Depression affects around 350 million people worldwide and can have a devastating impact on your life and relationships, including in the bedroom.

Sadly, when it comes to depression and low libido, men tend to suffer the most. Whereas women can say “Not tonight, I have a headache,” men often feel that avoiding sex somehow emasculates them or changes the way their partner views them. And, to be honest, many times women do not understand that all men aren’t in the mood for sex sometimes, even if they aren’t depressed. It’s just one of many urban legends in this country that needs to be debunked if men and women are going to able to communicate honestly in the bedroom.

Now that you know that low libido is common among depressed men, you might be wondering: Why does this happen?

There are many reasons. First, there is the emotional aspect. If you are feeling dejected and worthless, you aren’t going to feel very sexually desirable or very sexually desiring. In fact, you may shy away from all forms of physical affection, even kissing or snuggling with your mate.

Second, your physical health might be taking a hit (which means your sexual health will suffer as well). When men are depressed, they tend to pack on the pounds and avoid the gym—and they might be even reach for a few extra beers each night, all of which can do great harm to their sexual function and ability to perform.

Last, medication for depression often comes with sexual side effects. Many people who take anti-depressants report that they suffer decreased libido or decreased sexual response as a result.

However, there is good news. There are many medications that have been shown to have less of an impact on libido, so talk to your doctor about these options or about changing or lowering your dose if possible. You should also find ways to motivate yourself to get back in the gym, whether it is by making a pact with a buddy to workout together or simply by staying more active during the day (like taking a walk during your lunch break or playing with your kids in the snow after work instead of lounging on the couch).

You should also be honest with your spouse about where you are at right now emotionally. Otherwise, when you pull away from her advances or shut down in the bedroom, she is only going to assume the worst (i.e. “Is he no longer attracted to me?” or “Is there another woman?”). Let her know that you are feeling stressed and sad lately, and troubleshoot ways you can still stay connected during this time (maybe you aren’t in the mood for sex but you could enjoy a hot bubble bath together).

Finally, don’t be afraid to speak out and ask for help. Depression is a common occurrence and it can happen to everyone, men and women alike. Asking for help isn’t weak, it actually shows strength of character and a willingness to work hard and improve. Click here for more information on depression.

Laura Berman, PhD, is a world renowned sex and relationship educator and therapist; popular TV, radio and Internet host; New York Times best-selling author; and assistant clinical professor of ob-gyn and psychiatry at the Feinberg School of Medicine at Northwestern University in Chicago. Dr. Berman is a New York Times best-selling author of many books on sexual health and pleasure, a weekly columnist for the Chicago Sun Times, and host of the radio program "Uncovered with Dr. Laura Berman."