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What It Means to Be Fraysexual

Key Takeaways

  • Fraysexual people feel a strong attraction to strangers and less attraction to people they know well.
  • Fraysexuality can affect traditional relationships, but open communication can help maintain them.
  • Fraysexuals may explore non-monogamous relationships to keep sexual interest alive.

Fraysexuality, also known as ignotasexuality, is a sexual identity in which people experience a strong attraction to strangers, and less attraction to people they know well.

A fraysexual person generally prefers having sex with people they don’t know over those they do. It’s the opposite of demisexuality, where a person needs to know someone well and feel connected to them before experiencing sexual attraction.

This identity is on the asexual spectrum, and it has its own flag: The colors are four stripes of blue, cyan, white, and gray. The blue represents strangers, the cyan acquaintances, white for lack of attraction, and gray for sexual attraction confusion.

Ahead, we’ll discuss more about fraysexuality, signs a person may exhibit as a fraysexual, and how this identity might impact your love life.

Fraysexuality Exists on the Asexuality Spectrum

Asexuality is considered an umbrella term for people who have sexual identities that involve an aversion to sex, and it includes other identities such as graysexual, autosexual, and demisexual. 

Dr. Edward Ratush, Board Certified Psychiatrist, sex therapist, and co-founder of SOHOMD, explains that fraysexuality “falls under the umbrella of the asexual spectrum because of the specific aversion a fraysexual individual will have toward sexual contact with their most intimate partner. Simply stated, the more a fraysexual person is emotionally connected with their intimate partner the less they are inclined to have overt sexual desire for this partner.”

Fraysexual individuals do not necessarily identify as asexual. Rather, the term asexual is used as an umbrella one that fraysexual falls under.

Can Anyone Identify as Fraysexual?

One does not need a specific sexuality to be fraysexual. A person can identify as fraysexual whether they are gay, straight, or pansexual, and they can be of any gender. It’s an identity that a person may use to describe themself, or someone else may refer to someone as fraysexual if they notice that that person is more sexually attracted to strangers than to people they know.

Even if someone calls you fraysexual, though, that doesn’t mean you have to identify with the term. Sexuality is highly personal, and we all have the right to identify as whatever feels best for us.

6 Signs You May Be Fraysexual

While an attraction to strangers is the most prominent sign of fraysexuality, there are numerous other signs too.

  • Loss of sexual interest with a partner: Dr. Ratush says this occurs “despite a growing love and connection with one’s intimate partner outside the sexual realm.”
  • Desire for romantic stability: Sex therapist Aliyah Moore, Ph.D tells us that “despite experiencing a decline in sexual attraction, the individual may still desire romantic stability and emotional connection with their partner. They may feel fulfilled romantically and emotionally even as their sexual interest wanes.”
  • High interest in new experiences: Moore explains how “novelty and new experiences might be significant factors that spark their sexual attraction.”
  • Unstable sexual interest: A Fraysexual person may feel inconsistent in their attractions and physical desires for others.
  • Challenge maintaining sexual desire: “Emotional closeness and familiarity with their partner might lead to a decrease in sexual desire,” says Moore. She adds that “when trying to rekindle sexual interest in an established relationship, they may struggle to regain the initial level of sexual attraction.”
  • Disconnect between emotional and physical attraction: Moore says that “Their emotional bond remains meaningful, but sexual attraction might not align with it in the same way.”

Fraysexuality vs. Demisexuality

Fraysexuality

  • Attraction to strangers

  • Less attraction to people they’re close to

  • May seek out casual encounters with strangers

  • Does not require emotional connection for intimacy

Demisexuality

  • Lack of attraction to strangers

  • More attraction to people they’re close to

  • Won’t seek out casual encounters with strangers

  • Requires emotional connection for intimacy

Can fraysexuals still be in serious committed relationships?

From what you know thus far about fraysexuality, you may think a fraysexual person isn’t capable of being in a serious, committed relationship, but that isn’t necessarily the case. “Fraysexual individuals may still experience romantic attraction and emotional connections with their partners even as their sexual attraction diminishes over time,” says Moore.

Ratush explains that “sexual interest, sexual activity, or even monogamy are not the only reasons people enter relationships, and they are not necessarily required for a relationship to work,” and notes that “people engage in relationships for a multitude of reasons that are, themselves, dynamic and can evolve throughout our lives.”

Whether or not a committed relationship with a fraysexsual person will involve the same amount of sex throughout the relationship as it did in the beginning is a different topic. It’s normal for couples who have been together long term to have less sex than they did initially. It’s also normal for people to have less sex as they age, period.

To keep a relationship in a good place, Moore says that “it’s essential for fraysexual individuals to communicate openly with their partners about their changing sexual needs and explore relationship structures that accommodate both partners’ desires for intimacy and connection.”

Does being fraysexual mean that I have issues with sex and intimacy?

Someone who is fraysexual will experience a waning interest in sex as they get to know someone, but that doesn’t innately mean they have intimacy and sex issues. “It simply represents a unique pattern of sexual attraction where the intensity of attraction may change based on emotional proximity to a person,” explains Moore.

“Fraysexual individuals can experience fulfilling romantic relationships, and their sexual orientation does not dictate their ability to engage in meaningful emotional connections with others,” she says.

