A Time for Post SSRI Sexual Dysfunction?

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December 28, 2021 | 14 Comments

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  1. That is a saddening truth… I often think we are just left alone, abandoned, with no resources, with no one to care. Though some doctors are starting to consider that this issue is real we are far far away from a solution. It seems that life goes on for everyone except for us. I keep thinking “what’s left for me?”

  2. It is very hard for me to fathom how the human psyche rationalizes or compartmentalizes Post SSRI Sexual Dysfunction. One would assume that clinicians would have a better understanding/empathy towards a condition that is hardly ever talked about. There is never any mention that the tools clinicians use can bring deleterious harm to one’s sexual arousal. The most common synopsis: It is all in your head and therefore, how can any medicine or procedure create such a disabling outcome? It is similar to what is happening now with the Covid-19 vaccines.
    Clinicians and many other organizations have colluded together to abort any acknowledgement or understanding of serious adverse drug reactions that have occurred in the past. Some clinicians have lied or downplayed serious reactions. The black and white tests do not always capture the medical problems therefore, it is always psychologically inclined. They are also censoring people from talking the truth. People are already to judge without lending an ear to facts.
    The guidelines, for Covid-19 vaccines are not only demoralizing but devoid of any accountability or responsibility if a second re-occurrence of an adverse drug reaction was to occur again. They deliberately outcast you and compartmentalize you into a category of ‘we don’t give a damn’ what happens to you and because you have not been to a clinician for such a long time, we are not going to support you or prevent another adverse reaction from occurring again. If you have many tests and procedures, which pose a rxisk to your health, then we shall help you ~ too late!
    I find this ‘Russian Roulette’ scenario disturbing and very dehumanizing. I find the whole entire establishment not only lacking care but devoid of any compassion/empathy or sympathy. I feel for the people who are told that if they do not have the Covid-19 vaccines, they will die. Coercion at its worst!
    Right now, as I am tapping away, I believe that many clinicians who have let us down in the past are not looking out for anyone’s best interests at the moment. We are all being fed lies and clinicians who are meant to care are not so sincere or genuine when it comes to our well-being. They even close their appointment books to avoid assisting or supporting us. This is definitely not ‘duty of care!’ Is having the Covid-19 vaccine a ‘wait and see’ what happens scenario because I would have thought that intelligent people would protect people from going through a major crisis again. No one is learning from past mistakes. The people who suffer are those who cannot defend themselves from those who did them wrong many, many years ago. We are back to square one again, with one foot in the grave and no one to turn to if an unforeseen tragedy were to occur again. So yes, we are alone in all of this mess because the system that failed us many years ago has come back to repeat itself again. Where is the safety net?
    Some clinicians and other cohorts need to experience what many unfortunate souls had to go through to understand our dilemmas.
    Discrimination is not the word to describe our sense of frustration. Dehumanizing ones adverse experiences and not learning from past mistakes is what I call criminal.

  3. Walk on By Simon W
    Sounds home page
    My Sounds
    Radio 4

    Today – 21/12/2021 – BBC Sounds
    Today
    21/12/2021

    Released On: 21 Dec 2021Available for 21 days
    This is a so called debate between S W and Mark H where Mark H completely showed up the nonsense spouted by S.W
    (on R4 SOUNDS at segment 2:52:14 at 8.45am TODAY news from 6am – 9am)Worth listening to hear Simon Wessely making an arse of himself by admitting ‘I haven’read it yet’ ie the report he was on the radio to discuss. Back tracked saying ‘we are having trouble reading it’ (what a liar to be blunt – it was widely available – why else was he on the prog apart from promoting himself as ever.? he was just trying to be dismissive but Mark wise to his tricks got the last word pointing out that S W was referring to an outdated study in his counter argument.

