Frequently asked questions

Many causes can lead to sexual dysfunction. These include:

• Physical causes such as cardiovascular diseases, hormonal changes, diabetes, surgical interventions in the genital organs (for example, cervical removal/prostate removal), cancer, rheumatism or Parkinson's disease. Physical pain during sex, caused by inflammation, for example, can also lead to dysfunctions.
• Taking medications can cause side effects that lead to sexual dysfunction. Antidepressants can reduce libido and hormone-based contraceptives reduce sexual desire.
• Excessive consumption of alcohol and the use of drugs such as marijuana can reduce sexual desire or excitability.
• Mental causes such as anxiety about pregnancy or stress, grief and conflict can impair sexual function.
• Problems in a partnership can also be the cause of sexual dysfunction. Constantly arguing or paralysing routine, tabooing of sexual desires or lack of tenderness have a negative effect on lust, excitability and ability to have an orgasm. 

There is still no real explanation as to how obsessive-compulsive disorder develops. As with many mental illnesses, a genetic predisposition is one of the triggering factors. However, heredity alone is usually not enough to trigger the onset of the disorder.

Another factor could be a disease of the brain, particularly due to changes in metabolism. However, it is not clear whether these actually cause the disease or merely accompany it. However, it has been shown that they disappear after successful treatment. It is also assumed that psychological factors play a role in OCD. These include upbringing, traumatic childhood experiences, negative later life events and a personality predisposition.

From a medical standpoint, this is strongly contraindicated. Withdrawal means liberation of the body from the addictive drug. Depending on the addictive substance, withdrawal can have serious physical consequences. Withdrawal should therefore always take place under inpatient psychiatric supervision. It is easier to confront the disease outside the familiar environment which may be tightly connected to the addiction. Without supervision, the risk of failure is very high.

For people suffering from sexual dysfunction, it is particularly important to talk openly about the problem. Sexuality is still a taboo subject that is not discussed for many people. Openness can help if the dysfunction leads to problems in the partnership or if problems in the partnership are responsible for the dysfunction.

Successful treatment starts with the insight that you have an addiction disease. Even if this confession is painful and possibly shameful, it puts you in a position to act and face your disease.

Withdrawal, which broadly means the elimination of the toxic substance from the body, is followed by recovery. During mental recovery, the issue is to rebuild your life without the addictive drug. Several protective factors can support you: a positive way to deal with stress and problems, a supportive social milieu, the opportunity to shape your own life, a positive self-image, and high resilience.

Participation in self-help groups can also be beneficial. You can meet people with similar experience and feel that they understand you. You can find more on the topic self-help here.

It is important for those affected to become aware of the disease, to accept it and to face it. The tendency to avoid fear-causing things or situations can add to anxiety or phobias. Facing these fears can be understood as training that helps to reduce the anxiety itself. For many of those affected, however, this is a particularly daunting challenge.

Anyone seeking medical attention for fears or phobias is not revealing personal weakness, but rather a desirable way of dealing with the disease. This also includes involving one's own environment, such as family or friends. Valuable support can come from those close to them.. In addition, the visit of self-help groups for exchanges with other sufferers shows good results for some sufferers.

Relaxation techniques such as yoga, autogenous training or progressive muscle relaxation can also be helpful for therapy. Exercise is generally recommended, especially endurance sports such as running or cycling.

Treatment success depends on your participation. It is of critical importance to admit that you are ill. This insight is difficult, especially since an eating disorder produces shame, guilt feelings, secrecy, or self-control. Use the professional help that you receive as part of your treatment to deal in a candid way with your problems, including those that are not obviously connected with the disease.

As part of the treatment, you will learn a new approach to eating. You should support this process. The path to normal eating behaviour includes eating regularly and in an alert state of mind, recognising satiety, and relishing your food. Interaction with other affected individuals is also helpful.

The treatment of a sleep disorder depends on its cause. If it is a symptom of another disease, this disease must be treated first. If sleep itself is the problem, behavioural therapy or sleep therapy are usually used. In addition, sleep hygiene must be improved. This means behaviour that promotes good sleep. You can contribute significantly to this:

• Eliminating the midday nap
• Using a cool, dark, well-ventilated sleeping room only for sleep
• Getting up at the same time every day
• Set up a sleep ritual (e.g., a yoga session, a cup of tea, reading several pages)
• Avoid heavy meals in the evening, avoiding alcohol, avoiding nicotine
• Go to bed only when very tired
• Eliminate caffeine after lunch
• Eliminate electronic devices or TV from the bedroom
• Practice regular physical activity
• Use relaxation techniques (e.g., self-training, meditation)

Internal restlessness often prevents affected individuals from sleeping. Ongoing conflicts, persistent stress, worry, and physical or mental overload can also impair sleep. It is important to look for the concrete causes of these types of stress and to find better coping mechanisms. Psychotherapy can help.