However, it’s worth noting that a fraysexual person may not receive the same relationship benefits as someone who experiences more attraction to those they’re emotionally close to. “psychological intimacy may enhance the physical experience as physical intimacy enhances the emotional connection between people who are in love,” says Ratush.

“Fear and anxiety often lead the charge for reasons why someone would avoid something, and losing a sexual/emotional connection is one obvious thing to avoid, avoiding that loss may be a self-fulfilling prophecy of sorts,” he explains.

How Being Fraysexual May Influence Your Sex Life

An identity of fraysexuality can impact one’s sex life due to their lowered levels of desire for someone they know well. ” Individuals who identify as fraysexual may face challenges in traditional monogamous relationships if their sexual attraction decreases over time,” says Moore. She adds that ” some fraysexual individuals may explore non-monogamous relationship structures to maintain their sexual fulfillment while nurturing emotional connections with their partners.”

Ratush says fraysexuality “is an identity that will require a lot of mutual understanding,” and both therapists stress the importance of open and honest communication around sex and one’s relationship to it to keep the relationship working.

When a person has a sexual preference or a limit, the need to set it will increase the likelihood of there being a barrier to connection with partners,” Ratush says, so those in relationships with fraysexuals may need to find other ways of connecting with their partner in addition to sex. But, because healthy romantic relationships require many different types of connection, fraysexuality doesn’t have to be a deal breaker.

Knowing oneself and understanding how to create a relationship given your nature is important for all relationships. Establishing what you are seeking in a relationship is helpful for both you and your partner when filling any type of sexual or emotional need, especially for fraysexual people.

“Understanding and embracing one’s fraysexual orientation can lead to more fulfilling relationships and personal growth as individuals embrace and communicate their sexual needs with their partners,” says Moore.

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By Ariane Resnick, CNC

Ariane Resnick, CNC is a mental health writer, certified nutritionist, and wellness author who advocates for accessibility and inclusivity.


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How Youngest Child Syndrome Shapes Development


Key Takeaways

  • Youngest children may be more likely to become entrepreneurs and risk-takers.
  • Parenting styles and family dynamics affect youngest children, but personality traits aren’t solely defined by birth order.
  • Youngest children should have an open conversation with caregivers if they feel left out and consider their own strengths and individuality.

Are you the “baby” in your family? If so, you might identify with youngest child syndrome. Youngest child syndrome refers to the characteristics and traits of being the youngest child in a family. While youngest child syndrome is not an official diagnosis or condition, research has been done on the birth order of children in the family construct. 

When scientists look at personality in adulthood, Julia Rohrer, personality psychologist at Leipzig University, says that they mostly find no systematic differences between firstborns, middle children, and lastborn children with respect to major dimensions of personality, such as emotional stability, extraversion, agreeableness, neuroticism, and openness to experience. 

However, common characteristics and traits have been found. 

“There are some that are associated with being the youngest child in a family (such as being risk takers, being spoiled), but there is little evidence that confirms such stereotypes,” says Rohrer. 

Characteristics of Youngest Child

Some common traits and behaviors associated with the youngest children include:

  • Risk-taking
  • Entrepreneur mindset
  • Prosocial
  • Resilient
  • Being spoiled 

Research from the University of Birmingham and the University of Reading found that the youngest children in families who are not self-employed are nearly 50% more likely to take the risk of going into business. The findings were based on analyzing traits of more than 17,000 children born in 1970, who were surveyed again at 38 years old.

Another study found that the youngest children had the lowest rate of mental health challenges, including emotional, conduct, and attention problems. 

Rohrer says of all the research conducted, scientists consistently find small effects on intelligence in samples from the global north. “Firstborns are a little bit smarter, and then on average intelligence declines with birth order position,” she says. However, she adds that these effects are small on average and not deterministic.

“So, in any given family, the youngest child may actually be the smartest. Just when we average across thousands of people do we detect that on average, firstborns are a few points smarter,” says Rohrer. 

The reason for characteristics associated with birth order may be age effects. 

“[We] know that personality matures and within a family, the youngest child may end up with the ‘least mature’ personality just by virtue of their younger age,” says Rohrer. 

While the age-related personality differences would disappear with age, they may be “kept alive” within the family context. 

“Think of the firstborn who, as a child, gets more responsibility due to her age, and then later keeps being the responsible sibling when the family gets together for Christmas (but not necessarily in other contexts, such as at work or with their peers),” explains Rohrer. 

Psychological Impact on Youngest Children

Louis J. Kraus, MD, director of child and adolescent psychiatry at Rush University, says how kids are raised and their genetics both have psychological effects, “but as time goes on and as they grow, the effects are somewhat less obvious and you have to be careful formally labeling anybody,” he says. 

Relationships between the youngest child and their older siblings may be influenced by family dynamics. For instance, Kraus says it is not uncommon that the oldest child is more helpful with their younger siblings and that the youngest child is more animated and attention-seeking. 

[If] you grab an average family with three kids or more, they would describe this dynamic probably more often than not, even if there is no definitive research to support it.

“With that, there is a question of whether there is a more immature quality with them that they tend to infantilize a bit more, and are a little closer to mom than their older sibling counterparts,” Kraus says. “[If] you grab an average family with three kids or more, they would describe this dynamic probably more often than not, even if there is no definitive research to support it.” 