    In thebmj
    FIONA MACDONALD21 DECEMBER 2021
    Millions of people take antidepressants each day, but a major new review of the data brings up some concerns with how the drugs are currently prescribed.
    In fact, when taken over long periods for mild and moderate depression, antidepressants may be doing patients more harm than good, the review explains.
    That’s not to say we shouldn’t use antidepressants at all – in many instances, they save lives and work well.
    But the authors of the new review, which appears in the British Medical Journal’s Drug and Therapeutics Bulletin, suggest doctors should prescribe fewer antidepressants for shorter periods of time, and focus on people with severe depression.
    In other cases, the evidence is unclear on how effective the drugs really are – and whether the benefits outweigh the side effects.
    “There continues to be considerable uncertainty about the benefits of antidepressant use in the short- and long-term, particularly in regard to the lack of a clinically significant difference between antidepressant and placebo treatment,” explain the authors, psychiatrist Mark Horowitz from University College London and pharmacist Michael Wilcock from Royal Cornwall Hospital.
    “In light of this uncertain balance of benefits and harms, we should re-visit the widespread – and growing – prescription of antidepressants.”
    One of the big issues highlighted by the review is that most clinical trials only look at the efficacy of the drugs over a six- to 12-week study period. In the real world, however, people are prescribed antidepressants for years.
    More worryingly, most studies don’t look at outcomes that matter most to patients, such as quality of life – they only measure symptoms.
    “About a fifth of patients on SSRIs report sleepiness during the day, dry mouth, profuse sweating or weight gain,” the review notes. “A quarter of patients report sexual dysfunction, and about one in 10 report restlessness, muscle spasms or twitching, nausea, constipation, diarrhea or dizziness.”
    A survey of self-rated side effects in long-term use was even more concerning: 71 percent reported emotional numbness, 70 percent said they felt ‘foggy or detached’, 66 percent said they experienced sexual difficulties and 63 percent reported drowsiness.
    Another potential problem flagged by the authors is that the long-term use of antidepressants often starts in childhood.
    In reality, there’s very little clinical evidence that antidepressants work effectively in teenagers and young adults. And yet, antidepressants are one of the most commonly used drugs by adolescent girls, and the number of 12 to 17-year-olds prescribed antidepressants is increasing rapidly in some countries.
    Of course, this isn’t the first paper to question the effectiveness of antidepressants. For years, there has been discussion over whether they offer benefits.

    A 2017 meta-analysis on the most widely used type of antidepressants, SSRIs (selective serotonin reuptake inhibitors), found there was only a 2-point difference between people taking active drugs and a placebo when measuring their outcomes on the Hamilton Depression Rating Scale, which ranges from 0 to 52.
    The UK’s National Institute for Health and Care Excellence says a 3-point difference is needed to make a ‘clinical difference’ – but other studies say it should be at least a 7-point difference if a drug is to be deemed clinically important. Either way, many modern antidepressants fall short.
    This latest review doesn’t offer new data in terms of evidence – or lack there of – regarding the efficacy of antidepressants. But what it does is weigh any potential benefits up against the side effects and risks.
    It comes on the back of new guidance from the UK Royal College of Psychiatrists on how to stop taking antidepressants in a tolerable way. It’s not talked about often, but patients can experience withdrawals such as headaches, anxiety, insomnia, agitation, fatigue and diarrhea, particularly if they stop their treatment too quickly.
    “The recognition that withdrawal effects from antidepressants are more common, more long-lasting and more severe than previously recognized prompted the Royal College of Psychiatrists to issue a position paper, alerting prescribers to this issue, including the recommendation that patients be informed of this risk,” note the authors.
    Currently the best way we know of to stop taking antidepressants is to reduce the dose gradually. But “there is no guarantee that patients will avoid consequences such as long-lasting sexual side effects or persistent withdrawal symptoms even with a cautious taper,” the researchers write.

    They also flag that the currently available doses don’t go low enough to help patients taper off gradually, something else that needs to be revisited as we think about how best to use antidepressants going forward.

