Archive for Anxiety

Am I Having a Nervous Breakdown

Are You Experiencing a Nervous Breakdown?

Although it appears to be increasingly falling out of the common lexicon, the term “nervous breakdown” was once used to describe any number of mental health problems that appeared to strike suddenly. Unfortunately, the term is often used loosely or casually, and sometimes, as in films and TV, for comic effect. But is there really such as thing as a nervous breakdown? Well yes, and no.

Yes – a person can indeed ‘break down’ suddenly. The human body is a fragile mechanism that, when put under too much stress, will stop functioning normally. A person exposed to long-term, unrelenting severe stress is particularly vulnerable to experiencing a ‘breakdown.’ How does a breakdown manifest itself? The primary characteristic of a breakdown usually involves some sudden disintegration of the self. This means that an individual who usually follows a set pattern of behaviors will suddenly break away from their routine. Imagine this scenario: a person wakes every morning, goes to work, seems to function normally, visits with friends as usual, and then returns home. Imagine this person suddenly waking one morning and unable to get up. They have lost their drive, their ability to function normally, to communicate with family or friends. Perhaps they are even incapable of dressing or eating. This person is experiencing a nervous breakdown.

What other types of symptoms might be described as those associated with having a nervous breakdown? Some individuals might experience the uncontrollable need to cry, loss of energy, withdrawal, confusion, despair, inability to think clearly, sleep disruption or insomnia, loss of pleasure in everyday activities, feelings of worthlessness and depression. These “down and out” feelings are characteristic of depressive disorders.

Some individuals have breakdowns that manifest symptoms of psychosis. Breakdowns involving psychosis may involve hearing voices, seeing visions, feelings of paranoia, feelings of being pursued, feeling sensations that are not really present, grandiose or delusional behavior, bizarre public behavior, feeling of jealousy, and feelings of violence.

Whatever the nature of the breakdown, all breakdowns have in common the inability to function as normal.

What is a nervous breakdown really? A person who experiences symptoms of a nervous breakdown is suffering from some sort of mental disorder. That is, despite what we used to think, a nervous breakdown in and of itself is not an illness or disease. They are merely symptomatic of a larger problem. In fact, no legitimate physician or mental health professional would ever diagnose someone as having a nervous breakdown. The characteristics of a nervous breakdown can be symptomatic of a large variety of mental illnesses. The most common illness that resembles these characteristics is a Major Depressive episode. Other disorders that are related to what we think of as a nervous breakdown include panic attacks, generalized anxiety disorder, post-traumatic stress disorder and other trauma disorders, acute stress disorder, schizophrenia, psychotic disorders, bipolar disorder, depression, and mood disorders. All of these mental disorders are characteristic of what many laypeople would characterize as a nervous breakdown.

Who is most likely to suffer from a nervous breakdown? Almost anyone who is subjected to undue stress is capable of experiencing a nervous breakdown. For instance, any person who has been subjected to extreme stress and trauma is vulnerable to experiencing a disorder that mimics the general perception of a nervous breakdown. For instance, a young person returning from battle may experience symptoms of post-traumatic stress disorder. A woman experiencing severe depression after the birth of her child may experience post-partum depression.

How can a person suffering any of the characteristics of a nervous breakdown get help? Sometimes the hardest part of recovery is getting the person to visit a doctor. For some kinds of mental disorders, a nervous breakdown can be a blessing in disguise. An individual suffering from severe anxiety or depression may find her self speaking to a psychotherapist for the first time. A person who suffered alone for long time may suddenly find himself getting better with medical attention. In many fortunate cases, the person who experienced the nervous breakdown may emerge from therapy stronger and healthier than ever before. Treatments can include antidepressant and psychotropic medications, psychotherapy, and prescribed periods of rest.

Prevention of nervous breakdowns is an oft-ignored subject that researchers are beginning to study. The characterization of a nervous breakdown as something that happens very suddenly can be misleading. In many cases, symptoms of the coming breakdown are present, but either the individual or their family and friends ignore them. Individuals who sense themselves becoming increasingly stressed, depressed, angry, or violent are encouraged to seek help immediately.

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Coping with Anxiety

Ranges from mild, persistent worry to disabling fear and full-blown panic attacks.

Causes: Anxiety may be the result of a traumatic experience, a genetic predisposition, or an imbalance of brain chemicals. It can also occur for no apparent reason.