Relationship with Siblings and Family Dynamics

Parenting may have something to do with the dynamics, he adds, noting that when parents have their first child, they typically are overprotective. “Everything gets sanitized, they do everything by the book, and by their second child, they’re a little easier going,” he says. “If the pacifier falls on the floor, maybe they’ll wipe it off and give it back to the child. It’s no longer a big deal.” 

When there are more than two children, he notes that parents need additional help and unintentionally involve the oldest child, or the child takes on the role themselves without being asked. 

In families with more than two kids, the youngest child may receive somewhat less attention in the early years of life because they have to “share” it with older siblings. “At the same time, they are likely to experience a period later when the older siblings have moved out, and they get ‘exclusive access’ to parents,” says Rohrer. 

She adds that the middleborn children are theoretically the ones who have the largest disadvantage in parental attention. “Maybe attention in younger years matters more and so youngest children do get a worse deal, but in any case, we don’t have much evidence that it affects their personality in the long run,” she says. 

Coping Strategies for Youngest Children and Parents

Parenting or being the youngest child can come with challenges and advantages. However, acknowledging that birth order may affect your child or you is a great way to embrace it. 

Experts share ways to navigate the youngest child syndrome for parents and those living life as the youngest child. 

For Parents

As you raise your youngest child, Kraus says, think about what not to do with all your children:

  • Don’t give your oldest child too much responsibility
  • Don’t ignore your middle child
  • Don’t infantilize your youngest child

“What you do, is you do the best you can as parents. You try to love your kids equally, you try and support them, and you realize they’re going to have different personalities and are going to be different kids,” he says. 

Recognizing that you can’t make kids fall into a line and be exactly as you expect is key, Kraus stresses. “Kids have their own genetics and they react to environmental stressors and support differently. You might see similar characteristics with your kids and you might not,” he notes. 

Taking parenting advice from books is okay, but keep in mind that your children are who they are. 

“Parents may read one book or another book about how it should be and they might even have certain expectations, but at the end of the day, kids are surprise packages. You don’t know what you’re going to get for sure and the best you can do as a parent is to love and support your kids as equally as you can,” Kraus says. 

If you notice your youngest child is struggling with family dynamics, encourage open communication, and if needed, seek out help from a mental health professional who specializes in family therapy

For Youngest Children

If you are currently a minor and struggling with being the youngest child, talk with your parents about what’s bothering you and ask if they can help you find a therapist to talk to. If you are uncomfortable talking to your parents, ask a teacher, coach, or another trusted adult to help you. 

If you are an adult looking back on your dynamic as the youngest child, Kraus says to try to accept how you were raised and understand that it does not have to define how you live your life today.

Rohrer stresses that the differences between each family dwarf any systematic effects of birth order position. “This does not mean that siblings do not matter for personality; it is quite possible that they do matter—but in highly individual ways that do not result in something like a ‘typical youngest child’ pattern,” she says. 

With this notion in mind, try to embrace your unique qualities and strengths as an individual despite your birth order. Consider ways your qualities as a youngest child can help you feel empowered. For inspiration, consider many celebrities and successful people who are the youngest children, including Zooey Deschanel, Jake Gyllenhaal, Hilary Duff, and Harry Styles.

If you need help processing your family dynamics and place as the youngest child, reach out to a mental health professional for guidance.

What This Means For You

Being the youngest child can be difficult at times, and if you feel left out or unheard in your family, talking with your parents or siblings may help. Reaching out to a mental health professional can also help you process being a youngest child. Parents, trying to understand and support your youngest child in their personal growth and development will help them fit into the family dynamic.


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Why Emotional Availability Matters in Your Relationships


Key Takeaways

  • Understanding your emotions and why you feel certain ways can help you be more emotionally available.
  • Practicing empathy and managing your emotions are important steps to improve your emotional availability.
  • Take small relational risks and be vulnerable with people you trust to nurture your emotional availability.

We hear it all the time on dating apps or when we’re talking about our love lives with our friends, “it didn’t work out, he was emotionally unavailable” or “I’m looking for someone that’s emotionally available”.

Whether we’ve just ended a serious relationship or coping with mental health issues, being emotionally available is a state of mind that ebbs and flows. It plays a major role in determining whether or not a relationship will blossom, because if one person in a pair isn’t able to connect with the other person emotionally, intimacy can’t grow.

“To say a person is emotionally available means being present in a way that goes beyond physical proximity. It’s about being open to truly understand, empathize, and reciprocate the emotions of others,” explains Joel Frank, PsyD, clinical psychologist and owner, Duality Psychological Services. “It refers to our ability to share an emotional connection with others and to be open to receiving their emotions in return,” he adds.

Emotional availability is a critical component in any type of relationship. But knowing what emotional availability is, and putting it into practice in your life, are two different things. We’ll give some perspective on signs of being emotionally available, insight on barriers to emotional availability, and how you can enhance the emotional health of your relationships.

Signs Someone is Emotionally Available

When you’re in a relationship with someone who is emotionally available, both of your actions help to nurture a strong, healthy connection. But whether it’s a friend, coworker, spouse, or parent, there are a lot of specific indicators that someone is emotionally available. Here are some examples.

You are vulnerable

You have meaningful, in-depth conversations, and don’t shy away from things that are difficult or sensitive for you to talk about. Of course, the level of intimate conversation depends on the relationship, but you are generally comfortable being open with how you feel.