    This review definitely isn’t any kind of final word over the use of antidepressants – there are lots of hard decisions ahead and more research needed. But there’s mounting evidence that the way we currently use these common medications may not be the best, and the more honest conversations we have now, the better care we can offer people with mental health concerns in future.

    “Increasing knowledge about the difficulty that some patients have in stopping antidepressants should lead to more cautious prescribing practice – with antidepressants given to fewer patients, for shorter periods of time,” the authors conclude.

    The review has been published in the Drug and Therapeutics Bulletin.

  4. This could be useful as doctors will be obliged to be clear about their understanding of conditions and give opportunity to ‘challenge’ what is recorded eg sexual probs = psychological etc This is what is being put on womens notes when suffering from menopausal problems leading to inappropriate prescriptions for anti depressants
    Government commits to making writing outpatient letters to patients standard practice in the NHS England
    Re: Writing outpatient letters to patients Peter Rees, Robina Shah, et al. 368:doi 10.1136/bmj.m24
    Dear Editor
    The Government has just published its response to the Paterson inquiry. https://www.gov.uk/government/publications/government-response-to-the-in

    The inquiry recommended “that it should be standard practice that consultants in both the NHS and the independent sector should write to patients outlining their condition and treatment in simple language, and copy this letter to the patient’s GP, rather than writing to the GP and sending a copy to the patient.” (Recommendation 2)

    The government has accepted this recommendation in full and agrees that the language used by consultants when writing to patients should always be accessible.

    Over the next 12 months, it will explore with providers how their systems can change to make the process of writing to patients easier for healthcare professionals and how this can be monitored.

    The AoMRC, PRSB, IHPN and NHSEI have committed to write to their members to remind them of this guidance and encourage them to use it in conjunction with the publication of this government response.

    The government recognises “that this will require a significant cultural shift in the way in which information is conveyed to patients regarding their treatment, and we know that more must be done in order to understand why guidance is not always followed even where it is in place”.

    It will be very interesting to see how clinicians and organisations respond to this directive.

    Competing interests: No competing interests

    21 December 2021
    Hugh C Rayner
    Retired nephrologist
    Private
    @WMRenalN

  5. well written L and pretty spot on. Pssd is unfortunately a needle in a haystack when it comes to the public eye, mainly because its pretty much erectile dysfunction if you don’t include all the other symptoms, anhedonia, sleep issues, etc. in other words the other symptoms are not talked about as much they should. the name pssd is narrowed down to “sexual dysfunction”, and would make people assume its just sexual side effects. when in fact anhedonia and all the other symptoms are just as, or even worse than the sexual aspect of pssd. pssd sits in the ED category which to doctors has aleady been solved, with viagra, or celexa. unless we shed light on the other symptoms, and show that this isnt just sexual suppression but emotional and pleasure supression as well we are again a needle in a haystack sad to say.

  6. One way of avoiding dialogue with critics is to use the I’m not lowering myself to respond stuff. Who is really doing the ‘sneering’? Bit sneaky to ‘follow’ and learn from’ without responding GeorgeThread on George Ikkos twitter
    See new Tweets
    Conversation
    Dr James Davies PhD
    @JDaviesPhD
    ·
    20 Nov
    Who would you recommend following on Twitter for incisive critical content on all matters relating to psychiatry, psychology & mental health?
    George Ikkos
    @gikkos1
    ·
    21 Nov
    As far as professionals go

    @AllenFrancesMD

    @ProfRobHoward

    @awaisaftab

    @HengartnerMP
    Anne Cooke
    @AnneCooke14
    ·
    23 Nov
    I agree these are great people to learn from – but what about some non-medics too?
    George Ikkos
    @gikkos1
    Replying to
    @AnneCooke14

    @JDaviesPhD
    and 4 others
    Sorry answered a different tweet! Well,
    @HengartnerMP
    is a non-medic Many others take too comprehensive a hostile position against psychiatry though I appreciate that you have very measured tone. Often relentless sneering prevents me from recommending, though follow with interest
    8:11 am · 23 Nov 2021·Twitter Web App
    3
    Likes

