Category: Mental Health

High levels of anxiety have been found in women with dyspareunia,^28-30 who seem to experience severe pain during sexual intercourse.³¹ The pathophysiological factors that regulate this phenomenon are unknown. An interesting hypothesis suggests that a strong relationship exists between anxiety and hypervigilance in patients with anxiety and SD, with attention being allocated to threatening stimuli during sexual intercourse.^32-34

Recent studies have significantly increased the understanding of pain perception and have demonstrated that a complex series of spinal, midbrain, and cortical structures are involved in pain perception.³⁵ Pain perception can be roughly divided into a lateral, somatosensory system involved in discrimination of pain location and intensity,³⁶ and a medial system that mediates the anticipatory, fearful, affective quality of pain through limbic structures.³⁷ Dysfunctions of these limbic structures, including the hippocampal cortex, may be involved in SDs in which pain represents the prevalent symptom.³⁸ Patients with chronic pelvic pain have often been found to have a history of sexual trauma or abuse. Moreover, similar alterations in limbic structure have been demonstrated both in patients with chronic pelvic pain and in survivors of trauma.³⁹ This may suggest that pain represents not only a symptom of SD but also a symptom of a more specific anxiety disorder such as PTSD.

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The complex relationship between anxiety disorders and desire disorders is rarely clarified in the medical literature. Kaplan¹ underlines a strong prevalence of panic disorder (25%) in patients affected by $exual aversion disorder. Anxiety is also relevant in sexual arousal. Induced by different stressors, anxiety can distract from erotic stimuli and impair $exual arousal, principally through an increased sympathetic tone.^3,4 This may result in poor erection in males and a reduction in lubrication and clitoral tumescence in females.

Various aspects of anxiety are historically considered in arousal disorders, particularly the vicious circle of anxiety/dysfunction/performance anxiety.⁵ Honeymoon impotence is a specific example of this, as suggested by Shamloul,⁶ who studied 100 patients with this problem.

Several studies have found that the prevalence of anxiety disorders varies from 2.5% to 37% in males affected with erectile dysfunction (ED).^7-9 However, these studies failed to point out a significant correlation between a sin-gular type of anxiety disorder and ED. Recently, however, a link between free-floating anxiety and ED has been suggested.¹⁰ Others report that the association between anxiety (as a feeling) and ED is strongest in patients aged 45 to 54 years.¹¹

One study found that the presence of anxiety symptoms in patients with arousal disorders was associated with poor treatment outcomes.⁷ Hyperarousal syndromes, such as persistent sexual arousal, are not found in DSM-IV-TR. The specific role of anxiety in these cases is unknown. Leiblum and colleagues¹² described 103 women with involuntary genital and clitoral arousal. An anxious experience represented the trigger in one third of these women. Anxiety-related symptoms such as worry, panic attacks, and obsessive thoughts or behaviors were also seen in significant numbers of these patients, as were secondary anxiety symptoms (worry and embarrassment).

In addition to desire and arousal, orgasm may also be impaired by anxiety. While it is widely accepted that anxious thoughts or feelings disrupt female orgasm, few studies have examined this relationship or tried to identify specific aspects of anxiety related to impaired orgasm.^13-15

Negative emotions, including anxiety or fear of failing to meet a partner’s expectations, represent one of the most common causes of premature ejaculation (PE).^16-20 This has been explained by investigators as being caused by a sympathetic hyperactivity that reduces ejaculation control.^20-22 Others have pointed to the role of attention, suggesting that men who are anxious during sexual intercourse are worried about sexual performance or sexual adequacy, and that these thoughts may distract attention from the sexual sensations that precede orgasm and ejaculation.^18,21,23

Hyperattention to performance and fear of inadequacy in meeting others’ expectationare typical of social phobia, in which concern about performance and judgment reflect a high sympathetic tone. This has been confirmed by Tignol and colleagues²⁴ and Corretti and colleagues,²⁵ who report that the prevalence of social phobia is 47% and 25.5%, respectively, in patients with PE. This link between social phobia and PE was also substantiated by reports of 2 cases in which worry about social performance led to uncontrolled ejaculation.²⁶

Other investigators propose a significant role of free-floating anxiety in PE.¹⁰ The relationship between anxiety and retarded ejaculation is unclear, although some investigators suggest that sexual performance anxiety can contribute to retarded ejaculation.^18,27

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In this article, we examine the relationship between anxiety disorders and SDs, using DSM-IV-TR categories, although we are conscious of the limits of this approach. In doing so, we will consider not only the dichotomy between normal and pathological functioning but also the issue of sexual satisfaction as part of wellness.