“When we are emotionally available, we give ourselves and others the space to be congruent and authentic,” explains Domenique Harrison, MPH, LMFT, LPCC, Founder & Psychotherapist, The Racial Equity Therapist. “Authenticity is about being genuinely ourselves. It’s about not judging ourselves with harshness,” she adds.

You’re there for someone in good times, and in bad times

A person who is willing to give of their energy and insight to support you when you’re having a rough time, is making themselves available to you emotionally.

You’re not afraid to apologize

No one gets it right all the time. Taking ownership and saying you’re wrong shows a person is mature and will expend emotional energy on making a situation right. 

You show genuine interest in the other person in the relationship

Have you ever spent time talking with someone, and can hardly get a word in? They are happy to discuss their thoughts and feelings, but seem to give little regard for yours? Someone who is willing to be available to you emotionally wants to know how you’re doing and is as invested in talking about you as they are about discussing themselves. 

You honor their boundaries

When you are emotionally invested in a relationship, the other person’s boundaries matter to you. Whether it’s a mental, physical, or emotional guard that they’ve put in place, you do your best to honor it.

You show affection

Comfort levels with affection vary from person to person. But showing warmth and affection, whether through a smile or a hug, conveys that you are a person who is emotionally available and invested in the relationship.

“Regarding relationships, the importance of emotional availability cannot be overstated. It is the cornerstone of meaningful and fulfilling relationships. When someone is emotionally available, they foster a sense of security and trust with their loved ones, allowing them to express themselves freely. Such openness encourages deeper connections, fostering a bond that is strengthened over time through shared experiences and mutual understanding,” notes Dr. Frank.

Emotional availability has mental health benefits. It can help relieve stress and anxiety. It also fosters a sense of belonging.

With all those benefits, it’s worth the effort to nurture your emotional availability.

Nurturing Emotional Availability

You may recognize that you are not as well-developed in the areas of emotional availability as you would like to be. Working on your self-awareness can help with that process.

“Understanding your emotions, reactions, and triggers can greatly enhance your emotional availability. If you know why certain scenarios make you uncomfortable, you can work on addressing these issues,” Dr. Frank states.

Domenique Harrison, MPH, LMFT

When we are emotionally available, we give ourselves and others the space to be congruent and authentic.

— Domenique Harrison, MPH, LMFT

Learning how to manage your own emotions and exercising empathy for others’ feelings can also help nurture your own emotional availability. Working through your own process may give you a greater capacity to engage others.

As you work to develop this skill, give yourself grace. Don’t try to change everything all at once; in fact, experts say working in your safety zone initially can be a good start. “Take relational risks and practice vulnerability with folks you trust: Start by taking small relational risks with the people you trust,” says Harrison.

Overcoming Barriers to Emotional Unavailability

Once you begin the process of nurturing your emotional health, having a plan to overcome problems or issues is key for yourself, and for dealing with someone who is emotionally unavailable.

Effective communication is a great start.

[Take] some time to calm down before communicating (even five deep breaths have been shown to make a difference). Figure out how you feel, and then communicate with ‘I statements’,” explain Eileen Anderson, EdD, Anne Templeton Zimmerman, MD Professor of Bioethics and Director of Educational Programs, Bioethics and Medical Humanities.

Showing empathy and patience is also important, both with yourself and others. Building your emotional vulnerability takes time and effort. And seeing the changes you desire in your relationship takes time as well.

Be clear on your boundaries. What makes you uncomfortable? What takes you more time and space to process? Insist on having those boundaries respected. Likewise, honoring those boundaries in relationships may make the other person more willing to be emotionally available to you.

And be willing to seek help if you need it. A mental health professional can help you with the tools you need to get to a healthier place emotionally.

Above all, focus on taking care of yourself physically and mentally. Being in a healthy space and practicing your own self-awareness is a critical step in the process.

Above all, focus on taking care of yourself physically and mentally. Being in a healthy space and practicing your own self-awareness is a critical step in the process.

“Identifying and acknowledging your emotions without judgment is an essential first step. Learning to communicate your feelings effectively, setting healthy boundaries, and practicing vulnerability are other valuable tools for fostering emotional availability,” Dr. Frank concludes.


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Specific Phobia DSM-5 Diagnostic Criteria


Key Takeaways

  • A phobia is an excessive and overwhelming fear that results in avoidance or extreme distress.
  • The DSM-5 states that symptoms must limit a person’s ability to function, last at least six months, and not be due to another mental disorder.

A specific phobia is an intense and irrational fear of a specified object or situation. A phobia is an excessive and overwhelming fear that results in avoidance or extreme distress. Some phobias are centered on a specific fear object, while others are complex and tied to different situations or circumstances. 

Phobias affect about 19 million adults, and women are two times more likely than men to have a specific phobia. Some people experience multiple specific phobias simultaneously. Approximately 75% of people with a specific phobia fear more than one object or situation.

DSM-5 Criteria for a Specific Phobia Diagnosis

A fear and a phobia are not the same, so it’s important to know the difference. Many people experience fears or aversions to objects or situations, but this does not necessarily mean that they would be diagnosed with a specific phobia.

