Friday, July 25, 2008

Viagra helps me get my rocks off

A great article came out in JAMA this week: Sildenafil Treatment of Women with Antidepressant-Associated Sexual Dysfunction by a group in New Mexico (with 3/6 female authors!). Although it is not the magic solution that men have, it seems that Viagra (Sildenafil) is successful in increasing orgasms in women on anti-depressants. That is no small feat. Anti-depressants are notorious for decreasing libido and orgasmic potential. These reasons are, in fact, a major cause of medication non-compliance. The inability to have pleasing sex is deleterious to a marriage in which one partner is already battling with depression. According to the authors:
Antidepressant treatment–associated sexual dysfunction is estimated to occur in 30% to 70% of men and women treated for major depression with first- or second-generation agents, a principal reason for a 3-fold increased risk of nonadherence that approaches 70% in the first months of treatment and leads to increased relapse, recurrence, disability, and resource utilization by affected patients.
The Definition:
  • decreased sexual interest, genital sensitivity, and vaginal lubrication; delayed or absent orgasm; dyspareunia; reduced sexual activity; and overall dissatisfaction or loss of pleasure in sexual relations.
The Study:
  • 8-week prospective, parallel-group, randomized, double-blind, placebo-controlled clinical trial (Sounds like a well designed trial...)
  • 7 US research centers (Lowers bias from one population group...)
  • 98 previously sexually functioning, premenopausal women with remitted major depression on SSRIs (the most common type of anti-depressant) who were experiencing sexual dysfunction (It's a small study, but a start)
The Conclusions:
  • Viagra + SSRI = :)

Update: Check out this week's Savage Love! He talks about this same study. Warning: link not safe for work.

34 comments:

Habladora said...

I'm so glad you read the actual study and reported on it here... I must admit I originally saw it in the popular press and thought 'ugh, they're just looking for another market for Viagra.' Looks like this is legit, though...

And it is an important issue. I'm glad someone is taking women's sexuality seriously.

I wonder if this will change John McCain's thoughts on Viagra being covered by insurance...?

Black Thirteen said...

So, Viagra is only taken seriously once it can help women?

Men with sexual dysfunction are great for making jokes about, but when it's a woman, it's a serious problem that people need to take seriously?

Forgive me, but the way this seems set up bothers me.

Though, as an aside, people wonder why I refuse such things as antidepressants. If you take a person that already doesn't enjoy sex, and feed them those, what horrors do you create?

Mächtige Maus said...

Black thirteen, I'm missing where this post was at all a joke about men with sexual dysfunction. I find a main take home point to be that women's sexuality is just as important as men's and that the "little blue pill" can have a valid medical use for both.

I do find your aside intriguing. "People wonder why I refuse such things as anti-depressants?"

Is that to mean that you personally refuse to take them as a treatment or that you refuse to grant them as a treatment need for others? If it is the former, refusal of treatment isn't the best of choices. If it is the latter, while the side effects may be negative, when placed up against a major depressive episode with suicidal tendencies I think the side effects pale in comparison.

Black Thirteen said...

Black thirteen, I'm missing where this post was at all a joke about men with sexual dysfunction.

No, no. I didn't mean this post. I mean in general, and in response to the earlier comment. About how important it is to take women's sexuality seriously, and by extension , any dysfunctions thereof.

Coupled that with the fact that tons of people (and yes, feminists too, quite often) making Viagra jokes, or or acting as though men's sexuality (and any dysfunction thereof) isn't important.

Is that to mean that you personally refuse to take them as a treatment or that you refuse to grant them as a treatment need for others?

I refuse them personally.

Mind you, that's only one of the many reasons I choose not to take them.

I admit, being depressive alienates me from most people, especially within the context of a romantic relationship. Within those, I already don't care about sex. Why take a pill that would (possibly) assist me in associating with people, or improve romantic relationships, if it makes me like sex even less?

I'm no expert on women, but from what I've noticed, they take great offense when their partner doesn't want to have sex with them.

Mächtige Maus said...

Aha...I follow you on both counts now. Perhaps before I post in the morning I should finish my second cup of coffee. It might help me interpret comments more accurately.

It is ironic that one of the side effects of an anti-depressant is something that can exacerbate certain aspects of major depressive disorder. And that the answer is to medicate the medication to counter the effect.

Habladora said...

