Mental Health and Sex

There are a large number of mental health conditions that individuals can experience throughout their lifetime, with them affecting both males and females, however, often in different ways. In this blog post, I will aim to cover just a couple of the most commonly experienced conditions and how they can impact men specifically. 

Anxiety: First up, we have anxiety. While almost everyone you know will experience some form of anxiety in their lives, it will only be considered to be part of an anxiety condition if the symptoms become severe or last for long periods of time. While both men and women can experience anxiety, there is one type that appears more common in men - and that is performance anxiety. Chances are you have probably heard of this, but haven't considered its links to mental health.

Even today, little is known about sexual performance anxiety, as there has been little research conducted on the topic. It commonly occurs in men (9-25%); however, it does still appear in women too (6-16%). Usually, the performance anxiety comes from the maintenance of an erection - this anxiety about maintenance can then lead to the loss of an erection, which creates this cycle of performance anxiety and erectile dysfunction.

A recent study conducted by Bockaj, Muise, Belu, Rosen and O’Sullivan (2024) found the common responses when men and women were asked about their performance anxiety when engaging in sexual intercourse. These included feeling inadequate (unattractiveness, not sexually skilled or comparing poorly to previous partners), maintaining arousal, matching their partner's level of arousal and distractions due to difficulty focusing.

ADHD: While commonly known by its acronym, this mental health condition is known as Attention Deficit Hyperactivity Disorder. Men are more likely to be diagnosed with this condition, with 3 times as many men being affected as females. Like every mental health condition, the symptoms experienced may vary between individuals; however, within adult men, ADHD symptoms appear in two main categories, which include inattention and hyperactivity. 

Symptoms of inattention include: getting distracted during conversations or during tasks, losing important items, forgetting daily activities, careless mistakes and lacking in time management skills. Symptoms of hyperactivity include: leaving often when expected to stay seated, interrupting conversations, trouble waiting their turn, fidgeting, feeling restless and talking excessively.

This mental health condition can have an impact on individuals' sex lives, with it sometimes being linked to less stability within romantic relationships, less satisfaction with partners, a higher number of sexual partners, as well as being more likely to engage in risky sexual behaviours (unprotected sex, sex while intoxicated). There is also a suggested relationship between hypersexuality and problematic pornographic usage, leading those diagnosed with this condition to also report greater masturbation frequency, less sexual satisfaction and greater sexual dysfunction than those without (Hertz, et al., 2022). A healthy sex life is also an important factor for mental wellness. If you find yourself engaging in risky behaviours, please ensure you are keeping yourself and those around you safe.

Bipolar Disorder: This mental health condition causes extreme mood swings along with changes in energy levels. Individuals with this condition experience a wide range of moods from deep depression with potential for suicidal thoughts up to manic highs accompanied by psychosis and hallucinations. The common symptoms in men, which occur in two separate categories, are the mania episode symptoms and the depressive episode symptoms. 

Mania symptoms in men include: intense happiness, talking fast, racing thoughts, short temper, excessively irritable, inflated sense of self, poor judgment and reckless behaviour. Depressive symptoms include: sadness, feeling hopeless, change in eating (too much/not enough), isolating themselves from others, difficulty concentrating, sleeping too much, substance abuse and in some cases suicidal thoughts. 

While symptoms vary between individuals, this condition can have an impact on their sex lives. A study found that males who experience bipolar disorder are more likely to also experience the symptoms of erectile dysfunction. As previously explained, bipolar disorder includes episodes of varying symptoms. During depressive episodes, men may experience hyposexuality (lack of interest in sex, feeling unattractive, disinterested in personal hygiene and physical exhaustion) and during manic episodes experience hypersexuality (increased sexual confidence, willing to experiment sexually, constantly thinking about sex, frequent masturbation and risky sexual behaviours. 

BPD: Also known as Borderline Personality Disorder, is a disorder that impacts mood and interaction with others. Symptoms can be grouped into 4 main categories, as there is a wide range of symptoms an individual could experience with this disorder. The areas include emotional instability (intense negative emotions, mood swings, suicidal feelings), disturbed patterns of thinking (upsetting thoughts about self, episodes of strange experiences or hallucinations), impulsive behaviour (self-harm, binge drinking, drug misuse, gambling spree or unprotected sex with strangers) and unstable relationships (fear of abandonment, feelings others are too close).