Effect: Generalized Anxiety Disorder causes you to feel restless, impatient and constantly ‘on edge’. You may suffer from panic attacks, dizziness, fatigue, palpitations, aching muscles, excessive sweating, digestive problems and insomnia.

Phobias are also a type of anxiety disorder. Someone with a specific phobia knows the exact trigger for their anxiety, for example spiders (arachnophobia), leaving the house (agoraphobia) or entering small spaces such as lifts (claustrophobia).

Post Traumatic Stress Disorder arises after a very traumatic or life-threatening event, and usually includes flash-backs.

Social Anxiety Disorder is diagnosed when a person experiences disabling anxiety in social situations.

Solutions:

Relaxation techniques are helpful in combating anxiety disorders. These include breathing exercises and meditation.

Cognitive Behavioural Therapy.

Flooding and Exposure Therapy are techniques in which you are forced to confront the things you fear, either suddenly (for specific phobias) or gradually, until you no longer respond to the trigger with anxiety.

Medication may be prescribed when anxiety is severe.

Cutting out caffeine and nicotine may help.

Yoga and pilates.

Exercise such as brisk walking helps to reduce anxiety.

Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults. These disorders fill people’s lives with overwhelming anxiety and fear. Unlike the relatively mild, brief anxiety caused by a stressful event such as a business presentation or a first date, anxiety disorders are chronic, relentless, and can grow progressively worse if not treated.

Effective treatments for anxiety disorders are available, and research is yielding new, improved therapies that can help most people with anxiety disorders lead productive, fulfilling lives. If you think you have an anxiety disorder, you should seek information and treatment.

This feature will help you identify the symptoms of anxiety disorders, explain the role of research in understanding the causes of these conditions, describe effective treatments, help you learn how to obtain treatment and work with a doctor or therapist, and suggest ways to make treatment more effective.

The anxiety disorders discussed in this feature arepanic disorder,

  • obsessive-compulsive disorder,
  • post-traumatic stress disorder,
  • social phobia (or social anxiety disorder),
  • specific phobias, and
  • generalized anxiety disorder.
  • Each anxiety disorder has its own distinct features, but they are all bound together by the common theme of excessive, irrational fear and dread.

Discuss coping with anxiety

Coping with OCD

If you have obsessive-compulsive disorder (OCD), you feel you have no control over certain thoughts, idea or urges, which seem to force themselves into your mind, like a stuck record. These thoughts – obsessions – are often frightening or distressing, or seem so unacceptable that you can’t share them with others. Contained within the obsession is an underlying belief that you, or other people, may come to harm. However absurd or unrealistic this belief, you can’t dismiss it or reason it away. It creates unbearable anxiety, and makes you feel helpless to do anything except perform the particular ritual which can neutralise the devastating thought.

The irresistible urge to carry out such rituals is known as a ‘compulsion’. This could be something like repeatedly opening and closing a door, washing hands, repeating a litany, or counting. In other words, exaggerated elements of everyday actions and routines. You may feel compelled to do these actions over and over again, because of an unquenchable fear that you didn’t do it properly last time, or because the unwanted thoughts intrude again. The relief from the anxiety is only temporary.

OCD is similar to a phobia, which is another anxiety disorder. In both cases, fear brings on symptoms of anxiety and panic, including a racing heart, churning stomach, dizziness, shortness of breath, sweating and trembling. A phobia also involves an exaggerated fear of something that doesn’t represent a realistic danger, but other people can usually relate to it, or even share it. But with OCD the fear is of your own thoughts, and other people may not be able to relate to this or understand them at all. What’s more, someone who has a phobia can avoid the thing that triggers their phobia, such as cats or spiders, but with OCD, these devastating thoughts are unavoidable, and are constantly ready to emerge.

OCD isn’t a psychotic disorder, such as schizophrenia, whereby people feel that certain thoughts and ideas come from somewhere outside themselves (hallucinations). If you have OCD, you know that it s your own thoughts tormenting you. Some people only experience obsessive thoughts, without having any compulsions. Others have compulsions without knowing why they feel the need to do them.

The anxiety caused by experiencing obsessions and compulsions feeds back into the problem, creating a vicious circle and making the OCD worse. Often, people with OCD are also depressed, and this may also be partly or wholly due to the experiene of OCD.

