Sexual activity is not just a biological matter, but also a matter of health and emotional balance – Firstpost

In the labyrinth of human experience, the intersection of sexual activity and mental health reveals a complex web of physical pleasure and psychological well-being. Imagine a symphony in which every note—from stress relief to sexual satisfaction—plays a crucial role in harmonizing the human experience.

Sexual activity is not just a biological function. It is an expression of overall health and emotional balance. Like a finely tuned instrument, the body and mind must be in harmony to truly experience the deep pleasure that sexual activity can offer. This dialogue with Dr. Anshu Kulkarni, a senior psychiatrist from Mumbai, unravels the delicate threads that connect physical intimacy to mental health, shedding light on how different dynamics – whether in heterosexual or LGBTQ+ relationships – shape experiences and perceptions.

How do you observe the connection between sexual activity and stress reduction?

Sexual activity requires a healthy body. A healthy body includes a healthy brain and general well-being both physically and mentally. Just as every system in the body has its own functions, the reproductive system also has its role.

Since it is about achieving a state of emotional, mental and physical balance, this contributes to good sexual health. However, this is only one aspect of it. Stress relief can be achieved through socializing, reading or other activities. Likewise, the practice of sexuality varies from person to person.

What patterns have you observed regarding the impact of sexual satisfaction or dissatisfaction on overall psychological well-being?

Like other forms of learning and activities, all of these things work by providing some sense of pleasure, right? This pleasure is processed by the brain through the release of dopamine. Similarly, sexual activity is also associated with the release of dopamine. The release of dopamine is similar to positive learning that makes us feel good when we engage in activities that give us pleasure. The same is true for sexual activity.

How do sexual dysfunctions contribute to mental disorders such as anxiety and depression, or vice versa?

It's a vicious cycle. You have to have a healthy body and brain to be sexually active, which is a perfectly normal part of daily life. There's nothing particularly different about it. However, since all activity starts in the brain, when we're happy we feel motivated to engage in it. This motivation also extends to talking and bonding emotionally and physically with our partner or partners, as it varies greatly from person to person.

When we are mentally healthy, we are more likely to engage in sexual activity. Conversely, when someone is mentally unwell, whether due to anxiety, depression, psychosis, or other conditions, sexual activity, like other activities, can be affected. This can affect the desire for pleasure, perception of one's partner, and ability to relate to one's partner, among other things.

And don't forget: certain medications can cause decreased sexual libido or problems with ejaculation or erection in men and decreased libido in women. These effects can also affect sexual activity, so as mental health professionals we need to be informed and aware that there is no specific age limit for sexual activity.

It is important to talk openly with our clients about their physical intimacy with their partners. We should ask them how they feel about this because if their illness or medications are affecting them, they may be too shy or hesitant to open up unless we encourage this dialogue.

I also want to stress that not all psychotropic drugs cause these problems and not all people experience them. It is important to be aware of this. For example, if I take a certain drug, my reaction to it may be different than someone else's. This varies from person to person. Therefore, it is not true that all psychotropic drugs cause sexual dysfunction.

In your opinion, what role does self-esteem and body image play in a person's sexual and mental health?

When a person feels comfortable in their body, they are more likely to engage in healthy sexual activity. Some people are so uncomfortable with their appearance that they won't look at themselves in the mirror or in the shower. It's important that people feel comfortable with their appearance, even though this can be very subjective.

A person may become preoccupied with their appearance and worry about how they look or how they are perceived by their partner. This preoccupation can affect their ability to engage in sexual activity because it all starts in the brain.

How do these factors differ in their impact on heterosexual and LGBTQ+ people?

I think it's important to remember that these factors affect people differently in opposite-sex relationships than in relationships between LGBTQ people. For LGBTQ people, the impacts may be similar, but their experiences may be more complex due to their personal and social issues.

For example, I have a patient with schizophrenia who is in treatment and has a same-sex orientation. He is very cautious about medication and wants to know what effect it might have on him, especially in terms of his sexual expression. For some people, the way they express themselves sexually is crucial as it significantly affects their lives due to the social challenges they face, so it is important to understand and address these concerns.

