Archives for Sexuality


Do You and Your Partner Need a Sex Therapist?

Do you giggle at the thought of someone having the job title of "sex therapist"? Or do you think those people must have the best job in the world??? (Nudge, wink.)

Get over it...Sex therapists are like any other psychotherapist, except that they specialize in helping individuals and couples who are having sexual problems. These therapists generally have counseling, social work, or psychology degrees as their training basis, but choose to do additional training beyond what's minimally required in sexuality study as part of their degrees. There's even a credentialing body for sex therapists: the American Association of Sexuality Educators, Counselors and Therapists (AASECT).

However, despite the alluring job title, no sex between clients happens in their offices, and the therapist does not participate in sexual encounters with clients, either. (Sorry to disappoint you!)

Once you recover from the giggles, you might want to consider whether you and your partner could benefit from the services of a sex therapist.

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Back to the Basics: Sex and SSRIs

When your partner goes on medication for depression, they will likely be prescribed one of the selective serotonin reuptake inhibitors--or SSRIs, for short. Those include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Prozac Weekly, Sarafem), paroxetine (Paxil, Paxil CR, Pexeva), sertraline (Zoloft), and fluoxetine combined with the atypical antipsychotic olanzapine (Symbyax). These drugs are popular because they work to block the reabsorption of serotonin in the brain, which allows chemical messages to be sent and received better in the brain. As a result, your partner's mood is improved.

That's the good news.

The bad news: SSRIs come with side effects, like any drug might. But one of the biggest complaints people have about taking SSRIs is a change in sexual functioning. Common issues include reduced sexual desire, inability to maintain an erection, inability to orgasm, and numb genitals. These particular side effects are so common, approximately half of the people taking SSRIs experience them.

What do you do if this is the case for your partner?

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Sex and Your Partner With Depression

Probably the number one reason patients give for stopping their antidepressant medications are that they have no libido while taking them. They say, "It's bad enough that I'm depressed--I'm not willing to give up my sex life, too!"

For the healthy partners, this presents a conundrum: you want your partner to feel relief from the depression, but hey, you've got needs, too, right?

According to a 2009 USA Today report, the amount of Americans using antidepressants rose in 2005 to close to 27 million people, or about 10% of the population.

As you've probably figured out as the partner of someone with depression, the mood disorder and sexual concerns and difficulties--including changes in sexual desire and lowered arousal--often go hand-in-hand. During a depressive episode, lowered sexual interest is common for both men and women. Antidepressants can cause many types of sexual concerns, such as the inability to have an orgasm or to achieve an erection.

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Anxiety and Panic

Mental Health and Pregnancy: What Partners Need to Know

Pregnancy is an exciting time for couples, and there are many things to think about, plan for, and do to get ready for the new arrival. But for a woman with mental illness, pregnancy also means extra special attention needs to be paid to her illness, as well as to the needs of the fetus. As a supportive partner, you play a major role in this.

According to the Stanford School of Medicine, "A common myth states that hormones released during pregnancy protect women from psychiatric disorders and foster a period of emotional well-being. Recent studies, however, have shown that up to 20% of women suffer from mood or anxiety disorders during the gestation and postpartum periods. Whether the symptoms develop at the onset of pregnancy or are a continuation of a previous history, women face a difficult decision about how to manage their illness during pregnancy."

How do you ensure that the entire family gets through the pregnancy with everyone doing well at the end?
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It’s Not Just for Kids: Your Partner with ADHD (Part 2)

Last week, Part 1 of this entry had some quick facts about adult ADHD, and discussed two of the four top issues that affect the relationships of adults with ADHD: relating to others and success at work.

Today covers the remaining top issues adults with ADHD have in relationships: contributing equally at home and sexual functioning.

3. Contributing equally at home: As mentioned in
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It’s Not Just For Kids: Your Partner with ADHD (Part 1)

Your partner forgot to pick up the kids at daycare, again.

The dinner with friends was going great until your partner suddenly made a blunt comment that hurt your best friend's feelings.