Causes: OCD sometimes occurs for no reason, but it may be triggered by stressful life events. It can be caused by a lack of serotonin in the brain. It also tends to run in families, suggesting that some people have a genetic predisposition to OCD.

Effect: People with OCD are tormented by unwanted thoughts and feel compelled to carry out rituals to free themselves of these thoughts. For example, you may be very worried that there are germs on your hands, and to make yourself feel better you wash them. Washing relieves your anxiety for a while, so it becomes a ritual. This creates a vicious cycle and you might wash your hands twenty or more times an hour, even when your skin is raw from scrubbing. Other OCD behaviours include counting objects, checking switches are turned off and doors are locked, or rearranging furniture so it is symmetrical. If a person cannot carry out their rituals, they feel panicky and fear that a disaster will happen.

Explore these Possible Solutions

The first step is breaking the cycle. Remind yourself that your desire to carry out a ritual is a symptom of OCD, and will not protect you from harm. When you have resisted a compulsion a few times, it will get easier

Cognitive Behavioural Therapy may help

Anti-Depressants

Coping with OCD Help and Advice

Coping with Panic Attacks

Cause: A Panic attack may be the result of Post Traumatic Stress Disorder. They can also be caused by a specific phobic trigger, for example, if you have a phobia of spiders then seeing one may cause a panic attack. They can also occur for no obvious reason. Because a panic attack is a scary experience in itself, you fear having another, making the anxiety cycle worse.

Effect: During a panic attack, a person has an overwhelming sense of fear and may feel that they have lost touch with reality. Nausea, sweating, shaking, palpitations, a choking sensation and faintness are common symptoms, which usually peak within ten minutes.

Solutions: During a panic attack, it may be helpful to breathe in and out of your cupped hands, as this makes you re-breathe the excess oxygen you are taking in and reduces the frightening sensations of hyperventilation. Try to distract yourself by focusing on something you can see, or visualise yourself in a calm, safe place. Relaxation techniques such as yoga and meditation may help to prevent further attacks. Cognitive Behavioural Therapy is another option, and SSRI antidepressants may help cases of severe Panic Disorder.

The help for a panic attack can come in a wide variety of forms. The most important first step for the individual sufferer is to form the determination to overcome the panic disorder. Once that has been accomplished, that individual will be able to live a life that is closer to normal.

A panic attack or a panic disorder frequently will result from a mental issue the person possesses. There are many varieties of panic attacks. They all seem to have one thing or another to do with the mind and the way an individual perceives things.

Doctors And Psychiatrists

We have determined that panic attacks result from our mental processes. Therefore, we need to consult with those doctors who have studied and learned about such things. Psychologists and psychiatrists are the primary specialists for people who suffer from panic disorders.

Seeking help for panic attacks disorders is something that individuals should do early on. The goal is to prevent the development of deeper issues and conditions. Those issues and conditions often are connected to panic disorders.

Our medical doctors usually will recommend the traditional methods of help for panic attack disorders. These traditional methods usually involve some therapy combined with medication.

The intention is to get the individual on the road to recovery, wellness and stability. You can expect the doctor to make a preliminary assessment before prescribing any methods of help for panic attacks.

Alternative Help For Panic Attacks

Alternative medicine has several different remedies for how to cure panic attacks. Alternative medicine usually places the focus more on the natural ways to treat these disorders.

Customarily herbs and some alternative methods are prescribed for people seeking help for panic attack disorders. There are numerous herbs that can naturally combat the anxious and fearful feelings people get during panic attacks.

In addition to the herbs, there are the alternative methods such as massage, aromatherapy, hypnosis, acupuncture and countless others. These alternative methods to provide help forpanic attacks disorders can be helpful to a certain extent.

There are several forms of panic attacks that cannot be treated readily with the alternative methods. That is because it takes time for some of the alternative methods to be effective. A few of these methods, such as hypnosis, can have lasting effects on people.

Get help coping with panic attacks

Dealing with Anxiety

Everybody suffers from anxiety now and again. It is both normal and necessary. It is necessary because it primes us to deal with demanding situations. But for some people, their anxiety becomes all-consuming. It interferes with, and impacts negatively upon, daily life. Sufferers may experience difficulty sleeping, display symptoms of panic attacks and find it difficult to focus. Fortunately it is possible to adopt strategies which stop anxiety before it becomes disabling. Sometimes, in order to regain control over their lives, people must force themselves to think realistically. It is a case of ‘get real’. It can be helpful to look at problems by identifying those things you have control over.