  7. A young Italian psychiatrist and psychotherapist (whom I prefer not to link) has published a couple of videos on PSSD, at the beginning with a summary of the characteristics, the etiological hypotheses and the literature. Alas, in the second part of the video comes the part about possible solutions and here he explains his hypothesis, namely that sexual symptoms caused by the drug have a psychological maintenance. He says that he has had patients concerned about PSSD who have found his strategies of psychotherapy to be decisive. At the end of the video he listed 2 cases, which in fact do not even fit the necessary PSSD diagnostic criteria recently proposed.

    Granted that compared to what the PSSD is “naked and raw” and to the eyes of those who lucidly understand that they have PSSD all this is ridiculous and useless… I want to summarise what he has exposed, because I think that there can also be people who perhaps do not have the PSSD, or who have it but are so confused, autosuggested, concentrated on the problem as to self-create or self-worsen the symptoms through psychological dynamics such as those described by him:

    – “Be spontaneous” paradox: I strive to control something that is actually spontaneous such as sexual response and in doing so I inhibit it.
    – Self-fulfilling prophecy: one believes oneself to be doomed, creates a belief of biological condemnation and gives up.

    His proposed interventions are:
    Don’t complain because that makes the situation worse.
    Declaring one’s own ‘perturbing secret’ in sexual intimacy.
    Putting oneself in the situation of not wanting to feel pleasure.
    Enjoy the rest of the context without trying not to have a specific problem.
    Break the belief that it is permanent, which is fuelled by the literature and online patient groups.
    Prohibition of searching for information online in order not to feed paranoia.

  8. Comment from Spruce

    I have been wanting to properly comment about the social implications of having PSSD for a long time, and I feel this blog post is a good opportunity to do it.

    I have touched on the social effects of me having PSSD before in other comments, but I have never really explained it in as much detail as I would like.

    Partly because there is so much to say, and secondly because some of the social effects of having PSSD, are so embarrassing, and humiliating, that it is difficult to do, even under a pseudo name.

    First of all, PSSD can have large negative social implications in almost all areas of your social life.

    This includes the obvious of dating and romantic relationships, but also friendships, within peer groups, with work colleagues, within family life; and even sometimes when dealing with the general public, and acquaintances in day to day life.

    I have lived with PSSD for just over 14 years, and have unfortunately had a lot of time to experience many different negative social effects of living with PSSD.

    I was originally going to try to comprehensively explain the negative social effects of living with PSSD, but if I was to do so, this comment would become ridiculously long; so a lot of it will have to wait for other comments. There is so much to say.

    In this comment I will focus on the social effects of PSSD on my friendship groups, and sexual life (mostly lack of), during my 20’s and early 30’s.

    Below contains some quite embarrassing experiences I have had living with PSSD, and I have thought a lot about whether it was right for me to post about them; but I want to show people the reality of living with PSSD, so here goes.

    One noticeable effect of having PSSD, is that sometimes “friends” or what I like to call frenemies, will exploit it.

    Before developing PSSD I was an ordinary looking, slimly built, but tall man; who wasn’t particularly attractive, and who wasn’t very successful with women.

    Ironically about a year after developing PSSD (I developed PSSD at 22), I put on some weight, hit the gym quite hard, and my facial features seemed to change and fill out; and I blossomed into a good looking young man, and I started getting quite a lot of attention off women.

    I say ironic, because I had finally started to find my feet, and I had gained some confidence around women, just after my sexuality was completely taken away. It was cruel really.

    I finally had young attractive women taking an interest in me, who only a year or two before, wouldn’t have even looked at me once; and it was pointless, as I was completely a-sexual.

    At the age of 23 I even managed to get a girlfriend for about 3 months, and we had quite a bit of sex; but the sex was almost completely pleasure less for me, and the relationship fizzled out because of the PSSD.