You try to have a conversation with your partner, but always feel as if their attention is elsewhere, or they get up abruptly and walk away when you are mid-sentence, or they fiddle with whatever is within reach and wiggle in their chair like they are a child again until you give up and stop talking.

Such is life with a partner with untreated ADHD.

Some quick facts about ADHD in adults:

Although ADHD is often diagnosed in childhood, it's estimated that 30-70% of adults still have symptoms. Many adults were never diagnosed as children, or they were misdiagnosed with other disorders, such as learning disabilities, depression, anxiety or bipolar disorder. As a result, adults with ADHD sometimes do develop depression or have low self-esteem because they were not treated appropriately or were called "stupid," "lazy," or "unmotivated" because of their ADHD-related behavioral patterns.
Forty to sixty percent of adults with ADHD also have a child with ADHD (Waite, 2010).
To be given a diagnosis of ADHD (for the first time) as an adult, the symptoms must have been present during childhood. If the symptoms first appear in adulthood, it is likely that the symptoms are related to a different disorder.
The pharmacological treatments for adult ADHD are similar to that for children--namely, stimulants and sometimes also antidepressants--but these medications may work differently in an adult than they would in a child.
ADHD is recognized as a disability under federal legislation (the Rehabilitation Act of 1973; the Americans With Disabilities Act; and the Individuals With Disabilities Education Act). Appropriate and reasonable accommodations are sometimes made in the workplace for adults with ADHD, which help the individual to work more efficiently and productively.

If you look at most ADHD-related websites (see below), they have a special section dedicated just to how this disorder manifests in adults.
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Is It Love or Is It Sexual Addiction?: Partners Who Cross the Line

How do you know when your partner's use of pornography is "too much"?

Where is the line between someone just "really liking sex" and needing sex in order to function?

Have you had fights with your partner about their sexual behaviors, with promises from them that they will change, only to have the patterns continue (or escalate)?

If you have found yourself wondering about some of these questions, or others related to your partner's seemingly "excessive" needs around sex, you may have a partner with sexual addiction.

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Anxiety and Panic

You, Me and PTSD: Relationships with Partners Who Have Suffered Trauma

I will begin this post by saying an entire blog itself could be (and should be--anyone out there an expert??) dedicated to the topic of PTSD, and the havoc it wreaks on the lives it touches. This blog entry is mostly to acknowledge the partners and relationships that are struggling under the weight of PTSD from past trauma, and it will be a topic I return to from time to time.

When I think of PTSD and therapy clients, I think of experiences such as military service, rape, sexual abuse, and traumatic car accidents, and the subsequent paralyzing symptoms of nightmares, flashbacks, the inability to relax (hyperarousal), intense fear of something bad happening again, and panic attacks.

What I don't often hear about is the role the non-traumatized partner has in the life of the partner with PTSD. Again, this blog entry will just touch the tip of the iceberg, but it will be a start and guide you towards other helpful resources. Also, in this entry, I will be speaking generally about PTSD, not to specific causes, such as military experience vs. sexual abuse history, which can look very different.

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Anxiety and Panic

“I Have to Do This”: Your Partner with OCD

You did it again. You didn’t fold the laundry right, you didn’t wash your hands long enough before touching the lettuce to make a salad for dinner, or you threw away what looked to you like trash, but now has your partner rifling through the garbage can to retrieve because it was “important.”

The rest of the day is ruined and your partner can’t relax until they do something to “make it right again.”

Welcome to the world of obsessive compulsive disorder (OCD).

What people often don’t realize is that OCD is a form of extreme anxiety for the person experiencing it. They can’t stop the thought in their head that they need to do whatever the behavior is, even if they realize the thought is distorted, unrealistic, or out of control.

People with OCD have a “short” in their brain’s wiring system that controls the brakes on distressing thoughts. Like all other mental disorders, it is not something the person can just “snap out of,” although they desperately wish they could.

What must it be like to live with a brain that says you are constantly in danger, and the only way to protect yourself is to perform a certain behavior? And as the partner of this person, what can you do to help?

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