Saying that I'm glad that people are taking women's sexuality seriously was not meant to imply that I feel like people shouldn't take men's seriously. I think that, generally, people already take men's sexuality seriously as a health issue (hence Viagra's generally being covered under medical insurance)- although I see what you mean about the jokes. My first reaction to the story, before Loup's excellent coverage, was that the story was a marketing ploy. Sorry if it came off as belittling of ED, which, on a side note, can impact women indirectly - since it impacts couples.

As for medicating against the side effects of medications - yeah, it gets complicated, huh? Whatever works, though, since :) for everyone seems to be the result.

Black Thirteen said...

I don't think "whatever works" is a good stance.

I'd rather be depressed, and single, than medicated fake-happy and be even further uninterested in sex.

Being depressed doesn't bother me one bit. I'm used to it. Sure, it bothers the occasional woman that's in my life, but I don't really care about that. Further crushing the interest in sex would be more than a problem, though.

Mächtige Maus said...

Hmm...I think the notion of "fake happy" does a disservice because that certainly is not what the anti-depressant medications give a person. The side effects are, like with any drug, real and necessary considerations to keep in mind. However, the overall benefit is an ability to function better. I'll take that any day.

Black Thirteen said...

Well...perhaps.

I wrote a big rant in my blog thing, about the psych standard of "normal" that illustrates my point better than brief comments.

I do think it's "fake happy", because whatever you're feeling when you're on them, is not you anymore. It's the chemically induced version of you.

I might be incredibly difficult to deal with, frustrating to those around me, and have periods where I can't get out of bed, but, at the end of the day, that's me. It's who I am. And I'm okay with that.

Besides, many of us that make it enough years without killing ourselves, eventually learn to function in what appears to be a very normal capacity.

Sure, other aspects of life might be limited (relationships, as said earlier), but it's a worthwhile trade off.

Because, what good is it to function better in a romance, on an emotional level, if you're unable to give the physical level?

It's not even just the fact that anti-depressants bury the physical ability for sex, they crush the libido itself. When you take someone with a low sex drive, and low interest anyway, all you'll do is succeed in making them completely asexual.

Which doesn't even address the fact that most anti-depressants work no better than placebos, while making you suffer insomnia, sexual dysfunction, and various other real problems. Which just require more drugs. Which, I do not find to be a coincidence at all.

Le Loup-garou said...

Antidepressants do work better than placebos. That is a requirement for approval by the FDA. Each individual drug, however, may not work for a given individual, perhaps this is what you are referring to Black 13. A person who has failed multiple drugs is NOT more likely to fail a drug in another class. There is also virtually no predictive ability to say who will respond best to each type of drug. Side effects can definitely be a problem with all drugs (especially anti-depressants), however, not all people on the drugs experience bad problems. Sometimes the side effects can even be beneficial--like weight gain in a depressed cancer patient (see mirtazapine; Psychiatry Clin Neurosci. 2008 Feb;62(1):75-83).

The real problem is that depression is an organic issue--not just a psychiatric issue. We have no idea what exactly causes it and therefore how to optimally treat it. We have a ways to go, but often times an anti-depressant, even with side effects, is better than the alternative.

Black Thirteen said...

Antidepressants do work better than placebos. That is a requirement for approval by the FDA.

The last study I read showed that their efficacy was more than questionable, and in most cases, no different than a placebo.

There is also virtually no predictive ability to say who will respond best to each type of drug. Side effects can definitely be a problem with all drugs (especially anti-depressants), however, not all people on the drugs experience bad problems.

I refuse to be a guinea pig for drug companies, thanks. I take virtually no medication whatsoever in my daily life. I suffer my frequent headaches and migraines, rather than take something for them. I take soporifics as a last resort if my insomnia has gone on more than 2 days, I don't get flu shots, I reserve antibiotics for cases of extreme need, etcetera.

Yes, though, not all people experience those side effects. Is it worth the risk? No. It's not. Besides, being bounced from 20 different types of medication until they find one that works, is still filling my system with dozens of different chemicals, doing untold damage or alteration to my brain and body, all while emptying my wallet for the pleasure of them being wrong in their choice.

I have more important things to spend my money on. :D

You can say it's better than the alternative, but as an organic issue, what you're saying is no different than the archaic notion that gay people need to be "treated" for being different.

daedalus2u said...

