my first few masturbation attempts after starting medication were characterized by trepidation. “Your poor, sad vagina, you’re never going to come again” played through in a loop in the back of my head. Have you ever cautiously masturbated before? It’s very odd, do not recommend. 

When I was able to achieve orgasm—and an achievement it was!—I felt more relief than I care to admit. In later sessions when I struggled, if I came at all, I felt frustrated and annoyed by the end. Was it the meds that made this difficult, or was it me being stressed about the meds? It was like a strange chicken-egg masturbation cycle. 

As time went on, serotonin building up in my system, I found myself reaching for myself less (decreased libido is also potential side effect). But I’ve also now moved away from a utilitarian approach to pleasure. Masturbation is supposed to be fun, and without fully knowing it, I’d turned it into treatment. Starting on the antidepressant works to keep me mentally healthy, but in turn it has also matured my relationship with my body. By tempering my expectations of my body, I’ve come to enjoy myself. I acknowledge and appreciate the pleasure I am capable of experiencing, even if sometimes it’s not the really, really good kind.