This is kind of a confession of sorts. I was (still am?) in the latter category. I know people who were in the former category. I can completely understand both. This is one of the many things that make it difficult to be in a relationship with someone who’s depressed, the former for obvious reasons but the latter too. Sex becomes too important, it’s the only thing that validates one’s existence. I’ve had a number of relationships die because of this, because having sex was more important than just being together. But I can tell you that in those moments, all the mental pain was brushed aside and it did feel wonderful to have those voices silent and actually feel good. No feelings of emptiness, loneliness, or worthlessness. And when you’re depressed, those moments are treasures.