    Between the age of 24-28, I had two frenemies, who exploited my PSSD situation, nicely to their advantage.

    One we shall call Mr A.

    Mr A and me would often go out and socialise together, often in different social groups. He wasn’t a very nice person to be honest (for a variety of different reasons I won’t go into here), but we had some common interests, and I didn’t have many friends, so I continued to be friends with him.

    I told Mr A once about how the medications had affected me sexually, without going into too much detail about the PSSD, so he knew I struggled in this area. His response was to say “don’t mention about that again to me, as I am struggling not to take the piss”.

    Within these social groups, there were a number of young women who showed a definite interest in me over the years. But because of the PSSD,

    I either wouldn’t bother to do anything about it, because of fear of being sexually humiliated (I had unreliable erections because of the PSSD; although with some effort I could usually have sex); or because my libido was so non existent, that there just seemed to be no point.

    Occasionally I would have sex with one of the women that showed an interest in me, but it would be an almost completely pleasure less experience, with no anticipation, or excitement, no arousal, lust, fantasy, or sense of pleasure in the genitals. There was also no emotional connection at all.

    The women seemed to sense something was wrong, and would often take it as a personal rejection, when I either didn’t have sex with them; or when I did, they sensed that I wasn’t enjoying the sex.

    Over the years of my “friendship” with Mr A, there were two women we both knew, who at different times I had feelings for (feelings muted by the emotional anaesthesia, but still feelings).

    Both of these women showed an interest in me at first, before taking an interest in Mr A.

    The first incident happened when I was 24. I had a history with the woman in question before PSSD, and although we had never had sex, or done anything sexually; we had been friends, and I had liked her for many years, even before PSSD.

    My “friend” knew that I liked her.

    She hadn’t found me attractive before PSSD, when I wasn’t as physically attractive, but now that I had grown into my looks, she made it obvious she was attracted to me.

    So she started hanging out with me and Mr A. She tried getting physical with me one evening, and because of the PSSD I couldn’t maintain an erection long enough to have sex, and nothing ended up happening (sometimes I was able to maintain an erection long enough to have sex, and at other times not). She hung out with us for a while longer, and then suddenly stopped hanging out with us.

    I got a phone call off her a short while after she stopped hanging out with us, where she told me she had been meeting Mr A in a local B and B, for sex sessions; and that he had tried to seduce her from almost the moment we had started hanging out. He had been messaging her behind my back, and they were having sex sessions behind my back, despite him knowing I had a history of liking her. I never spoke to her again.

    I had a big falling out with Mr A, and for about a month we didn’t talk; but after a while he apologised, and said he wouldn’t do it again.

    Because I didn’t have many friends, I eventually decided to give him another chance.

    The point I am trying to make, is that if it hadn’t have been for the PSSD, this wouldn’t have happened. She had liked me first, and had tried to be intimate with me first; but ended up having sex with him, because I couldn’t be sexual, because of the PSSD.

    The second incident with Mr A happened when I was 28.

    We were socialising in a different social group by now, and there was a very attractive young woman in the group, who made it obvious she found me attractive. She showed no interest in Mr A, and in fact seemed to dislike him.

    At this point I was half way through a long benzodiazepine taper, and had switched from lorazepam, to diazepam, as it had a longer half life; and being on the diazepam for some reason, made it almost impossible to get an erection. This on top of the PSSD, made having sex impossible (before on the lorazepam I was usually able to have sex, although it was sometimes difficult to maintain an erection).

    Of note I feel 90 % of my sexual problems came from the PSSD and not the benzodiazepines, as I had been on benzodiazepines before ever taking an SSRI, and they hadn’t affected me sexually at all. But for some reason the diazepam seemed to make the unreliable erections from the PSSD worse.

    This young woman really liked me, and over the space of about 6 months, repeatedly tried letting me know she liked me, and that she wanted to have sex with me. She was quite forward about it. I liked her too.

