Dr. Betty Ellen Rich, PHD

Collectively, anxiety disorders are the most common mental health issues diagnosed in the United States -- even more common than depression. Women are more likely than men to be diagnosed with anxiety, and it is extremely common for a person with anxiety to have another illness at the same time, such as depression, a physical illness, or substance abuse.

Treatment for anxiety usually involves medication and psychotherapy together. Medications used may include antidepressants (which also work for anxiety), anti-anxiety medications, or beta blockers (which can be used to control the physical symptoms of anxiety). Psychotherapy can be useful to teach patients new ways of thinking and reacting so that they can manage their feelings of worry and fear. Support groups can also be very effective for anxiety, and they can be a form of treatment themselves for social phobias. Stress management, relaxation techniques, and meditation all help reduce feelings of anxiety or of being out of control. Finally, having a strong support network of family and friends is an excellent way to help manage the difficulties of life with anxiety.

We don't yet know what causes depression, but it's thought that it is a combination of genetic, biological, environmental, and social influences. Because of this, the most effective treatments for depression combine medication with psychotherapy. Therapy, especially cognitive-behavioral therapy, can be extremely helpful in resolving the negative thoughts and feelings that come with depression. It gives patients new tools that they can use themselves to cope when their depression is making them feel down.

Some of the common medications used to treat depression include antidepressants such as SSRI's (Prozac, Paxil, Zoloft) or atypical antidepressants (Cymbalta, Wellbutrin). It's important to remember that these medications have different effects on everybody, and no one medication works right for everyone. Patients may have to try a couple before finding the one that works just right for them. If the first medication they try doesn't work, they should talk to their doctor about trying something else. In extreme cases where medication is not enough, electro-convulsive therapy and hospitalization may be the answer to keeping a severely depressed person safe.

Depression is a difficult illness to deal with, but it is more common than believed and there are many people who can help. With the right treatment, individuals with depression can get back to fully enjoying life again.

Sexual intimacy disorders are those that cause problems with the act of sexual intercourse, such as erectile dysfunction or vulvodynia. Erectile dysfunction, the inability to get or maintain an erection hard enough for sexual intercourse, is extremely common. It affects fully half of men over 40 to some degree. It is treated with medications, devices, or surgery. Vulvodynia, burning pain in the vulva that can be made worse with sexal activity, has no known cause. It is treated with oral or topical medications.

Sexually transmitted diseases, including HIV/AIDS, herpes, gonorrhea, and chlamydia, are bacterial or viral infections that are contagious in the bodily fluids exchanged during sexual contact. Barrier methods of contraception, such as condoms, help prevent the spread of STDs. HIV is a virus that can be caught from an infected person's sexual fluids or blood. When the virus infects the body, it interferes with the immune system and causes the disease known as AIDS. There is no cure, but anti-viral medications can help people with AIDS live a long and healthy life. Herpes is also a virus found in sexual fluids, called HSV-2. It causes blisters that come and go on the genitals. There is no cure for herpes, but anti-virals can minimize outbreaks. Gonorrhea and chlamydia are both bacterial infections. They are extremely common and often have no symptoms. The most common signs of an infection are burning pain and discharge. Gonorrhea and chlamydia can be treated with medications.

Reproductive health refers to both contraception and infertility treatment. Contraceptives prevent and plan the timing of pregnancy. Some, such as a vasectomy or tubal ligation, are extremely effective at preventing pregnancy. Others, such as spermicides, are less reliable. Popular contraceptives include condoms, birth control pills, IUDs, and diaphragms. On the other side of reproductive health, infertility is the inability to carry a pregnancy to term after one year of trying. It can be due to problems in either the man or the woman, and both genders are affected equally. In total, about 15% of the population suffer from infertility. Infertility treatments include medications and surgery.

Gay and transgender people have a few specific health care needs that may sometimes fall under the sexual health umbrella. First, many LGBT people still face discrimination from healthcare providers, so providing supportive and appropriate care is an issue. Because of social attitudes surrounding sexual orientation and gender identity, many gay and transgender people struggle with their identities. Rates of depression, substance abuse, and suicide are all higher in this group. Providing mental health support and counseling to those in transition is critical. Finally, transgender patients who are undergoing gender affirmation require sensitive medical health care, including surgical and hormonal treatment.

Sexual violence can be defined as any unwanted or non-consensual sexual activity. It ranges from sexual harassment to touching to rape. It affects women more than men and is widespread: 1 in 4 women report being victims of sexual violence at the hands of a partner, and as many as 1 in 3 girls report their first sexual contact as being violent. Sexual violence has lasting physical and emotional consequences for victims, but educating both girls and boys can prevent violence. Care for those who have endured sexual violence includes counseling and mental health support, medical care, and legal support.

Sexuality is more than a reproductive requirement -- it is a form of expression and identity. Sexual health blends all these aspects of experience together and helps people lead sexually fulfilling lives.