A Comprehensive Overview of Dhat Syndrome

Introduction

Dhat syndrome [1] is a condition that has received a lot of attention in the South East Asia region. While it is understood to be more of a culture-related state, it dramatically impacts an individual’s psychology. Dhat syndrome is a medical condition involving a person’s reproductive health and presents several emotional signs and symptoms along with some physical ones.

What is Dhat syndrome?

Dhat comes from the Sanskrit word Dhatu, which means ‘metal’, ‘elixir’ or ‘constituent part of the body’. The prominent issue individuals with Dhat syndrome[2] report is loss of semen, usually through wet dreams during sleep, masturbation or sexual relations. According to sociocultural beliefs, semen is considered a precious body element or ‘dhatu’, made up of many drops of blood coming together and which should be preserved. Thus a loss of semen generates concerns for individuals with Dhat syndrome, who think this will weaken them and even cause sexual dysfunction. As a result, a person with Dhat syndrome may present with complaints of:   

• Anxiety

• Depression

• Physical or mental tiredness

• Inability to perform sexual acts.

According to the International Classification of Diseases, Tenth Revision (ICD-10) and the Diagnostic & Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), Dhat syndrome is a mental disorder with culture-bound origins.

What are the causes of Dhat syndrome?

Studies conducted on Dhat syndrome have not found a cause for the condition that is directly related to any body organ. Research has indicated that the syndrome occurs due to the prevailing sociocultural beliefs, which drive the opinions of individuals. As discussed earlier, Ayurvedic and cultural beliefs consider semen precious and emphasise its preservation. In this sociocultural mindset, any activity, such as watching or reading pornographic content or engaging in sexual relations, could create feelings of guilt and anxiety in individuals with Dhat syndrome, which they tend to report as symptoms of the condition. 

What are the symptoms of Dhat syndrome?

Individuals with Dhat syndrome usually come from a rural background with little or no education. They are typically young males who believe that the loss of semen can have severe consequences. The symptoms of Dhat syndrome[3] can include:

• Anxiety and apprehension

• Reduction in appetite and sleep

• Inability to enjoy things that usually give pleasure

• Body pain and lack of energy 

• Negative thoughts about self and the world.

Individuals tend to blame these symptoms on the loss of semen, which could have happened due to excessive sexual thoughts leading to masturbation or wet dreams. They generally fear that these symptoms will eventually lead to a decrease in sexual prowess and bring them a bad name in society.

How is Dhat syndrome treated?

There is no clear consensus on the treatment of Dhat syndrome. Because the condition is so attached to indigenous beliefs and practices, most people seek treatment from local practitioners of indigenous therapies. Some opt for dietary interventions and eat butter, milk or proteins. 

Methods that can help an individual with Dhat syndrome are:

• They listen to their issues with empathy, reassuring and counselling them to correct their beliefs. In addition, providing education about sexual organs and healthy sexual practices to individuals will allay their fears and dispel myths. There is no worry about things such as masturbation and wet dreams.

• They are treating the symptoms of the condition, which are generally depression and anxiety. Psychiatric medicines are necessary in some cases.

Dhat syndrome and anxiety

Anxiety regarding semen loss is the most common issue reported by individuals with Dhat syndrome. The fact that sociocultural beliefs link the loss of semen with loss of health is one of the major causes of this anxiety. Many studies have shown that anti-anxiety drugs are effective in individuals with Dhat syndrome, typically young, unmarried men with no prior sexual experience, which adds to their anxiety.

Dhat syndrome and depression

As a result of persistent and prolonged anxiety, people with Dhat syndrome can go into depression, a common symptom, along with fatigue and stress. Timely management of depression is crucial in individuals with Dhat Syndrome. Those with clinical depression should be prescribed antidepressant drugs to control their symptoms. In addition, these individuals should undergo regular counselling to learn how to manage their symptoms. 

Dhat syndrome and sexual dysfunction

Sexual health forms an integral part of an adult person’s overall health, and several things affect it, from diet to attitude and society. It is in addition to the adult’s genetic and biological makeup, which is an essential component of an individual’s health. The sexual misconceptions and myths surrounding Dhat syndrome[4] can lead to the low esteem in individuals to the extent that they may not be able to lead an everyday sex life even when they have no underlying disease or condition. It, along with depression and anxiety, can push the individual into severe mental illness. Hence, such individuals must receive expert psychiatric care at the earliest.

Conclusion

Dhat syndrome is a commonly reported condition in the Indian subcontinent, and experts study it in great detail to find the best possible cure. But given the existing difference in opinion on several aspects of Dhat syndrome, there is still a crucial need to study the syndrome in greater detail to understand its causes and treatment with greater clarity.

References:

1. A. Sumathipala, S. H. Siribaddana, and D. Bhugra, “Culture-bound syndromes: the story of dhat syndrome,” Br. J. Psychiatry, vol. 184, no. 3, pp. 200–209, 2004.
2. V. Mehta, A. De, and C. Balachandran, “Dhat syndrome: a reappraisal,” Indian J. Dermatol., vol. 54, no. 1, pp. 89–90, 2009.
3. O. Prakash and S. K. Kar, “Dhat syndrome: A review and update,” Journal of Psychosexual Health, vol. 1, no. 3–4, pp. 241–245, 2019.
4. O. Prakash, S. K. Kar, and T. S. Sathyanarayana Rao, “Indian story on semen loss and related Dhat syndrome,” Indian J. Psychiatry, vol. 56, no. 4, pp. 377–382, 2014.
5. Ahuja, Niraj. (2006). A Short Texbook of Psychiatry. Https://Eprints.Ncl.Ac.Uk, 278.

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