Therapists cannot use a lab test to make this diagnosis, so they and other mental health professionals consult the DSM-5-TR (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, text-revision). This guide provides diagnostic criteria for specific phobia from the American Psychiatric Association:

  • Unreasonable, excessive fear: The person exhibits excessive or unreasonable, persistent and intense fear triggered by a specific object or situation.
  • Immediate anxiety response: The fear reaction must be out of proportion to the actual danger and appears almost instantaneously when presented with the object or situation.
  • Avoidance or extreme distress: The individual goes out of their way to avoid the object or situation, or endures it with extreme distress.
  • Life-limiting: The phobia significantly impacts the individual’s school, work, or personal life.
  • Six months duration: In children and adults, the duration of symptoms must last for at least six months.
  • Not caused by another disorder: Many anxiety disorders have similar symptoms. A doctor or therapist would first have to rule out similar conditions such as agoraphobia, obsessional-compulsive disorder (OCD), and separation anxiety disorder before diagnosing a specific phobia.

Recognizing Fear As Irrational Is Not Required

In previous DSM editions, adults with specific phobias had to recognize that their fears are out of proportion to reality, but children did not. The 2013 edition now says the adults no longer have to recognize the irrationality of their behavior to receive a diagnosis.

Types of Specific Phobias

There are five types of specific phobias:

  1. Natural/environment type: These are phobias of nature, weather, and environmental events or situations. These can include the fear of thunder and lightning (astraphobia) or water (aquaphobia).
  2. Injury type: This type of fear is related to a fear of physical harm or injury. These include a fear of the dentist (dentophobia) or injections (trypanophobia).
  3. Animal type: These fears are centered on animals or insects. This can include the fear of dogs (cynophobia), snakes (ophidiophobia), and insects (entomophobia).
  4. Situational type: This type of phobia centers on fears triggered by specific situations. These include the fear of washing (ablutophobia) and enclosed spaces (claustrophobia).
  5. Other types: Fears that don’t fit into the other four types are included in this category. This can include things such as a fear of dolls, vomiting, or loud sounds.

Causes of Specific Phobias

There are a number of different factors that can contribute to the development of specific phobias. These include:

  • Temperament: Research suggests that people who exhibit more behavioral inhibition have a higher risk for a variety of anxiety disorders, including specific phobias. 
  • Genetics: People who have a family member with an anxiety disorder or phobia are more likely to also develop some type of phobia.
  • Experiences: Stressful or traumatic experiences can also play a role in the formation of a phobia. A single incidence of being bitten by a dog, for example, can play a role in the development of a fear of dogs.

Treatment for Specific Phobia

While specific phobias can be serious and debilitating, effective treatments are available. These can help reduce or even eliminate symptoms. They include:

Medication

While medication is not usually used on its own to treat phobias, it may sometimes be prescribed to help people manage physical and emotional reactions associated with phobias. Such medications are usually most effective when paired with psychotherapy.

Psychotherapy

There are a number of psychotherapy techniques that may be used to treat phobias, but exposure therapy and cognitive-behavioral therapy (CBT) are the two that are more commonly used. 

  • Exposure therapy involves gradual and progressive exposure to the feared object or situation. Such exposure is paired with relaxation strategies until the fear reaction is reduced or extinguished.
  • Cognitive-behavioral therapy involves helping people learn to identify and then change the automatic negative thoughts that contribute to phobic reactions. 

The DSM-5 states that people with specific disorders also have an elevated risk for suicide. These phobias also tend to commonly occur alongside other mental health conditions including panic disorder, post-traumatic stress disorder (PTSD), and substance use disorder. Because of this, getting appropriate treatment is essential.

Preparing for Treatment

If you have decided it’s time to seek professional help for your fear, take some time to prepare yourself for your first appointment. To make the most of your appointment, and help your therapist determine if you have a fear or a phobia, create three lists:

  1. Symptoms: Make a list of physical and psychological symptoms, including your trigger, how you cope with your fear, and things that make your anxiety better or worse.
  2. Personal life: Make a list of anything stressful going on in your life, including relationship issues or trouble at work. Listing new situations that seem like a positive thing, including promotion or a budding romance, is also important, as good news can cause anxiety, too.
  3. Medication and supplements: Make a list of all medication and supplements you take regularly, such as vitamins and herbal teas. These substances can affect your mental state and interfere with treatment.

Questions to Ask Your Therapist

While you’re in the therapist’s office, you have an opportunity to ask questions. Worried you won’t be able to think of any on the spot? Here are some you can use:

  • What options for treatment do you recommend?
  • How can I best manage my other health conditions while in treatment?
  • If I follow the recommended treatment plan, how much improvement can I expect to see, and when?
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Anxiety and Depression Association of America. Facts & statistics.

  2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Washington, DC; 2013.

  3. Perelman School of Medicine at the University of Pennsylvania. Specific phobias.

  4. Eaton WW, Bienvenu OJ, Miloyan B. Specific phobiasLancet Psychiatry. 2018;5(8):678-686. doi:10.1016/S2215-0366(18)30169-X

  5. Fox NA, Pine DS. Temperament and the emergence of anxiety disordersJ Am Acad Child Adolesc Psychiatry. 2012;51(2):125-128. doi:10.1016/j.jaac.2011.10.006

  6. Van Houtem CM, Laine ML, Boomsma DI, Ligthart L, van Wijk AJ, De Jongh A. A review and meta-analysis of the heritability of specific phobia subtypes and corresponding fears. J Anxiety Disord. 2013;27(4):379-88. doi:10.1016/j.janxdis.2013.04.007

  7. Kaczkurkin AN, Foa EB. Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidenceDialogues Clin Neurosci. 2015;17(3):337-346. doi:10.31887/DCNS.2015.17.3/akaczkurkin

  8. American Psychiatric Association (APA). Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022

By Lisa Fritscher

Lisa Fritscher is a freelance writer and editor with a deep interest in phobias and other mental health topics.