Take any practical measures you can to ameliorate difficult circumstances, but then move on. It is important to accept also, those things that you have no control over. No matter how much you worry, it will not change the situation. It is helpful to view negative situations in a positive light. It is often possible to retrieve good things from even the worst events. People often learn valuable lessons when things go wrong. They often gain useful insights into themselves, those around them and about life in general. Look at bad situations as an opportunity to learn. It is important not to view problems as part of a series of events.

Some people join the dots between problems by superstitiously viewing them as a pattern relating to their personal fortune or destiny. Or they may decide they are having a ‘bad hair day’ and therefore everything is bound to go wrong. It is vital to isolate unpleasant incidents and draw a line beneath them. Forget about it and turn your attention to the next thing that needs to be done. Learning relaxation techniques can be very useful for anxious people. Shortness of breath, chest and stomach pains can all be physical symptoms of anxiety.

Learning proper breathing techniques or enrolling in a yoga class can all help to beat stress and anxiety. Massages and other spa treatments can help those of an anxious disposition to relax and let go of their tension. Poor self esteem is often associated with feelings of anxiety. The anxious person often finds it difficult to say no, because they are worried about what people think of them. They end up taking on too much, and inevitably feel stressed. It is important to learn to put aside time for yourself, to do the things you enjoy and to take care of yourself. If you feel anxious then exercise and good diet can help to alleviate the condition. Some people develop what is known as generalized anxiety disorder or GAD.

This is a real illness and sufferers should seek professional medical guidance. Doctors may prescribe medication, however, this is often just a short-term measure. In the long run cognitive therapy and counseling may be needed. Feelings of anxiety are unlikely to disappear overnight. Nevertheless, a little dogged persistence and a refusal to allow negative thoughts to occupy your mind will gradually erase anxiety. With the right frame of mind, life can change for the better.

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Dealing with Panic Attacks

Panic attacks occur due to overwhelming anxiety and fear. Experiencing it, is the most uncomfortable situation in a person’s life. It gives a sense of dying. Difficulty comes in trying to break out of the attacks and removing yourself from the situation which can even make the attacks even more worse. Understanding what it is will bring great relief and will make one realize that it is quite common. Once a person gets to know what it is, he will definitely develop a curiosity to know how to manage a panic attack. There are many tips to manage a panic attack as given below. It can be as short as few seconds or it may last up to an hour. Regardless of how you get them, they are manageable and can be treated.

Managing panic attacks does not always go with taking medicines and consulting a doctor. There are other proper prevention methods which are available to manage such panic or anxiety attacks. The following points are some which could help you to manage these attacks.

  • Once you feel it coming breathe slowly in and out of a paper bag. A paper bag will help your oxygen levels to return to normal.
  • Avoid junk foods and drinks outside. Have regular meals to keep your blood sugar level stable.
  • Dont bottle up your emotions. Always find someone may be a family member or a friend and share your thoughts so that you feel relaxed.
  • Listen to some good music and do a pleasurable task allowing the panic to subside.
  • Once u sense an attack, close your eyes, breathe slowly and deeply and always keep in mind that you are safe.
  • Firmly tell yourself that the symptoms you feel are temporary and they are not harmful.
  • Avoiding exposure to unnecessary stress helps to managing these attacks.
  • Try to exercise on a daily basis to have a healthy physic which keeps you away from panic attacks.

Managing panic attacks is simple if we get to know the cause for it. It is always better to avoid the circumstances that cause the attack. Severe attacks can be managed by learning how to breathe properly. You can use a breathing technique that you are comfortable with, once you feel an attack.

Get Help Dealing with Panic Attacks

Embarrassment Help, Coping with Feeling Embarrassed

Causes of Embarrassment 

Loss of poise or self-control, feeling incompetent, receiving public praise or criticism, or having people intrude on your private life can all make you feel embarrassed. It may be something as simple as dropping your shopping on the bus. Other situations include making a mistake during a work presentation, having rumours spread about your love life, or saying something taboo at a social event.

Effects of Embarrassment

Blushing, sweating, feeling exposed, self-conscious and intensely uncomfortable. You may be unable to make eye contact with people and go out of your way to avoid them.

