How a healthy sex life can help minimize depression and anxiety symptoms
When you struggle with anxiety or depression, sex may be the last thing on your mind. But understanding the physiological and mental benefits of a healthy sex life can help it become a tool for well-being.
- The physiological responses our bodies have to sex can minimize the symptoms of anxiety and depression.
- Deficiencies in nitric oxide are associated with irritability, depression, anxiety, insomnia, and less energy. Having sex increases your body's nitric oxide levels.
- Sex also increases epinephrine, oxytocin, dopamine and serotonin, all of which are linked to mood, behavior, and well-being.
Depression can steal your sex drive and leave you feeling the deepest kind of lonely. And yet, sex can not only make you feel connected to another person, but the physical and biological responses our bodies have to sex can actually minimize some of the symptoms of depression.
And then there's anxiety. When you're suffering from anxiety, you feel cornered, lost and stuck; not able to take any steps forward. Sex is the last thing on your mind… and yet again—the physical and biological responses our bodies have to sex can minimize those symptoms, too.
Sex might not be a cure-all (wouldn't it be amazing if it was?) but there is a lot of evidence to prove that sex can have a positive impact on your state of mind, as well as your physical and mental health.
What happens in our bodies during sex
Photo: "Someone Great" via Netflix
To explain this in more detail, let's talk about what biologically happens within our bodies when we are aroused and have sexual intercourse. This process begins before you have sex (and continues for a while after you have an orgasm), which is how having a healthy sex life can affect your moods, behaviors, and thoughts.
Arousal provokes activity in the “emotions” area of our brains
MRI studies have shown that the first thing to happen when we are aroused is that there is an increase in activity to the part of the brain that controls your emotions—this is called the limbic system.
During this initial arousal stage, a few physical things happen, as well: our blood pressure and blood flow increases, sensitive areas of our body (such as the genitals and breasts) become tender and our hearts beat faster. In general, arousal acts like an "on" switch for our bodies to prepare us for intercourse.
Sexual intercourse increases our nitric oxide activity, which impacts our anxiety and depression levels
When it comes to having intercourse, there are many complex things happening in our bodies and brains all at once. Along with the increased blood flow that happens when we're aroused, there is also a surge of nitric oxide released in our bodies while we have sex.
Nitric oxide molecules are essential in terms of our blood vessel health because these molecules relax the inner muscles of the blood vessels, which then causes those vessels to widen. This surge in nitric oxide explains why some areas of our bodies are tender during arousal and intercourse, and why our skin may become flushed when we are aroused.
It's important to note that some of the side effects of nitric oxide deficiency (which you can read more about here) are irritability, depression, anxiety, insomnia, and less energy.
People who struggle with nitric oxide deficiency often experience symptoms of anxiety and depression—and the reverse is also true: people who have an influx of nitric oxide (let's say, by having sex) can minimize their symptoms of depression and anxiety.
Sexual intercourse releases dopamine and serotonin, the “balancing chemicals” in our brains
Photo: Getty Images
An influx in nitric oxide isn't the only thing that happens in our bodies when we have sex.
Having sexual intercourse releases some other messages from our brain to our body, as well. These messages are called neurotransmitters.
Dopamine is one of those neurotransmitters, and it plays a huge role in how we feel pleasure. Not only that, but dopamine also plays a role in motivating our brains to feel that pleasure again.
When we have sex, our bodies spread the dopamine chemical along the various major pathways of our brains. This happens during many other pleasurable activities (not just sex), and like a car that's running smoothly until it isn't, you likely won't notice your body is doing this unless there is a problem with how your body carries out that function.
Anyone who has struggled with this affliction can tell you that motivation and incentive are extremely difficult to find when you're experiencing depression.
Now, let's talk about serotonin because there is also an influx in serotonin when we have intercourse. Serotonin and dopamine affect many of the same things in our bodies, just in different ways. Both are equally important in regulating various bodily functions like sleep, emotions, and metabolism.
Researchers have been studying and analyzing the link between serotonin and depression for half a century now and while it was originally believed to be as simple as "low serotonin causes depression", the reality is far more complex.
