Health

PTSD Can Supercharge Sex Drive and Researchers Aren't Sure Why

Many PTSD sufferers report a drop in libido, but for another subgroup, sex becomes an all-consuming obsession.
02 August 2019, 4:31am
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Carrie* isn’t certain why in the last eight years she saw her sex drive plummet, only to manically explode. But she has her suspicions.

“I think it was the PTSD,” she says. “Getting older too, that happens. Or maybe it’s a combination of everything.”

Carrie first enlisted in the military at age 17, serving in the Navy for years, and then spent the next two decades raising a family with her then-partner Kate* in a small city in southern Texas. After 9/11, though, Carrie felt an immense sense of “I have to do something” and decided to re-enlist—this time in the Air Force—in 2005. For almost seven years Carrie faced direct combat through eight military deployments, until she finally hit a wall.

“The getting shot at, and shooting back, and seeing the bodies, it wasn’t one particular thing,” she explains. “But it was my last deployment to Iraq that, halfway through, I couldn’t function anymore. I just sat in the Humvee and I was still supposedly in charge at the time. But [my unit] kind of carried me. Not physically, but they knew their job.”

Three months later, in December 2011, despite desperately wanting to carry on, Carrie was diagnosed with Post-Traumatic Stress Disorder (PTSD) and was medically retired. Upon her return to Texas she struggled with insomnia, irritability, forgetfulness, and sudden outbursts of rage and anger. She’d lash out at anyone around her. But while Carrie had been educated on PTSD symptomatology via a military brief, she didn’t anticipate any change to her sex life.

Prior to deployment Carrie describes her sex life as relatively normal. Being in her late 30s as well as in a longterm relationship, she says she was having sex twice a month, on average. But once home, Carrie lost her drive completely. Then, 13 months later, her libido came back on just as suddenly as it had left, giving her an insatiable appetite. For close to a year, Carrie was having sex two to three times a day, five times a week, secretly having sex with men and women she didn’t know. Even after the motions of guilt, shame, and therapy, and her eventual confession to Kate, Carrie’s craving remained, which she later attempted to control through masturbation.

Medical researchers have long known that PTSD can diminish sexual desire, although they still don't know why. What’s perplexing, though, is how it can sometimes do the opposite. For reasons researchers still don’t understand, a small subset of sufferers become avidly aroused, with seemingly little correlation between age, gender, background, or even the type of trauma they experienced.

“We don’t understand [the connection] and that’s why we’re studying it," says Dr Rachel Yehuda, the author of a 2015 study that explored PTSD-induced sexual dysfunction, and a leader in the field of traumatic stress studies. “I think the idea is to first acknowledge it, and not assume it is a side effect of the treatment. That’s the most important thing. And to acknowledge that it has something to do with being traumatised, and not just sexually traumatised.”

One theory espoused by Dr Yehuda, and currently being researched by her colleague Dr Amy Lehrner, suggests that the same neurochemicals are released during arousal as those during trauma. This theory is compellingly simple, but it only explains why there would be an aversion to sex, not an attraction. While the majority of research only explores decreased libidos within veterans, there are studies—one in 2014 and another from 2017—that report symptoms of compulsive sexual behaviour in veterans with combat-related PTSD.

“Yes, I’ve heard that anecdotally. I think the idea is that one reaction to almost dying is to try to live, and sexuality can be life-affirming,” Dr Yehuda explains. “I think that is something that I’ve heard anecdotally, but I’m not aware of any research on this per se.”

Meanwhile, those living with PTSD have drawn conclusions of their own. Faye*, a 52-year-old former emergency service worker, attributes her heightened interest in sex to its accompanying rush of dopamine. “One of the big things with PTSD is isolation, and I’m really good at isolation. Like, it’s a problem, so sex is a way to connect with someone else,” she says.

Nine years ago, Faye experienced trauma on the job and began experiencing irritability, mood swings, and flashbacks, which were eventually diagnosed as PTSD. Two years later she experienced a rush of sexual cravings, and was soon participating regularly in BDSM sessions and threesomes, a penchant that gradually metastasised into something dangerous. Faye recalls how the tipping point for her was almost meeting strangers she’d found online at a public park to act out a rape fantasy.

“I actually wonder if I was upping the ante because I needed more dopamine, or if I was subconsciously putting myself into situations where I could die,” she muses.

Faye also believes her charged libido could be related to her PTSD in other ways, like a manifestation of her need for control, or possibly a form of self-punishment. Maybe it was about just wanting to feel something in the midst of PTSD-fuelled dissociation, she suggests. But she can’t be sure.

Faye currently moderates a forum of 52,000 other PTSD sufferers from all around the world. While pondering her changed sex drive, Faye looked to her online community, where dozens of people, from all completely different demographics admitted they too had seen a change in their libidos. This is just one of the many reasons she believes sex drive variability should be listed as a symptom of PTSD.

Speaking to people living with PTSD, there seems to be widespread frustration about the lack of information. One potential explanation for this could be a general lack of discussion among sufferers.

When it comes to veterans, Mark Sawyer, founder and moderator of Facebook group Veteran's Peer Support for PTSD, tells VICE that many don’t report their sexual problems to Veteran Affairs because there’s a lack of trust with their younger and seemingly inexperienced therapists. “Because of this I speak with far too many who refuse to use the VA for any help, let alone sexual help,” he says.

And although this example is veteran-specific, perhaps part of the underlying issue is something of a catch 22—a lack of reporting from a lack of awareness; a lack of awareness from a lack of a platform; and a lack of a platform from a lack of reporting. It’s difficult to know for certain. What we do know is that many people with PTSD are suffering flow-on effects in their sex lives, without remedy.

Meanwhile, for Carrie—whose heightened sex drive continued for almost a year, only to suddenly plummet to such a low point she no longer expects it to return—this is just the new normal; a reality she reluctantly accepts.

“I would love to have sex every day, but my body and mind aren’t there,” she says. “I’d like it to change, but I don’t see it changing.”

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*name changed at subject’s request.