Individuals with BPD will likely appear sexually impulsive or, in contrast, sexually avoidant, which can complicate relationships, as individuals will often seek out sex more often but will have some difficulty in maintaining healthy relationships. This disorder can cause various issues within an individual's sex life, as it is often associated with feelings of low self-worth and insecurity; it can affect sexual interactions.

Depression: This mental health condition is also viewed as a serious medical condition which can range from lasting feelings of unhappiness to feeling extreme sadness. Many individuals who experience depression also experience symptoms of anxiety. Brain chemistry, hormones and life experiences are believed to be the reasons why men and women experience depression differently. While some symptoms are experienced by both sexes (feelings of hopelessness, tiredness, sleep issues and less enjoyment in activities), there are some behaviours in men that could indicate depression. These symptoms include: problems with relationships, spending lots of time at work, physical symptoms (headaches, digestive problems), alcohol/drug use, violent behaviour, irritability, anger and risky behaviour.

Depression among men is a commonly missed condition, with men often not being diagnosed. This could be due to numerous reasons; some may not recognise what they are feeling as depression. Everyone’s symptoms vary, making it essential that you are aware of your feelings and seek help when you are not feeling your best, whether you think it is depression or not. Some men will downplay their symptoms, not admitting to themselves or others how they are truly feeling will only lead to an increase in those negative emotions. Some may not get diagnosed as they want to avoid mental health treatment; this could be due to stigma, which makes awareness on the topic even more important to prevent men from missing their diagnosis. 

Depression is known to cause sexual dysfunction, which can also complicate relationships. The sexual dysfunction can include erectile dysfunction or anorgasmia (trouble orgasming). Sex is affected in those with depression because of the way neurotransmitters communicate with the brain. When an individual experiences depression, their sex-related chemicals are not balanced, which could lead to low sexual desire and dulled pleasurable feelings.

References

ADDA. (2023, September 22). A Guide for Men With ADHD (and Their Loved Ones) - ADDA. Attention Deficit Disorder Association. Retrieved November 19, 2024, from https://add.org/adhd-symptoms-in-men/

bipolarUK. (2024, May 28). What is bipolar? Bipolar UK. Retrieved November 15, 2024, from https://www.bipolaruk.org/understanding-bipolar

blueheart. (2021, May 30). Understanding BPD and Sex. Blueheart. Retrieved November 19, 2024, from https://www.blueheart.io/post/borderline-personality-and-low-libido

Bockaj, A., Muise, M. D., Belu, C. F., Rosen, N. O., & O'Sullivan, L. F. (2024, June 7). Under Pressure: Men’s and Women’s Sexual Performance Anxiety in the Sexual Interactions of Adult Couples. The Journal of Sex Research, 1-13.

Cleveland Clinic. (n.d.). Depression & Sex: SSRI Side Effects, Depression & ED. Cleveland Clinic. Retrieved November 19, 2024, from https://my.clevelandclinic.org/health/diseases/9296-sexual-problems-and-depression-

Daino, J. E. (2021, November 19). Bipolar Disorder in Men: Signs, Tips, & Treatment. Talkspace. Retrieved November 19, 2024, from https://www.talkspace.com/mental-health/conditions/articles/bipolar-in-men/

Hertz, P. G., Turner, D., Barra, S., Biedermann, L., Retz-Junginger, P., Schöttle, D., & Retz, W. (2022, May). Sexuality in Adults With ADHD: Results of an Online Survey. Frontiers in Psychiatry, 13.

Legg, T. J. (2019, March 1). Bipolar and sex: What's the connection? MedicalNewsToday. Retrieved November 19, 2024, from https://www.medicalnewstoday.com/articles/324595

Mayo Clinic Staff. (n.d.). Male depression: Understanding the issues. Mayo Clinic. Retrieved November 19, 2024, from https://www.mayoclinic.org/diseases-conditions/depression/in-depth/male-depression/art-20046216

McLaughlan, D. (n.d.). Anxiety in men: symptoms, causes and treatment. Priory Group. Retrieved November 14, 2024, from https://www.priorygroup.com/mental-health/anxiety-treatment/anxiety-in-men

NHS. (2022, November 4). Treatment - Borderline personality disorder. NHS. Retrieved November 19, 2024, from https://www.nhs.uk/mental-health/conditions/borderline-personality-disorder/treatment/

NIH National Institute of Mental Health. (n.d.). Attention-Deficit/Hyperactivity Disorder (ADHD) - National Institute of Mental Health (NIMH). National Institute of Mental Health. Retrieved November 15, 2024, from https://www.nimh.nih.gov/health/statistics/attention-deficit-hyperactivity-disorder-adhd