In simple terms, low serotonin isn't a direct cause of clinical depression (as there isn't just one cause and they are extremely difficult to pinpoint due to our complex systems). However, raising your serotonin levels has proven to be one of the most effective depression treatments.
Why? Because serotonin is known to help regulate your mood, social behaviors, emotions, appetite and digestion, sleep, memory and sex drive. Some of the more prominent symptoms of anxiety and depression include erratic sleep, bad memory, hard-to-manage emotions and mood swings that alter your social behavior.
Taking this information into account, it makes total sense that regulating some of these body functions (by having regular sex and releasing these hormone-balancing chemicals) would help decrease the symptoms of these specific mental health concerns.
Sexual intercourse, epinephrine and the “feeling alive” sensation
We also have to talk about the epinephrine chemical that is released during sexual intercourse. Epinephrine is an adrenaline hormone. This hormone activates our sympathetic nervous system, which makes you feel that "heart pounding in your chest" kind of exhilaration you feel when you're out for a jog, getting a new tattoo or (you guessed it) having sex.
According to Medical News Today, low levels of epinephrine can often result in physical and mental symptoms such as feeling anxious or depressed.
The 2 big “O”s
The "O"s are "orgasm" and "oxytocin". Orgasms, you (hopefully) have when you have sexual intercourse. Oxytocin is the hormone that is released during orgasm.
Known as the 'love hormone', oxytocin is that "let's be together forever" feeling that plays a vital role in our pleasurable climaxes as well as how our body feels after we've reached climax. You get a big dose of oxytocin during an orgasm, but that's not the only time oxytocin makes an appearance. For women, oxytocin is also released during labor and while breastfeeding, which helps create that motherly bond between herself and her newborn baby.
See, oxytocin doesn't just make you feel good, and it's not just about feeling "in love"—but when our bodies experience surges in oxytocin we also begin to feel attachment and trust as a result of this hormone surge.
According to PET scans taken at the moment of orgasm, the reward circuits in our brains light up like fireworks and the center of reasoning and behavior temporarily shut down as you spiral into what can only be described as sexual bliss. You can see a really cool video by Rutgers University of said sexual fireworks shown in the female brain below.
Knowing what we know about anxiety disorders and how easily things are overthought to the point of bringing on a panic attack, that temporary shut off of reasoning can be incredibly helpful for someone who is feeling "stuck" in their own mind.
Given the link between orgasm and oxytocin (and the link between oxytocin and feeling good), it's not a far leap to consider the effect oxytocin released by sex can have on someone who is struggling with an anxiety or depression disorder.
It is impossible for science to arrive at ultimate truths, but functional truths are good enough.
- What is truth? This is a very tricky question, trickier than many would like to admit.
- Science does arrive at what we can call functional truth, that is, when it focuses on what something does as opposed to what something is. We know how gravity operates, but not what gravity is, a notion that has changed over time and will probably change again.
- The conclusion is that there are not absolute final truths, only functional truths that are agreed upon by consensus. The essential difference is that scientific truths are agreed upon by factual evidence, while most other truths are based on belief.
Does science tell the truth? The answer to this question is not as simple as it seems, and my 13.8 colleague Adam Frank took a look at it in his article about the complementarity of knowledge. There are many levels of complexity to what truth is or means to a person or a community. Why?
First, "truth" itself is hard to define or even to identify. How do you know for sure that someone is telling you the truth? Do you always tell the truth? In groups, what may be considered true to a culture with a given set of moral values may not be true in another. Examples are easy to come by: the death penalty, abortion rights, animal rights, environmentalism, the ethics of owning weapons, etc.
At the level of human relations, truth is very convoluted. Living in an age where fake news has taken center stage only corroborates this obvious fact. However, not knowing how to differentiate between what is true and what is not leads to fear, insecurity, and ultimately, to what could be called worldview servitude — the subservient adherence to a worldview proposed by someone in power. The results, as the history of the 20th century has shown extensively, can be catastrophic.
Proclamations of final or absolute truths, even in science, shouldn't be trusted.
The goal of science, at least on paper, is to arrive at the truth without recourse to any belief or moral system. Science aims to go beyond the human mess so as to be value-free. The premise here is that Nature doesn't have a moral dimension, and that the goal of science is to describe Nature the best possible way, to arrive at something we could call the "absolute truth." The approach is a typical heir to the Enlightenment notion that it is possible to take human complications out of the equation and have an absolute objective view of the world. However, this is a tall order.
