Abstract
Masturbation is a common sexual behavior in humans. However, it is viewed negatively across cultures and is prohibited by almost all religions. These views lead to certain cultural beliefs that affect the sexual behavior of people and have implications on the mental health of the individual. There is limited literature linking masturbatory guilt with psychopathology. Here, we present a case in which masturbatory guilt contributed to the development of a depressive illness in a young male. The patient presented with typical symptoms of severe major depressive disorder with resulting impairment of academic and social performance. Our approach to treatment included utilizing a combination of psychotherapy, antidepressant and antipsychotic medications and vitamin supplementation with notable clinical improvement. The article highlights the importance of incorporating various cultural beliefs into an individualized treatment plan, particularly in unique cases where behaviors that may be stigmatized - perhaps wrongfully so - are involved.