Solutions to Embarrassment 

Remember that everybody is human. Try to see the funny side of the embarrassing situation. Chat to friends about it, then put it out of your mind. Read the ‘embarrassing moments’ page in a magazine. Apologize if appropriate, and fix any damage you have caused.

Embarrassment Help in our messageboard

Help with Anxiety Attacks

There’s a great deal of interest in how to stop panic attacks and anxiety without medication nowadays. In the main, sufferers just don’t want to be dependent on mind-numbing drugs such as antidepressants and tranquilizers for long periods of their lives. They would much prefer to handle things totally naturally.

Here you’ll learn of one such natural approach to eliminating your anxiety and panic attacks…

FOREWORD ON STOPPING PANIC ATTACKS AND ANXIETY WITHOUT MEDICATION

When considering how to stop panic attacks and anxiety without medication, there are several important things you should bear in mind…

(1). The first thing is that we aren’t dealing with a mental condition, rather we’re dealing with a behavioural one. You are not going mad. And, because it’s behavioural, it can be corrected with the proper guidance and information.

(2). Another consideration is that an attack cannot cause you any harm, you are perfectly safe. You may feel as though you are about to, but you won’t die. Your body is quite capable of handling the terrifying symptoms of an attack. In fact, it’s your body’s fight or flight response that triggers your attacks in the first place!

(3). Although you may think you lack courage, you certainly don’t. Remember that, on a daily basis, you face a range of challenges that the average person very rarely has to.

(4). Because of point (1) above, you don’t have to worry about being stuck with your anxiety problem for the rest of your life. It can be cured, with the correct approach. These are very important points to understand because they are all positive ones and so form a solid starting point for your cure.

MAINSTREAM TREATMENT FOR PANIC ATTACKS AND ANXIETY

You have no doubt visited your doctor and been diagnosed with general anxiety and panic attacks. And, as in most cases, you’ve been prescribed drugs, usually antidepressants, tranquilizers and even beta blockers. You may also have been referred to a therapist. The problem here is that neither of these address a fundamental aspect of your ongoing problem, and that is that they don’t address your fear of having another panic attack.

FEAR OF PANIC ATTACKS AND YOUR ANXIETY CYCLE

You see, your unconscious or conscious fear of your next attack can actually trigger such an attack. But where does this fear come from? It’s so simple really. The experience of your first attack was so terrifying that you live (consciously or subconsciously) in dread of another. This is understandable. The problem is that as long as this persists it only adds to your already high anxiety levels. So the key is to break out of this cycle of anxiety by getting rid of your fear of another panic attack. If you can do this then you are able to address your underlying general anxiety much more effectively and so eliminate it. But if mainstream treatment cannot do this effectively what other options are there?

HOW TO STOP PANIC ATTACKS AND ANXIETY WITHOUT MEDICATION

One serious option is to get rid of your fear of panic attacks by taking a counter-intuitive approach. By that I mean, instead of running away or hiding from your next panic attack, i.e. never putting yourself in a position where one might occur, you actually tackle your fear head-on. For example, try to make yourself have an attack right this second. I know that, try as hard as you might, you cannot. You’ve faced up to it. You met the challenge head on. And so the next time you feel an attack about to come on, recognize it for what it is. You now know what causes it. Know that it cannot harm you and will end shortly. Even repeat to yourself that you know what it is and that you aren’t in danger. And focus outwards on things around you, not inwards on your symptoms.

I’ve actually, in my head, told an attack when it began to ‘do its worst.’ In other words meet the attack head on and wrestle back control. There is no doubt that you can eliminate panic attacks and anxiety using totally natural techniques. And by now understanding that these attacks cannot cause harm and that your fear of them is what is actually holding you back, you are better positioned to go on and get your freedom back. So, no more fear of going out because of the fear of an attack, no more putting off holiday plans or business travel, no more fear of getting stuck in traffic or on trains, etc., and no more living a very trapped existence.

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Lack of Sex Drive

Lack of Sex Drive Causes

Emotional stress, depression, anxiety, hang-ups from past, sexual abuse, lack of privacy, anaemia, alcoholism, drug abuse, certain prescription medications, hormonal changes and the trauma of childbirth.

Effects: Reluctance to have sex, no interest in sex, feeling angry or frustrated with your partner, not enjoying sex, and relationship difficulties.