It is tempting to believe that science is the best pathway to truth because, to a spectacular extent, science does triumph at many levels. You trust driving your car because the laws of mechanics and thermodynamics work. NASA scientists and engineers just managed to have the Ingenuity Mars Helicopter — the first man-made device to fly over another planet — hover above the Martian surface all by itself.
We can use the laws of physics to describe the results of countless experiments to amazing levels of accuracy, from the magnetic properties of materials to the position of your car in traffic using GPS locators. In this restricted sense, science does tell the truth. It may not be the absolute truth about Nature, but it's certainly a kind of pragmatic, functional truth at which the scientific community arrives by consensus based on the shared testing of hypotheses and results.
What is truth?
Credit: Sergey Nivens / 242235342
But at a deeper level of scrutiny, the meaning of truth becomes intangible, and we must agree with the pre-Socratic philosopher Democritus who declared, around 400 years BCE, that "truth is in the depths." (Incidentally, Democritus predicted the existence of the atom, something that certainly exists in the depths.)
A look at a dictionary reinforces this view. "Truth: the quality of being true." Now, that's a very circular definition. How do we know what is true? A second definition: "Truth: a fact or belief that is accepted as true." Acceptance is key here. A belief may be accepted to be true, as is the case with religious faith. There is no need for evidence to justify a belief. But note that a fact as well can be accepted as true, even if belief and facts are very different things. This illustrates how the scientific community arrives at a consensus of what is true by acceptance. Sufficient factual evidence supports that a statement is true. (Note that what defines sufficient factual evidence is also accepted by consensus.) At least until we learn more.
Take the example of gravity. We know that an object in free fall will hit the ground, and we can calculate when it does using Galileo's law of free fall (in the absence of friction). This is an example of "functional truth." If you drop one million rocks from the same height, the same law will apply every time, corroborating the factual acceptance of a functional truth, that all objects fall to the ground at the same rate irrespective of their mass (in the absence of friction).
But what if we ask, "What is gravity?" That's an ontological question about what gravity is and not what it does. And here things get trickier. To Galileo, it was an acceleration downward; to Newton a force between two or more massive bodies inversely proportional to the square of the distance between them; to Einstein the curvature of spacetime due to the presence of mass and/or energy. Does Einstein have the final word? Probably not.
Is there an ultimate scientific truth?
Final or absolute scientific truths assume that what we know of Nature can be final, that human knowledge can make absolute proclamations. But we know that this can't really work, for the very nature of scientific knowledge is that it is incomplete and contingent on the accuracy and depth with which we measure Nature with our instruments. The more accuracy and depth our measurements gain, the more they are able to expose the cracks in our current theories, as I illustrated last week with the muon magnetic moment experiments.
So, we must agree with Democritus, that truth is indeed in the depths and that proclamations of final or absolute truths, even in science, shouldn't be trusted. Fortunately, for all practical purposes — flying airplanes or spaceships, measuring the properties of a particle, the rates of chemical reactions, the efficacy of vaccines, or the blood flow in your brain — functional truths do well enough.
Using urinals, psychological collages, and animated furniture to shock us into reality.
- Dada is a provocative and surreal art movement born out of the madness of World War I.
- Tzara, a key Dada theorist, says Dada seeks "to confuse and upset, to shake and jolt" people from their comfort zones.
- Dada, as all avant-garde art, faces a key problem in how to stay true to its philosophy.
In a world gone mad, what can the few sane people left do? What can someone say when there are no words that seem up to the job? How can anyone hope to express ideas so terrible when doing so will only reduce those ideas?
These are some of the things that inspired the Dada movement, and in its absurd, surreal, and chaotic nonsense, we find the voice of the voiceless.
The origin of Dadaism
Dada was a response to the madness of World War I. Reasonable, intelligent, and sensitive people looked at the blood and mud graveyards of the trenches and wondered how any meaning or goodness could ever be found again. How can someone make sense of a world where millions of young, happy, hopeful men were scythed down in a spray of bullets? How could life go back to normal when returning soldiers, blinded and disfigured from gas, lay homeless in the streets? Out of this awful revulsion, there came one bitter voice, and it said: "Everything is nonsense."
