Sunday, January 25, 2009

Sex and Depression: In the Brain, if Not the Mind

As everyone knows, sex feels good.

Or does it? In recent years, I’ve come across several patients for whom sex is not just unpleasurable; it actually seems to cause harm.

One patient, a young man in his mid-20s, described it this way: “After sex, I feel literally achy and depressed for about a day.”

Otherwise, he had a clean bill of health, both medical and psychiatric: well adjusted, hard-working, lots of friends and a close-knit family.

Believe me, I could have cooked up an explanation very easily. He had hidden conflicts about sex, or he had ambivalent feelings about his partner. Who doesn’t?

But search as I could for a good explanation, I could find none. Though his symptoms and distress were quite real, I told him he did not have a major psychiatric problem that required treatment. He was clearly disappointed leaving my office.


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