    I eventually told her I had a low libido because of the medication, but I didn’t go into detail, and I am not sure if she believed me.

    No way was I going to risk not getting an erection, and embarrassing myself, and everyone in the social group knowing I couldn’t get an erection (young people can be quite unforgiving). Eventually she got really annoyed, and became almost nasty towards me, in her frustration at me not making a move on her.

    It was about this time that Mr A started getting quite close to her, and shortly after this, they were hanging out together quite a lot. I then started to notice she was flirting with him quite a lot, and I felt she was almost deliberately rubbing this in my face.

    Shortly afterwards I found out from a mutual friend, that she was going around to his house for sex sessions.

    So again I had lost a girl I liked because of PSSD, and there was nothing I could do about it. It really hurt.

    I distanced myself from Mr A, and we soon stopped hanging out all together. I think he knew why. The girl in question then got a boyfriend, so that was the end of that.

    Between the ages of 25-27 (running at the same time as my friendship with Mr A), I was living in shared accommodation for young people with mental health problems (I had OCD). A new young man moved in next to me. We were initially quite friendly. I will call him Mr B.

    There were quite a lot of young women who would come around to the shared accommodation, and we developed a social group within the house.

    When I was 25, one of the girls again made it quite obvious that she liked me, so obviously, that she asked to have a look at my room; and then after a short while, jumped on my bed, and then took all of her clothes off. She was 20 years old, and had a nice body, but I felt nothing. She asked me to have sex with her. I tried to have sex with her, but again I was unable to maintain an erection, because of the PSSD, so we didn’t end up having sex.

    She seemed a little disappointed, but wasn’t unpleasant about it.

    The next night she went into Mr B’s room. Mr B had a girlfriend, but she needed a place to stay for the night. I still remember him saying to her “don’t worry I have a girlfriend, so I won’t try anything on”, just before he closed the door for the night. I didn’t think too much of it, and settled down to go to sleep.

    About 30 minutes later I heard noises coming from his room. They were going at it like rabbits.

    I remember feeling very angry that I had a chance with her the night before, but again I had lost another girl because of PSSD. I drifted off to sleep that night, seriously pondering the chances of me getting away with murdering my ex psychiatrist.

    Shortly after this another girl, who knew the first girl, started hanging out in the house. She was very attractive, and I let her know I was attracted to her.

    One night after we had both been chatting in the communal room, she opened the door to my room, and jumped on my bed. This time I managed to maintain an erection, and we did have sex, but it was completely pleasure less for me. I got nothing out of the experience.

    She tried being intimate with me again a few evenings later, but by this time I just didn’t see the point; as because of the PSSD, I was getting nothing from the experience.

    Within 2 weeks she was having regularly sex with Mr B.

    I started to really dislike Mr B, and we developed quite a rivalry, and I developed quite a strong resentment towards him. To cut a long story short, over about the next year of him living in the shared accommodation, I lost out to two more girls to Mr B, because of PSSD.

    He still had a girlfriend as well, and was regularly cheating on her, but he didn’t seem to care.

    Mr B had a really good time over those years, and a lot of it indirectly happened because girls who were initially interested in me, were going to him, because of my PSSD. I enjoyed nothing. I couldn’t even enjoy pleasuring myself.

    Between the ages of 28-31, I started hanging out in a younger social group, as a new friend I had made, was younger than me. He was 20, and
    I was 28. He was quite mature for his age, so the friendship worked.

    There was a guy within this social group, who was very popular with the women, we shall call him Mr C.

    Mr C was quite a player, and was with a different girl almost every week. He would often brag about how many women he had, had sex with, and was quite arrogant about it; often rubbing his sexual conquests in other guys faces.

    He would regularly cheat on his different girlfriends, and didn’t seem to have much of a problem, about having sex with other people’s girlfriends.

    A lot of men didn’t like him, but the women seemed to love him.

