Sunday, September 13, 2015

Mental Health and Decreased Sex Drive

I'm so glad that my wife suggested this topic for my next blog entry.

I know, it's an uncomfortable topic for some. It's a crucial part to a relationship, however. Sexual intimacy is important to the health of any relationship because of the intimacy it brings. Read my previous posts, and you'll discover that intimacy is absolutely priority one (along with a few other virtues) in maintaining a healthy relationship with a survivor of PTSD. I'm talking romantic relationships here, not necessarily friend relationships.

Libido inevitably suffers with the onset of PTSD. It is as sure as the calm after the storm. The entrance of SSRI and atypical antipsychotic medications bring this reality even more surely. Libido doesn't just affect the survivor in this case, it can also affect the survivor's partner.

Results of low libido

What's important to keep in mind is that this is not an uncommon problem among survivors and relationships. Research has surfaced that has formed the hypothesis that "sexual difficulties in PTSD may occur as the brain connects the sensation of arousal to aggression instead of healthy sexual function." Traditionally, research has posed that sexual difficulties occur only when the survivor is exposed to rape or sexual trauma, not necessarily PTSD. However, combat veterans and survivors of other trauma can also develop sexual dysfunction, rendering this conclusion faulty.

The connection of sexual arousal and PTSD is a direct relationship: the hyperarousal cluster of symptoms can take over (read: hijack) the normal sexual arousal response and substitute it for aggression. This happens involuntarily: physiological arousal brings feelings of fear or being threatened when this involuntary response occurs. This Reuters article by Lisa Rapaport explains in greater detail this involuntary, albeit unfortunate, connection.

Treatment options & education

So what can a survivor and their partner do to help? The answer might be right in front of the nose, but it bears repeating: couples therapy seems to be one of the greatest measures a couple can take to help address this connection.

This article explains in great detail a method of therapy closely aligned with cognitive behavioral therapy (CBT)—considered a gold standard in PTSD treatment circles—that can help survivors and their partners address the issues and symptoms (not just low libido) that PTSD and their SSRI counterparts bring with them. CBCT, or Cognitive-Based Conjoint Therapy. This particular article is a commentary on the potential benefits of CBCT versus no therapy at all.

If low libido or high PTSD symptoms are detrimental in your relationship (and often they are), couples therapy might be an option to explore. There is some good news regarding PTSD according to the preceding article: PTSD is highly treatable, and the best thing a partner can do is be supportive and be willing to seek help—together.