Hello all you urchins of intervention, and welcome to Ask Dr NerdLove, the dating advice column that plays support to your dating DPS. This week, we're talking about relationship conflicts. What do you do when you and your partner can't agree about how to prevent pregnancy? What are the best ways to help someone who's dealing with a massive anxiety attack and nothing seems to be working?
It's time to move the payload. Let's do this thing.
So the lady and I have been dating for over a year. Are very solid about communicating or at least very solid about continuing to sit down and rectify any breakdowns in communication. Both of us are responsible enough adults who are happy with each other and the time we spend together, et cetera.
I recently voiced complaints because our sex life has been in the dumps as I cannot handle the nerves of her ultimatums when it comes to our sex life. She wants it less than at the beginning of our relationship, which is normal, but what does not seem normal is her approach to safety.
At the beginning we were using latex protection but she has always hated them (which to be fair, same) stating that "they make my vagina hurt" and "you are too large already". So she keeps insisting on the withdrawal method but insists on having her orgasms with unsafe penetration. I went along with it a few times because I was caught up in the moment and was trying to maintain my anxieties and desires for "not children" at this moment in my life.
I brought this up to her and her solution is "we can just not have sex ever again". She is unwilling to take any personal risks with her body hormonally and the copper IUD she says is a risk that could end in death or infertility so she refuses it outright. She keeps insisting that she has done this her entire sex life with every relationship, and if she was going to have gotten pregnant now she would have already.
I brought up the idea of a vasectomy and have done research that states that reversal is not entirely out of the question any more. This idea was shot down. I just recently purchased non latex protection to try but am running out of options and patience as I am the only one willing to take the burden of our not-family planning as the case may be right now.
So. At this point I'm deciding between celibacy or terror. I hate it.
Raincoats In The Shower
OK RitS, let's talk protection.
First of all: Your ladyfriend seems to be working off of old and incredibly outdated information. What your partner may be thinking of is the Dalkon Shield, an IUD made in the '70s that's been off the market for decades. In reality, copper IUDs are among the safest and most effective forms of non-hormonal birth control out there. Not only are they cheap and incredibly effective, but they're also safe. The biggest risks are heavier periods or more intense cramps and no, IUDs don't come with a risk of permanent infertility.
But hey, not everyone wants an IUD. So let's talk options.
First, there are condoms. It's entirely possible that your partner has a latex allergy; they're fairly common and it can make using latex condoms incredibly uncomfortable. Fortunately, there are a number of non-latex options, including brands such as Lifstyle Skyns. Among other benefits, non-latex condoms often feel better than the latex version; they're thinner and transmit heat better than other forms.
Another option would be what's known as the "female condom" or a condom that she puts into her vagina; these are made of nitrile and don't trigger latex allergies. Plus, like non-latex condoms, you can use a wider variety of lubricants.
Also, while it's mostly known for being a punchline to a Seinfeld episode, the contraceptive sponge is another birth control option, and can be inserted up to 24 hours earlier. There are also cervical caps and diaphragms - a tad old-school and not as effective as an IUD or hormonal birth control, but all viable options.
And in fairness to your partner: The pull-out method does work… as long as you both execute it perfectly. When done with rigorous discipline, it's about 78 per cent effective at preventing pregnancy. If you combine this with fertility tracking, then the odds of pregnancy are reduced even further.
But there are also other ways of having sex that don't run the risk of pregnancy. Oral sex, for example, doesn't run the risk of pregnancy. Neither do sex toys, anal sex or mutual masturbation. Expanding your repertoire of what you consider "sex" beyond penetration gives you more options for pleasure and intimacy, without having the boner-killer spectre of "but what if…" hanging around in the back of your head.
One more thing to consider is that she may like the psychological thrill that comes with going bareback. The sense of risk, the breaking of taboos, even just the idea that you're doing something you shouldn't can add spice to already enjoyable sex. Half of arousal happens in the brain, after all.
At the end of the day, safe sex practices are part of being sexually compatible. Not only should you make sure you're both cool with the methods you use, but you should also be on the same page about what if there is an unintended pregnancy. The worst time to find out you disagree about birth control is after your lady realises she's late or the condom breaks.
However, I do want to stress that there's more to safe sex than just preventing pregnancy. IUDs and the like don't prevent against STIs; only condoms do. Many STIs are asymptomatic and incredibly common; it's possible to have chlamydia, for example, without ever realising it. It's entirely possible for one or both partners to have been exposed and simply not know. If you're not going to not use condoms, you both should get tested.
