Category Archives: Psycological Health

4 Things Men Don’t Know About Antidepressants

4 Things Men Don’t Know About Antidepressants

2019-02-20

Including how they don’t have to wreck your sex life.

Last Tuesday was bittersweet. One of my “guys,” a 29-year-old writer, came in for his final session. He was better. When we’d met he’d never seen a psychiatrist and never thought he’d take a medication. “I hear they are addictive, and the side effects…I don’t want to be a zombie.”

Misperceptions about psychiatric medications and mental health treatment kill a lot men. While we have half the risk of depression compared to women, we are four times as likely to die by suicide. I’ve helped hundreds of men with mental health concerns and for many, medications are a part of the path to recovery. A few of the facts I wish men knew about them:

1. Sexual side effects are variable and manageable.

True, between 30 and 50 percent of men have sexual side effects from SSRI antidepressant medications. But sexual side effects can be easy to fix—if they need fixing. The most common side effect is a delay in climax, so for some guys this is a plus. But if the problem is that you can’t get it up, don’t worry; you’re not stuck with it. You can change meds. Different meds affect different people differently (this could be my mantra). I’ve seen men have sexual side effects taking Prozac but not when taking Zoloft and vice versa.

A few antidepressants, namely Wellbutrin (bupropion), Remeron (mirtazapine), and St. John’s Wort, have no sexual side effects. You can also consider taking a medication holiday—the half-life of most antidepressants is 24 to 36 hours (talk to your prescriber before taking days off). Finally, there are medications like Viagra and Cialis if an antidepressant medication is necessary but causes sexual dysfunction.

2. Antidepressants aren’t just for making you happy

Depression is not just a disease of sadness. Instead of being tearful, some men get irritable, isolated, and sleepless. Most antidepressant medications influence serotonin, and can help with those symptoms. In addition, this molecule is involved in more than our moods, namely our sex drive, appetite, sleep, cognition, and creativity. Men are often poor judges of the effects of depression on our own lives. So don’t just consider the medications’ effects on your mood; they can have a much more global impact on your functioning.

3. They work

Look, I take no money from big pharma. I’ve treated folks with depression for almost two decades. Medications don’t work for everyone, but they work. I like to start with low doses and try to avoid complex combinations of medications i.e. “polypharmacy”. Many people have had side effects from medications like weight gain, increased anxiety, and sedation, but many have none. Still, in the right hands, there is little as powerful or rapidly helpful as medications for certain mental health concerns like severe depression, insomnia, and feelings of suicidality.

4. Meds aren’t the whole picture

Patients assume that meds are my first move as a psychiatrist – and sometimes they are. But treatment today is about preference, options, and empowerment. Many things have an antidepressant effect. Talk therapy, lifestyle changes (sleep, exercise, eating right, reducing alcohol consumption), mindfulness and a few supplements all have evidence they help. Medications can help these other options to work. Engaging in psychotherapy and healthy lifestyle changes is much easier without severe symptoms.

Is it normal to be anxious about sex?

Is it normal to be anxious about sex?

2019-01-30

It’s more normal than you’d think. But don’t panic – from erectile problems to low libido, here’s how to tackle the sex problems keeping you awake at night

 

I’ll let you into a secret: you’re not the only one whose sex life isn’t perfect all the time. “Sexual problems are way more common than people think and even the numbers we do have are likely to be much lower than in reality, because cases are under-reported due to embarrassment,” says Kate Moyle, a sexual and relationship psychotherapist.

However, it’s key we don’t let shame hold us back from seeking help, adds Ms Moyle. “The longer sexual problems go on for, the more prominent they can become because of a cycle of anxiety: the more anxious we get, the more prevalent the problem,” she points out.

The best thing to do is go and see a pharmacist or GP, and the good news is there will be zero embarrassment involved. “Medical professionals are just that – professionals,” says Ms Moyle. “To them, it’s just another health problem, just another body part.”

So here’s how to start addressing those common sex anxieties…

Anxiety 1: ‘I have erection problems’

Struggling to get – or keep – an erection? You’re not alone: 4.3 million men in the UK are affected[1]. There’s a whole raft of potential causes, from the physical (such as high blood pressure or the effects of medication) to psychological (such as stress, anxiety or depression). If it’s a recurrent problem, see your pharmacist or GP – the latter can rule out health conditions and discuss potential treatments, from medication to therapy.

“Men can feel under immense performance pressure,” explains Ms Moyle. “There’s a sense the responsibility for sex is on them, because once you have an erection you can have penetrative sex. So as a couple it can help to take the emphasis away from penetrative sex – literally ‘banning’ it for now – and instead focus on foreplay and intimacy. This allows you to enjoy the sensations and you might find you become naturally aroused.”

Anxiety 2: ‘I’m never in the mood’

According to Ms Moyle, there is no “normal” level of sexual desire or amount of sex to have. But if your normal has shifted, potential causes include anxiety, depression, relationship problems, hormonal changes (such as during menopause), and side effects of medication. Her advice to is have a chat with your GP if it’s worrying you.

“It can help to remember sexual desire is usually responsive,” she continues. “You might not be in the mood for sex but if you were to read or watch something that aroused you, or your partner started kissing you, you might respond.

“There’s a lot of miseducation that we should be spontaneously aroused and that’s not really how it works. So try making more opportunities for arousal to happen. And remove other distractions. Often people are struggling with an inability to switch off – so turn everything off around you to get turned on.”

