Can anxiety cause erectile dysfunction?

Can severe stress and anxiety really lead to erectile dysfunction?

Can severe stress and anxiety really lead to erectile dysfunction? How long does it last and what can I do to improve it? Is it physical, or all mental?
I'm a male in my mid-30s. A year ago, I realized I would need to break things off with my wife. We'd only been married a couple years, but we almost never had sex and had grown apart emotionally, professionally, etc. In addition, she is bipolar. For years I had been realizing I was increasingly attracted to other women, but never acted on it. Yet thoughts of sex with other women consumed me. I couldn't think of anything else. I was masturbating 2-3 times daily. My wife was very sweet, but very fragile and sad, and I felt tremendously guilty over a period of years that I wasn't more attracted to her because of the emotional complications.

Just around the time I broke things off, I was hardly sleeping, my heart was constantly racing, it felt like my body was breaking down. Suddenly, I woke up in the morning with no erection. And then every morning. This hadn't been true in 20 years. I began to obsess over it because I was also taking Propecia, but I'd been taking that for 10 years and, as many doctors since then have corroborated, it would be extremely unlikely to suddenly have sexual side effects after that long.

A year later now, I barely have the desire to masturbate. Mostly I've missed my wife and felt horrendously guilty how things shook out. The only times I've felt "normal", sexually, was when it seemed like I had a chance of working things out with her, but I'm 90% sure those chances are gone. Of course, the irony is painful - now that I finally have the freedom to pursue other women, I can't even get aroused.

I have seen multiple urologists and family doctors and they've all said it wasn't the Propecia, it's just mental. But no real gameplan to getting better. A lot of days, my urethra and pelvic muscles feel "tight" and vaguely sore, kind of like the fatigued sensation men have after having sex. It's like there's a lack of circulation. I'm vaguely tempted to masturbate a few times a week, and even then it feels forced and my erections are weak.

Has anyone ever experienced this? Did anything help? I've tried sleeping more, meditating, prostate massage, antibiotics just in case there is prostatitis. I don't know what else to do and I feel virtually suicidal, as I've lost my wife, my ability to reconcile with my wife, and my ability to have other women, all at the same time. I am not working and am having a hard time getting out of bed each morning.

Springer Vascular Andrology: Erectile Dysfunction, Priapism and Varicocele
Book (Springer)

You aren't the problem

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