It may well be worth your partner talking to her gynaecologist or visiting a family planning clinic about her options, including getting the facts about IUDs. And then the two of you need to have some conversations about the methods that work for both of you… as well as the attendant risks and how to handle the potential consequences.
About two and half years ago, my 13-year relationship with my now-ex ended (amicably and respectfully; can't imagine a better break-up). After a year of taking time for myself I felt I was ready to start dating again.
A few months in to my online dating adventures, and after a fair few dates both good and bad, I met a girl, who I will call Lisa. I won't say that I fell head over heels for her, but I was a bit smitten. Sweet, intelligent and endearingly shy (and cute to boot!), Lisa was a girl I was willing to put in some real effort to get to know better. We went on more than a few dates, and had great chemistry, both physical and emotional.
However, I learned early on that Lisa suffered from a fairly low self-image and extreme anxiety. What I once thought was just her being shy I now understood was a manifestation of her anxieties. To her credit, she never tried to hide this part of herself from me; to the contrary, she told me about her struggles very openly and honestly, and how it often led to her sabotaging her relationships in the past.
Having dealt with family and friends who suffer from depression, I told her how much I respected her honesty and how brave she was for opening up to me, and how much it meant to me that she trusted me enough to tell me her truth. I tried to counteract her low self image by "talking her up" and focusing on her great qualities and how much I liked her for who she was, despite her struggles. I had never dealt with anyone with anxiety (at this level), but I was willing to learn how with her.
Ironically (and paradoxically?), my willingness to deal with what she called "her bullshit" ended up exacerbating her anxieties further. She explained that she felt it was wrong of her to put me through that, and furthermore it showed her how much I cared about her, and that freaked her out, and she realised how unready she was to have someone care for her that much. She also fully acknowledged that this was probably another way of sabotaging something good, and that just reinforced her anxiety into a sort of death spiral of shame and self hate. She asked to end things, apologised for being "fucked up", and hoped we could still be friends.
Not one to be an arsehole, and also not knowing what else to do, I accepted the reality that Lisa was not ready for a relationship (and may not ever). I still cared for her, so I resolved to continue to be her friend. And I'm proud to say we have done so. A combination of keeping our physical distance in the short term after our relationship ended coupled with new jobs for both of us that created opposite schedules and even more physical distance have conspired to keep our friendship online only. We haven't been face to face in about a year, but we have remained in friendly contact with each other through social media throughout the year since things ended between us.
Recently, after a fair amount of success with dealing with her anxieties (a new job that she loves had certainly helped), her personal anxieties have come roaring back, and she has shared as much with me, though not the cause. Maybe she doesn't know why, or maybe she doesn't want to share the reasons (which is up to her; I think it's clear it would be wrong to demand her to tell me).
All I know is that she has admitted her anxieties are at a near all-time high, she has largely isolated herself from friends (mostly work friends), she feels very lonely, and all of this has her feeling, in her words, "in a low place". I don't know who else, if anyone, she has told this to, but I also don't assume to be special enough to be the only one. I have no way of knowing or finding out anyway, as I know none of her other friends except by names from stories.
I want to help my friend who I care very deeply about, but I don't know where to start. I'm afraid, based on my past experience with her, that attempts to comfort her and reassure her will only drive her away because of the twisted mind games her anxiety plays with her head, but I also feel like doing nothing is also wrong. She volunteered this information to me. She went out of her way to tell me she was suffering and that she felt lonely as a result.
Doc, what do I do?
I feel you, WTH. I've been on both sides of this equation. I'm someone who deals with chronic depression and let me tell you: It's a motherfucker. But trying to be the supportive partner to someone with anxiety, depression or mental health issues can be hard too.
But first, my standard disclaimer: Dr NerdLove is *not* a real doctor. This is all out of my experience in dealing with my own mental health issues and the research I've done because of it.
Let's talk about the realities of depression and anxiety WTH because what the outsider sees and what the person going through it feels are two very different things. This can be a problem because the things that you might reasonably think as being helpful just end up pissing people off, or making things worse.
Talking someone up when they're dealing with depression, for example, can be shockingly counterproductive. Depression isn't just "the blues", it's like a void or singularity that drains colour and life from everything. It's like everything you care about is meaningless and you're numb at best and you actively loathe yourself at worst. The good things in life just sort of bounce off of you. Either you don't feel them, or you feel bad about them because you don't deserve them. So when someone tries to talk you up… well, it can be kind of annoying. You know you should care. You know it should make you feel better. But it doesn't, and that's frustrating.