Anxiety 3: ‘Sex is painful for me’

For men, common causes of painful sex include infection, inflammation and a tight foreskin. For women, infection, vaginal dryness, lack of arousal and vaginismus (a condition where muscles in or around the vagina shut tightly) are some typical causes. Again, the advice from Ms Moyle is to get it checked out by a GP.

“If you experience pain during sex, the positives like anticipation and excitement are replaced with fear, anxiety or tension,” she says. “So you might start to avoid sex or, for women, it can become a vicious circle where you tense up and that causes sex to be painful.

“While you’re working out what’s wrong, don’t force it or you’ll reinforce sex as something negative,” adds Ms Moyle. “You need a ‘partner pact’ where it’s OK for you to say when you’re uncomfortable having sex.”

Anxiety 4: ‘I come too soon’

There’s no “correct” amount of time for sex to last. So the speed at which you orgasm is only a problem if it’s a problem to you. However, premature ejaculation in men can be caused by a whole host of things, including prostate problems, thyroid problems and depression, so if you’ve noticed a change, see your GP.

“Men can feel under pressure because there’s this idea that when they climax the sex is over,” says Ms Moyle. “But sex doesn’t have to be linear where the end goal is intercourse. Non-penetrative sex isn’t just a route to penetrative sex, it’s sex in itself. So even if a man has ejaculated he can still engage in that with his partner.”

The same goes if the woman comes first in a hetrosexual couple – she might not feel comfortable carrying on with penetrative sex. But, as Ms Moyle notes, “The focus should be on mutual pleasure.”

Anxiety 5: ‘I’m not confident in the bedroom’

Worried about a lack of experience? Know this: it counts for nothing. “There’s no objective measure of being ‘good at sex’,” says Ms Moyle. “Because you had good sex with someone doesn’t mean the next time you have great sex with someone it will be the same kind of sex.”

But what if it’s body insecurities that are getting you down? “When it comes to body confidence, it doesn’t really matter what your partner thinks about you – it’s about what you think about yourself,” she says. “As much of a buzz-phrase as self-care is, looking after yourself is important so you learn to value yourself.”

For you as an individual, that might mean exercise, a warm bath, therapy or simply spending more alone time.

Anxiety 6: ‘I can’t orgasm’

“Exploring what you like with your partner or through masturbation can make a real difference,” suggests Ms Moyle. However, there can be other issues that play into an inability to orgasm for men (including stress, depression, diabetes and effects of certain medication, and for women (depression, relationship problems and previous traumatic sexual experience are among the potential causes), so seek advice from your GP if you’re concerned.

Removing reaching orgasm as a goal can really help, too. “Having a goal means pressure to succeed,” says Ms Moyle. “If we’re preoccupied with that we’re in our heads, and then we can’t really be in our bodies.

“But it’s the bodily sensations we experience that are going to lead to orgasm. So it’s about trying to be mindful – bringing your focus back to your senses and experiences every time your mind wanders.”

Finding a way forward

This series of Telegraph articles, brought to you by VIAGRA Connect, addresses the myths and misconceptions around erectile problems and helps men find the right treatment

VIAGRA Connect is the first medicine available in the UK without a prescription to help men with erectile dysfunction. It is available from pharmacies and registered online pharmacies.

To find out more about erectile dysfunction, how VIAGRA Connect can help and how it can be bought, go to viagraconnect.co.uk

VIAGRA Connect: 50mg film coated tablets. Contains sildenafil. For erectile dysfunction in adult men. Always read the leaflet. PP-VCO-GBR-0200

Footnotes:

[1] Prevalence based on men reporting occasional and frequent difficulty getting or maintaining an erection [ref. Kantar TNS Omnibus Survey Dec 2010 – in a survey of 1,033 men]

http://www.srhmatters.org/wp-admin/post-new.php?lang=en

 

Do men really exaggerate their number of sexual partners?

Do men really exaggerate their number of sexual partners?

2018-09-07

When it comes to sexual partners, what’s in a number? For one recent survey study, researchers at the University of Glasgow analyzed the responses of over 15,000 men and women and concluded that men are more likely to exaggerate their number of opposite-sex partners, possibly because men estimate rather than count all of their partners.

Men, it turned out, claimed an average of 14 sexual partners over their lifetime, while women reported only seven. The people surveyed were between the ages of 16 and 74.
The investigators claim that such studies are an important part of human sexuality research and in assessing the risk of sexually transmitted infections. But my fellow sex therapists and I aren’t so sure. Rather than focusing on one’s number of partners, “We should be talking about what folks want for their future and what they’ve learned from past relationships,” sex therapist Gracie Landes said.
I asked Landes and several of my other colleagues to weigh in on the continued fascination that the public — and media — seems to have with people’s number of sexual partners.

Are men exaggerating or overestimating their number of partners?

The answer to this question appears to be a resounding “yes.” Indeed, it’s simple math: “Given that there are not significantly more women in the population than men, if men are reporting higher numbers and women are reporting lower numbers, many are reporting inflated or deflated numbers due to the tendency to answer questions in a way that they think they’re supposed to,” sex therapist Dulcinea Pitagora explained.
In fact, statistics released by the dating app Tinder show that men use a broader strategy, indicating their approval of someone’s photo by swiping right on 46% of profiles, while women swipe right on only 14%. A study of raw data from Tinder also found that about 80% of female users are all competing for the same 20% of men.
“This seems to indicate that the number of sex partners would be especially skewed in the male population in favor of the more desirable men and that a majority of men are not having much success,” sex therapist Michael Aaron said. “It’s possible, then, that surveys such as this one, which find higher overall partners amongst men, may be indicative of men inflating their numbers, perhaps due to underlying shame.”