I am a man who has had depression, who has been on antidepressants which has greatly relieved that depression and which also resulted in sexual side effects. The net result of feeling better from less depression was definitely worth the sexual side effects. The sexual side effect I had was that it took longer (sometimes a lot longer) to reach orgasm, which my last girlfriend actually said she didn't mind at all. I didn't mind it either. My experience with Viagra at that time was it didn't change the libido, or the time to reach orgasm, the only thing it changed for me was what it took to get ready.

But that is my experience. Other people might have other experiences. The only way to know how you will react to antidepressants is to try them. They are all different and what they do to different people is different also. The only way to test them is trial and error. Antidepressants are not "happy pills". They do not create a sense of artificial happiness.

Black Thirteen said...

I would consider it artificial because it's unnatural. My natural state is the one I experience now. Chemicals are artificial, and the mental state they induce is therefore equally artificial.

The fact that I'd also have to add Viagra to my life, which is an additional expense, is not worth it.

(Anyone find it coincidental that Eli Lilly makes Proazac... AND Cialis? I don't.)

The whole trial and error thing bothers me. Why should it be up to MY body to do the trial and error? Shouldn't the drug companies have done that?

Is it worth being fake-happy, if you no longer have an interest in sex, and can't "get it up" to have sex anyway?

That would make me depressed right there.

Mächtige Maus said...

Who knew a post about Viagra would evolve into such a discussion? I do so enjoy seeing how a blog can take on a life of its own.

Black Thirteen, I appreciate what you are saying. I'll give you the antibiotics as a last resort. I also don't get flu shots. I save my migraine medicine for worst possible scenarios. I do respect your decision to deal with depression without medication. To each their own. I still disagree with the notion of anti-depressants as fake-happy pills. I can assure you that I do not suddenly become a bubbling, vivacious, overly outgoing individual because of them. I am not suddenly someone I am not, but rather slowly and surely someone that I always have been. It is not something that can be explained well. I will hang my hat on the fact that it is indeed better than the alternative because I have experienced the alternative.

I'd also say that comparing depression to the notion of "treating gay people" is off base. My being gay does not affect my ability to function from day to day. Being an untreated depressive does. Apples and oranges with that comment, in my opinion.

Wow...when you string that all together, I am a depressed lesbian blogger. Never would have guessed that as a little girl. :)

Mächtige Maus said...

Okay, Black Thirteen, I have to ask this of you. Why is it that, for you, treating depression seems completely different from treating any other disease. I know this is a simplistic, cliché comparison, but a diabetic treats their "normal" organic deficiency in order to live. Why is treating a neurotransmitter deficiency (which can also just as easily lead to death if left untreated) any different, regardless of certain negative side effects?

Black Thirteen said...

Who knew a post about Viagra would evolve into such a discussion? I do so enjoy seeing how a blog can take on a life of its own.

Discussions are living, breathing things. That's why I hate places that enforce rigid "on-topic" rules. All that does is stifle the very nature of human discourse, and I find it counter-productive. Discussion flows on it's own path, you know?

I do respect your decision to deal with depression without medication. To each their own. I still disagree with the notion of anti-depressants as fake-happy pills. I can assure you that I do not suddenly become a bubbling, vivacious, overly outgoing individual because of them. I am not suddenly someone I am not, but rather slowly and surely someone that I always have been.

See, you can say that, but I would say anything that fundamentally changes how I think, feel, and view the world around me, is making me "not-me". It wasn't really a choice for me not to take them, as taking them wasn't ever an option I was willing to consider.

It had always been completely out of the question. No personal offense, mind, but I find it weak to take pills for something like that.

I will hang my hat on the fact that it is indeed better than the alternative because I have experienced the alternative.

I experience that alternative every single day. It doesn't seem so bad, once you've spent enough years getting used to it.

'd also say that comparing depression to the notion of "treating gay people" is off base. My being gay does not affect my ability to function from day to day. Being an untreated depressive does.

I'm an untreated depressive, (amongst other things). I can function from day to day. Most of it is from sheer force of will, but I still function.

I say the analogy of "treating gay people", because both are things you were born with. They've always been a part of you, whether or not you knew it.

Who is to say that either of them is "wrong", or "abnormal" or requires "treatment"?

It's like treating left-handedness.

Why is treating a neurotransmitter deficiency (which can also just as easily lead to death if left untreated) any different, regardless of certain negative side effects?

Well, for one, diabetics can have verifiable direct harm from their condition.

Most science can't even truly verify that your neurotransmitters are off, and the "chemical imbalance in the brain" is largely a guess. The entire industry of psychoactive drugs is mostly guesswork, hit or miss, trial and error. You just shove random chemicals into someone, and hope fora good result.