Intellectual disabilities accompany those affected throughout their lives. Depending on their severity and characteristics, there are therapeutic measures that can improve their quality of life:

• Occupational therapy with regard to individual performance levels
• Sports and exercise therapy
• Physiotherapy exercises
• Social-therapeutic care, including the social environment
• Cognitive training depending on the extent of the loss of intelligence
• Supporting psychological conversations, provided that cognitive performance and communication skills are sufficient for this
• Stress tests in the current or new environment, including work tests in a workshop for disabled people
• Psychopharmacotherapy for pronounced behavioural abnormalities or accompanying mental disorders such as depressive syndromes

There are several approaches to prevent a relapse. One aspect of addiction treatment is to explore life circumstances that favoured dependence. Strategies to deal with these very individual factors are then worked out.

In addition, there are some general principles to avoid relapses:

• Regular participation in a self-help group enables the exchange of information with other affected individuals, developing motivation, and mutual support.
• The brain has become accustomed to the feeling of reward through the addictive drug. When the drug is no longer used, an empty space is created. New habits, hobbies or interests can fill this empty space.
• Stress and overload in the family or at work increase the risk of relapse. Professionals can teach you strategies to deal with mental overload.
• In certain cases, the social milieu favoured the dependence. It is important to critically evaluate who and what places are not conducive to an addiction-free life.
• The need for the addictive drug will be overwhelming at times. An emergency plan to guide the behaviour in moments of high risk of relapse is helpful and should be drawn up in advance.

Rapid heart rate, dizziness, shortness of breath – the symptoms of acute anxiety or panic attacks - are varied and usually last a few minutes to half an hour. Patients can either go to an emergency room with a psychiatric ambulance or try to help themselves with simple measures. These include breathing exercises, such as the 4-6-8 technique, in which they inhale for four seconds, hold the air for six seconds, and then exhale for eight seconds. Another self-help measure is not to suppress or control the feeling, but to accept the panic attack. It can also be helpful to look for a distraction, for example, to talk to people or to concentrate on a specific activity.

Those affected by obsessive-compulsive disorder initially present relatives and friends with a great puzzle. The symptoms of the disorder seem strange and senseless - when a sufferer washes their hands in one go, collects masses of empty bottles in the home or makes sure a dozen times that the stove is really switched off.
 

Instead of getting angry about this behaviour, relatives and friends should recognize it as an illness and react appropriately. First of all, this means that they should not support those affected in giving in to their compulsions. This would allow them to become entrenched and subsequently dominate the lives of their relatives. Family and friends should convince those affected to seek professional help as soon as possible. This is because OCD will not disappear if left untreated, whereas the chances of success with treatment are very high.

The main thing is to find the cause of the ongoing problem to fall asleep. The sleep disorder can be conquered over the long term with targeted measures, therapy, or lifestyle changes. Difficulty in sleeping is often exacerbated by worry about not being able to sleep and not being in best shape the next day. Affected individuals should also try to relax as best they can, even though inability to relax may be the main problem.

The following recommendations could help:

• Getting out of bed and seeking distraction with a relaxing activity
• Doing breathing exercises
• Writing down thoughts, worries and feelings to get them out of mind
• Listening to a relaxing podcast, a piece of meditation, or some relaxing noise such as the sound of the sea
• Reading something that does not provoke excitement or tension

Sleeping pills, even plant-based, should never be taken without medical supervision or for a long time. The danger of becoming dependent is very high. Doctors prescribe sleeping pills in most cases only as a short-term temporary solution. In healthy people, the natural sleep-wakefulness cycle regulates itself without outside help. That is why the most important goal in the management of sleep disturbances is to find the cause and correct it.

Alcohol withdrawal can have both physical and mental symptoms. The most common physical symptoms include shaking, sweating, restlessness, nausea, headache, sleep disturbance, high blood pressure, and seizures.

A particularly severe form is delirium tremens. This condition manifests itself through short-term memory impairment, respiratory problems, and heart and circulatory symptoms. Altered consciousness is a life-threatening complication which can progress to coma. This can develop when alcohol is discontinued abruptly after prolonged regular use.

Mental withdrawal symptoms can include depressive mood, anxiety state, concentration problems, mood swings, and aggressiveness.

Alcohol withdrawal should always take place under medical supervision.

The boundary between temporary changes or limitations on sexuality and sexual dysfunction cannot always be clearly defined. Since sexuality is complex and the body and psyche are equally involved, many influences can have a short-term negative effect on sexual life. Occasional periods of unhappiness or orgasm difficulties are normal and occur in many people.

A central feature of a sexual dysfunction is that the symptoms persist for at least half a year. They also can cause distress: Sexuality, as you know it and like it, can no longer be interpreted satisfactorily. This leads to problems in partnership, to psychological effects and to a generally stressful life.

So-called selective serotonin reuptake inhibitors (SSRIs), which are also used for depression, are recommended for the medicinal treatment of obsessive-compulsive disorder. If the desired effect is not achieved, it can be enhanced by adding a low dose of an atypical antipsychotic.