Why would someone inflate or deflate their actual number?

As Aaron suggests, society’s focus on the number of people someone has slept with may lead some to exaggerate — or decrease — their actual number out of embarrassment.
“Women might underreport out of fear of being judged negatively, while men might overreport in order to be looked at more favorably,” sex therapist Rachel Needle said. “In other words, men who have a high number are considered studs, while women are often slut-shamed. In addition, women might round down so their partner feels more important and special.”
Sex therapist Barbara Gold agreed. “I believe this is attributable to shame. It goes back to the gender myths that women aren’t supposed to enjoy or expose their sexuality lest they be judged in a negative way, while whatever sexual shame men may carry, social norms not only allow them to be sexual creatures but expect them to be,” she explained.

Should you ask your partner their ‘number’ — or tell them yours?

Whether you choose to talk numbers with your partner is entirely up to you. “You should do whatever you’re comfortable with,” Gold said. “You might ask why they want to know and what the number represents to them and then decide if or how you want to respond.”
“I find that more men ask this question of their female partners than vice versa,” sex therapist Deborah Fox noted. “Although men make some meaning out of the number they receive, it’s not really the question they want an answer to. They really want to know how they stack up to the previous partners, but that question requires way more nerve to ask. They want to know, ‘Am I the best lover you’ve ever had?’ but they’re also unlikely to ask that question.”

What should couples be discussing instead?

Rather than fixating on the number of people you or your partner have had sex with, I advise turning the conversation so that you’re having an open discussion about your interests.
“Instead of discussing a number, you should be talking about what you know you enjoy sexually, what you’re curious about and what you might want to explore in terms of sensations, types or scenarios, monogamy/non-monogamy and your top erotic triggers,” sex therapist Sari Cooper said.
And while you should certainly ask about your partner’s sexual health — and get tested — the number of sexual partners you’ve both had shouldn’t affect the need to practice safe sex.
It can be tempting to focus on one’s number of sexual partners, and studies like this one allow curious folks to compare themselves to others. But the fact is that there’s no right or wrong number. What matters most is your relationship with your current partner and how you can both make that as satisfying as possible.

https://edition.cnn.com/2018/09/06/health/number-of-sex-partners-kerner/index.html

Intercourse isn’t everything for most women, says study — try ‘outercourse’

Intercourse isn’t everything for most women, says study — try ‘outercourse’

2017-08-29

By Ian Kerner, CNN

Many of us equate “sex” with “intercourse” and use those words interchangeably. Yet highly satisfying sex doesn’t have to be limited to penetration — and doesn’t even have to include it at all.

ccording to a recent study, many women report that they require clitoral stimulation to have an orgasm.
For the study, Debby Herbenick, director of the Center for Sexual Health Promotion at Indiana University and a research fellow and sexual health educator at the Kinsey Institute, and her colleagues assessed data from 1,055 women ages 18 to 94 who answered a detailed online survey about their sex lives. “Our purpose was to understand more about women’s experiences with … the kinds of touch they find pleasurable and how clitoral and vaginal stimulation contribute to their orgasms,” she explained.
In reading her results, I’m struck by the idea that the majority of women report that they often don’t reach orgasm through intercourse alone. This flies in the face of the stereotype of intercourse as the be-all and end-all of sexual activity — and suggests that couples should explore the whole range of pleasurable options for achieving climax. The study contained a few compelling findings worth enumerating.

Intercourse isn’t everything

This study found that only about 18% of women reported being able to climax during intercourse from vaginal penetration alone. About 36% said they needed clitoral stimulation in order to orgasm during intercourse, and another 36% said it enhanced the experience. Yet, many women still fake orgasm during intercourse, according to therapist Laurie Mintz, author of the new book “Becoming Cliterate.”
“The main reasons they give for faking is that they want to appear ‘normal’ and want to make their male partners feel good,” she said.
“This is one of the saddest and most common problems I deal with in my clinical practice,” added Anita Hoffer, a sexuality counselor and educator. “Women who either are uninformed or insecure and therefore easily intimidated by ignorant partners bear a great deal of shame and guilt at being unable to climax from intercourse alone. Many are greatly relieved when they learn that they are among the majority of women who engage in sexual intercourse.”

Orgasms vary

Do some orgasms feel better than others? According to 78% of the survey respondents, the answer is yes. These so-called better orgasms aren’t necessarily dependent on the length of an encounter. In fact, fewer than one in five women surveyed believed that longer sex contributed to better orgasms.
Instead, the most common contributors to orgasmic bliss included spending time to build arousal, having a partner who knows that they like, emotional intimacy and clitoral stimulation during intercourse, said Herbenick. “A woman’s general mood and stress level — including the degree to which she is able to mindfully immerse in the sexual encounter — can have an impact on orgasm quality too,” Mintz explained.