Also, because I feel that, since it's a mental issue, one should be able to work past it on their own.

You can't force your body to produce the appropriate amount of insulin, through "mind over matter", as it were, but through force of will, I can force myself to stand up out of bed, force myself to go to work, force myself to do all the duties therein, and finally return home and collapse into my bed.

Whether or not I feel miserable while I do these things doesn't matter. Because I'm still doing them.

daedalus2u said...

I can only speak for myself, but as someone who has been depressed my entire life, from before I was 10 years old, the only time I realized what it was like to not be depressed was while I was on meds that worked the best they had ever worked in my life (when I was in my early 40's). I had energy, I wanted to do stuff, I looked forward to the next day when I could do more stuff. It was a type of energy and joie de vivre that I had never experienced before. Yes, the meds I was on did cause sexual side effects. My identity and self-worth as a person is not solely tied up in my sexual identity and my ability to perform sexually. Yes, it is important, but there are more important things. Providing for my family, making the world a better place, saving the world from global warming are more important to me than whether it takes me 5 minutes or 15 minutes or 45 minutes to have sex.

If antidepressants are not working for you, you need to try a different type. I have been on more than half a dozen. I don't think about the meds I am on, I think about my life and doing the things I want to do with it. That is what not being depressed lets me do.

Mächtige Maus said...

Fascinating. Seriously. I am appreciating this discussion immensely.

I can do the same as you, force myself through each day out of sheer force of will. I did that for years. Most people at work, now or then, had no idea that I was struggling with depression.

Seriously though, there is no direct verifiable harm from depression, unlike diabetes? Interesting.

And the idea that someone with a mental issue should be able to push through it on their own is the very reason why society dismisses mental illness. In fact, it is why it is never referred to as a disease.

We could go around in circles on this forever. We clearly come at the issue from different corners. I guess I just don't see why my life should be such a force of will. Getting out of bed, going to work, living, feeling miserable all the while just trying to exist. Obviously depression is a real, crippling disease. And there are treatments for it not unlike any other treatment for diseases. Just because the manifestation is mental does not make it less of an illness. The brain is an organ no different than any other in the body. And it can not function.

If you chose to fight it every day without medication, I respect that. But, it certainly doesn't work for everyone.

I will go back to the initial concept of this post, the side effects of certain anti-depressants. They can be detrimental. No doubt about it. I don't like the concept of having to medicate the medication. However, I don't like the concept of throwing out the medication altogether as a valid treatment, because death can be an end result to untreated depression.

Le Loup-garou said...

As long as a patient is not a harm to his/herself or others, I have absolutely no problem with letting them choose to take medication or not. The most important thing is making sure that the decision is fully informed. This is a difficult conundrum in all of medicine, but especially psychiatry. How do you make sure that a patient is making the right decision for themselves, when if treated, they might see things differently? The most important thing is to always make sure a patient is in control of their own body and decisions, not just to follow the medical literature. It is a difficult lesson to learn that physicians are just consultants, even on the most complex issues.

However, just because you didn't benefit from medication, in no way implies that everyone is the same. In fact, in my experience, the majority of people with depression do benefit from medication. Are the drugs perfect? NO! But to those with debilitating disease, the alternative is unacceptable.

daedalus2u said...

There are adverse physiological effects from depression. Observing how my depression changed when I raised my NO level has been extremely informative to me (it has gotten fabulously better). I see depression as primarily a metabolic disorder, a symptom of reduced ATP in the brain. Essentially anything that reduces ATP in the brain will bring it on, the best described associations are seen in vascular depression. Reduced blood flow is strongly associated with depression, especially in the elderly.

I see depression as an absolutely necessary aversive state between the "normal" high ATP state and a severely depressed ATP state characteristic of sever metabolic stress and even life threatening metabolic stress. Severe life-threatening metabolic stress will induce a euphoric state. This is the euphoria of near death experiences, drowning, autoerotic hypoxia, some types of drug abuse, bipolar. Your body has to invoke euphoria in a metabolic near death crisis so you have even a slim chance of surviving it. When you are running from a bear, to stop and rest is to be caught and die. Physiology produces what is known as the runner's high. A euphoric state where you have the delusion that you can run forever. You can't run forever, but all you need to do is run until you have escaped from the bear chasing you, or until you drop dead from exhaustion. If the bear catches you, you are dead anyway, so dropping dead from exhaustion while still being chased has no detrimental effect over being caught.

