Although much debate exists about whether sex addiction is a true addiction or a mental illness related to obsessive-compulsive disorder, there is no question that droves of people seek help from therapists and rehabilitation centers with managing sexual behaviors they cannot control.
These sexual behaviors damage individuals and their loved ones.
People struggling with sex addiction may spend much of their income on sexual activities, prostitutes, or pornographic films, or they may stop going to work, school, or other social activities so they can engage in sexual encounters, masturbate, or watch pornography. Like other addictions, people struggling with sex addiction report that they need more of the activity – sexual encounters, masturbation, pornographic films or images, or other sex-related experiences – to achieve the same high as when the addictive behaviors started.
- Intense and uncontrollable impulse to have sex or pursue a sexual encounter
- Strong drive toward certain types of sexual experiences
- Lack of pleasure at encounters or intense depression after encounters
- Using sexual activities as an escape from problems in life
- Other relationships, such as friendships, familial relationships, and romantic love, are damaged due to sexual activity
- Unable to stop pursuing sexual activities
- Needing more stimuli to achieve the same “high”
- Preoccupation with sexual activity or encounters leading to a ritual, such as spending hours setting up a date on an online forum
- Progressively negative consequences, which the individual sees but still cannot control the behavior
Although many people who suffer this condition feel unable to stop, much like substance addicts, several psychologists are beginning to call this condition hypersexual disorder rather than sex addiction to demarcate the behavioral component of the condition, which does not appear in brain scans like other types of addiction. This change is also being pursued by medical professionals because the DSM-5 has not listed hypersexual disorder or sex addiction as conditions due to lack of empirical evidence to support diagnosis. This does not mean that people suffering from hypersexual disorder or sex addiction are wrong and do not need treatment, but that the underlying cause of these issues has been insufficiently explored for consistent treatment recommendations. Many researchers admit that the scientific community suffers a lack of understanding about normative sexual impulses and behavior.
Sex Addiction’s Relationship to Substance Abuse
Although the definition of sex addiction or hypersexual disorder is in flux, some researchers have noted a link between some drugs, both legal and illegal, and hypersexuality or sexually transgressive behavior.
For example, gambling addiction and sexual boundary pushing have both been noted in people undergoing treatment with “dopamine agonists,” or medications that increase the amount of dopamine in the brain. This has been especially well noted in patients diagnosed with Parkinson’s disease because reduced dopamine production and uptake are the primary causes of the condition. Some patients have suffered side effects of these dopamine agonists that include impulse control disorders, like gambling addiction or hypersexuality, because the amount of dopamine in their brain changes their perceptions of risk and reward.
Prior to the DSM-5’s release in 2012, some researchers posed a question published by Mayo Clinic regarding a potential link between other substances and hypersexual disorder. Patients with cocaine addictions in particular, the group suggested in 2009, might have addiction pathways primed for other stimulating addictive behaviors or substances. However, the researchers noted that more information must be gathered on whether or not the addictive behaviors began before the substance abuse, after substance abuse began, or concurrently with substance abuse.
As with other impulse disorders and addictive behaviors, a person suffering from sex addiction alongside a substance abuse condition most likely has an underlying psychiatric condition. Two of the more common mental health problems involving hypersexuality are borderline personality disorder (BPD) and antisocial personality disorder (ASPD). Rather than causing hypersexual disorder, BPD and ASPD feature hypersexual behavior as a symptom of the condition among other diagnostic criteria. People suffering BPD or ASPD have impulse control problems, issues determining appropriate risks and rewards, and sometimes intentionally or unintentionally violate social norms, including in regard to sexual conduct. People suffering either BPD or ASPD are also more likely to impulsively pursue addictive substances or ignore social norms around those substances.
Treatment for Sex Addiction
Because little is understood about the causes of sex addiction or the relationship between sex addiction and other underlying or comorbid issues, there is not a standard of recommended treatment yet. When an underlying cause like depression, anxiety, borderline personality disorder, or antisocial personality disorder causes hypersexuality, medications alongside talk therapy and group therapy can prove useful. In other instances, Cognitive Behavioral Therapy can help a person suffering from hypersexual disorder unlearn problematic behaviors, examine the impulses to engage in such behaviors, and learn new coping strategies to deal with stress, depression, or boredom.
Oftentimes, inpatient rehabilitation can radically help people suffering any addiction, including sexual addiction. People who experience compulsive behavior issues or impulse control problems, like gambling or sex addiction, often benefit from entering a new environment that reduces stress and triggers. When individuals are in a new environment, they more able to examine the behaviors and how they have objectively affected their lives, and the lives of their loved ones. They are better able to start making changes to their behaviors by trying new coping mechanisms, and talking these through in individual and group therapy sessions. They also build social bonds with others, which can be very helpful when they re-enter their lives and must face their original triggers and life stresses.