‘Outercourse’ matters

This term “outercourse” refers to sex that isn’t intercourse and doesn’t involve penetration. It can include kissing, touching, erotic massage and using sex toys, just to name a few options.
“When we equate intercourse and sex and call everything that comes before intercourse ‘foreplay,’ we are buying into the cultural script that sex should proceed as follows: foreplay (just enough to get her ready for intercourse), intercourse (during which both women and men orgasm), and game over,” Mintz said. But sex doesn’t have to involve intercourse at all. Even when it does, other forms of stimulation can add to the experience and may improve the odds of reaching orgasm.
Herbenick suggested that couples take a lesson from the early days of their relationship. “Sometimes, when people are first getting together, they spend time making out and touching each other’s genitals long before they start having oral sex or intercourse with each other,” she explained. “All too often, once oral sex and intercourse become part of their routine, the rest fades away — which is too bad, considering how powerful genital touching can be.”

Communication is key

The study found that 41% of women prefer just one style of touch. “This underscores how important it is to have conversations about sex and pleasure or even to show your partner what you like, since otherwise, the chances of just stumbling upon that one preference are pretty low,” Herbenick said. “Couples should be having conversations about what they like, what they don’t like, what feels good and leads to orgasm, as well as what feels good but doesn’t necessarily lead to orgasm.”
One good source of information about women’s sexual pleasure that can help you get the conversation started is the website for OMGYES, which sponsored the study. The site, which states it’s for 18-year-olds and older, contains a series of videos that demonstrate different types of touch that real women find pleasurable, including techniques labeled “edging,” “layering” and “orbiting.” There is a free preview but a cost to access all of them.
I’ve found this site very helpful to my female patients and their partners who want to learn more about female pleasure. “It tastefully and unselfconsciously names, describes and normalizes behaviors that are universal and, by example, invites the viewer to experiment and learn,” Hoffer said. “As Leonore Tiefer (sex researcher, therapist and activist) has said, ‘Sex is not a natural act,’ and good lovemaking is an art that must be learned and practiced.”

More Men Are Taking Antidepressants Than Ever Before

More Men Are Taking Antidepressants Than Ever Before

2017-08-17

Nearly 1 in 10 men report taking the pills in the last month, a new report finds

 

Do you pop a pill to beat the blues? If so, you’re not alone: More men are taking antidepressants than ever before, according to a new report from the Centers for Disease Control and Prevention (CDC).

After combing through the numbers from 2011 to 2014—the most recent data available—the CDC found nearly 1 in 10 men reported taking antidepressant medication in the past month. That’s a 69 percent increase from 1999 to 2002, when only 5 percent of men reported taking antidepressants.

What’s more, 21 percent of men reported taking antidepressants for 10 years or more. While women were twice as likely to report taking antidepressants as men, there was no significant difference in how long both genders used the medication.

It’s worthy to note that nearly half of all antidepressant prescriptions are given out to treat conditions other than depression each year, according to one 2016 JAMA study. Physicians reported prescribing the pills for anxiety, pain, insomnia, and panic disorders, too.

But the scary part is, when looking at antidepressants as a depression treatment in men, it’s possible these numbers might not paint the whole picture. That’s because men deal with depression differently than women, and may not even be coming forward about their symptoms.

“Male depression sometimes manifests through the ‘male code’ that says you cannot show weakness, sadness, or vulnerability,” Fred Rabinowitz, Ph.D., a professor of psychology at California’s University of Redlands, told Men’s Health in December.

And depression in guys tends not to be as easily identifiable, either—so it’s possible that men might not identify what they’re feeling as depression. Symptoms of depression in men can show up as things like anger, impulsivity, and substance use, rather than just simply sadness or the blues. In fact, when researchers from the University of Michigan surveyed more than 5,600 men and women using symptoms of depression more common in men as the basis for diagnosis, 6 percent of men met the criteria compared to 22 percent of women. But when they used the traditional symptoms of depression, more women fit the criteria than men.

Another reason guys may put off depression treatment? Some guys don’t like dealing with the side effects of antidepressants, says Rabinowitz. They includes weight gain, insomnia, and yes, even sexual problems like erectile dysfunction and delayed ejaculation.

Selective serotonin reuptake inhibitors—a common class of antidepressants that includes Prozac, Zoloft, and Lexapro—may manipulate the neurotransmitters in your brain, which can delay your orgasm, according to urologist Tobias Köhler, M.D. But don’t use fear of those sexual side effects as a reason to put off seeking care: Other types of antidepressants don’t seem to cause the same problems. (Here are four more common medications that can kill your sex life.)

Suicide is the seventh leading cause of death in men—and untreated depression can act as a possible trigger. So if you think your sadness or other mood symptoms may be something more serious, see your doctor. He or she will be able to determine if something else might be causing your symptoms, like a medication with unpleasant side effects.

Plus, he or she may be able to refer you to psychiatrist if they think your symptoms point to depression. Research suggests that a combination of therapy and medication is the best treatment. However, every guy is different—a lot of men need to be encouraged to seek therapy by a family member or friend before they even consider it.

Additional reporting by Melissa Romero

http://www.menshealth.com/health/antidepressant-use-on-the-rise-in-men

Confidentiality concerns may deter teens from sexual, reproductive health care services

Confidentiality concerns may deter teens from sexual, reproductive health care services

2017-04-06

According to a national survey, 12.7% of sexually-active teenagers and young adults who were on their parent’s insurance plan would not use sexual and reproductive health services due to concerns that their parents would learn about it.

