Active Stocks
Thu Mar 28 2024 15:59:33
  1. Tata Steel share price
  2. 155.90 2.00%
  1. ICICI Bank share price
  2. 1,095.75 1.08%
  1. HDFC Bank share price
  2. 1,448.20 0.52%
  1. ITC share price
  2. 428.55 0.13%
  1. Power Grid Corporation Of India share price
  2. 277.05 2.21%
Business News/ Mint-lounge / Sex and depression |In the brain, if not the mind
BackBack

Sex and depression |In the brain, if not the mind

Sex and depression |In the brain, if not the mind

Premium


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.

Post-coital blues

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."

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 when he left my office.

I didn’t think much about his case until some time later, when I met another patient with a similar complaint. She was a 32-year-old woman who experienced a 4 to 6-hour period of intense depression and irritability after an orgasm, either alone or with a partner. It was so unpleasant that she was starting to avoid sex.

Recently, a psychoanalyst colleague—a man known for his skill in uncovering psychopathology—called me about yet another case. He was puzzled about a 24-year-old man whom he viewed as psychiatrically healthy except for intense depression that lasted several hours after sex.

There is nothing strange about a little sadness after sexual pleasure. As the saying goes, after sex all animals are sad. But these patients experienced intense dysphoria that lasted too long and was too disruptive to be dismissed as mere unhappiness.

Still, the temptation to speculate about psychological explanations of sexual behaviour is hard to resist. Psychiatrists like to joke that everything is about sex except for sex itself, which is another way of saying that just about all human behaviour is permeated with hidden sexual meaning.

Perhaps, but I wondered whether in these cases it might be nothing more profound than a quirk in the neurobiology of sex that made these patients feel awful.

Little is known about what happens in the brain during sex. In 2005, Gert Holstege at the University of Groningen in the Netherlands used positron emission tomography to scan the brains of men and women during orgasms.

He discovered, among other changes, a sharp decrease in activity in the amygdala, the brain region involved in processing fearful stimuli. Aside from causing pleasure, sex clearly lowers fear and anxiety.

Anthropologist Helen E. Fisher of Rutgers University used functional magnetic resonance imaging (MRI) to look more broadly at the neural circuitry of romantic love. She showed a group of young men and women who reported being passionately in love a photo of their beloved or a neutral person. Subjects showed marked activation in the brain’s dopamine reward circuit only in response to the beloved, similar to the brain’s response to rewards such as money and food.

Could it be that some patients have particularly strong rebound activity in the amygdala after orgasm that makes them feel bad?

Research literature is virtually silent on sex-induced depression, but a Google search showed several websites and chat rooms for something called “post-coital blues". Who knew? There, I read many accounts nearly identical to those of my patients, with reports of various remedies for the malady.

Less pleasure = happiness!

When physicians run through the usual treatments to no avail or find themselves—as I did—in uncharted territory with little evidence as to what to do, they can consider so-called novel treatments. Often, you design such a treatment based on your speculation about the underlying biology of the syndrome at hand. This can involve using approved drugs in situations for which they are hardly ever prescribed.

A clue to a possible treatment is that Prozac and its cousins, selective serotonin reuptake inhibitors (SSRIs), commonly interfere with sexual functioning to some degree. Serotonin is good for your mood, but too much of it in your brain and spinal cord is decidedly bad for sex.

I thought that if I could somehow modulate my patients’ sexual response, make it less intense, it might blunt the negative emotional state afterward. In other words, I would exploit the usually undesirable side effects of the SSRIs for possible therapeutic effect.

As anyone who has taken one of these drugs for depression can tell you, it may take a few weeks to feel better, but side effects, such as sexual dysfunction, are often immediate. For my patients, that turned out to be an advantage. After just two weeks on an SSRI, both said that while sex was less intensely pleasurable, no emotional crash followed.

Not all in the mind...

Now, there are at least three possible reasons my patients felt better: The drug worked; it had a placebo effect; or there was a random fluctuation in symptoms—they would have improved if I had done nothing.

I suggested stopping the treatment and restarting it if the problem recurred. In both cases, the symptoms came back and then abated with the drug—suggesting, based on this admittedly small sample, that the effect was real.

If these patients taught me anything, it’s that sexual problems don’t always bespeak deep, dark psychological problems. The truth is that the most important sexual organ of humans is actually the brain. Sex may be the most physical of acts, but depression can be physical, too —and sometimes no more significant than a quirk of biology.

©2009/The New York Times

Write to us at businessoflife@livemint.com

CONNECT

The UN’s International Civil Aviation Agency, which sets standards for air transport, is drawing up new safety rules to take into account a silent killer: pilot fatigue.

Over the past 15 years, nearly a dozen fatal crashes and numerous close calls have been blamed on pilot fatigue, whose effects safety experts compare with driving drunk. Air safety organizations and pilot unions have for years been pressing for tighter regulations and enforcement of working hours and rest periods. The new guidelines, drawing on the latest research into sleep and other factors affecting crew performance, are due to be reviewed in spring and released later in the year. AP

TREAT

Water poisoning? Yes, it’s called hyponatraemia, and it occurs when a large amount of water is drunk in a short period.

Is it dangerous? “If not corrected, severe brain damage can occur, which may also lead to paralysis," says Sunil Prakash, consultant nephrologist, Artemis Health Institute, Gurgaon. “Secondly, excess water makes kidneys work more, increasing the risk of hypertension and cardiac failure in later years."

Symptoms: The warning signs are subtle, and oddly similar to dehydration—nausea, muscle cramps, disorientation, slurred speech.

Treatment: Consume a sodium-rich beverage (a sports drink or salted lemonade) or salty foods.

Who’s at risk? Babies, athletes, those on medicines such as diuretics and strict “detox" diets. Kavita Devgan

DEBATE

Young men who have frequent sex—and masturbate—may be raising their risk of prostate cancer, British researchers claim.

Men in their 20s and 30s who ejaculated at least 20 times a month were more likely to be diagnosed with the cancer later in life, according to a study from the University of Nottingham in BJU International. Masturbation accounted for most of the differences in cancer rates, in contrast to the results of other research that raised a connection between frequent intercourse and prostate cancer. The link is related to men’s hormone levels, which play a role in both the cancer and sex drive, said the researchers, led by Polyxeni Dimitropoulou, now at the University of Cambridge. The study conflicts with earlier research, however. A 2004 Harvard study found men who reported frequent sexual activity had a 33% lower cancer risk. Bloomberg

AVOID

Steroid drugs, a common treatment for young children prone to wheezing and colds, do not help and may even be harmful, according to new research. Preschoolers in Britain hospitalized with a wheezing attack and treated with the steroid prednisolone stayed just as long as those given dummy pills. In another study, Canadian children who had wheezing trouble and took the steroid fluticasone as a preventive showed modest improvement, but the possible side effect of stunted growth outweighed benefits, researchers said.

Steroids to open up airways are a standard treatment for adults and for children with asthma, but apparently does not help children with transient wheezing. AP

Unlock a world of Benefits! From insightful newsletters to real-time stock tracking, breaking news and a personalized newsfeed – it's all here, just a click away! Login Now!

Catch all the Business News, Market News, Breaking News Events and Latest News Updates on Live Mint. Download The Mint News App to get Daily Market Updates.
More Less
Published: 11 Feb 2009, 10:08 PM IST
Next Story footLogo
Recommended For You
Switch to the Mint app for fast and personalized news - Get App