    The more he cheated on them, and disrespected them, the more they seemed to chase after him.

    I remember one day we were in a nightclub, and he told me he betted he could have any woman in the club, if he wanted to.

    I didn’t like him much.

    Shortly after this, a young woman came into this social group. I almost fell in love with her, from the moment I saw her, a reaction I have never had so quickly before.

    She was beautiful, and she was exactly my “type”. She was the only woman since developing PSSD, that I developed proper feelings for (even the emotional anaesthesia only slightly dampened my feelings towards her).

    It wasn’t just her looks I was attracted to, I really liked her personality too, and we had a lot of things in common.

    She was 10 years younger than me (I usually go for women nearer my own age, but because of circumstance, we were mixing in the same social group). She was also quite sexually inexperienced just like me, and I later found out she was a virgin.

    She was almost perfect for me in a lot of ways, as I was looking for a woman who was at a similar level of sexual inexperience as me.

    I was near the end of my benzodiazepine taper, and I naively thought that when I completely got off the diazepam, my sexuality might return; and that maybe if she was interested, we could get together, and we could explore being in a proper relationship, and our sexuality together; as we were both at a similar level of relationship, and sexual inexperience (any of the sex I had had before this was almost completely muted by the PSSD, and wasn’t real sex, I felt).

    I was a little nervous about letting her know I liked her, because of the age gap, but eventually I built up the courage to let her know I liked her. Unfortunately, the feelings weren’t reciprocated, and she wasn’t interested in me romantically.

    She then promptly lost her virginity to guess who? Yes, that’s right, Mr C.

    I was devastated.

    Unfortunately for me she seemed obsessed with him, and would follow him around almost everywhere he went. Mr C spent that summer having sex with her, while I sat there, with my numb penis; unable to even enjoy pleasuring myself, because of the PSSD.

    My resentment towards him grew, monumentally.

    What particularly annoyed me about it, was that he didn’t even like her; and after a while he got bored of her, and just went onto another girl.

    I had genuinely liked her. Again, I got nothing.

    Although this time I didn’t lose the girl because of PSSD, as she didn’t like me anyhow, the fact that she lost her virginity to Mr C was particularly cruel.

    After everything I had been through, I could have been spared that.

    I still don’t like Mr C to this day, at over 6 years later.

    I bumped into that girl I liked recently actually, after not seeing her for a number of years; and I was still open to the idea of something happening between us, as I still like her. I thought as so much time had passed, she might see me in a new light.

    Unfortunately, I found out she has had a boyfriend for the last two years. It breaks my heart that she is off exploring her sexuality, and a serious long term relationship with him; while I still can’t even enjoy pleasuring myself, and the longest relationship I have had is 3 months when I was 23 (which came to an end because of PSSD).

    She is ten years younger than me, and from being in a similar situation as to relationships, and sex as me a number of years ago; she has since had a serious long term relationship, and likely much more pleasurable sex, than I have ever had, in my whole life.

    The thought of this, makes me feel very emasculated; and it wouldn’t have been this way, if it wasn’t because of the PSSD. She has basically lapped me in experience, many times over. How humiliating can you imagine that feels for me as a man.

    When I found out she had a boyfriend, I was really upset. She was the only woman to make me properly feel anything during the 14 years of having PSSD, and I really liked her.

    The main point I want to make with this long comment, is that if you develop PSSD (especially as a young person), you will spend the prime of your life; watching everyone else having a good time, exploring their sexuality, and young love; while you sit on the side lines, unable to join in, and unable to do anything about it.

    And let me tell you it is an absolutely miserable situation to be in, and it often left me feeling suicidal. And once when I was 27, I actually attempted suicide.

    Your love rivals will run rings around you, as you are basically competing with them, when you have a serious sexual, and emotional disability.

    I promise you all of these incidents that I have mentioned, have genuinely actually happened to me; and I have heard of many similar experiences with other young people who have PSSD. To be honest the effects of PSSD on your social and personal life can be devastating.