“Changes in the U.S. health care system have permitted dependent children to remain on a parent’s health insurance plan until the child’s 26th birthday and required coverage of certain preventive services,” Jami S. Leichliter, PhD, from the Division of Sexually Transmitted Disease Prevention, the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention at the CDC, and colleagues wrote. “Although these provisions likely facilitate access to the health care system, adolescents and young adults might not seek care or might delay seeking care for certain services because of concerns about confidentiality, including fears that their parents might find out.”

To ascertain the prevalence of confidentiality concerns among teenagers and young adults, the researchers examined data from sexually-experienced individuals aged between 15 and 25 years (n = 10,205) included in the 2013-2015 National Survey of Family Growth. In addition to information on marriage, divorce, family life, having and raising children and medical care, the National Survey of Family Growth also measures reproductive health status and examines the efficacy or need of health education programs.

The survey included questions concerning confidentiality that addressed whether those aged 15 to 17 would “ever not go for sexual or reproductive health care because their parents might find out,” whether they had “time alone with a provider in the past 12 months without a parent, relative or guardian in the room” and the status of their current health insurance.

Respondents who received STD services were defined as those who had a sexual risk assessment or other clinical services in the past year. A risk assessment included a doctor or health care provider questioning about sexual orientation or the sex of their partners, number of partners, condom use and type of sex (vaginal, oral or anal). Other services include chlamydia testing for girls in the last 12 months or receiving treatment for an STD in the past year for both boys and girls.

Among sexually-experienced youth aged 15 to 17 years, 22.6% responded that they would not seek services with concerns that their parents would know. Girls who were concerned about confidentiality were less likely to report receipt of chlamydia testing (17.1%) compared with girls who did not have concerns about confidentiality (38.7%).

When both male and female youth received more time alone with their health care providers, researchers noted that

they were more likely to report receipt of risk assessment (71.1%); however, when parents were present, reporting dropped to 36.6%. Girls who spent more time alone with their health care provider reported a  higher rate of chlamydia testing (34.0%) than those who had a parent present (14.9%).

“Several medical organizations have emphasized the need for confidentiality for youths seeking care such as STD services,” Leichliter and colleagues wrote. “Previous research has found that females might have more general and sexual and reproductive health-specific confidentiality concerns than do males.” – by Katherine Bortz

Disclosure: The researchers report no relevant financial disclosures.

When a Partner Dies, Grieving the Loss of Sex

When a Partner Dies, Grieving the Loss of Sex

2017-03-07

After Alice Radosh’s husband of 40 years died in 2013, she received, in addition to the usual condolences, countless offers of help with matters like finances, her car and household repairs. But no one, not even close friends or grief counselors, dared to discuss a nagging need that plagues many older women and men who outlive their sexual partners.

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Dr. Radosh, 75 and a neuropsychologist by training, calls it “sexual bereavement,” which she defines as grief associated with losing sexual intimacy with a long-term partner. The result, she and her co-author Linda Simkin wrote in a recently published report, is “disenfranchised grief, a grief that is not openly acknowledged, socially sanctioned and publicly shared.”

“It’s a grief that no one talks about,” Dr. Radosh, a resident of Lake Hill, N.Y., said in an interview. “But if you can’t get past it, it can have negative effects on your physical and emotional health, and you won’t be prepared for the next relationship,” should an opportunity for one come along.

Yes, dear readers of all ages and the children of aging parents, many people in their golden years still have sexual urges and desires for intimacy that go unfulfilled when a partner becomes seriously ill or dies.

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“Studies have shown that people are still having and enjoying sex in their 60s, 70s and 80s,” Dr. Radosh said. “They consider their sexual relationship to be an extremely important part of their lives. But when one partner dies, it’s over.”

In a study of a representative national sample of 3,005 older American adults, Dr. Stacy Tessler Lindau and co-authors found that 73 percent of those ages 57 to 64, 53 percent of those 65 to 74 and 26 percent of those 75 to 85 were still sexually active.

Yet a report published by the United Kingdom’s Department of Health in 2013, the National Service Framework for Older People, “makes no mention of the problems related to sexual issues older people may face,” Dr. Radosh and Ms. Simkin wrote in the journal Reproductive Health Matters. “Researchers have even suggested that some health care professionals might share the prejudice that sex in older people is ‘disgusting’ or ‘simply funny’ and therefore avoid discussing sexuality with their older patients.”

Dr. Radosh and Ms. Simkin undertook “an exploratory survey of currently married women” that they hope will stimulate further study of sexual bereavement and, more important, reduce the reluctance of both lay people and health professionals to speak openly about this emotionally and physically challenging source of grief.

As one therapist who read their journal article wrote, “Two of my clients have been recently widowed and felt that they were very unusual in ‘missing sex at my age.’ I will use your article as a reference for these women.”

Another wrote: “It got me thinking of ALL the sexual bereavement there is, through being single, through divorce, through disinterest and through what I am experiencing, through prostatectomy. It is not talked about.”

Prior research has “documented that physicians/counselors are generally uncomfortable discussing sex with older women and men,” the researchers noted. “As a result, such discussions either never happen or happen awkwardly.” Even best-selling memoirs about the death of a spouse, like Joan Didion’s “The Year of Magical Thinking,” fail to discuss the loss of sexual intimacy, Dr. Radosh said.