Depression is associated with all of the other chronic degenerative diseases that are also characterized by reduced ATP in different organ systems.

Black Thirteen said...

I can do the same as you, force myself through each day out of sheer force of will. I did that for years. Most people at work, now or then, had no idea that I was struggling with depression.

For me, nobody knows. People that are close to me personally don't usually know, unless they're around me often, (which, due to other things in my personality, most people are not.).

Seriously though, there is no direct verifiable harm from depression, unlike diabetes? Interesting.

Physically, I'm fine. Give me an MRI, a CAT scan, a few x-rays, and a full physical. Aside from the damage to my lungs from smoking, they'll find nothing physically wrong with me.

That's the difference. Diabetes causes physical harm, on it's own.

And the idea that someone with a mental issue should be able to push through it on their own is the very reason why society dismisses mental illness. In fact, it is why it is never referred to as a disease.

I can't help how I see things.

I guess I just don't see why my life should be such a force of will. Getting out of bed, going to work, living, feeling miserable all the while just trying to exist.

Well, I was born this way, this is me, and, one could say it's a testament to personal strength, that I do this, every day, and have done this, every day, and I haven't sucked the barrel of a gun yet.

If I can function like this, regardless of the quality therein, any changes would just be OTHER people asking me to change, for their convenience. The change wouldn't benefit me, it would make life easier for those close to me.

And considering I keep people from getting there in the first place, it all works out quite well.

If you chose to fight it every day without medication, I respect that. But, it certainly doesn't work for everyone.

Well, like I said, it was never really a choice for me.

As long as a patient is not a harm to his/herself or others, I have absolutely no problem with letting them choose to take medication or not.

I say, remove the "harm to themselves" part.

How do you make sure that a patient is making the right decision for themselves, when if treated, they might see things differently?

Well, of course people would see things differently on drugs. Altered mental states produce altered thoughts.

However, just because you didn't benefit from medication, in no way implies that everyone is the same. In fact, in my experience, the majority of people with depression do benefit from medication. Are the drugs perfect? NO! But to those with debilitating disease, the alternative is unacceptable.

I've never taken a single one. I refuse to. I forced myself to go from spending two solid weeks in bed without moving, to working, functioning, and having basic interactions with other people. It's difficult, unpleasant, and miserable, but it's me, and I didn't need to be filled full of brain altering medication to do it.

Mächtige Maus said...

Loup, I fully agree with your statement, "The most important thing is making sure that the decision is fully informed." It wasn't until graduate school when I had a suicide note written, a plan in the works, that I realized that mind over matter was not a valid option for me. And that is the key. I was an informed patient. Bottom line, I have had several severe depressive episodes, each of them worse than the previous one. For me, battling through that through sheer force of will was no longer an option. Others might find that to be a weakness. Society certainly does. I chose to see it as a strength...an acknowledgment of the fact that depression is a debilitating disease for some when left untreated.

daedalus2u said...

black 13, I disagree that there are no physical symptoms. There are. A SPECT would show reduced brain metabolism. An MRI would show white matter hyperintensities, brain regions of reduced water diffusion. This reduced diffusion is due to reduced ATP consumption by the motors moving stuff around in axons. An MRS (magnetic resonance spectroscopy) would show reduced energy metabolites. Osteoporosis is associated with depression as are lots of other disorders.

There is a great deal of misinformation out there on what antidepressants do, much of it put out by scientologists.

Depression is a very serious disease, on that has a very high fatality rate. It was the 11th leading cause of death in 2005. Antidepressants are an effective treatment for some. Some people can through force of will keep themselves doing stuff. It is not an easy life to live. It is very hard on the people around you too.

Black Thirteen said...

Perhaps, perhaps not.

I feel physically fine.

There is a great deal of misinformation out there on what antidepressants do, much of it put out by scientologists.

There's a great deal of misinformation out there on what they do, and it's put out by pharmaceutical companies.

They don't really want the public knowing it's a huge industry of guesswork.

Some people can through force of will keep themselves doing stuff. It is not an easy life to live. It is very hard on the people around you too.

Never said it was easy. But it works. I function, I live, I breathe, I persist.

As for it being hard on people around me, to be perfectly blunt...I don't care. If someone doesn't want to be around me, more power to them. I don't force anyone to keep company with me.

Nine times out of ten, I prefer to keep the company of my cats, and that's about it.

