Depression and Sexual Dysfunction Among Men

What is Depression?

Depression also known as major depressive disorder, is a mood disorder that makes you feel instant sadness or lack of interest in life.

Sadness is a common emotion that is a normal reaction to loss or life’s changes and challenges. So how can you tell the difference between sadness and depression?

Depression is intense sadness- including feeling helpless, hopeless, and worthless; that lasts for many days to weeks and sometimes years. It keeps you from living your best life. This is clinical depression, a treatable medical condition.

Mental health among the male population is on a steady rise. In the recent National Health Morbidities Survey 2015, the prevalence of mental health in both men and women were 27.6% and 30.8% respectively, which showed a marked increase since 2006 (10.4% and 12.1%). The rates of disability and other preceding medical condition: heart disease, hypertension and so on have a higher chance among individuals with depression or mental health disorders.

In men, major depression accounts for 45% of the cases seen. Hence, we hope to raise awareness for men to step forward to seek help as there are various treatment modalities available, bearing in mind to protect patient confidentiality.

Is Depression Curable?

There are various treatment modalities for depression depending on the severity of the condition. These treatments offer remission and patients enjoy a long, healthy life.

Depression Symptoms:

  • Your mood is depressed for most of the day, especially in the morning.
  • You feel tired or lack of energy almost every day.
  • You feel worthless or guilty almost every day
  • You feel hopeless or pessimistic.
  • You have a hard time focusing, remembering details or making decisions.
  • You cant sleep or sleep too much almost every day.
  • You have no interest in pleasure in most activities nearly every day.
  • You often think of death or suicide
  • You feel restless or slowed down
  • You have lost or gained weight
  • You feel cranky and easily irritable
  • Overeating or stop feeling hungry
  • Have aches, pains, headaches, cramps or digestive problems
  • Have sad, anxious, or “empty” feelings.

While these symptoms are common, not everyone with depression will have the same pattern. Duration, severity and symptom recurrence varies according to the individual.

The reason patients have joint pain, back pain, sleep problems, digestive problems and appetite changes are because the brain chemicals linked to depression, specifically serotonin and norepinephrine, play a role in both mood and pain.

Depression Causes:

  • Brain structure. People with depression seem to have physical differences in their brains from people who don’t suffer from this condition.
  • Brain chemistry. Chemicals in your brain called neurotransmitters play a part in your mood and these chemicals are disrupted in depression.
  • Genetics. Family history of depression are genetically passed on.

Depression Diagnosis:

  • Physical examination by your doctor
  • Lab tests. Blood work in relation to hormone levels.
  • Psychiatric evaluation. Your doctor will have a questionnaire for you during consultation.
  • Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This is a criteria set by international standards to see if you fit the standard.

Depression and Sexual Dysfunction Among Men

Men’s health is defined as a discipline that promotes the physical, mental and social well-being of men throughout their life cycle (from boyhood to manhood) and addresses health problems related to men. According to WHO, the globally recognised definition of health, a healthy man is one who is empowered to experience optimum physical, mental and social well-being and who experiences health as a resource for everyday living.

It is important to recognise that men’s health status is simply more than a consequence of biological, physiological and genetic functioning, but that is also affected by cultural, social and environmental factors. This is why, most males DO NOT step forward seeking for help especially mental health disorders.

Depression has a strong co-relation to sexual dysfunction OR erectile dysfunction(ED). Erectile dysfunction is often under-diagnosed as doctors do not routinely enquire about this problem. The age adjusted prevalence of moderate or complete ED in Malaysia is 22%, with most being in the age group of 65 to 70 years old.

Currently in Malaysia there is no specific public health service that caters for men’s sexual problems. The doctors at Dr. Tan and Partners Clinic offer various treatments for men sexual dysfunction problems. We urge men to come and seek help from our professional team to help improve your well-being. Our team consists of supportive doctors, nurses and even tele-consultations.

Why Depression Causes Sexual Dysfunction / Erectile Dysfunction?

  • ANXIETY. Depression often comes along with anxiety. Men who suffer mental health are anxious and unable to focus to sustain an erection or have an erection at all.
  • Low-self esteem
  • Guilt- Men feel guilty of not being able to perform well during sexual intercourse.
  • It is a cycle, where reduced sexual intercourse leads to worsening of depressive symptoms.

Symptoms of Erectile Dysfunction

  • Trouble getting an erection
  • Trouble keeping an erection
  • Reduced sexual desire

The brain plays a key role in triggering the series of physical event that cause an erection, starting with the feelings of sexual excitement. Hence why, depression significantly causes erectile dysfunction.

Depression Treatment

The type of treatment your doctor will recommend depends on your symptoms and how severe they are. You may need one of the following:

  • Antidepressant medication
  • Cognitive behavioural therapy (CBT) and talk therapy.
  • Hospital or residential treatment for very severe cases with suicidal attempts.
  • Electroconvulsive therapy (ECT)

Erectile Dysfunction Treatment

Treatment for ED works best after identifying the cause of the sexual dysfunction. Since depression falls under the psychological causes of erectile dysfunction. We advise patients to go for counselling or seek treatment from a psychiatrist to first cure the depression and the sexual function improves.

Treatment Options for Physical Causes of Erectile Dysfunction

  • Oral medication: Viagra / Cialis tablet
  • P-Shot (Platelet rich plasma injected to the penis tissue, which improves erection outcomes)
  • Electro-shockwave Treatment (ESWT) (high success rate of more than 80%)

All these treatment options are available at Dr. Tan and Partners Clinic (DTAP).

In conclusion, as a resident physician at DTAP Clinic, I urge all men who are suffering in silence to come and consult us, so we can help regain your confidence and achieve the best sexual pleasure both for you and your partner. Sexual health is important in maintaining healthy relationships, uplifting your mood, improving your hormone regulations, reducing other health co-morbidities and improving your mental health.

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