Rather than studying widows, she and Ms. Simkin chose to question a sampling of 104 currently partnered women age 55 and older, lest their research add to the distress of bereaved women by raising a “double taboo of death and sex.”

They cited a sarcastic posting from a woman who said she was not a good widow because “a good widow does not crave sex. She certainly doesn’t talk about it…. Apparently, I stink at being a good widow.”

The majority of survey participants said they were currently sexually active, with 86 percent stating that they “enjoyed sex,” the researchers reported. Nearly three in four of the women thought they would miss sex if their partner died, and many said they would want to talk about sex with friends after the death. However, “76 percent said they would want friends to initiate that discussion with them,” rather than bringing it up themselves.

Yet, the researchers found, “even women who said they were comfortable talking about sex reported that it would not occur to them to initiate a discussion about sex if a friend’s partner died.” The older the widowed person, the less likely a friend would be willing to raise the subject of sex. While half of respondents thought they would bring it up with a widowed friend age 40 to 49, only 26 percent would think to discuss it with someone 70 to 79 and only 14 percent if the friend was 80 or older.

But even among young widows, the topic is usually not addressed, said Carole Brody Fleet of Lake Forest, Calif., the author of “Happily Even After” who was widowed at age 40. In an interview she said, “No one brought up my sexuality.” Ms. Fleet, who conducts workshops for widowed people, is forthright in bringing up sex with attendees, some of whom may think they are “terrible people” for even considering it.

She cited “one prevailing emotion: Guilt. Widows don’t discuss the loss of sexual intimacy with friends or mental health professionals because they feel like they’re cheating. They think, ‘How can I feel that?’ But you’re not cheating or casting aspersions on your love for the partner who died.

“You can honor your past, treasure it, but you do not have to live in your past. It’s not an either-or situation. You can incorporate your previous life into the life you’re moving into. People have an endless capacity to love.”

However, Ms. Fleet, who remarried nine years after her husband died, cautioned against acting precipitously when grieving the loss of sexual intimacy. “When you’re missing physical connection with another person, you can make decisions that are not always in your best interest,” she said. “Sex can cloud one’s judgment. Maybe you’re just missing that. It helps to take sex out of the equation and reassess the relationship before becoming sexually intimate.”

Dr. Radosh urges the widowed to bring up grief over the loss of sexual intimacy with a therapist or in a bereavement group. She said, “Even if done awkwardly, make it part of the conversation. Let close friends know this is something you want to talk about. There is a need to normalize this topic.”

Hyperfocus: The other side of adult ADHD

Hyperfocus: The other side of adult ADHD

2016-07-18

By Jenara Nerenberg, Science of Us

http://edition.cnn.com/2016/07/15/health/adult-adhd-hyperfocus/index.html

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Writers, entrepreneurs, and creative leaders of all types know that intense focus that happens when you’re “in the zone”: You’re feeling empowered, productive, and engaged. Psychologists might call this flow, the experience of zeroing in so closely on some activity that you lose yourself in it. And this immersive state, as it turns out, also happens to be something that some adults with ADHD commonly experience.

