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Sex and Schizophrenia - Page 2


© Ian Chovil
Page 2

Historically people with schizophrenia were often segregated from the general population in day hospitals and group homes. Men and women with schizophrenia were much more likely to marry each other partly because they simply didn't have much contact with ordinary people of the opposite sex. There has never been a recognition of sexuality in people with schizophrenia. Sexuality was something to be prevented, end of story.

Part of this pervasive attitude results from the taboos of our society. We are very hung up when it comes to sexuality. We prosecute all manner of sexual offence, and our ideal role model simply doesn't have a sex life. Scandinavia took a much more balanced approach to the sexuality of disabled people. In fact someone receiving disability benefits in Scandinavia is allowed regular prepaid visits to one of the state approved brothels, in the same way someone in North America would receive a drug card to cover the cost of their prescriptions.

When you think of it we expect a lot from people with schizophrenia. They're expected to live solitary lives of poverty, ostensibly because they're disabled. Anybody would have a difficult time living a solitary life of poverty. In the Judeo-Christian bible the first thing God did after he created Adam, was to create a female partner for him. It is the natural course of human life to live with someone of the opposite sex. It is instinct, it is hormones, it is very human. There is virtually no recognition of sexuality in people with schizophrenia, except when male clients become sexually attracted to mental health workers, which they do on a regular basis across the continent. You can't blame them too much. They could justifiably say, like movie stars in old movies, "I'm not made of stone you know!".

One of the characteristic symptoms of depression is a loss of libido. People have no interest in sex when they are depressed, and it is something that often causes a lot of friction in couples where one experiences depressive episodes. About 40% of people with schizophrenia experience a major depressive episode, but it is often indistinguishable from the negative symptoms of schizophrenia. Forty percent attempt suicide at some point, often in a depressive episode. At the very least an interest in the opposite sex is a positive sign that the patient is not suffering from depression and is unlikely to attempt suicide. I can't help but wonder how many psychiatrists, case managers, and family members, would become concerned when the patient lost interest in the opposite sex. Would it even register as a possible symptom of depression? How many people died as a result?

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