Sex addiction can be conceptualized as the compulsive engagement in sex despite negative consequences. Moreover, it is a behavior that is emotionally distressing rather than fulfilling. While not always recognized as a legitimate diagnosis, sex addiction has real consequences, including a negative impact on relationships and well-being.
What Is Sex Addiction?
The concept of sex addiction has been thought of in a variety of ways. A sexual addiction does share many of the hallmarks of clinical addiction. One of these hallmarks is that the person will be unable to control their behavior even if the negative consequences are clear (or even likely).
As opposed to someone with a healthy sex drive, a person with a sex addiction will spend a disproportionate amount of time seeking or engaging in sex while keeping the activity secret from others.
People with a sex addiction will be unable to stop the behavior unless there is some sort of intervening event. As a result, personal and professional relationships may suffer. There may even be an increased risk of sexually transmitted infection, including HIV, if a person is unable to rein in their sexual impulses.
People with a sex addiction often will use sex as a form of escape from other emotional and psychological problems, including stress, anxiety, depression, and social isolation.
Not everyone in the medical community is convinced that sex addiction is an established diagnosis. Because of this, it is not listed as a clinical diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association (APA).
As a result, the diagnostic criteria for a sex addiction is often vague and subjective. However, several defining features common to people with sex addiction have been suggested.:
- Sex dominates the person’s life to the exclusion of other activities.
- Sexual activities may be inappropriate and/or risky and may include exhibitionism, public sex, sex with prostitutes, or regular attendance at sex clubs.
- The constant urge for sex is typically interspersed with feelings of regret, anxiety, depression, or shame.
- The person engages in other forms of sex when alone, including phone sex, pornography, or computer sex.
- The person engages in sex with multiple partners and/or has extramarital affairs.
- The person masturbates habitually when alone.
In fact, a sexual addiction is most often characterized by a vicious circle of hypersexuality and low self-esteem. Although sex can bring short-term relief, the harm to the person’s psychological well-being will often increase and worsen over time.
A person does not have to engage in extreme or “strange” sex to have an addiction. They will simply be unable to stop themselves despite the harm that they know may result from their behavior.
There are a number of theories as to why a sexual addiction occurs. Some of these involve conceptualizing a sex addiction as a form of impulse control, obsessive-compulsive or relationship disorder. They also include the idea that in some individuals sexual addictions emerge as a consequence and way of coping with early traumas, including sexual trauma.
In some forms of mental illness (such as bipolar disorder), hypersexuality may be a symptom. In certain instances, neurological disorders (such as epilepsy, head injury, or dementia), have been known to cause hypersexual behaviors. Certain drugs that impact dopamine may also rarely do the same.
Sexual addiction requires treatment from a medical professional experienced in the field, such as a psychologist, psychiatrist, or sex therapist. Treatment can vary based on the underlying cause, but will typically be conducted on an outpatient basis with counseling and behavioral therapies.
If the sex addiction is associated with an anxiety disorder or mood disorder, medications may be prescribed as part of the treatment plan. There are currently no established recommendations on the appropriate use of medications to treat a sex addiction outside of the realm of these clinically classified disorders.
The first point of contact can be a family doctor or local psychiatric association, both of which can make a referral to the appropriate specialist. Marital therapy may also be helpful.6
There are also a growing number of sex addiction support groups, some of which deal with co-additions (such as sex and substance abuse) and others of which are built on a 12-step recovery model.