I keep very few friends, and the ones I do keep, don't mind. I don't date, so I'm good there, too.

I'm simply very, very anti-medication. I'd sooner take the suicide route, than make a simulacrum of myself via medication.

daedalus2u said...

black 13, you are welcome to make any decisions that you want to about your own treatment and care. You are free to use any criteria you choose to make those decisions. Don't expect anyone else to accept your choices as wise and as choices they should emulate when they are based on complete ignorance of what any of these medications actually do.

Antidepressants simply do not modify cognition in the way that you are afraid of. In no way, shape or form do any of them turn anyone into a simulacrum.

I have been depressed my entire life. I distinctly remember as a child asking my mother for permission to kill myself. I was completely serious. I think I was maybe 8? Having been actively suicidal for 40+ years I have never made a suicide attempt. I know what you mean by "force of will". I have been on perhaps half a dozen antidepressants in the last 25 years. None of them take away that "force of will". I am quite certain that given the degree of depression that I had that if I had not used antidepressants I would not be alive today.

I am trying to walk a fine line between not criticizing you for the choice you have made, but making clear to anyone who might read this that I consider that choice to be reckless, foolish and self-injurious, and a choice that I hope you change and that no one else follows.

I am not in the mental health profession, I have no stock in companies that make antidepressants, my only connection is as someone who has been remarkably helped by them and who hopes that people don't reject a path that might help them due to ignorance and misinformation. Why? "Any man's death diminishes me, because I am involved in Mankind; And therefore never send to know for whom the bell tolls; it tolls for thee." John Donne

Having been suicidal for many years, I have no fear of death. What I do fear is dying without having made the world a better place to the best of my ability. That is what I feel I owe to future generations. Applying my "force of will" to that is far more productive than applying it to maintain my actions as an automaton.

Black Thirteen said...

I wouldn't say my choices are ignorant.

For instance:

http://news.bbc.co.uk/2/hi/health/7263494.stm

and,

http://www.guardian.co.uk/society/2008/feb/26/mentalhealth.medicalresearch

I say simulacrum because I was once involved with a woman on anti-depressants, and I saw the difference between when she was on them, and when she wasn't. Two different people.

I have been on perhaps half a dozen antidepressants in the last 25 years.

That's my point exactly. It's all guesswork. I'm completely uncomfortable with being a test tube for dozens of different pills.

I consider that choice to be reckless, foolish and self-injurious, and a choice that I hope you change and that no one else follows.

I have no intention of changing my mind. Even if I did, I don't have the money to waste on expensive prescriptions, month after month, attempting to find one that actually does something more than nothing.

my only connection is as someone who has been remarkably helped by them and who hopes that people don't reject a path that might help them due to ignorance and misinformation.

That's also my point. The pharmaceutical companies spread their fair share of misinformation about the efficacy of what they sell, because they want to keep selling them and making money.

Especially if you have to take that one, and then take another or two to offset the side effects of the first. (Like Viagra)

The drug companies responded very badly to the study results that show that Prozac and many others simply don't work.

What I do fear is dying without having made the world a better place to the best of my ability.

Call me fatalistic, call me cynical, but that's not something I care about. I will not be reproducing, so after I die, nothing of me will be left in the world, so I have no concern in making it better.

daedalus2u said...

I would call you depressed. Ennui and cynicism are unfortunate effects of depression. They are better fixed than endured. There are multiple approaches to treatment, talk therapy works, so do meds, so do other things. It usually takes much more effort to change than to endure.

Another Anonymous Poster said...

I would call you depressed. I would also suggest the possibility of a personality disorder. Based on your comments so far, to wit:


DSM IV Criteria for schizoid personality disorder:

A. A pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:

1. neither desires nor enjoys close relationships, including being part of a family
2. almost always chooses solitary activities
3. has little, if any, interest in having sexual experiences with another person
4. takes pleasure in few, if any, activities
5. lacks close friends or confidants other than first-degree relatives
6. appears indifferent to the praise or criticism of others
7. shows emotional coldness, detachment, or flattened affectivity



Unfortunately, personality disorders are brutally difficult to treat, since the individual sees the disorder as part of who they are, and they define themselves and their personality in light of the pathology. The depression and paranoia about the evil 'drug companies' and their lies are part and parcel of a Cluster A personality type. Argue all you want about the capriciousness of psychiatry and the arbitrary nature of the definitions; the pathologies are unmistakable once you've seen enough of them.