Some people who have panic attacks find it difficult to recall what happened just before or during an attack. Panic-related memory loss can happen for some of the same reasons that general anxiety leads to memory loss.

Panic attacks — brief episodes of extreme fear — are a type of anxiety. They come on quickly, often without warning, triggering symptoms that can feel overwhelming and terrifying:

• difficulty breathing or feelings of choking
• pounding or racing heart
• sweating, trembling, or shaking
• numbness, tingling, or blurred vision
• feeling of doom
• feeling of losing control

Some people having a panic attack might believe they’re dying or having a heart attack. You might feel totally preoccupied by these unpleasant feelings, lose track of time, and think about nothing except getting through the attack.

Afterward, you might recall the intense panic vividly, but you might not recall exactly how you made it through.

If you’ve had a panic attack before, you might also worry about having one again, especially when you find yourself in a situation that triggers feelings of worry or fear. When this increase in anxiety occupies your focus, you might also notice some memory trouble.

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If you live with anxiety, you know it can serve as a powerful distractor.

Your worries might occupy your thoughts to the point where you can’t seem to escape them, even when you try. Worry and distress might eventually become repeating background tracks for your day. No matter what you do, you’re also attempting to manage and cope with anxious thoughts at the same time.

This divided brainpower often makes it harder to give your whole attention to what you want to focus on, since anxiety keeps getting in the way.

As you continue to focus on your worries and their causes, your brain begins prioritizing these potential threats in order to keep you safe.

As a result, other information may begin to fade into the background.

Once you realize you’ve forgotten some important things, you might even start to wonder whether something serious is going on. And you might begin to fixate on those concentration and memory issues.

In turn, minor moments of forgetfulness that might happen to anyone, especially people under stress, stand out more and more. Normal forgetfulness, then, fuels the cycle by becoming another trigger for anxious thoughts.

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Anxiety can make it tough to get enough restful sleep. If you aren’t lying awake, replaying a loop of anxious thoughts, you might wake up frequently or have troubling dreams.

A few nights of poor sleep can leave you feeling foggy, distracted, and unable to concentrate, though you probably won’t experience any major health impacts.

Regular sleep deprivation can have serious health consequences, including memory loss. This is because sleep is essential for both memoryTrusted Source and overall brain function Trusted Source.

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Ever heard of the stress hormone? Cortisol earns this nickname because it helps kick your body into fight-flight-freeze mode during times of increased stress.

This hormone has several important functions, and the right amount can even help you form memories. This might help explain why mild anxiety can actually help improve memory.

Too much cortisol, on the other hand, can have the opposite effect. People with chronic or severe anxiety tend to have higher levels of cortisol, which makes sense considering that anxiety involves extreme, frequent worry about potential threats.

The constant stress you experience can keep your body stuck in a fight-flight-freeze response, ready to respond to danger.

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You won’t necessarily find yourself unable to recall key events in your life, since anxiety generally affects working memory.

Instead, you might have difficulty remembering things like:

• task instructions
• directions to a friend’s house
• a child’s play date
• conversations you had with others
• information in a textbook chapter you just studied

A few different factors play a part in anxiety-related memory loss:

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Anxiety conditions provoke strong, persistent feelings of worry and fear, often about things and situations you can’t change or control.

With anxiety, you might find yourself stuck in a cycle of nervousness and worry, unable to stop mentally running through dreaded potential outcomes. This anxiety loop can take up a lot of mental energy.

Many people find that this state of near-constant stress and hypervigilance takes a toll on their memory.

Anxiety-related memory loss can lead to more anxiety as you:

• are unable to recall key details at work or school
• forget things, like birthdays and other significant events, leading to tension or conflict in personal relationships
• have trouble remembering things that can make essential daily tasks, like driving, parenting, or cooking, easier (and safer)

Wondering why anxiety causes memory problems? Looking for tips to stop the cycle? You’ll find more details below.

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