Dhat is a sexual neurosis found in the Indian subcontinent. Dhat is considered “semen-loss anxiety” because the symptoms, which are fatigue, weakness, anxiety, loss of appetite, guilt and sexual dysfunction are caused by loss of semen according to the patient. Whether it is through nocturnal emissions, urine, masturbation, or sexual activity, the patient feels that it is the loss of semen that is causing him to feel these symptoms. This syndrome began long before modern times, being documented as early as between 5th millenium BC and 7th century AD. Early in history, Hindu traditional medicine considered semen production to be a long process, in which food would convert to blood, and blood would convert to flesh, which converts to marrow, and the marrow converts to semen. It would take 40 days for 40 drops of food to be converted into one drop of blood, then 40 days for 40 drops of blood to be converted into one drop of flesh and so on. Since it would take so long for such little semen to be produced, to an individual, even a little bit is important, and if a little bit is lost, they would feel stress.
Dhat is categorized by severe anxiety and hypochondriasis so many of the symptoms are not biologically based and are caused by the fear of the semen loss. It has a cultural basis because it is the culture that puts an importance on semen, considering it an elixir of life. It guarantees health, longevity, and supernatural powers. When the the individual loses this, they begin to feel anxiety, like they have lost something, which makes them feel the somatic symptoms of fatigue, weakness, loss of appetite and sexual dysfunction.
Dhat is more common is lower socioeconomic classes because they react to the belief system of the culture since they do not have education. If an individual is educated about the facts of semen loss, then the symptoms usually disappear. With increasing literacy and sex education, Dhat should become increasing less common.
A. Sumathipala MD, S.H. Siribaddana MD, and Dinesh Bhugra PhD, “Culture-bound syndromes: the story of dhat syndrome,” The British Journal of Psychiatry (2004)184: 200-209doi:10.1192/bjp.184.3.200
Malhotra, HK, and NN Wig. “Dhat syndrome: a culture-bound sex neurosis of the orient.” US National Library of Medicine-National Institutes of Health. Accessed July 18, 2014. http://www.ncbi.nlm.nih.gov/pubmed/1191004.