Worse is the way that depression or anxiety whispers into your brain that of course they'd say that, they have to, it doesn't mean anything. Or maybe they mean it, but the fact is that you're really a horrible person and all you're going to do is make things worse so it's better if they get away before you drag them down with you…
And here's the thing: You can be perfectly aware that you're doing this. It's not something that can necessarily be willed away with rational thinking. You can recognise that your anxiety is talking bullshit, but it's talking so very fucking loudly that it drowns everything else out.
The fact that you can't pull yourself out like you know you "should" be able to (more on "should" in a second) just makes things worse. It's like a confirmation of the worst things you believe - and then dialed up to 11. And to add insult to injury, it becomes a self-reinforcing cycle. You feel the anxiety or depression start to flare up, you end up withdrawing, which makes things worse. You feel overwhelmed. Your emotional bandwidth goes from a stream to a trickle. You're so low on emotional spell-points that you just can't fucking person now and all you want to do is curl up like a wounded animal in its den until things get better.
Which, of course, makes you feel worse. Wash, rinse, repeat.
Of course, part of what makes dealing with all of this so pernicious is that there's no one way to handle this. There aren't any silver bullets, and effective treatments are incredibly variable and personal. Medication helps, but not all of it works the same way for every person, it takes time to start working (if it does), and the side-effects fuckin' blow. Talk therapy and cognitive behavioural therapy can help too, but not as much when the cause is biochemical, not emotional.
What you often need is a multi-spectrum solution that encompasses a blend of everything: Effective self-care (that is, eating, showering, cleaning and Handling Your Shit), medication, exercise and meditation, some form of therapy, getting fresh air and sunshine, and having the love and support of your friends. Which is where you come in, WTH.
See, it isn't that your friendship and support aren't helping, it's the way that those things interact with your friend's depression that are the issue. You can't really talk someone out of a depressive spiral because it's not logical. Logic can help mitigate anxiety and give someone more control… but it isn't the cure. What's often more effective - and I stress that this is strictly in my experience - is your presence.
Remember what I said about anxiety and depression making you want to curl up in your den? Well, sometimes what someone needs is another person being physically there with them, just caring for them. Not trying to make them feel better, not trying to cajole them out of their anxiety but just being there, a reminder that people really do care and want them around.
Now, this can be difficult. Guys especially are socialised to be doers. We want to express our feelings and support for someone by solving problems and doing things that make things better. Just being a reminder that someone isn't alone or unloved is hard because… well, you're just there. But it's important.
That doesn't mean that there aren't things that you can do. There are. You can help make sure that they're eating more than just processed junk or simple carbs and drinking water instead of soft drinks or energy drinks. You can help them clean or organise their place so that the clutter doesn't add to their anxiety. You can keep them from isolating themselves and sitting in the dark, spiralling away. But that sense of support, of knowing someone is there, who cares for them, who isn't going to abandon them or get pushed away? That's huge.
And don't forget: Anxiety and depression don't just manifest in freak-outs or the blues. They show up as anger and lashing out at others, too. Think less Marvin The Robot and more Rocket Raccoon. Sometimes people going through anxiety or a depressive period will get ugly. They will get mean. They will try to push you away before you can leave them because at least then it will be on their terms.
And that's hard to deal with. It's hard to be able to say "OK, that's just the depression talking" because good God damn, having anxiety tends to come with the ability to pinpoint other people's weak spots, too.
Sometimes you need to be able to absorb the blows and still just be around, loving them and letting them know they're not alone. You have to be the one to reach out because they're not going to. You have to ignore the temptation to argue with their depression and just be that big warm bag of caring. You have to be the voice at the other end of the phone or the Skype call that's a reminder they're not alone… even if it's just leaving the call open and they can hear you puttering around like you're there with them.
You can't fix things for them. You can't love someone into being better. But you can lend them your strength and your love when they need it. You can help give them the space and the room to recover, and make sure the tools they need are on hand and ready to be used.
And sometimes that's enough.
Did you and your partner fight about safe-sex techniques? Have you dealt with anxiety attacks? Share your thoughts and experiences in the comments. We'll be back with more of your questions in two weeks.
Ask Dr Nerdlove is Kotaku's fortnightly advice column for matters of the heart, hosted by the one and only Harris O'Malley, AKA Dr Nerdlove.
Harris O'Malley is a writer and dating coach who provides geek dating advice at his blog Paging Dr NerdLove and the Dr NerdLove podcast. He is also a regular guest at One Of Us. He can be found dispensing snark and advice on Facebook and on Twitter at @DrNerdLove. Dr Nerdlove is not really a doctor.