Dada is the art of the nihilist. It smashes accepted wisdom, challenges norms and values, and offends, upsets, and provokes us to re-examine everything.
And so, the Dada movement expressed itself in absurdity. Tzara, the closest you get to a Dadaist philosopher, put it like this: "Like everything in life, Dada is useless. Dada is without pretension, as life should be." Dada rejects all systems, all philosophy, all definite answers, and all truth. It is the living embrace of contradictions and nonsense. It seeks "to confuse and upset people, to shake and jolt". It aims to shout down the "shamefaced sex of comfortable compromise and good manners," when actually "everything happens in a completely idiotic way."
In short, Dada is a response to the world when all the usual methods have broken down. It's the recognition that dinner party conversations, Hollywood blockbusters, and Silicon Valley are not how life actually is. This is a false reality and order, like some kind of veneer.
The Dada response to life is to embrace the personal and passionate madness of it all, where "the intensity of a personality is transposed directly, clearly into the work." It's to recognize the unique position of an artist, who can convey ideas and feelings in a way that goes beyond normal understanding. Art goes straight to the soul, but the intensity of it all can be hard to "enjoy" in the strictest sense.
Where is this Dada?
For instance, Dada is seen in the poems of Hugo Ball who wrote in meaningless foreign-sounding words. It's in Hausmann, who wrote works in disconnected phonemes. It's found in Duchamp's iconoclastic "Fountain" that sought to question what art or an artist really meant. It's in Hans Richter's short film "Ghost before Breakfast," which has an incoherent montage of images, loosely connected by the theme of inanimate objects in revolt. And, it's in Kurt Schwitters' "psychological collages" which present fragments of objects, juxtaposed together.
Dada is intended to shock. It's an artistic jolt asking, or demanding, that the viewers reorient themselves in some way. It is designed to make us feel uncomfortable and does not make for easy appreciation. It's only when we're thrown so drastically outside of our comfort zone in this way that Dada asks us to question how things are. It shakes us out of a conformist stupor to look afresh at things.
The paradox of Dadaism
Of course, like all avant-garde art, Dada needs to address one major problem: how do you stay so provocative, so radical, and so anti-establishment when you also seek success? How can maverick rebels stay so as they get a mortgage and want a good school for their kids? The problem is that young, inventive, and idealistic artists are inevitably sucked into the world of profit and commodity.
As Grayson Perry, a British modern artist, wrote: "What starts as a creative revolt soon becomes co-opted as the latest way to make money," and what was once fresh and challenging "falls away to reveal a predatory capitalist robot." With Dada, how long can someone actually live in a world of nonsense and nihilistic absurdity?
But there will always be new blood to keep movements like Dada going. As the revolutionaries of yesterday become the rich mansion-owners of today, there will be hot, young things to come and take up the mantle. There will always be something to challenge and questions to be asked. So, art movements like Dada will always be in the vanguard.
Dada is the art of the nihilist. It smashes accepted wisdom, challenges norms and values, and offends, upsets, and provokes us to re-examine everything. It's an absurd art form that reflects the reality it perceives — that life is nothing more than a dissonant patchwork of egos floating in an abyss of nothing.
Two different studies provide further evidence of the efficacy of psychedelics in treating depression.
- A phase 2 clinical trial by Imperial College London found psilocybin to be as effective at treating depression as escitalopram, a commonly prescribed antidepressant.
- A different study by the University of Maryland showed that blocking the hallucinogenic effects of magic mushrooms in mice did not reduce the antidepressant effect.
- Combined, these studies could lead to new ways of applying psychedelics to patient populations that don't want to trip.
Due to stigma, their illegal status and difficulty in finding control groups, research with psychedelics has been a challenge. But research increasingly shows that this class of drug has legitimate medicinal uses, and they may be just as good or even better than more traditional therapies.
Now, the Centre for Psychedelic Research at Imperial College London reports in the New England Journal of Medicine that when pitted against escitalopram (brand name: Lexapro), psilocybin was as effective as the popular SSRI (selective serotonin reuptake inhibitor) in treating moderate to severe depression. Perhaps most significantly, these results were obtained when comparing 6 weeks of daily doses of escitalopram to just two administrations of psilocybin.
