DEPRESSION PSYCHOSEXUAL ISSUES Julie GithiriGoko Psychodynamic Psychotherapist and

DEPRESSION & PSYCHO-SEXUAL ISSUES. Julie Githiri-Goko Psycho-dynamic Psychotherapist and Psychosexual therapist.

De·pres·sion 1. feelings of severe despondency and dejection. 2. "self-doubt” creeps in and that swiftly turns to depression Psycho-sexual issues. Psychosexual dysfunction is the inability to become sexually aroused or achieve sexual satisfaction in the appropriate situations because of mental or emotional reasons.

DSM V (2013)-. diagnostic & statistical manual of mental disorders. ■ calls for the consideration of associated features: partner factors, relationship factors, individual vulnerability factors, cultural and religious factors, and medical factors when making diagnosis

Sexual dysfunction: A systematic review of South African research. Ref: SAMJ, S. Afr. med. j. vol. 104 n. 6 Cape Town Jun. 2014 ■ 40 - 45% of women and 20 - 30% of men, with the prevalence increasing as individuals grow older. ■ A global study of sexual attitudes and behaviours, targeting an adult population, identified early ejaculation and difficulty in achieving and maintaining an erection as the problems most commonly reported by men, affecting 24% and 17%, Lack of sexual interest and inability to reach orgasm were the most commonly reported complaints for women, affecting 32% and 25%. ■ Diabetes mellitus, cardiovascular disease, genitourinary disease, psychiatric or psychological disorders, and poor general health have been identified as common comorbid conditions associated with sexual dysfunction in both sexes. ■ Despite the high prevalence of sexual problems and comorbidity with commonly presenting diseases and disorders, <20% of people experiencing sexual difficulties seek assistance from healthcare providers and only 9% report being asked about their sexual health by their healthcare practitioner.

Female FSIAD- Female sexual interest arousal disorder GPPPD- Genital Pelvic Pain Penetration Disorder Anorgasmia- absence of orgasm.

Male ED- Erectile dysfunction: PE-Premature ejaculation DE- Delayed Ejaculation Low desire

Psychologica l impact of depression Depressed mood, Situational/major/ chronic loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, and poor concentration. Depression is different from feeling down or sad. Depression can happen to anyone.

Psychological Impact of PS Anger/ shame/ blame Situational/ life-long/acquired Resentment Confidence/ anxiety psycho-education Relational conflict

Arousal cycle

36 yrs. old man Unemployed RFP of 1 yr. Living with RFP- 9/12 Using PDE 5 ∆ ED

Treatment options for Depression. Anti- psychotics SSRI- Selective serotonin reuptake inhibitors Talking therapies Alternative options Contact with a MH practitioner

Treatment options- PS Psychosexual therapy Medication (PE) (ED) Medical intervention Sensate focus Qualified practitioner

References ■ Heiman J, (2009) Becoming orgasmic: a sexual pleasure growth programme■ Hawton, K (1985). Sex therapy: A practical Guide. New York. Oxford University Press. , pp 205. ■ Basson, R (2000). The female sexual response: A different Model, journal of sex & marital therapy, 26: 1, 51 -65 ■ Binik, Y. , Hall, K (2014). Principles and practice of sex therapy. 5 th ed. The Guilford press. , pp 159. ■ Tiefer, L. , (2001). The selling of ‘female sexual dysfunction’ J Sex Marital Therapy. 200 : 27: pp 625– 628. ■ Bernie Zilbergeld, (1999). The new male sexuality. Bantam. , pp 220. ■ Balint, E (1993). Unconscious communications between husband wife. In S Ruszczynski, 1993. Psychotherapy with couples. Karnac (books) Ltd. , pp 30 -44. ■ Schnarch, D. M. , (1997). Passionate marriage: Love, sex, and intimacy in emotionally committed relationships. WW Norton & Company. , pp 58

Contact details: ■ Julie Githiri-Goko ■ Email: Julie@coupleandrelationshiptherapy. info ■ Tel: +254 (0)715 175 790