Lack of Sex Drive Solutions

Counselling,

psycho-sexual therapy,

‘Desire Cream’; increases blood flow to the genitals,

‘EROS’ suction device,

‘Intrinsa’ testosterone skin patch.

SheKnows.com: What exactly is libido?

Kelli Young: Libido refers to one’s sex drive or appetite for sexual activity, either alone or with a partner. A woman’s libido encompasses her sexual thoughts, fantasies, desires and interest in engaging in sexual behaviors.

SheKnows.com: Is there such thing as a normal sex drive?

Kelli Young: In a word… no. There really is no such thing as a “normal” sex drive. Women vary greatly in their desire for sex. It is not uncommon to experience a temporary decline in sex drive and, in fact, many women do at various times in their lives.

SheKnows.com: When should a woman worry about her libido?

Kelli Young: If a woman notices that this drop in sex drive persists, or that her formerly normal sex drive is gone completely, it may be cause for concern. In medical terms, low sex drive, or hypoactive sexual desire disorder, is defined as a persistent or recurrent lack of sexual fantasies, thoughts and/or interest in sexual activity that causes personal distress. Women experiencing low desire may notice signs such as: a decline in the frequency of sexual thoughts and fantasies; reduced sexual desire; reluctance to initiate or engage in sex; and less frequent masturbation.

Many factors dampen sexual desire

SheKnows.com: What can affect a woman’s sex drive? Why does it change?

Kelli Young: All women will notice natural and normal fluctuations in their sexual appetites over time. Many of these changes result from hormonal fluctuations (during menstruation, pregnancy, perimenopause, etc.) and may affect a woman’s body image and self-image (she may feel less desirable or sexy, and, in turn, less sexual).

Lack of arousal can also be associated with insufficient vaginal lubrication, which can lead to vaginal irritation or pain and may even trigger vaginal or urinary tract infections. When sex is unfulfilling or painful, a woman is unlikely to desire it, and she may begin to fear or avoid it.

Many physical and mental illnesses can negatively affect a woman’s libido, as can the medications often used to treat these illnesses. Several medications have serious sexual side effects.

Lifestyle, nutrition and stress level can also play a role in dampening sexual desire. The demands of juggling work, family and other responsibilities can be exhausting and overwhelming; there may be little energy and enthusiasm left for sex. Negative sexual experiences can also impact a woman’s enjoyment of and desire for sex. Finally, relationship problems and difficulties in communication can have a major detrimental influence on a woman’s sex drive.

Natural ways to liven your libido

SheKnows.com: How can a woman increase her libido/sex drive?

Kelli Young: There are some relatively simple steps women can take to improve their libido.

These may include:

Talk to a doctor. Consult with a medical and/or naturopathic professional who can test for, and treat, potential underlying illnesses or physiological causes of low libido. If you are prescribed medications, be sure to discuss possible sexual side effects. Sometimes, an equally effective medication can be prescribed that has fewer (or no) sexual side effects.

Consider a natural libido supplement. Many women have noted significant improvement in vaginal lubrication and sensitivity while using a natural libido supplement, such as FemMED’s Libido formula.

Get to know your own body, sexually. Self-stimulation (masturbation) can be an excellent way for a woman to develop a good understanding of the types of stimulation she finds arousing.
Use a water-based lubricant. Even if you have adequate natural lubrication, the extra slipperiness afforded by a water-based lubricant can be highly arousing for women and their partners!

Make lifestyle adjustments. Moderate exercise and a healthy diet are vital to maintaining a good sex drive. Chronic dieting can have a devastating impact on your energy level, metabolism and body image. Moreover, diets that are very low in fat are particularly problematic because your body needs some fat to make hormones such as testosterone, a hormone essential for sexual drive and response. Yoga, mindful meditation and courses in assertiveness and stress management can also help women acquire important tools to deal with the daily stressors that can dampen one’s sexual desire.

Do Kegels. Kegel exercises strengthen the pelvic floor muscles, which can improve sensation and enhance sexual pleasure.

Address relationship issues. The quality of a relationship, particularly a couple’s communication, has a significant impact on their sexual satisfaction.

Seek counseling when necessary. At times, it may be helpful to seek counseling from a sex therapist or couples counselor skilled in addressing sexual issues.