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It sounds like a contradiction in terms: You think ADHD and you think of a spaced-out, scattered kid, right? But by definition, ADHD is a “maldistribution” of attention — that is, people who have it often oscillate between splintered and hyperfocused attention. The latter is what Brandon Ashinoff, a psychologist at the University of Birmingham who studies hyperfocus, has called an “interesting paradox” — it’s too much focus, as opposed to a scattered attention span. “You’re focused so intently on something, no other information gets into your brain,” Ashinoff has said.
In other words, ADHD shows up in different ways depending on the person; the goal is to help people regulate their attention and harness the kind of attention necessary for the task at hand. (And recent research from Brazil and King’s College London, by the way, has suggested that despite its reputation as a childhood problem, it’s more common than you might think for the condition to show up for the first time in adulthood, even among people who never showed signs of it in childhood.) Generally speaking, ADHD is classified into two broad categories: inattentive type, and hyperactive/impulsive type. Hyperfocus is seen among both of these types — and yet it’s been largely neglected in academic research.
That’s surprising, especially considering the significant impact — both positive and negative — hyperfocus can have at work and at home. Hyperfocus is great for engaging in longer tasks which require intense concentration — but it’s not so great if that means that the more mundane tasks, chores, and assignments fall by the wayside. When composing a song or coding a new program, the tendency to lose sight of all else proves beneficial; when failing to get laundry or dishes done for days on end, the tendency becomes a potential problem.
One of the few pieces of research on the hyperfocus piece of ADHD is from South Africa, and was the subject of a University of Johannesburg master’s thesis by researcher and writer Rony Sklar — indeed, much of her work has raised the question of why hyperfocus isn’t being looked at in the literature, since her own work was limited by sample size. “The field is wide open and people really need to start researching it,” Sklar told Science of Us. “It’s not about having an attention deficit, it’s more a maldistribution of attention. It’s not about not being able to concentrate; it’s about being able to concentrate in different forms and different intensity.” Put another way, there is a spectrum along which attention gets channeled for human beings; those diagnosed with ADHD don’t have less attention than normal — it’s more accurate to say that their attention can be splintered or hyperfocused, or it can swing between the two. Their challenge is to learn ways to distribute their attention more evenly, by regulating it or even manipulating it to serve their purposes according to the task at hand, often through the use of practical tools like timers, calendars, reminders, alarms, and breaking tasks into concrete steps.
In Sklar’s limited research, she’s found that people with ADHD tend to use less mental effort to play a computer game than people without ADHD, “which could mean that they entered the flow state more readily than the non-ADHD group,” says Sklar. Additionally, the ADHD group had higher activation in the parietal lobe, which is notable because most studies have found that ADHD individuals have lower parietal lobe activation. This makes sense if you think about it — under normal day-to-day circumstances where shifting attention is required, the ADHD individual may struggle; the usual lower activation in the parietal lobe of those with ADHD is thought to be linked to impaired attention. But in Sklar’s sample, where people were intensely focused — or in a state of “hyperfocus” — those with ADHD had higher parietal lobe activation than the non-ADHD group, which “could support the idea of people with ADHD being able to sustain attention depending on the specific context,” says Sklar. So this could suggest something rather exciting: that ADHD individuals have, at least in some contexts, a leg up over non-ADHD folks, in that ADHD in fact helps people sustain attention for longer periods than normal in some situations. Under the right conditions, hyperfocus is ADHD’s secret superpower.
For a child or adult with ADHD, the determining variable is interest — if the person loves to play music, they can do it for hours. If they hate doing dishes, they will clean one dish, lose focus, and jump to another activity. One metaphor that captivated Sklar’s attention paints an interesting picture — first put forth by author Thom Hartmann, the theory suggests that those with ADHD have more of a “hunter” orientation, evolutionarily speaking, and those without ADHD are the “farmers.” One group is more nomadic and needs to constantly scan the environment, with attention darting here and there for prey; the other group possesses the patience, calm, and nurturing ability to tend to repeated farming tasks with long-term consistency. The hunter mindset in some ways explains hyperfocus — once the prey is identified, the hunter intensely focuses on her pursuit.
But Arthur Caye, the lead researcher in Brazil’s recent study, asserts that hyperfocus may be a result of overcompensating: that is, people who have ADHD may tend to zero in on one particular pursuit as a way to make up for the distractedness in other areas. So it may not be that hyperfocus is a clinical symptom of ADHD — and, indeed, hyperfocus is not listed in the DSM-5 — but it could be a response to having the condition, according to Caye, and it can be channeled into productive or unproductive pursuits. Hyperfocus is not a common topic of conversation among researchers, including Caye and his counterparts at King’s College London, but it is among those with ADHD and their therapists and coaches.
This narrative sounds familiar to Maria Yagoda, a writer and Yale graduate who has ADHD. “I will definitely get sucked into something and have to devote all my time and energy into that,” Yagoda told Science of Us. She has written previously for The Atlantic about how the condition affects her and how people are often surprised that someone like her — a successful Ivy League graduate — could have ADHD. “Sometimes on days that are the craziest — different news stories breaking, too many meetings, family drama — I’m able to focus more intensely than I could on a normal day. I feel like I kick into this special productivity gear.”
Yagoda is an adult female with ADHD — an overlooked demographic in treatment and research circles — and yet the positive and negative symptoms of ADHD for her resemble what many other individuals with ADHD experience, regardless of age or gender.
Specifically with regard to hyperfocus, says Yagoda, “It’s like when I worked at a sandwich shop — during the lunch rush, I was a total beast. Slicing meats, throwing baguettes around, squeezing mayonnaise — I just got into a zone. Instead of being overwhelmed — which is really easy for me to be — all the pressure and stimulation helped me focus. I was great at it,” says Yagoda.
Borrowing Hartmann’s evolutionary metaphor, one could say that a chaotic newsroom is Yagoda’s “hunting” ground — she has to field fast-paced input when adrenaline-inducing news events happen around her, mentally scan her environment, and prioritize her stories of prey according to a hierarchy that is not based on size of the “kill” but the urgency of the story.
Sklar echoes this description — she says that many people with ADHD actually thrive in a more urgent environment where hyperfocus gives the person an advantage in terms of homing in on what’s important. This sentiment has also been expressed by high-profile people with ADHD, such as soccer star Tim Howard or musician Adam Levine of Maroon 5, who both say the energy of ADHD helps them perform at their job.
There are downsides to a tendency to hyperfocus on things, too, of course. Some people get lost in video games or TV shows and have trouble switching their attention to more pressing tasks. But for Yagoda, in particular, that has not been the case, and hyperfocus does not stand out as an impediment. “It’s a new thing for me to think about it as a strength,” she admits. “That’s a revelation.”
So far, the anecdotal evidence from stories like these is clear — the supporting data, alas, is not, namely because there is not yet enough of it. Sklar, for one, is hoping that changes. She receives regular contact from those in the ADHD community, particularly from coaches and therapists, who say that her conclusions are spot-on as evidenced by working with individuals who experience hyperfocus. And Sklar says that she is confident that research is heading in the right direction and that more people are taking note. “This is where the research is going and where it needs to go,” she says. “Hyperfocus can be very powerful. My hope is that people can become the best versions of themselves using the tendency.”

Screen violence — real and fictional — harmful for kids, experts say

Screen violence — real and fictional — harmful for kids, experts say

By Jacqueline Howard, CNN

http://edition.cnn.com/2016/07/18/health/screen-violence-children/index.html

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Dead bodies. Bloodied faces. Tears. Terror.

