Неврозы – Neuroses

There are short term and long term risks associated with pollutants in the air. The short term risks of breathing polluted air include headache, eye irritations, inflamation of the respiratory tract and asthma related disorders. In the long term, air pollution can contribute to the development of cancer, emphysema, birth defects and behavioural problems in children.

Lead, once a major domestic pollutant as an ingredient in house paint, is now pumped into the air in vehicle exhaust or found in soil contaminated by industry. In children, high lead levels are thought to be responsible for a lowering of the intelligence quotient, loss of concentration and hyperactivity. Workers in certain industries run a high risk of lead poisoning. These include zinc miners, petroleum plant workers, car mechanics, sheet metal workers and those dealing with explosives. Lead poisoning results in nervous disorders and stomach and brain related illnesses. To avoid its effects, workers should wear appropriate protective clothing. Parents can have their children’s blood lead levels tested and may consider moving to an area of lower contamination if levels are high. Avoid walking, cycling or jogging in heavy traffic or wear a face mask.

Insecticides, fertilisers, bleaches and blooms of toxic algae affect many of our waterways and can seriously affect our health. Even within our reservoirs, the fluoride and chlorine added to the water to kill bacteria are themselves under a health cloud. Try to drink the purest water available to you and invest in a good water filter. Otherwise, always drink from the cold tap as hot water has sat still in a tank and in pipes and will contain more metals.

Chemicals are not the only pollutants of the atmosphere. Concern is mounting over the dangers of electromagnetic waves to human health, particularly to those living in the vicinity of high voltage power cables. The links between television and computer screen emissions and conditions such as cancer, nervous disorders and cataracts are being investigated. Sit at least 2.5 metres from a television screen and if possible, fit a shield to the screen of your computer.

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Greater enjoyment of sex and improved sexual functioning are among the most commonly reported contrasts between the effects of St John’s Wort and those of the selective serotonin reuptake inhibitors (SSRIs) such as Prozac, Lustral and Seroxat. Although the literature on the SSRIs reports very low levels of sexual side-effects (for example, less than 1 per cent for Prozac and 2.5 per cent for Lustral), any clinician who uses these medications will tell you that these figures are grossly underestimated. One survey of patients on SSRIs reported the frequency of such side-effects to be approximately 34 per cent, and it would not surprise me to find an even higher percentage depending on how carefully the patients are questioned. Considering the importance of sex in the lives of many (if not most) people, it is worth considering the difference in the sex lives of people who have switched from an SSRI to St John’s Wort.

In some people the sexual side-effects of the SSRIs can be extremely marked. For example, they may cause impotence in men or complete inability to achieve orgasm in women. Depressed people generally have a diminished interest in sex to start with, and any anti-depressant may improve the level of interest and overall drive to connect with others sexually as well as socially by reversing7 the symptoms of depression. Initially people are so grateful to be free of their depression that any sexual side-effects they might experience might seem like a small price to pay for feeling better. After a while, though, the side-effects become less and less acceptable as they begin to take a toll on a person’s relationships and impair one’s quality of life.

Sexual side-effects of the SSRIs can involve decreases in sexual interest or arousal or subtle changes in the experience of sex. A colleague of mine, for example, who was previously on Lustral and is now taking St John’s Wort, described how on Lustral he had been able to function sexually but the orgasms just did not feel as good. ‘On Lustral’ he recalls, ‘I was still interested in sex and my erections were fine, but it took me longer to reach orgasm and, when I did, the arc of the orgasm was slower and more protracted and did not reach its previously satisfying level of intensity. I am glad to say that on St John’s Wort my orgasms are back to normal again.’

It would not surprise me, however, if in the course of time evidence emerges for alterations in sexual functioning on St John’s Wort as well, though perhaps only in a very small percentage of those who use the herb. This might be more likely to occur if people push the dosage of the herb above 900 mg per day, as I predict many will in their attempts to explore the full range of the herb’s efficacy. I have already encountered two people who claim some alteration in libido and sexual pleasure on St John’s Wort, albeit to a lesser degree than on the SSRIs. Given our best understanding, that St John’s Wort probably works at least in part by increasing the availability of serotonin, the biological mechanism believed to be responsible for the sexual side-effects of the SSRIs, some sexual side-effects might be expected to be reported as the herbal anti-depressant is more widely used.

It is important to remember that a slight decrease in sexual enjoyment may be an acceptable trade-off in exchange for being free of the painful symptoms of depression. One man whose depression had been successfully treated with Prozac for the previous two years switched to St John’s Wort after seeing a television programme about it. Two weeks after the switch he wrote to me that ‘the ol’ sex drive has come back with a vengeance … my wife is thrilled.’ Several months later, however, I checked up on how he was doing and learned that his depression had returned and that he had developed panic attacks, which resulted in his returning to conventional anti-depressants. It must be acknowledged that no medication, herbal or otherwise, is right for everyone. Nevertheless, St John’s Wort may actually turn out also to be of some value in panic disorder, as the following accounts suggest.

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