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How Long Does Ativan (Lorazepam) Stay in Your System?


Key Takeaways

  • Ativan can stay in your urine for up to six days and in your blood for up to three days.
  • Ativan is mainly cleared through the urine, so drinking lots of fluids may help it leave your body faster.
  • If you plan to stop taking Ativan, do it slowly with a doctor’s help to avoid withdrawal symptoms.

Ativan (lorazepam) is a benzodiazepine sedative used to treat anxiety disorders. It depresses the central nervous system and, as a result, has risks when combined with other depressants or alcohol—including the possibility of fatal respiratory depression. This makes it important to understand how long lorazepam stays in your system if you’ve been prescribed this drug.

How Long Does Ativan Stay in Your System?

Urine: Up to six days

Blood: Up to three days

Saliva: Up to 8 hours

Hair: 30 days or longer

How Long Does It Take to Feel Ativan’s Effects?

Ativan is a benzodiazepine, which means that it has sedative and hypnotic effects. The drug works by enhancing the effects of a natural chemical called GABA, which depresses the central nervous system (CNS) and leads to a calming or relaxing effect. 

Ativan can be given as a tablet, liquid concentrate, or by injection. The different routes have different timetables for when they take effect. With tablets or liquids, the peak effects are seen in two hours. An injection of Ativan begins to have effects within 15 minutes and these effects generally continue for six to eight hours.

How Long Does Ativan Last?

While it is a fast-acting drug, Ativan has a relatively long half-life. A medication’s half-life refers to the amount of time its concentration in the body reduces by half which, in the case of Ativan, is every 12 hours.

This drug is metabolized primarily by the liver. It is then eliminated by the kidneys, through the urine. In all, Ativan may be present in the body up to nine days past the last use.

If you will be taking a urine drug screen for employment or other purposes, it will test positive if you are taking Ativan. Disclosing your prescription to the testing lab helps them accurately interpret the test results.

Blood

Ativan can be detected by blood tests six hours after ingestion. This type of test can also detect the drug for three days after the last use. The detection window may be longer for people who’ve been taking Ativan at higher doses for three days or more. 

Urine

Ativan is eliminated in the urine for one to six weeks, depending on how much is administered and for how long. Urine screening tests can detect intermediate-acting benzodiazepines such as Ativan up to five days after the last use.

In those who have been taking the drug regularly or at higher doses, this detection window may be longer. If testing looks for the metabolite lorazepam-glucuronide, which is produced as the drug is broken down by the body, older studies suggest that detection may take place up to eight days after the last use.

The longer detection window for lorazepam-glucuronide may be due, in part, to having a half-life of 18 hours versus lorazepam’s 12 hour half-life.

Hair

As with other substances, Ativan can be detected in hair samples for much longer than with other methods. If given a hair test, this drug can be detected for up to 30 days after use. 

Factors that can influence the level to which drugs are incorporated into or eliminated from one’s hair include:

  • hair color
  • a person’s ethnicity
  • whether the hair has been treated with bleach, dye, or relaxants
  • weather damage

If a person has no hair on their scalp, a hair test can be conducted with hair taken from the armpit, pubic area, or arm.

Saliva

While no recent studies could be located in this area, older research suggests that Ativan could be detected in saliva samples up to eight hours after use. However, saliva tests are rarely used to screen for benzodiazepines such as Ativan. 

False Positive Testing

Some medications may result in a false positive urine screen for Ativan. The antidepressant medication Zoloft (sertraline) is one such drug known to cause a false positive for benzodiazepines. Efavirenz, an antiviral drug used to treat HIV, is another.

Always disclose any prescription or over-the-counter medications to lab clinicians so they can accurately interpret your drug screen results.

Factors That Affect Detection Time

There are a number of things that can influence how long Ativan remains in a person’s system. While rates usually follow a fairly consistent timeline, some people metabolize and clear the drug more quickly than others.

Biological Factors

Some of the factors that can influence how long Ativan remains in your body include the following.

  • Age: Older people tend to clear medications more slowly than younger people. This is because older individuals tend to have slower metabolisms, decreased organ function, lower blood flow, and other health issues that can affect how quickly the drug is processed and excreted.
  • Kidney function: Liver impairment does not appear to have much of an impact on Ativan clearance rates; however, kidney problems are associated with prolonged drug half-life.
  • Height and weight: Taller people and those at a higher weight typically clear the drug more quickly than individuals who are shorter and/or weigh less.

Dosage and Frequency of Use

Higher doses of Ativan take longer to metabolize. The drug is also detectable for longer periods in individuals who have been taking the drug for a longer period of time.

Use of Other Substances

The concurrent use of other substances can have an impact on how quickly each is processed and excreted from the body. For example, valproate (a mood stabilizer) can reduce lorazepam clearance by 40% when taken at the same time, while certain oral contraceptives can increase lorazepam clearance.

