Dear Counsellor:

I am 40 years old and married with children. I have a career and feel that I have achieved some success in life. There is, however, a problem which is giving me some sleepless nights. I have lost interest in sex and my husband is not pleased. I don't know what to do.

- Ann

Dear Ann:

Sexual problems are common in males and females. There can be physical causes as well as emotional and psychological reasons for lack of interest. The problem can be either acute or chronic. You need to see your doctor, as well as a therapist.

The psychological aspect of sex is very important. Our intimate relationships are affected by anger, frustration, conflicts and disputes. If you and your partner have unresolved issues, this can affect your love life. Individuals have sex because they are stressed, frustrated, depressed or, on the other hand, happy or feel affectionate towards their partner.

Women need men to be attentive and caring. If a woman's needs are not being met, then she might become angry, insecure and unpleasant. In a relationship, partners have to give and take with each other. It is good to examine your thoughts to identify areas of problems so that you can deal with them. If you are depressed, you should discuss the problem with your doctor and therapist. Women who have been raped or sexually abused have difficulty with sexual issues.

There are sex therapists with whom you can assess your sexual behaviours and this will enable you to function well sexually.

Dear Counsellor:

I was diagnosed with schizophrenia as an adolescent. It caused an interruption in my education. I was, however, able to complete college and was working in a profession of my choice. I take an injection monthly and tablets daily.

Sometimes I get depressed and lonely and wish that my life were different. My family members are the only ones who know that I am sick. I would like to get married and have a family.

- Maria

Dear Maria:

Schizophrenia tends to start in the adolescent period and young adulthood. Some of the symptoms are social withdrawal, lack of energy, hallucinations and delusions. Hallucination is when an individual sees things that nobody else sees and hears things that only he can hear. Delusions are fixed, false beliefs that are not amenable to reasoning. It is treated with medication and counselling. Many people have a good outcome if they are compliant with treatment. Compliance, however, is affected by tolerability of the medication as well as the side effects. Some side effects can be treated and nowadays there are a variety of medications from which we can choose.

It is good that you were able to finish college and that you are working. Strong family support is a positive for a good outcome. Counselling is good as it helps the individual to cope with the illness, stigma and side effects. Individuals are taught techniques to deal with hallucinations and delusions. Individuals can learn to deal with negative thinking and physical symptoms.

Adequate medical care

We need to encourage patients with schizophrenia to get an annual medical to identify and treat physical illness. Many patients have been discovered to have diabetes mellitus and die early because of lack of adequate medical care.

Lack of insight is a big problem that affects treatment. Individuals don't accept that something is wrong and that they should seek medical treatment. Many individuals fall through the cracks in the system because of a variety of reasons. People are unwilling to come forward for treatment because of the stigma and discrimination in having a mental illness or seeing a psychiatrist.

The mental health system has been looking at ways to reduce stigma and discrimination. In Jamaica, people are encouraged to take their medication and there are mental health nurses who do home visits to give injections and medications and provide support to patients and family members.

Sometimes you may feel lonely, but there is a support group for people with mental health problems which you can join. You need to socialise with others so you can meet an eligible male with whom you can have a relationship. Count your blessings and persevere with your dreams.