More on Lovesickness

Acute cases of lovesickness involve torrid love affairs which are utterly consumptive.  That is, the two parties cannot stand any separation and become completely enmeshed in each other to the point that they ignore the world around them.  How is this different from falling in love?  It’s a matter of degree.  Ordinary falling in love is certainly thrilling, but the man and woman and their respective partners can tolerate being apart and can still appraise one another and consider the reality of their attraction.  In lovesickness, the adoration is intense and not subject to scrutiny.  Neither party cares if there are differences in age, background, or education or culture.  Instead, the infatuation is complete, much as a child would cling to his or her mother.

Usually, someone else brings the matter of lovesickness to my attention.  A parent will tell me that her young daughter is “head over heels” in love with an older, married man.  They speak many times a day and she goes to his house after school.  The girl has lost interest in her schoolwork and spends time emailing and texting the man.  The daughter will not listen to reason and refuses to stop seeing him.  Fearing that the man is psychologically abusing their child, the parents notify the police but the girl is of the age of consent and the man is not in a position of authority over the girl so there is nothing the law can do about it. Boys can fall in love with teachers, teachers with students, and sex often enters the picture.  In older persons, a man and partner may have a torrid love affair to the point that they cannot be separated and must speak to each other many times daily lest they cause separation.  Without assurances, the anxiety becomes intolerable. There is almost an addictive quality to lovesickness.  Cravings and yearnings for affection are not unlike the need for the next fix of a drug, and to interrupt cases of lovesickness is very difficult.

Why would two adults, pathologically intertwined with one another, come to see me in the first place?  Typically, one or another of the party senses something is wrong with the relationship and is symptomatic.  Insomnia is common, anxiety is great, and despair is palpable. Often, the man or woman both want help but cannot abide by any separation.  So, if the patient agrees, I may prescribe medication for anxiety simply to make him or her amenable to some degree of reason.  In a previous post “Are There Medications for Lovelessness?” I discussed the possible use of antidepressants.  For the anxiety of lovesickness, however, I am more likely to reach for something to quench the agitation quickly.  The most common class of drugs here are the so-called benzodiazepines (benzo-die-aza-peens).  There are many, including Ativan, Xanax, and Klonopin.  It is safer to use a long-acting agent such as Klonopin because the blood level declines slowly.  When an anti-anxiety drug washes out of the blood quickly, drug hunger occurs.

I will describe more about the therapy of lovesickness.