What influence do relationship dynamics, including emotional intimacy, have on the mental health problems an individual faces?

In a physical relationship, intimacy is a crucial requirement. This question looks at how relationship dynamics, including emotional intimacy, affect a person's mental health issues. Emotional intimacy involves dealing with another person, interpreting signals, understanding conversations, recognizing subtle cues, and being aware of one's own reactions. When someone has mental health issues, emotional intimacy can be affected.

For example, someone with major depressive disorder or a thought disorder may be preoccupied with their own ruminations and thoughts, making it difficult to connect with others and pick up on their cues. As a result, their emotional intimacy may suffer. Similarly, if a person is overly focused on sexual activity and ignores their partner's needs and cues, they may not be on the same wavelength, which impacts the relationship. These dynamics illustrate how mental health issues can affect emotional intimacy and overall relationship quality.

Have you noticed different challenges or needs between heterosexual couples and LGBTQ+ couples? What challenges do you see in addressing sexual health in mental health care?

Yes, as I mentioned earlier, sexual identity expression is especially important for LGBTQ people. Psychologists need to be careful and considerate when discussing this aspect. For example, when dealing with two people – one with a different sexual orientation and the other LGBTQ – it is crucial for the psychologist to carefully address their expectations and challenges related to medication.

It is important to understand and respect the patient's thoughts, as sexual expression can be an important aspect of their life. Professionals should not overlook these concerns. Moreover, there is no fundamental difference in the way these issues should be addressed.

Are there particular barriers LGBTQ+ patients face when it comes to receiving appropriate sexual health care? How does societal stigma surrounding sexual orientation and identity impact the mental health of LGBTQ+ people?

Awareness of safe sex, family planning, gender-neutral practices, and preventive measures against sexually transmitted diseases, cancer, and fertility is significantly lacking in the LGBTQ+ community. Many LGBTQ+ people do not receive this important education at a young age, and prejudice and negative experiences with health care providers further exacerbate the problem.

How do you create a balance between sexual health and other aspects of a person’s mental well-being?

Negative mental wellbeing, including conditions such as depression, anxiety disorders and psychosis, can affect sexual health. Chronic conditions such as diabetes, high cholesterol and high blood pressure also impact sexual health, highlighting the need for greater awareness of their connections. There is a need to pay more attention to female sexual health, including sexual satisfaction and orgasms, and to address social and cultural biases. It is important to pay attention to mental health issues during difficult times such as pregnancy and menopause. Conversely, individuals with high life satisfaction and good mental wellbeing generally have better sexual health.

What influence do different sexual positions, such as a female-dominant position or a male-dominant position, have on intimacy and pleasure in people who suffer from erectile dysfunction or other problems?

Different positions can affect intimacy and pleasure in different ways. For example, a female-dominant position can increase the experience of affection and intimacy because it allows for a more expressive form of connection. On the other hand, if someone is suffering from erectile dysfunction, a male-dominant position may be more helpful and advisable in such cases. This adjustment can contribute to a more satisfying and enjoyable experience for both partners.

In what ways do expressions of affection such as kissing contribute to the overall experience of intimacy and joy in a relationship, especially when both partners are in tune and enjoying the activity together?

Expressions of affection such as kissing play an important role in increasing intimacy and pleasure. When both partners are on the same wavelength and fully engaged in the activity, kissing can serve as a meaningful expression of love and connection. This mutual pleasure and communication can enhance the overall experience and make the moment more enjoyable and fulfilling.

Does the dynamic of intimate moments change when one partner (male or female) lifts and carries the other? In particular, do these actions provide mental satisfaction in addition to the obvious physical satisfaction?

There are few tangible benefits beyond the personal pleasure and fantasy it can inspire. In fact, unless certain positions, such as a partner on top, improve mobility and sexual satisfaction, it might contribute to unrealistic expectations fueled by movies and media.