How to Get Ativan Out of Your System

After stopping Ativan use, some people want to speed up how quickly it clears their system. Since the drug is excreted through urine, staying well-hydrated by drinking plenty of fluids may slightly increase its elimination rate.

Important Information to Know About Ativan

Ativan is classified as a Schedule IV drug, which means that it has a lower potential for misuse and a lower risk of dependence than Schedule II and III drugs. But Ativan can still be habit-forming. As a result, it’s usually prescribed only for short periods.

With long-term use, you can build a tolerance such that larger doses are needed to achieve the same effect. Stopping Ativan after using it for an extended period can result in withdrawal symptoms such as increased anxiety, sleeplessness, and irritability.

Your healthcare provider may gradually lower your dosage to help reduce withdrawal effects. If you experience bothersome or severe withdrawal symptoms, contact your provider or seek emergency medical treatment.

Overdose Risk

An overdose with Ativan is most commonly seen when taken with alcohol or opiate medications like Vicodin (hydrocodone) and OxyContin (oxycodone). This combination can be life-threatening, and it is important that your family or household members know what symptoms to look for so they can get emergency help quickly.

If you suspect that someone has overdosed on Ativan, call 911 immediately. Signs of an Ativan overdose include:

  • Confusion
  • Poor coordination
  • Slow reflexes
  • Coma
  • Death

Whether taking, starting, or stopping Ativan, it’s important to be alert for the symptoms of an overdose—or severe side effects—and work closely with your physician to avoid these situations.

Precautions

If you take Ativan with alcohol or other medications that can depress breathing, you risk serious breathing problems, sedation, and coma. To prevent accidental overdose or other complications:

  • Do not use alcohol while taking Ativan.
  • Do not take any street drugs, as they may contain substances that can depress breathing.
  • If you are breastfeeding, be aware that this drug passes through into your milk and may affect your baby.
  • If you are pregnant or plan to become pregnant, discuss this with your doctor.
  • If you are depressed or have suicidal thoughts, avoid Ativan.
  • If you are older, you may experience more effects of Ativan, such as drowsiness.
  • Do not smoke cigarettes or use tobacco products, as these can reduce the effects of Ativan.
  • If you take or plan to take any opiate or opioid medications, discuss them with your doctor as they can result in a life-threatening reaction with Ativan. These include medications with codeine or hydrocodone (such as for a cough or pain), fentanyl, hydromorphone, Demerol, methadone, morphine, oxycodone, and tramadol.

Discuss all medications (prescription and over-the-counter), supplements, vitamins, and herbal products you take with your care provider as you may need dosages changed when you have Ativan in your system. Always tell your provider whenever you plan to start a new medication or stop using one.

Getting Help for Stopping Ativan

If you need help stopping Ativan use, start by talking to your physician. Physical dependence can occur, even if you take the drug exactly as prescribed. Quitting Ativan suddenly can be dangerous or even life-threatening due to the increased risk of seizures during the withdrawal process. That’s why it’s important to be monitored by a medical professional as you go through the withdrawal process.

In most cases, you can detoxify from the drug on an outpatient basis. There are no medications approved to treat Ativan dependence, but the standard approach is to slowly reduce the amount of the drug used over a period of time to prevent severe withdrawal symptoms. Your physician will monitor your progress as you slowly taper off of the drug.

They may also recommend other treatments, such as psychotherapy. Types of psychotherapy that may be used during drug recovery include cognitive-behavioral therapy and dialectical behavioral therapy. If you need help with your treatment, ask your provider to refer you to a psychiatrist or another mental health professional who specializes in addiction recovery.


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What Your Partner Can and Can’t Do


Key Takeaways

  • You must take responsibility for fulfilling your emotional needs instead of relying only on your partner.
  • Use the STOP method to help identify and manage your emotional needs.

Everyone has needs, and many people turn to their partners to fulfill all of them. But that’s a lot to ask of a partner—and a relationship. While helping to meet each other’s needs is important, the ultimate responsibility for emotional fulfillment rests on the individual.

Learn how to recognize your emotional needs in a relationship and what you can do to fulfill them yourself. We also share ways to help your partner meet their needs, further strengthening your relationship. But first, it’s helpful to be clear about what emotional needs are and why they’re important.

What Are Emotional Needs?

Clinical psychologist and author Willard F. Harley, Jr., PhD, shares that an emotional need is “a craving that, when satisfied, leaves you with a feeling of happiness and contentment, and, when unsatisfied, leaves you with a feeling of unhappiness and frustration.” These cravings include a need for affection, conversation, honesty and openness, and family commitment.

All humans have emotional needs, and when those needs are met, we experience emotional fulfillment. Importantly, as emotions come from within us, fulfillment must come from within, too,

“When we have an expectation that a husband or wife fulfill us, we set ourselves up for disappointment, because no human being can satisfy another human being,” says Mark Altrogge, creator of The Blazing Center. “To hope that another human can meet our needs is asking too much of anyone.”

Don’t look at where your spouse needs to change. Look to where you need to change. Don’t have expectations of your spouse. If you have expectations, place them on yourself.


MARK ALTROGGE, CREATOR OF THE BLAZING CENTER

In the end, a partner can help support us emotionally, but they can’t be the only way for us to feel fulfilled and content. That said, their emotional support is still critical, even if they can’t meet our every need.