Those are just some of the things that children see when they view news coverage of violent events, such as thetruck attack in Nice, France, on Thursday.
Screen violence — which includes violence in video games, television shows and movies — is associated with aggressive behavior, aggressive thoughts and angry feelings in children, according to a policy statement released by the American Academy of Pediatrics early Monday.
“Screen violence, particularly when it is real but even if it is virtual, is quite traumatic for children regardless of age,” said Dr. Dimitri Christakis, director of the Center for Child Health, Behavior and Development at Seattle Children’s Research Institute and lead author of the statement.
“It is not uncommon to see increases in nightmares, sleep disturbances and increased general anxiety in the wake of these events. While it is true that the horrific events of this past week can happen at any time, the real risk to individuals remains low,” he said. “Children need [that] reassurance.”
For the statement, which was published in the journal Pediatrics, Christakis and colleagues reviewed and summarized more than a dozen studies and meta-analyses about the effects of virtual violence and aggression on children’s attitudes and behaviors. They defined virtual violence as forms of violence experienced or witnessed virtually on a screen.
After the review, the statement authors made specific recommendations for doctors, parents, the media industry and policy makers to better prohibit easy access to violent media for young children.
“Parents should be mindful of their children’s media diet and reduce virtual violence especially if their child shows any aggressive tendencies,” Christakis said.
During a time of much conflict in the news, Christakis advises parents to reassure their children that there are still mostly good people in the world. He recommends that parents show children stories of people helping each other, and not hurting each other.
“We have done research showing that such eventsfrighten children,” said Brad Bushman, professor of communication and psychology at Ohio State University, who was not involved in the new statement.
The statement authors also called for the federal government to oversee the development of its own media rating system, rather than relying on the entertainment industry’s rating of violent content in video games, movies and television.
“We know from hundreds of studies on thousands of children that there is a link between ‘virtual violence’ and real-world aggression,” Christakis said. “On average, the effect is in what we would deem the small to moderate range, but equivalent to the link between passive smoke exposure and lung cancer — something that municipalities have reacted to by enacting non-smoking ordinances.”
Christakis is quick to point out that there are benefits when children consume nonviolent media. For instance, he led a 2013 study that found that prosocial and educational screen time — including television and video games — can significantly enhance social and emotional competence in children.
What do other scientists think of the new statement? Dr. Douglas Gentile, a professor of psychology at Iowa State University who has studied screen time and children, said the new statement suggests that often it’s not the quantity of media but the quality that can influence aggression in children.
“Often, there are people who like to take extreme positions. Either the studies show games are creating a generation of shooters, which the science does not support, or they say there is no evidence that there are harmful effects, which the science also doesn’t support,” Gentile said.
“It is important to have our public health organizations do these types of reviews so the public can cut through all of that opinion out there,” he said. “Everyone has an opinion, but not all opinions are supported by the science.”

Why men might underestimate women’s sex drive

Why men might underestimate women’s sex drive

2016-07-04

Most men may be missing the mark when it comes to gauging women’s interest in sex.

Psychologists have long known that when they first meet, men tend to overestimate how sexually interested a woman may be.
Once two adults are in an established relationship, however, men tend to underestimate their partner’s sexual interest, according to new research published last month in the Journal of Personality and Social Psychology.
And there’s a reason for this drastic shift in perception, said Amy Muise, a post-doctoral relationship researcher at the University of Toronto and lead author of the research.
“Our findings suggest that under-perception might keep men motivated to entice their partner’s interest, and it may also minimize sexual rejection,” which would help maintain the quality of the relationship, Muise said.
“[The findings] are surprising in the sense that it’s the opposite bias that men tend to show in initial encounters, but we did expect that these biases would differ in established relationships,” she added. “It makes sense, since the goal in initial encounters might be to attract a partner, so over-perceiving their interest can help men feel more comfortable initiating a conversation or date. But the goal in relationships is to maintain the relationship.”
The research, which was conducted on mostly heterosexual couples, included three separate studies. In the first study, 44 couples completed surveys each night for three weeks. The surveys measured the participants’ sex drive as well as their daily feelings about their relationship.
In the second study, members of 84 couples were interviewed separately in a lab about their sex drive, how satisfied they were in their relationship and what they thought of their partner’s sex drive.
The third study involved 101 couples who completed a five- to 10-minute survey each day for three weeks in which they answered questions about their own sex drive and why they either felt motivated to pursue sex with their partner or not.
It turned out that men’s under-perception of their partner’s interest in sex was associated with their partner feeling more satisfied and committed to the relationship. Additionally, the researchers saw no consistent over- or under-perception bias in women.
“But, when women were higher in desire or on days when they were more motivated to avoid rejection, they demonstrated an under-perception bias as well,” Muise said. “This suggested to me that it is not just about gender but about who is higher in desire. Men tend to be higher in desire than women, on average, in relationships.”
The samples of same-sex couples in the study were too small to make a difference in the results, the researchers noted. “We conducted the analyses with and without the same-sex couples and the pattern of results remained the same,” they wrote in the study.
Andrea Meltzer, an assistant professor of psychology at Florida State University who was not involved in the research, said the findings were surprising and interesting.
“People’s behaviors are a function of their judgments and perception. That is, they tend to react to their partners based on their perception of their relationships,” she said. “For example, if they perceive their partners as satisfied, they tend to behave more positively. Thus, to have the most complete understanding of relationships, it is important to understand the source and function of intimate perceptions.”
http://edition.cnn.com/2016/07/01/health/men-women-sex-drive/index.html