    And there is more.

    There are a lot of other incidents of a similar nature that I have experienced over the last 14 years, that I have never mentioned yet; including some unpleasant ones that happened just before the lockdown started in early 2020; and how a family member of mine, exploited my PSSD situation, in a really horrible way, in 2019.

    There is a lot more to say, but they will have to wait for other comments.

  9. Intended for healthcare professionals
    Therapeutic Advances in Psychopharmacology

    Full Article is free to view
    Abstract

    Open EPUB
    What I have learnt from helping thousands of people taper off antidepressants and other psychotropic medications
    Adele FramerFirst Published March 16, 2021 Review Article Find in PubMed
    https://doi.org/10.1177/2045125321991274

    Abstract
    Although psychiatric drug withdrawal syndromes have been recognized since the 1950s – recent studies confirm antidepressant withdrawal syndrome incidence upwards of 40% – medical information about how to safely go off the drugs has been lacking. To fill this gap, over the last 25 years, patients have developed a robust Internet-based subculture of peer support for tapering off psychiatric drugs and recovering from withdrawal syndrome. This account from the founder of such an online community covers lessons learned from thousands of patients regarding common experiences with medical providers, identification of adverse drug reactions, risk factors for withdrawal, tapering techniques, withdrawal symptoms, protracted withdrawal syndrome, and strategies to cope with symptoms, in the context of the existing scientific literature.

  10. I feel for Spruce and other who suffer from PSSD. It is a crime against humanity.
    I would not like to know how many people suffer in silence.
    I hope Spruce and many other innocent souls who suffer in silence get their second wind in life.

    https://www.youtube.com/watch?v=YhxjNYvJbgM

    The message in this song by Billy Joel is so powerful.
    Don’t forget your second wind!

    • Thanks ANON, I watched the music video, and it gave me some hope, and brightened up my day a little.

      I too hope that one day I, and others with PSSD, will get our second wind. The hope that things will eventually get better, is the only thing that keeps me going.

  11. You are very welcome, Spruce.
    I will keep you in my prayers.
    I am so happy the music video brightened up your day a little ~ knowing this made me happy : )
    Music is good for the soul.
    I <3 singing. Re-calibrates my nervous system.

  12. I realize that what I am about to write may not fit all PSSD cases, especially those who at the moment have lost the many aspects that revolve around sexuality.

    Recently (8 years pssd) I discovered a sexual potential through imagination + affectivity (I have no emotional numbness), although at the genital level PSSD remained the same (almost zero clitoral arousal, pleasure, erogenous sensation, difficult and forced orgasm). I then experienced greater desire, passion, emotional feelings in the groin. (I did not share any of this with the person concerned in the flesh and do not know whether these feelings would have increased even more or on the contrary for some psychological reason like inhibition would have been less).

    Despite the nice surprise, I think it is obvious that if I had fallen in love like that without the PSSD I would have felt even more (and suffered from passion even more).

    However, a little anecdote: I have heard from at least 3 people with PSSD that they have found a new dimension in which to experience sexuality, which is demisexuality, i.e. they can only function enought when there is a strong emotional and sentimental involvement.

    I think that in the mess of PSSD, in some cases perhaps certain paths remain more alive than others. Perhaps (example) the visual stimulus pathway is compromised, the reaction to physical stimuli also, but if the emotionality manages to function sufficiently, then in search of good feelings one learns to channel sexuality in that way which is the only one left alive. And by channelling sexuality in a certain way, perhaps that way becomes MORE POWERFUL than it was before the PSSD.

    Have you ever heard of a man paralysed from the waist down who had learned to reach orgasm with a non-erogenous body part (like an elbow)? I don’t know if it is fake news but I have read about this kind of story a few times.

    That doesn’t take away from the fact that the loss is huge and horrible, something that forces you to change course in some cases, but perhaps there is this possibility of adaptation around what is left.

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