Robin Carhart-Harris, head of the center who has published over 100 papers on psychedelics, is confident this study represents another step forward in applying psychedelics to mental health treatment protocols while also reducing fears a lot of citizens have around these substances. In a press release, he said:
"One of the most important aspects of this work is that people can clearly see the promise of properly delivered psilocybin therapy by viewing it compared with a more familiar, established treatment in the same study. Psilocybin performed very favorably in this head-to-head."
Credit: Robin Carhart-Harris et al, NEJM, 2021.
As depicted above, the phase 2 clinical trial included 59 volunteers. The escitalopram (control) group received six weeks of daily escitalopram in addition to two tiny (1-mg) doses of psilocybin — a dose so low that it is unlikely to produce hallucinogenic effects. The psilocybin (experimental) group received two 25-mg doses of psilocybin three weeks apart with placebo given on all the other days.
At the end of the study, both groups saw a decrease in depressive symptoms, though the results were not statistically significant. (That isn't necessarily bad because if the two drugs have similar effects, then they would not produce statistically significant results. Still, a larger study is needed to confirm that psilocybin is "just as good as" escitalopram.)
Additionally, several other outcomes favored psilocybin over escitalopram. For instance, 57 percent in the psilocybin group saw a remission of symptoms compared to 28 percent in the escitalopram group. This result was significant.
Psychedelics without tripping
As psychedelics become decriminalized and potentially legalized for therapeutic use, however, a large population of people might desire the antidepressant effects without the hallucinations. For example, the psychedelic ibogaine may be useful for treating addiction, so the company Mindmed is developing an analog that works without producing the unwanted hallucinogenic side effects.
A new research article, published in the journal PNAS, investigated the antidepressant effects of psilocybin on a group of chronically stressed mice. (Under immense stress, mice develop something resembling human depression.) As with humans, depressed mice lose a sense of joy, which can be assessed by determining their preference for sugar water over tap water. Normal mice prefer sugar water, but depressed mice simply don't care.
Once the mice were no longer juicing up on the sweetened water, the team dosed them with psilocybin alongside a drug called ketanserin, a 5-HT2A serotonin receptor antagonist that eliminates psychedelic effects. Within 24 hours of receiving the dose, the mice were rushing back to the sugar water, indicating that tripping is not necessary for psilocybin to work as an antidepressant.
While the team is excited about these results, they realize it needs to be replicated in a different population.
"The possibility of combining psychedelic compounds and a 5-HT2AR antagonist offers a potential means to increase their acceptance and clinical utility and should be studied in human depression."
Photo: Cannabis_Pic / Adobe Stock
The future of psychedelic therapy
Psychedelics such as psilocybin and LSD have a long track record of efficacy in clinical trials and anecdotal experiences. Almost all volunteers of the famous Marsh Chapel experiment claimed their experience on Good Friday in 1962 was one of the most significant events of their lives — and this was a quarter-century after the fact. A more recent, controlled study found that a single dose of psilocybin showed antidepressant effects six months later.
Proponents of macrodosing and ritualistic experiences sometimes argue that the full-blown mystical trip is the therapy, though this is anecdotal, not clinical research. As the Maryland team noted, a number of people are contraindicated for psychedelics, whether through a family history of schizophrenia or current antidepressant treatments.
Senior author Scott Thompson is excited for future research on this topic. As he said of his team's findings:
"The psychedelic experience is incredibly powerful and can be life-changing, but that could be too much for some people or not appropriate… These findings show that activation of the receptor causing the psychedelic effect isn't absolutely required for the antidepressant benefits, at least in mice."
Hopefully, with more research occurring in psychedelics than even in the 1950s (when studies predominantly relied on anecdotal evidence and little government support), the longstanding stigmatization of psychedelics is beginning to recede. This could open up new possibilities for both clinical research and, for those curious about the ritual effects, a continuation of introspective experiences.
Stay in touch with Derek on Twitter and Facebook. His most recent book is "Hero's Dose: The Case For Psychedelics in Ritual and Therapy."
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