Habladora said...

Stolen Disclaimer:

The medical analysis and opinions offered on this thread are those of the author individually and are not reflective or indicative of the opinions and positions of the author’s employer. Nothing on this blog is to be construed as medical advice and is not meant to be so. If you have medical problems, please hire a physician and consult with her/him.

Sincerely,
Management

Black Thirteen said...

They are better fixed than endured.

I'm not in need of repair. I'm not "broken".

I take umbrage at the implication that I am somehow damaged or in need of correction.

DSM IV Criteria for schizoid personality disorder:

I've been told this before.

Unfortunately, personality disorders are brutally difficult to treat, since the individual sees the disorder as part of who they are, and they define themselves and their personality in light of the pathology.

That's my point. There is no pathology. Being different isn't an illness.

The standard of "Well, "normal people" want to do this, you don't, so you are abnormal and require treatment!".

Just...no. You could say "Normal people want to have kids", and then say anyone who doesn't, requires mental help.

Arbitrary standards of "normal" based on fallacious ideals don't help anybody.

The depression and paranoia about the evil 'drug companies' and their lies are part and parcel of a Cluster A personality type.

It's not paranoia. Drug companies are in business. Businesses exist to make money.

If no one buys what you sell, you don't make money. You then need to convince people they should buy what you sell, and in fact, that they "need" it.

Which is why they react so badly to any studies doubting, questioning, or outright proving the lack of efficacy of their product. Because it will hurt sales.

It's how one can tell a businessman from an altruist.

One gives away for free what can be given to help people, the other sells something.

the pathologies are unmistakable once you've seen enough of them.

I posit that there's nothing wrong. All you're doing is looking for a strict criteria of "Doesn't do what everybody else does".

Stolen Disclaimer:

I don't know if it's the lack of sleep, or just the sudden way you posted it, but this was rather humorous to me.

Also, do all discussions here become so long and interesting? I'd be inclined to comment here a lot more often if that's the case.

Habladora said...

It would have been even funnier if I could have gotten the damn strike code to work with Blogger comments... sigh.

Another Anonymous Poster said...

Bullshit. There is an illness. It's just ego-syntonic, so you don't see it as such. It's blindingly obvious to everyone else. And to say that depression doesn't lead to death is so incredibly, obviously untrue that it doesn't even warrant a rebuttal.

Black Thirteen said...

Bullshit. There is an illness. It's just ego-syntonic, so you don't see it as such. It's blindingly obvious to everyone else.

Nope. This is why I think the vast majority of psychiatry is bunk.

It's the only "medical" science, where the definition for "illness" changes based on what's currently socially acceptable.

Remember "female hysteria"? Or being gay being a "mental illness"?

If I'm "mentally ill", what exactly is "wrong"? I don't care about sex or reproduction, and am not very social. So what? Not everyone has to fit a particular societal standard in order to be "mentally healthy".

Again, being different is not an illness. Does it cause me harm? Is it detrimental to my continued life? Nope! Not an illness.

That's why psychiatry is largely a joke. You can't expect everyone to think the same, or want the same things.

Mächtige Maus said...

Dear Readers:

I do find myself wondering how Black Thirteen managed to find his way to this post because it seems as if it went from trolling for Viagra related posts to a tirade against valid medical treatment for major depressive disorder. Well done.

As one of the moderators, I have tried my best to give voice to a differing opinion. Clearly, I speak here of the views that Black Thirteen has been offering. Should Black Thirteen wish to continue this thread on his own blog, where he can put forth his own opinion, then so be it. While I do appreciate a different perspective, I find that I must use my ability as a moderator to halt this particular thread.

Again, should Black Thirteen wish to exercise his own free will in order to decline valid medical treatment for a disease, that is his choice. However, The Feminist Underground will not be a platform for him to voice that free will in such a way as to set forth: (1) misleading information, (2) negative information, (3) disapproving information that does nothing but perpetuate an ingrained societal condemnation of mental illnesses.

Allow me to make this point vehemently...in no way does The Feminist Underground support the notion of lack of treatment for mental illness. Let me make that statement even more personal. In no way do I personally agree with Black Thirteen. I gave him a voice for as long as possible. I am afraid that I can no longer do so because I find that what is being said is detrimental to those who might be considering treatment for a mental illness. I find that what Black Thirteen says is exactly what society says each and every day in an effort to diminish the severity of the mental disease.

Moving on...