Importance of Meeting Emotional Needs In a Relationship

If your emotional needs in a relationship are being met, you feel more comfortable expressing your feelings to your partner. While you may certainly have disagreements, it becomes easier to fight fairly, knowing that the ultimate goal is to reach a mutually agreeable solution.

When partners are meeting each other’s needs, they are also likely to spend more time together and share details of their lives with one another. They both feel valued and validated, and they often experience higher levels of relationship satisfaction.

Steps to Identifying Your Needs

Sabrina Romanoff, PsyD, a clinical psychologist and professor who specializes in helping clients face relationship issues, suggests a four-step process for thinking about your own emotional needs. , This process comes from the field of dialectical behavior therapy (DBT).

An easy way to remember the four steps is with the mnemonic STOP:

  1. S stands for stop: When you feel that your emotional needs are not being met, stop. “Don’t react, just freeze,” says Romanoff. “Freezing for a moment helps prevent you from doing something impulsive, dismissing your needs, or acting without thinking.”
  2. T stands for taking a step back: If you feel overwhelmed, it’s difficult to identify your needs. “Give yourself some time to calm down and process how you’re feeling,” says Romanoff. “Take a step back, either mentally or physically, from the situation.” Use deep breathing to help regulate your emotions.
  3. O stands for observe: Look at what is happening around and within you. Who is involved? What are they doing or saying? “It is important not to jump to conclusions,” Romanoff advises. “Instead, gather the relevant facts to understand what is going on and what you need.”
  4. P stands for proceeding mindfully: Romanoff suggests asking yourself, “What do I need from this situation? What is my goal? What decision or behavior would make this situation better or worse?”

Ways to Fulfill Your Own Needs

Once you’ve identified your emotional needs, the next step is to find ways to fulfill them. Romanoff suggests that this begins with being alert to when you tend to reach out to others for emotional fulfillment. For many, this might be when you are bored, lonely, anxious, or need to regulate your emotions.

“Once you identify your triggers, you can begin to reduce your dependence on others in these situations,” says Romanoff. “If you delay reaching out, you could strengthen your internal resources to process difficult emotions, for example, by journaling, exercising, taking a warm shower, or another relaxing activity.”

Depending on a partner to meet your needs is not only difficult for them; it’s also holding you back. “By reflexively reaching out to others to meet your needs, you are reinforcing the idea that you are not capable of caring for yourself in these difficult moments,” says Romanoff. “It is important to prove to yourself that you are stronger than you think you are.”

Helping Your Partner Meet Their Emotional Needs

While self-soothing is important, you can still help your partner meet their needs in a healthy, non-codependent way, says Romanoff. Strive to be of help when your partner asks for it. “This will help strengthen the relationship,” she says, “as it will be based on intentional and purposeful connection instead of neediness or expectations that your partner can read your mind.”

Consider what your partner wants and values. Is it a home-cooked meal? A special dinner at a fancy restaurant or a quick burger at a fast-food eatery? Fixing that leaky faucet or loose door handle? An affirming word or affectionate gesture?

An Act of Kindness Goes a Long Way

It doesn’t really matter what the act of kindness is. The important thing is that your partner knows they are valued—that you recognize what they want and need and you are ready to provide it. An effort to understand and willingness to give is key to a good relationship, and ultimately, to having your own needs met too.

How to Talk About Your Emotional Needs

It’s important that partners can communicate their emotional needs in a relationship. Once you are in the mindset of being a loving and giving partner, you can then start to advocate for your own needs, but you have to be careful about how you go about it.

When you want your spouse to perform some kind of action to magically meet your needs, you are really asking for them to change, says Barton Goldsmith, PhD, a psychotherapist and author, and that’s a nearly impossible request. Instead, be direct.

Ask for what you need. Do you want change, understanding, or compatibility? Whatever your need, asking for it directly will greatly improve your chances of getting it.


BARTON GOLDSMITH, PHD, PSYCHOTHERAPIST AND AUTHOR

To be direct, you must be clear in your own mind about what you need. Romanoff explains why this is important: “Once you are able to self-reflect, sit with your emotions on your own, and understand what you need, you will be more able to communicate what you would like from your partner,” she says.

“Oftentimes what we need the most is to have a partner who is willing to be more accessible, emotionally receptive, and engaged,” Romanoff adds. This means being emotionally present during difficult situations.

“It is usually best to communicate your needs and expectations for your partner when you are calm and not acutely in distress,” says Romanoff. Otherwise, you might come across as blaming, which could lead your partner to feel defensive and not hear what you are trying to say.

What This Means For You

If your partner knows that you care for them and will be there for them through big things and small, they are much more likely to reciprocate. Having your emotional needs involves sharing and caring for your partner. A person who feels loved, cared for, and appreciated is far more likely to reciprocate in kind.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Yoo H, Bartle-Haring S, Day RD, Gangamma R. Couple communication, emotional and sexual intimacy, and relationship satisfaction. J Sex Marital Ther. 2014;40(4):275-293. doi:10.1080/0092623X.2012.751072

Additional Reading

By Sheri Stritof

Sheri Stritof has written about marriage and relationships for 20+ years. She’s the co-author of The Everything Great Marriage Book. 


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